MS-DRG 123 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 123 by major payers:
$9,202.76
$10,955.82
$12,782.57
$13,111.46
| 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 123 | ||||||
United | 123 | $12933.13 | 1912007931 - MERCY HEALTH, MERCY HEALTH - WEST HOSPITAL | 311091597 | OH | General Acute Care Hospital (282N00000X) |
United | 123 | $9239.04 | 1487607784 - NORTHWEST HOSPITAL LLC, NORTHWEST MEDICAL CENTER | 522379881 | AZ | General Acute Care Hospital (282N00000X) |
United | 123 | $8848.82 | 1366505463 - CLIFTON SPRINGS SANITARIUM CO, CLIFTON SPRINGS HOSPITAL AND CLINIC | 160743966 - (NY) CLIFTON SPRINGS SANITARIUM CO | NY | General Acute Care Hospital (282N00000X) |
United | 123 | $18445.49 | 1407866064 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | General Acute Care Hospital (282N00000X) |
United | 123 | $11844.53 | 1538199617 - MARIAN HEALTH CENTER-SMHC, MERCYONE SIOUXLAND MEDICAL CENTER | 311407377 | IA | General Acute Care Hospital (282N00000X) |
United | 123 | $18942.66 | 1891904942 - ST JUDE HOSPITAL INC, PROVIDENCE ST. JUDE MEDICAL CENTER | 951643325 - (CA) ST JUDE HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 123 | $7758.06 | 1902818883 - GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1, SAMARITAN HEALTHCARE | 916001698 | WA | General Acute Care Hospital (282N00000X) |
United | 123 | $16730.91 | 1932182599 - HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS, BENEDICTINE HOSPITAL | 141338470 - (NY) HEALTHALLIANCE HOSPITAL MARYS AVENUE CAMPUS | NY | General Acute Care Hospital (282N00000X) |
United | 123 | $13767.66 | 1043455199 - SISTERS OF CHARITY HOSPITAL, ST. JOSEPH CAMPUS | 160743187 - (NY) SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK | NY | General Acute Care Hospital (282N00000X) |
United | 123 | $15137.91 | 1487226106 - STEWARD NSMC, INC., PSYCH | 995054044 | FL | Psychiatric Hospital (283Q00000X) |
United | 123 | $8681.79 | 1952766263 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rural Acute Care Hospital (282NR1301X) |
United | 123 | $24557.83 | 1407479975 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY, UCHEALTH CCMC RADIATION ONCOLOGY OP | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 123 | $14682.50 | 1992432892 - SWEDISH EDMONDS | 272305304 - (WA) SWEDISH EDMONDS | WA | Psychiatric Hospital Unit (273R00000X) |
United | 123 | $17815.00 | 1851639280 - PALISADES MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 123 | $14503.37 | 1164539730 - ADVOCATE HEALTH AND HOSPITALS CORPORATION, ADVOCATE LUTHERAN GENERAL HOSPITAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | 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 123 vs. Other Diseases & Disorders of the Eye Codes
The MS-DRG 123 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 123 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 |
|---|---|---|
| 122-MS-DRG | High | Acute Major Eye Infections without CC/MCC |
| 123-MS-DRG | High | Neurological Eye Disorders |
| 124-MS-DRG | High | Other Disorders of the Eye with MCC or Thrombolytic Agent |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 123. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 123 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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