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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Hepatobiliary System and PancreasDRG 446-disorders-of-the-biliary-tract-without-cc-mcc
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    Disorders of the Biliary Tract without CC/MCC: Inpatient Reimbursement Overview

    DRG 446 encompasses inpatient stays for disorders of the biliary tract without Complication or Comorbidity or Major Complication or Comorbidity, focusing on uncomplicated biliary disease. Classification into this Diagnosis-Related Group affects Medicare inpatient payment because it aligns reimbursement with the typical resource needs for lower-severity biliary conditions.

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    DRG 446 Overview

    DRG 446 covers hospital admissions for disorders of the biliary tract without a Complication or Comorbidity and without a Major Complication or Comorbidity. It typically includes diagnoses such as uncomplicated cholelithiasis and certain benign biliary obstructions managed without significant complications. This Diagnosis-Related Group matters for Medicare payment because it groups services into a single prospective payment amount that reflects expected resource use for uncomplicated biliary disease. Accurate coding and documentation determine whether an admission is classified in this lower-severity payment category versus a higher-severity Diagnosis-Related Group.

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    Clinical Trials

    • Acute procedural intervention trials: randomized or pragmatic studies comparing different endoscopic or surgical approaches for acute biliary conditions such as symptomatic choledocholithiasis or acute cholangitis in patients without major comorbidities. These studies enroll hospitalized adults requiring urgent biliary decompression or stone extraction to evaluate time-to-procedure, complication rates (e.g., post-ERCP pancreatitis, bile leak), and short-term clinical resolution. Results inform hospital protocols, resource utilization (OR/Endoscopy suite time, ICU needs), and payer considerations around episodic inpatient costs and readmission risk.
    • Comparative effectiveness research on peri-procedural management strategies: observational cohorts or randomized trials assessing alternatives in anesthesia type, antibiotic prophylaxis regimens, or timing of cholecystectomy after bile duct clearance for patients admitted with biliary colic or uncomplicated biliary obstruction. These studies target typical inpatient populations without CC/MCC to determine differences in length of stay, procedure-related adverse events, and rates of subsequent biliary events. Findings help clinicians optimize care pathways and help payers evaluate which management approaches reduce inpatient days and downstream utilization.
    • Post-discharge outcomes and care-transition studies: prospective studies and quality improvement trials evaluating follow-up models, patient education, and outpatient monitoring to prevent readmissions for recurrent biliary symptoms in patients discharged after treatment for biliary tract disorders without severe complications. These investigations study metrics such as 30-day readmission, outpatient procedure uptake, and patient-reported symptom control among a broad adult inpatient cohort. Evidence from this research guides discharge planning, transitional care investments, and payer policies aimed at reducing avoidable post-discharge costs.

    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

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

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