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    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 412-cholecystectomy-with-c-d-e-with-cc
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    Cholecystectomy with Common Duct Exploration with Complication or Comorbidity: Inpatient Reimbursement Overview

    DRG 412 applies to inpatient cholecystectomy combined with common duct exploration when a Complication or Comorbidity is present; it encompasses biliary surgery with added clinical complexity. Proper assignment matters for inpatient reimbursement because the Diagnosis-Related Group classification determines relative payments under Medicare Severity Diagnosis-Related Group–based hospital payment systems.

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    DRG 412 Overview

    DRG 412 covers inpatient admissions for cholecystectomy with common duct exploration when a Complication or Comorbidity is present. It captures cases where biliary tract surgery includes exploration or intervention on the common bile duct and an associated clinical complexity that increases resource use. This Diagnosis-Related Group matters for Medicare payment because the presence of a Complication or Comorbidity adjusts relative resource weighting and influences inpatient reimbursement. Accurate coding of the biliary procedure and comorbid conditions directly affects the payment classification.

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    Clinical Trials

    • Perioperative management and acute intervention trials examining timing and technique of cholecystectomy with common duct exploration for patients presenting with acute cholecystitis or choledocholithiasis. These studies compare urgent versus delayed operative timing, types of anesthesia, and intraoperative strategies (for example, single-stage cholecystectomy with common bile duct exploration versus staged endoscopic clearance then cholecystectomy) in adult inpatients with complicated gallstone disease. Results inform clinicians about complication rates, length of stay, and resource utilization relevant to providers and payers who must optimize acute care pathways and reduce readmissions and procedure-related morbidity.
    • Comparative effectiveness trials assessing operative technique and intraoperative imaging for cholecystectomy with CDE in higher-risk or comorbid patients (such as elderly patients, those with cirrhosis, or significant cardiopulmonary disease). These studies evaluate outcomes across different surgical approaches (open, laparoscopic, laparoscopic converted to open) and adjuncts like intraoperative cholangiography or laparoscopic common bile duct exploration to determine which strategies reduce intraoperative complications, bile duct injury, and transfusion needs. Findings are directly relevant to clinicians deciding surgical approach and to payers concerned with cost-effectiveness, complication-related costs, and appropriate DRG assignment for complex surgical patients.
    • Post-discharge and long-term outcomes research focused on recovery trajectories, quality of life, and health care utilization after cholecystectomy with CDE for patients who had complicated biliary disease (including those with retained stones or recurrent biliary events). These cohort or registry-based studies track rates of readmission, late biliary complications, need for reintervention, and functional outcomes across different discharge dispositions and postoperative care plans. This research helps providers refine discharge criteria and follow-up protocols and helps payers anticipate downstream costs, rehabilitation needs, and the impact of care transitions on overall episode-of-care payments.

    Related Codes

    405-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITH-MCC

    Pancreas, Liver and Shunt Procedures with MCC: Inpatient Reimbursement Overview

    406-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITH-CC

    Pancreas, Liver and Shunt Procedures with CC: Inpatient Reimbursement Overview

    407-PANCREAS-LIVER-AND-SHUNT-PROCEDURES-WITHOUT-CC-MCC

    Pancreas, Liver and Shunt Procedures without CC/MCC: Inpatient Reimbursement Overview

    408-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITH-MCC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with MCC: Inpatient Reimbursement Overview

    409-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITH-CC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E. with CC: Inpatient Reimbursement Overview

    410-BILIARY-TRACT-PROCEDURES-EXCEPT-ONLY-CHOLECYSTECTOMY-WITH-OR-WITHOUT-C-D-E-WITHOUT-CC-MCC

    Biliary Tract Procedures Except Only Cholecystectomy with or without C.D.E.: Inpatient Reimbursement Overview

    411-CHOLECYSTECTOMY-WITH-C-D-E-WITH-MCC

    Cholecystectomy with C.D.E. with MCC: Inpatient Reimbursement Overview

    413-CHOLECYSTECTOMY-WITH-C-D-E-WITHOUT-CC-MCC

    Cholecystectomy with C.D.E. without CC/MCC: Inpatient Reimbursement Overview

    414-CHOLECYSTECTOMY-EXCEPT-BY-LAPAROSCOPE-WITHOUT-C-D-E-WITH-MCC

    Cholecystectomy Except by Laparoscope without C.D.E. with MCC: Inpatient Reimbursement Overview

    415-CHOLECYSTECTOMY-EXCEPT-BY-LAPAROSCOPE-WITHOUT-C-D-E-WITH-CC

    Cholecystectomy Except by Laparoscope without C.D.E. with CC: Inpatient Reimbursement Overview

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    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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