MS-DRG 445 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 445 by major payers:
$13,007.06
$14,563.88
$17,124.24
$17,534.14
| 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 445 | ||||||
United | 445 | $19640.00 | 1629027263 - WINCHESTER MEDICAL CENTER, WINCHESTER MEDICAL CENTER | 540505979 - VALLEY HEALTH SYSTEM | VA | Psychiatric Hospital Unit (273R00000X) |
United | 445 | $8298.79 | 1730103250 - | 751301362 - LUBBOCK COUNTY HOSPITAL DISTRICT | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 445 | $12741.79 | 1316047632 - TRINITY MEDICAL CENTER, TRINITY ROCK ISLAND | 362739299 - TRINITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 445 | $11382.54 | 1386694487 - GROVE HILL MEMORIAL HOSPITAL, INC | 630436871 | AL | General Acute Care Hospital (282N00000X) |
United | 445 | $20831.91 | 1033770284 - ADVENTHEALTH POLK SOUTH INC, ADVENTHEALTH LAKE WALES | 834672945 | FL | Psychiatric Hospital Unit (273R00000X) |
United | 445 | $20088.58 | 1568427383 - ALLINA HEALTH SYSTEM, CAMBRIDGE MEDICAL CENTER | 363261413 - ALLINA HEALTH SYSTEM | MN | General Acute Care Hospital (282N00000X) |
United | 445 | $10666.70 | 1396160396 - PROSPECT CHARTERCARE SJHSRI, LLC, ST. JOSEPH HEALTH CENTER | 464661337 | RI | Psychiatric Hospital Unit (273R00000X) |
United | 445 | $21776.75 | 1316002520 - VALLEY WEST COMMUNITY HOSPITAL | 364244337 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Critical Access Hospital (282NC0060X) |
United | 445 | $10339.53 | 1851946909 - ADAMS COUNTY REGIONAL MEDICAL CENTER | 812817266 - (OH) ADAMS COUNTY REGIONAL MEDICAL CENTER | OH | Critical Access Hospital (282NC0060X) |
United | 445 | $10845.00 | 1851705370 - MCDONOUGH COUNTY HOSPITAL DISTRICT, MCDONOUGH DISTRICT HOSPITAL | 376016777 | IL | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 445 | $19037.48 | 1588083745 - GREENVILLE HEALTH SYSTEM, GHS CANCER INST-GREER | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 445 | $1286.00 | 1366515256 - ARKANSAS METHODIST HOSPITAL CORPORATION, ARKANSAS METHODIST MEDICAL CENTER | 710230218 - ARKANSAS METHODIST HOSPITAL CORPORATION | AR | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 445 | $15196.46 | 1023398807 - AHS CLAREMORE REGIONAL HOSPITAL, LLC., HILLCREST HOSPITAL CLAREMORE | 452652006 | OK | General Acute Care Hospital (282N00000X) |
United | 445 | $9823.40 | 1427269174 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 445 | $11131.30 | 1124272547 - ADVOCATE CONDELL MEDICAL CENTER | 262525968 - (IL) ADVOCATE HEALTH CARE NETWORK | IL | 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 445 vs. Other Diseases & Disorders of the Hepatobiliary System & Pancreas Codes
The MS-DRG 445 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 445 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 |
|---|---|---|
| 444-APR-DRG | High | RENAL DIALYSIS ACCESS DEVICE PROCEDURES & VESSEL REPAIR |
| 444-MS-DRG | High | Disorders of the Biliary Tract with MCC |
| 445-MS-DRG | High | Disorders of the Biliary Tract with CC |
| 446-APR-DRG | High | URETHRAL & TRANSURETHRAL PROCEDURES |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 445. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 445 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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