MS-DRG 124 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 124 by major payers:

$15,106.12

$16,974.62

$20,486.67

$20,969.10
| 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 124 | ||||||
United | 124 | $5226.00 | 1649417643 - MANCHESTER MEMORIAL HOSPITAL | 812216981 | CT | General Acute Care Hospital (282N00000X) |
United | 124 | $22166.30 | 1962403865 - DEKALB MEDICAL CENTER, INC., EMORY HILLANDALE HOSPITAL | 581966795 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | 124 | $6289.00 | 1104897859 - CRESTVIEW HOSPITAL COMPANY, LLC, NORTH OKALOOSA MEDICAL CENTER | 650460321 | FL | General Acute Care Hospital (282N00000X) |
United | 124 | $24226.50 | 1396745832 - ARIZONA SPINE AND JOINT HOSPITAL LLC | 364399746 - (AZ) ARIZONA SPINE AND JOINT HOSPITAL LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 124 | $44212.64 | 1356350391 - BON SECOURS ST. FRANCIS MEDICAL CENTER LLC, BON SECOURS ST FRANCIS PROFESSIONAL FEE SERVICES | 311716973 | VA | General Acute Care Hospital (282N00000X) |
United | 124 | $41470.53 | 1861650780 - CHILDRENS NATIONAL MEDICAL CENTER | 530196580 - CHILDRENS HOSPITAL | DC | Children's Hospital (282NC2000X) |
United | 124 | $35573.57 | 1992996235 - EMANUEL MEDICAL CENTER, INC., EMANUEL FAMILY PRACTICE - COLORADO | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | 124 | $18441.83 | 1629170824 - ST CATHERINE HOSPITAL INC | 351738708 - (IN) ST CATHERINE HOSPITAL INC | IN | Psychiatric Hospital Unit (273R00000X) |
United | 124 | $14382.38 | 1982629630 - MERCY HOSPITAL SOUTH, MERCY HOSPITAL SOUTH | 430980256 - (MO) MERCY HOSPITAL SOUTH | MO | Rehabilitation Hospital Unit (273Y00000X) |
United | 124 | $27413.18 | 1518998699 - UNITED HEALTH SERVICES HOSPITALS, INC. | 161165049 - (NY) UNITED HEALTH SERVICES HOSPITALS INC | NY | General Acute Care Hospital (282N00000X) |
United | 124 | $5761.00 | 1407010622 - CR EMERGENCY ROOM LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL AUBREY | 262978009 | TX | General Acute Care Hospital (282N00000X) |
United | 124 | $8840.70 | 1275600967 - LAKELAND COMMUNITY HOSPITAL, INC., LAKELAND COMMUNITY HOSPITAL | 472367677 - (AL) LAKELAND COMMUNITY HOSPITAL INC | AL | Rural Acute Care Hospital (282NR1301X) |
United | 124 | $28850.47 | 1417032541 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 124 | $23321.66 | 1609817220 - ENDEAVOR HEALTH CLINICAL OPERATIONS, HIGHLAND PARK HOSPITAL | 362167060 - (IL) NORTHSHORE UNIVERSITY HEALTHSYSTEM | IL | General Acute Care Hospital (282N00000X) |
United | 124 | $14319.42 | 1912014564 - ADVOCATE NORTH SIDE HEALTH NETWORK, ADVOCATE ILLINOIS MASONIC MEDICAL CENTER | 363196629 - (IL) ADVOCATE NORTH SIDE HEALTH NETWORK | 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 124 vs. Other Diseases & Disorders of the Eye Codes
The MS-DRG 124 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 124 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 |
|---|---|---|
| 123-MS-DRG | High | Neurological Eye Disorders |
| 124-MS-DRG | High | Other Disorders of the Eye with MCC or Thrombolytic Agent |
| 125-MS-DRG | High | Other Disorders of the Eye without 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 124. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 124 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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