MS-DRG 429 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Diseases & Disorders of the Hepatobiliary System & Pancreas |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 429 by major payers:
$91,837.40
$116,085.44
$117,383.00
$134,631.37
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for MS-DRG 429 | ||||||
United | 429 | $39732.00 | 1578780870 - ASCENSION SETON, ASCENSION SETON WILLIAMSON | 741109643 - ASCENSION SETON | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $5130.00 | 1427265545 - ALBERT EINSTEIN MEDICAL CENTER | 231396794 - ALBERT EINSTEIN HEALTHCARE NETWORK | PA | General Acute Care Hospital (282N00000X) |
United | 429 | $96275.54 | 1093787384 - ST JOSEPH HOSPITAL OF NASHUA NH | 20222215 - (NH) ST JOSEPH HOSPITAL OF NASHUA NH | NH | General Acute Care Hospital (282N00000X) |
United | 429 | $221176.03 | 1154355188 - BANNER THUNDERBIRD MEDICAL CENTER | 270036484 - (AZ) BANNER THUNDERBIRD MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | 429 | $91321.22 | 1538812946 - ST. JOSEPH HEALTH SYSTEM, LLC | 510382045 | IN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 429 | $103898.85 | 1669870937 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621809851 | AZ | Rehabilitation Hospital Unit (273Y00000X) |
United | 429 | $37610.00 | 1972517365 - COVENANT MEDICAL CENTER | 822913146 - (TX) COVENANT MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $154034.20 | 1477508687 - AURORA HEALTH CARE NORTH, INC., AURORA MEDICAL CENTER MANITOWOC | 391211629 - (WI) AURORA HEALTH CARE INC | WI | General Acute Care Hospital (282N00000X) |
United | 429 | $129979.90 | 1992860910 - SAINT THOMAS WEST HOSPITAL, SAINT THOMAS WEST HOSPITAL PSYCHIATRIC UNIT | 620347580 - (TN) SAINT THOMAS WEST HOSPITAL | TN | Psychiatric Hospital (283Q00000X) |
United | 429 | $245213.64 | 1508899204 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | 751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $143369.00 | 1831975572 - DECATUR HEALTH SERVICES, LLC | 932081386 | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $16633.00 | 1194753590 - THHBP MANAGEMENT COMPANY LLC, BAYLOR SCOTT & WHITE THE HEART HOSPITAL - DENTON | 263603862 - (TX) THHBP MANAGEMENT COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $5761.00 | 1386647717 - MSH PARTNERS, LLC, BAYLOR SCOTT & WHITE MEDICAL CENTER - UPTOWN | 752829613 | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $105425.17 | 1538382239 - MEMORIAL HERMANN HEALTH SYSTEM, MEMORIAL HERMANN MEMORIAL CITY CICD | 741152597 - (TX) MEMORIAL HERMANN HEALTH SYSTEM | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $191533.54 | 1366450710 - CENTRAL GEORGIA REHABILITATION | 300371539 - (GA) CENTRAL GEORGIA REHABILITATION | GA | Rehabilitation Hospital (283X00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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MS-DRG 429 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 429 code is part of the Diseases & Disorders of the Hepatobiliary System & Pancreas services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The MS-DRG 429 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 428-MS-DRG | High | Multiple Level Combined Anterior and Posterior Spinal Fusion except Cervical without CC/MCC |
| 429-MS-DRG | High | Combined Anterior and Posterior Cervical Spinal Fusion with MCC |
| 430-MS-DRG | High | Combined Anterior and Posterior Cervical Spinal Fusion without MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 429. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 429 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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