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    v1.0.30
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 414-cholecystectomy-except-by-laparoscope-without-c-d-e-with-mcc
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    Cholecystectomy Except by Laparoscope without C.D.E. with MCC: Inpatient Reimbursement Overview

    DRG 414 applies to non-laparoscopic cholecystectomy cases without common duct exploration when a Major Complication or Comorbidity is present, encompassing higher-acuity patients. Correct assignment affects Medicare inpatient reimbursement because higher-severity Diagnosis-Related Group classifications carry greater relative weights to reflect increased resource use.

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    DRG 414 Overview

    DRG 414 covers inpatient admissions for cholecystectomy procedures performed without the laparoscopic approach and without common duct exploration, when a Major Complication or Comorbidity is present. This Diagnosis-Related Group captures patients with higher resource needs due to severe comorbid conditions or complications that affect perioperative care and length of stay. It matters for Medicare payment because the presence of a Major Complication or Comorbidity increases the relative weight and thus the inpatient reimbursement. Accurate clinical documentation and coding of the Major Complication or Comorbidity are critical to ensure the claim is assigned to the appropriate Diagnosis-Related Group.

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    Clinical Trials

    • Trials evaluating perioperative management strategies for patients undergoing open cholecystectomy with major complications (MCC), such as protocols for timing of surgery after biliary sepsis or optimization of comorbid conditions; these studies enroll high-acuity inpatients including those with acute cholecystitis complicated by sepsis, gangrene, or organ dysfunction and compare early versus delayed operative timing or different preoperative optimization bundles. This research is relevant to providers and payers because it targets reduction of in-hospital morbidity, length of stay, and intensive care utilization in the DRG population with MCC, which directly affects resource use and reimbursement costs.
    • Comparative effectiveness studies of surgical approach and intraoperative techniques for non-laparoscopic cholecystectomy in high-risk patients, comparing variations such as subtotal cholecystectomy, bile duct exploration strategies, and use of intraoperative imaging or drains; these trials focus on older adults and patients with anatomic difficulty or severe inflammation that precludes laparoscopic repair. Findings inform choices that may reduce reoperation, postoperative complications, and readmissions among DRG 414 cases, helping clinicians select techniques that balance safety and cost-effectiveness for complex biliary disease.
    • Post-discharge and chronic care outcome studies assessing recovery trajectories, readmission risk prediction, and transitional care interventions for patients discharged after open cholecystectomy with major complications; cohorts include patients with extended ICU stays, post-op infections, or biliary injury who are tracked for 30–90 day outcomes, functional status, and healthcare utilization. Results are highly relevant to payers and facilities because they identify targets for reducing readmissions and downstream expenditures (such as home health needs or repeat hospitalizations) and guide post-acute care planning for this high-cost DRG group.

    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

    412-CHOLECYSTECTOMY-WITH-C-D-E-WITH-CC

    Cholecystectomy with Common Duct Exploration with Complication or Comorbidity: Inpatient Reimbursement Overview

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

    Cholecystectomy with C.D.E. without CC/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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