Summary & Overview
Cholecystectomy Except by Laparoscope without C.D.E. with CC: Inpatient Reimbursement Overview
DRG 415 describes inpatient admissions for cholecystectomy performed without laparoscopy or common duct exploration and with a Complication or Comorbidity present, covering increased clinical complexity. It matters for inpatient reimbursement because the Diagnosis-Related Group assignment adjusts Medicare payment to reflect the higher expected resource use associated with these cases.
DRG 415 Overview
DRG 415 covers inpatient hospital admissions for cholecystectomy procedures performed by open or non-laparoscopic approaches without common duct exploration when a Complication or Comorbidity is present. It groups cases where additional clinical complexity increases resource use compared with uncomplicated cholecystectomy, which affects payment relative to lower-severity Diagnosis-Related Groups. Reimbursement under this Diagnosis-Related Group reflects the higher expected costs of care, including longer lengths of stay, greater perioperative management needs, and increased ancillary services. This grouping is used by the Centers for Medicare & Medicaid Services to standardize payment for comparable inpatient resource consumption.