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MS-DRG 117 Fee Schedule

Last Verified: March 2026

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.

Intraocular Procedures without CC/MCC
Key FactDetail
Service Type

Diseases & Disorders of the Eye

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Complexity LevelHigh

National average reimbursement for MS-DRG 117 by major payers:

bcbs

$12,380.39

uhc

$14,524.61

aetna

$17,058.19

cigna

$17,706.66

Preview provider-level rates for...
For billing codeMS-DRG 117
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for MS-DRG 117

United
117$25999.651013130145 - BANNER HEALTH900412842AZGeneral Acute Care Hospital (282N00000X)
United
117$11655.341144210253 - ASCENSION PROVIDENCE HOSPITAL381358212 - ASCENSION PROVIDENCE HOSPITALMIGeneral Acute Care Hospital (282N00000X)
United
117$11824.691477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY263694972MORehabilitation Hospital (283X00000X)
United
117$12369.371316505043 - ETHICUS HOSPITAL DFW LLC, LEGENT ORTHOPEDIC HOSPITAL263044485 - (TX) ETHICUS HOSPITAL DFWTXGeneral Acute Care Hospital (282N00000X)
United
117$11824.691477101376 - SSM SELECT REHAB ST. LOUIS, LLC, SSM HEALTH PHYSICAL THERAPY263694972MORehabilitation Hospital (283X00000X)
United
117$13319.621518945799 - FORT SANDERS REGIONAL MEDICAL CENTER, PATRICIA NEAL REHABILITATION CENTER620528340 - (TN) FORT SANDERS REGIONAL MEDICAL CENTERTNRehabilitation Hospital Unit (273Y00000X)
United
117$4158.001013346550 - MOUNTAIN STATES HEALTH ALLIANCE, UNICOI COUNTY HOSPITAL620476282 - MOUNTAIN STATES HEALTH ALLIANCETNGeneral Acute Care Hospital (282N00000X)
United
117$24770.051629138029 - ROCKWALL REGIONAL HOSPITAL, LLC, TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL202848116 - (TX) ROCKWALL REGIONAL HOSPITAL, LLCTXGeneral Acute Care Hospital (282N00000X)
United
117$6098.001497910012 - HUMC OPCO LLC, HOBOKEN UNIVERSITY MEDICAL CENTER452147328 - (NJ) HUMC OPCO LLC (D/B/A CAREPOINT HEALTH - HOBOKEN UNIVERSITY MED CENTER)NJRehabilitation Hospital Unit (273Y00000X)
United
117$32142.271538657267 - PALMETTO HEALTH582296052 - (SC) PRISMA HEALTH-MIDLANDSSCHospitalist Physician (208M00000X)
United
117$10403.001508835828 - THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO310537486 - (OH) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO DTD 01251995OHGeneral Acute Care Hospital (282N00000X)
United
117$18211.081437107208 - CASA GRANDE COMMUNITY HOSPITAL, CASA GRANDE REGIONAL MEDICAL CENTER450233470 - BANNER HEALTHAZGeneral Acute Care Hospital (282N00000X)
United
117$9420.131194969618 - HASAN AMIR161768258OHHospitalist Physician (208M00000X)
United
117$9972.111255384533 - COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP, MEDICAL CITY LEWISVILLE621682210 - (TX) DE MARKETING AND SALESTXGeneral Acute Care Hospital (282N00000X)
United
117$17906.911477578060 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF ORTHOPEDICS, FPP113465690NYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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MS-DRG 117 vs. Other Diseases & Disorders of the Eye Codes

The MS-DRG 117 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 117 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.

CodeComplexityDescription
116-APR-DRGModerateChimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies
116-MS-DRGHighIntraocular Procedures with CC/MCC
117-MS-DRGHighIntraocular Procedures without CC/MCC
121-APR-DRGHighOTHER RESPIRATORY & CHEST PROCEDURES

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 117. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 117 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.

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