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 | $5404.00 | 1336673250 - STEWARD SHARON REGIONAL HEALTH SYSTEM, INC. | 332621724 | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 429 | $41025.00 | 1376662296 - CEDAR PARK HEALTH SYSTEM LP, CEDAR PARK REGIONAL MEDICAL CENTER | 203904667 - (TX) CEDAR PARK HEALTH SYSTEM LP | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $241043.34 | 1750482022 - CHILDREN'S HOSPITAL OF WISCONSIN, INC. | 390812532 - CHILDRENS HOSPITAL OF WISCONSIN INC | WI | Children's Hospital (282NC2000X) |
United | 429 | $106451.07 | 1467706184 - PRESENCE HEALTHCARE | 992392397 | IL | General Acute Care Hospital (282N00000X) |
United | 429 | $99778.60 | 1780648352 - BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC. | 630997281 - BAPTIST MEMORIAL HOSPITAL UNION COUNTY INC | MS | General Acute Care Hospital (282N00000X) |
United | 429 | $48454.00 | 1376662296 - CEDAR PARK HEALTH SYSTEM LP, CEDAR PARK REGIONAL MEDICAL CENTER | 203904667 - (TX) CEDAR PARK HEALTH SYSTEM LP | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $5185.00 | 1386647717 - MSH PARTNERS, LLC, BAYLOR SCOTT & WHITE MEDICAL CENTER - UPTOWN | 752829613 | TX | General Acute Care Hospital (282N00000X) |
United | 429 | $32816.00 | 1861510521 - HARDEMAN COUNTY MEMORIAL HOSP, HARDEMAN COUNTY MEMORIAL HOSPITAL | 756002047 - (TX) HARDEMAN COUNTY HOSPITAL DISTRICT | TX | Critical Access Hospital (282NC0060X) |
United | 429 | $39732.00 | 1376662296 - CEDAR PARK HEALTH SYSTEM LP, CEDAR PARK REGIONAL MEDICAL CENTER | 203904667 - (TX) CEDAR PARK HEALTH SYSTEM LP | TX | 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 | $91321.22 | 1538812946 - ST. JOSEPH HEALTH SYSTEM, LLC | 510382045 | IN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 429 | $153650.53 | 1548982002 - COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL WEST, LLC | 845110509 - (IN) COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL WEST LLC | IN | Rehabilitation Hospital (283X00000X) |
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 | $171482.73 | 1215006101 - ALEGENT CREIGHTON HEALTH, CHI HEALTH MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | General Acute Care Hospital (282N00000X) |
United | 429 | $92733.00 | 1043328198 - WESTLAKE SURGICAL, L.P., THE HOSPITAL AT WESTLAKE MEDICAL CENTER | 820578078 - (TX) WESTLAKE SURGICAL L.P | TX | General Acute Care Hospital (282N00000X) |
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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