MS-DRG 113 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 Eye |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 113 by major payers:
$24,653.09
$29,024.96
$35,484.70
$36,516.90
| 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 113 | ||||||
United | 113 | $59960.12 | 1548378235 - MEDSTAR WASHINGTON HOSPITAL CENTER | 521272129 - (DC) WASHINGTON HOSPITAL CENTER CORPORATION | DC | General Acute Care Hospital (282N00000X) |
United | 113 | $39860.57 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 113 | $1518.00 | 1811092117 - MENA HOSPITAL COMMISSION, MENA REGIONAL HEALTH SYSTEM PSYCH UNIT | 710708660 - (AR) MENA HOSPITAL COMMISSION | AR | Psychiatric Hospital Unit (273R00000X) |
United | 113 | $8272.49 | 1629009964 - MERCY HEALTH YOUNGSTOWN LLC, MERCY HEALTH ST JOSEPH WARREN HOSPITAL | 340505560 - HUMILITY OF MARY HEALTH PARTNERS | OH | General Acute Care Hospital (282N00000X) |
United | 113 | $53232.16 | 1578944021 - INTEGRIS BAPTIST MEDICAL CENTER | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | Women's Hospital (282NW0100X) |
United | 113 | $22487.83 | 1538667035 - CARTHAGE HOSPITAL, LLC | 824005981 | TX | General Acute Care Hospital (282N00000X) |
United | 113 | $37233.89 | 1821367954 - AVERA MCKENNAN HOSPITAL AND HEALTH SYSTEM | 460224743 - AVERA MCKENNAN | SD | Children's Hospital (282NC2000X) |
United | 113 | $57453.03 | 1427504554 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH NORTH GREENVILLE LTACH | 811723202 - PRISMA HEALTH - UPSTATE | SC | Long Term Care Hospital (282E00000X) |
United | 113 | $40648.14 | 1902845068 - ST. LUKE'S HOSPITAL OF DULUTH, ASPIRUS ST LUKES HOSPITAL INPATIENT REHAB | 410714079 - ST LUKES HOSPITAL OF DULUTH | MN | Rehabilitation Hospital Unit (273Y00000X) |
United | 113 | $1800.00 | 1043880123 - LION STAR NACOGDOCHES HOSPITAL, LLC, CECIL B. BOMAR REHABILITATION CENTER | 871142127 - (TX) LION STAR NACOGDOCHES HOSPITAL, LLC DBA NACOGDOCHES MEMORIAL HOSPITAL | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 113 | $25711.69 | 1124654512 - UOFL HEALTH-LOUISVILLE INC, UOFL HEALTH - MARY & ELIZABETH HOSPITAL | 843178470 - UOFL HEALTH-LOUISVILLE INC | KY | General Acute Care Hospital (282N00000X) |
United | 113 | $42699.39 | 1194900654 - HUNTINGTON HOSPITAL ASSOCIATION | 111630914 - (NY) HUNTINGTON HOSPITAL ASSOCIATION | NY | Psychiatric Hospital Unit (273R00000X) |
United | 113 | $44886.03 | 1790876183 - OHIO STATE UNIVERSITY HOSPITALS, OHIO STATE UNIVERSITY HARDING HOSPITAL | 311340739 | OH | Psychiatric Hospital Unit (273R00000X) |
United | 113 | $3915.00 | 1164234308 - SOUTHWEST ARKANSAS REGIONAL MEDICAL CENTER, LLC | 201249189 - (AR) BRIM HOLDING COMPANY, INC. | AR | Critical Access Hospital (282NC0060X) |
United | 113 | $43087.30 | 1134252133 - VIRGINIA MASON MEDICAL CENTER | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
MS-DRG 113 vs. Other Diseases & Disorders of the Eye Codes
The MS-DRG 113 code is part of the Diseases & Disorders of the Eye 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 113 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 |
|---|---|---|
| 113-MS-DRG | High | Orbital Procedures with CC/MCC |
| 114-APR-DRG | High | DENTAL DISEASES & DISORDERS |
| 114-MS-DRG | High | Orbital Procedures without CC/MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 113. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 113 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like MS-DRG 113) and we'll show you how you compare in 15 minutes or less.