MS-DRG 625 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 | • Endocrine, Nutritional & Metabolic Diseases & Disorders |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 625 by major payers:
$32,130.72
$36,751.14
$44,609.32
$46,266.86
| 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 625 | ||||||
United | 625 | $95295.74 | 1154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 625 | $67566.07 | 1912969064 - BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC, MEMORIAL REGIONAL MEDICAL CENTER | 541744931 - BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC | VA | General Acute Care Hospital (282N00000X) |
United | 625 | $97118.21 | 1902463243 - MCKEE MEDICAL CENTER | 840826332 - (CO) MCKEE MEDICAL CENTER | CO | Psychiatric Hospital Unit (273R00000X) |
United | 625 | $54411.82 | 1982663423 - ST. CATHERINE OF SIENA MEDICAL CENTER | 61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 625 | $64248.87 | 1700359205 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH LANCASTER MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | General Acute Care Hospital (282N00000X) |
United | 625 | $47856.46 | 1497859649 - NORTHWESTERN MEMORIAL HEALTHCARE | 370960170 - (IL) NORTHWESTERN MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 625 | $57118.37 | 1487730636 - MEDSTAR, GEORGETOWN UNIVERSITY HOSPITAL | 522218584 - (DC) MEDSTAR-GEORGETOWN MEDICAL CENTER INC | DC | Psychiatric Hospital Unit (273R00000X) |
United | 625 | $45799.05 | 1518024751 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 625 | $58101.78 | 1548817117 - MEMORIAL HOSPITAL AT GULFPORT, MEMORIAL HOSPITAL AT STONE COUNTY | 646010232 - GULFPORT SURGERY CLINIC, LLC | MS | General Acute Care Hospital (282N00000X) |
United | 625 | $18550.14 | 1063471639 - COMMUNITY HEALTH CENTER OF BRANCH COUNTY | 386108110 - (MI) PROMEDICA COLDWATER REGIONAL HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 625 | $35343.60 | 1265445506 - WILLIAMSON COUNTY HOSPITAL DISTRICT, WILLIAMSON MEDICAL CENTER | 621501534 | TN | General Acute Care Hospital (282N00000X) |
United | 625 | $35250.98 | 1336841568 - ERLANGER HEALTH | 883616696 - ERLANGER HEALTH | TN | Critical Access Hospital (282NC0060X) |
United | 625 | $50227.28 | 1720454341 - SMSJ TUCSON HOLDINGS LLC, BRIDGES GEROPSYCHIATRIC PROGRAM AT ST. MARYS HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 625 | $35343.60 | 1265445506 - WILLIAMSON COUNTY HOSPITAL DISTRICT, WILLIAMSON MEDICAL CENTER | 621501534 | TN | General Acute Care Hospital (282N00000X) |
United | 625 | $24061.28 | 1306845557 - CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT 2, OLYMPIC MEDICAL CENTER | 916001709 - (WA) CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT 2 | WA | 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 625 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 625 code is part of the Endocrine, Nutritional & Metabolic Diseases & Disorders 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 625 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 |
|---|---|---|
| 624-MS-DRG | High | Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders without CC/MCC |
| 625-MS-DRG | High | Thyroid, Parathyroid and Thyroglossal Procedures with MCC |
| 626-APR-DRG | High | NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM |
| 626-MS-DRG | High | Thyroid, Parathyroid and Thyroglossal Procedures with CC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 625 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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