MS-DRG 630 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 630 by major payers:
$17,255.69
$19,022.40
$22,075.96
$22,933.27
| 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 630 | ||||||
United | 630 | $12938.12 | 1295764330 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS, MEMORIAL HERMANN BAPTIST ORANGE HOSPITAL | 741303720 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 630 | $28476.14 | 1265529887 - MEMORIAL HOSPITAL-WEST VOLUSIA INC, ADVENTHEALTH DELAND | 593256803 - MEMORIAL HOSPITAL-WEST VOLUSIA INC | FL | Psychiatric Hospital Unit (273R00000X) |
United | 630 | $32180.84 | 1710061023 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 630 | $23930.00 | 1255684460 - INOVA HEALTH CARE SERVICES, INOVA ALEXANDRIA HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 630 | $15279.19 | 1639170699 - LAKESIDE WOMEN'S HOSPITAL, LLC | 731493662 | OK | General Acute Care Hospital (282N00000X) |
United | 630 | $42669.42 | 1003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 630 | $11045.04 | 1013122571 - MIDWEST SURGICAL HOSPITAL, L.L.C. | 383712521 - (NE) MIDWEST SURGICAL HOSPITAL, LLC | NE | Special Hospital (284300000X) |
United | 630 | $18174.24 | 1427616002 - NYU LANGONE HOSPITALS, NYU LANGONE HOSPITAL LONG ISLAND | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 630 | $63473.01 | 1184654923 - DOCTORS MEDICAL CENTER OF MODESTO, INC., DOCTORS MEDICAL CENTER OF MODESTO | 952588614 | CA | General Acute Care Hospital (282N00000X) |
United | 630 | $38406.82 | 1033475959 - ORLANDO HEALTH CENTRAL, INC., HEALTH CENTRAL | 800764192 - (FL) ORLANDO HEALTH CENTRAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 630 | $15380.24 | 1356433015 - ST LUKE'S METHODIST HOSPITAL | 420504780 - ST LUKES METHODIST HOSPITAL | IA | Psychiatric Hospital Unit (273R00000X) |
United | 630 | $16975.34 | 1396006524 - ELMHURST MEMORIAL HEALTHCARE | 362167784 - (IL) ELMHURST MEMORIAL HEALTHCARE | IL | Chronic Disease Hospital (281P00000X) |
United | 630 | $5875.16 | 1760696546 - ST CHARLES PARISH HOSPITAL | 726014606 | LA | General Acute Care Hospital (282N00000X) |
United | 630 | $13705.50 | 1427058510 - SAN JUAN REGIONAL MEDICAL CENTER, INC. | 850127924 - SAN JUAN REGIONAL MEDICAL CENTER INC | NM | General Acute Care Hospital (282N00000X) |
United | 630 | $24987.74 | 1417377565 - GREENVILLE HEALTH SYSTEM, GHS INT MED/SUBSPEC CLINIC | 811723202 - PRISMA HEALTH - UPSTATE | SC | 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 630 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 630 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 630 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 |
|---|---|---|
| 629-MS-DRG | High | Other Endocrine, Nutritional and Metabolic O.R. Procedures with CC |
| 630-MS-DRG | High | Other Endocrine, Nutritional and Metabolic O.R. Procedures without CC/MCC |
| 637-MS-DRG | High | Diabetes with 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 630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 630 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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