MS-DRG 122 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 122 by major payers:
$8,271.96
$10,050.47
$10,862.94
$11,195.49
| 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 122 | ||||||
United | 122 | $13603.98 | 1962583823 - SAINT CATHERINE OF SIENA MEDICAL CENTER | 61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTER | NY | Rural Acute Care Hospital (282NR1301X) |
United | 122 | $23416.94 | 1790969269 - THE NEW YORK AND PRESBYTERIAN HOSPITAL, NEW YORK-PRESBYTERIAN HOSPITAL | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 122 | $7381.93 | 1427097716 - GENESIS HEALTH SYSTEM, GENESIS MEDICAL CENTER DAVENPORT | 421418847 - GENESIS HEALTH SYSTEM | IA | Rehabilitation Hospital Unit (273Y00000X) |
United | 122 | $12024.21 | 1184655953 - BROOKWOOD HEALTH SERVICES, INC., BROOKWOOD MEDICAL CENTER | 474757851 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 122 | $13861.58 | 1316137201 - MEDSTAR GEORGETOWN MEDICAL CENTER, INC, GEORGETOWN UNIVERSITY HOSPITAL PHYSICIANS | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | General Acute Care Hospital (282N00000X) |
United | 122 | $5372.00 | 1285681841 - ROH LLC, MERIT HEALTH WOMEN'S HOSPITAL | 640780035 | MS | Women's Hospital (282NW0100X) |
United | 122 | $17591.71 | 1467690891 - SENTARA HOSPITALS, SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER | 541547408 - SENTARA HOSPITALS | VA | Rehabilitation Hospital Unit (273Y00000X) |
United | 122 | $5878.56 | 1326339862 - VALLEY MEDICAL FACILITIES, INC, HERITAGE VALLEY KENNEDY | 251801532 - (PA) HERITAGE VALLEY HEALTH SYSTEM | PA | Psychiatric Hospital Unit (273R00000X) |
United | 122 | $8657.13 | 1124189733 - PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK, PRESENCE SAINT JOSEPH MEDICAL CENTER-REHAB UNIT | 992141118 | IL | Rehabilitation Hospital Unit (273Y00000X) |
United | 122 | $15098.95 | 1508453754 - NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER LLC, NOVANT HEALTH NEW HANOVER REHABILITATION HOSPITAL | 853777599 | NC | Rehabilitation Hospital (283X00000X) |
United | 122 | $12783.91 | 1487226106 - STEWARD NSMC, INC., PSYCH | 995054044 | FL | Psychiatric Hospital (283Q00000X) |
United | 122 | $4388.60 | 1144257023 - COMMUNITY HEALTH CENTER OF BRANCH COUNTY | 386108110 - (MI) PROMEDICA COLDWATER REGIONAL HOSPITAL | MI | Psychiatric Hospital Unit (273R00000X) |
United | 122 | $11981.49 | 1578648614 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 122 | $8291.54 | 1194750232 - COXHEALTH | 440577118 - LESTER E COX MEDICAL CENTER | MO | General Acute Care Hospital (282N00000X) |
United | 122 | $8657.13 | 1922846351 - SAINT JOSEPH HOSPITAL | 992115457 | IL | 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 122 vs. Other Diseases & Disorders of the Eye Codes
The MS-DRG 122 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 122 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 |
|---|---|---|
| 121-APR-DRG | High | OTHER RESPIRATORY & CHEST PROCEDURES |
| 121-MS-DRG | High | Acute Major Eye Infections with CC/MCC |
| 122-MS-DRG | High | Acute Major Eye Infections without CC/MCC |
| 123-MS-DRG | High | Neurological Eye Disorders |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 122. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 122 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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