MS-DRG 121 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 121 by major payers:
$13,313.27
$15,388.79
$18,419.67
$18,784.89
| 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 121 | ||||||
United | 121 | $15889.44 | 1588243117 - INTEGRIS HEALTH EDMOND, INC, INTEGRIS HEALTH JIM THORPE REHABILITATION HOSPITAL EDMOND | 451027361 - (OK) INTEGRIS HEALTH EDMOND INC | OK | Rehabilitation Hospital Unit (273Y00000X) |
United | 121 | $25597.80 | 1124346754 - INTEGRIS BAPTIST MEDICAL CENTER INC, INTEGRIS MENTAL HEALTH CENTER | 731034824 - (OK) INTEGRIS BAPTIST MEDICAL CENTER INC | OK | Psychiatric Hospital Unit (273R00000X) |
United | 121 | $26182.47 | 1922305606 - ST FRANCIS COMMUNITY HOSPITAL, FRANCISCAN HEALTH SYSTEM | 911267921 - (WA) ST FRANCIS COMMUNITY HOSPITAL | WA | General Acute Care Hospital (282N00000X) |
United | 121 | $6965.00 | 1922095116 - HUNTERDON MEDICAL CENTER | 221537688 - HUNTERDON MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 121 | $14845.91 | 1386453165 - SAINT JOSEPH MEDICAL CENTER | 992141118 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 121 | $12060.62 | 1477602860 - MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION, MORRISTOWN HAMBLEN HEALTHCARE SYSTEM | 620545814 - (TN) MORRISTOWN HAMBLEN HOSP | TN | Psychiatric Hospital Unit (273R00000X) |
United | 121 | $12128.69 | 1922514629 - COX BARTON COUNTY HOSPITAL, COX BARTON COUNTY HOSPITAL | 823300758 - (MO) COX BARTON COUNTY HOSPITAL | MO | Critical Access Hospital (282NC0060X) |
United | 121 | $27793.50 | 1639108434 - WILLAMETTE FALLS HOSPITAL, PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER | 611659489 | OR | General Acute Care Hospital (282N00000X) |
United | 121 | $10654.00 | 1679934277 - CHILDREN'S HOSPITAL COLORADO, CHILDREN'S HOSPITAL COLORADO THERAPY CARE BROOMFIELD | 840166760 - CHILDRENS HOSPITAL COLORADO | CO | Children's Hospital (282NC2000X) |
United | 121 | $26524.44 | 1891367629 - STEWARD NSMC, INC., STEWARD FLORIDA MEDICAL CENTER A CAMPUS OF NORTH SHORE | 862695690 | FL | General Acute Care Hospital (282N00000X) |
United | 121 | $24971.58 | 1881814903 - ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, PROVIDENCE SANTA ROSA MEMORIAL HOSPITAL | 814791043 - (CA) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | CA | Rehabilitation Hospital Unit (273Y00000X) |
United | 121 | $12876.62 | 1265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 121 | $11060.87 | 1952493512 - THE FINLEY HOSPITAL, UNITYPOINT HEALTH - FINLEY HOSPITAL | 420680354 - THE FINLEY HOSPITAL | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 121 | $18012.15 | 1033716147 - USC VERDUGO HILLS HOSPITAL | 851634852 - (CA) USC VERDUGO HILLS HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 121 | $28564.69 | 1558575746 - ST. JOSEPH HOSPITAL OF ORANGE, PROVIDENCE ST. JOSEPH HOSPITAL | 951643359 - (CA) ST JOSEPH HOSPITAL OF ORANGE | CA | 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 |
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MS-DRG 121 vs. Other Diseases & Disorders of the Eye Codes
The MS-DRG 121 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 121 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 |
|---|---|---|
| 117-MS-DRG | High | Intraocular Procedures without CC/MCC |
| 121-MS-DRG | High | Acute Major Eye Infections with CC/MCC |
| 122-MS-DRG | High | Acute Major Eye Infections 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 121. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 121 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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