MS-DRG 442 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 442 by major payers:
$11,497.47
$13,265.30
$15,404.81
$15,706.71
| 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 442 | ||||||
United | 442 | $15728.76 | 1447218482 - HEALTHEAST ST. JOHN'S HOSPITAL | 411456897 - (MN) HEALTHEAST ST JOHNS HOSPITAL | MN | General Acute Care Hospital (282N00000X) |
United | 442 | $17858.26 | 1508843566 - NOVANT HEALTH ROWAN MEDICAL CENTER LLC, NOVANT HEALTH ROWAN MEDICAL CENTER | 560547479 - (NC) ROWAN REGIONAL MEDICAL CENTER, INC. | NC | General Acute Care Hospital (282N00000X) |
United | 442 | $6196.00 | 1912918277 - JAY HOSPITAL, INC. | 592425149 - JAY HOSPITAL INC | FL | Critical Access Hospital (282NC0060X) |
United | 442 | $18431.23 | 1225195340 - INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC. | 350867958 - (IN) INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 442 | $24340.50 | 1699829929 - BANNER THUNDERBIRD MEDICAL CENTER | 270036484 - (AZ) BANNER THUNDERBIRD MEDICAL CENTER | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 442 | $30861.39 | 1013389089 - MAIMONIDES MEDICAL CENTER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | General Acute Care Hospital (282N00000X) |
United | 442 | $8543.13 | 1073200309 - PECOS COUNTY MEMORIAL HOSPITAL DISTRICT | 921628671 | TX | Critical Access Hospital (282NC0060X) |
United | 442 | $2626.00 | 1811915838 - TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC., TAKOMA ADVENTIST HOSPITAL | 510603966 - TAKOMA REGIONAL HOSPITAL INC | TN | Psychiatric Hospital Unit (273R00000X) |
United | 442 | $47107.07 | 1770502635 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | Psychiatric Hospital (283Q00000X) |
United | 442 | $8070.66 | 1447284898 - MERCY HOSPITAL LEBANON, MERCY HOSPITAL LEBANON | 431767432 - MERCY HOSPITAL LEBANON | MO | General Acute Care Hospital (282N00000X) |
United | 442 | $5606.00 | 1770921603 - WEIRTON MEDICAL CENTER | 550387249 - (WV) WEIRTON MEDICAL CENTER INC | WV | General Acute Care Hospital (282N00000X) |
United | 442 | $18234.13 | 1457005720 - ST LUKES | 260479484 - (FL) ST LUKES - ST VINCENTS HEALTHCAREINC | FL | Rehabilitation Hospital Unit (273Y00000X) |
United | 442 | $13578.86 | 1598829442 - METHODIST HEALTHCARE, METHODIST BEHAVIORAL HEALTH | 620479367 - METHODIST HEALTHCARE-MEMPHIS | TN | Psychiatric Hospital Unit (273R00000X) |
United | 442 | $13016.00 | 1255640819 - VHS OF ARROWHEAD, INC., ABRAZO ARIZONA HEART HOSPITAL | 621809851 | AZ | General Acute Care Hospital (282N00000X) |
United | 442 | $18310.46 | 1992735088 - DIGNITY HEALTH, MERCY GILBERT MEDICAL CENTER | 352263845 - (AZ) DIGNITY HEALTH | AZ | 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 442 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 442 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 442 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 |
|---|---|---|
| 441-APR-DRG | High | MAJOR BLADDER PROCEDURES |
| 441-MS-DRG | High | Disorders of Liver except Malignancy, Cirrhosis or Alcoholic Hepatitis with MCC |
| 442-MS-DRG | High | Disorders of Liver except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC |
| 443-APR-DRG | High | KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 442. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 442 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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