MS-DRG 637 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 637 by major payers:
$15,935.90
$18,670.65
$22,885.48
$23,293.20
| 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 637 | ||||||
United | 637 | $14985.33 | 1508172339 - PEDIATRIC EXPRESS CARE LTD. | 362170840 - (IL) COPLEY MEMORIAL HOSPITAL INC | IL | Children's Hospital (282NC2000X) |
United | 637 | $13968.00 | 1801804364 - NSUH @ PLAINVIEW PSYCHIATRIC UNIT | 113241243 - (NY) PLAINVIEW HOSPITAL | NY | Psychiatric Hospital Unit (273R00000X) |
United | 637 | $14883.38 | 1154563963 - BONNER GENERAL HOSPITAL INC., BONNER GENERAL HEALTH | 820207116 - (ID) BONNER GENERAL HOSPITAL INC | ID | Critical Access Hospital (282NC0060X) |
United | 637 | $12430.98 | 1891776217 - JEFFERSON COUNTY HMA, LLC, TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL | 452528414 | TN | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 637 | $4226.00 | 1770017675 - AMORY REGIONAL MEDICAL CENTER, INC, GILMORE MEMORIAL HOSPITAL | 320583236 - MONROE HEALTH SERVICES INC | MS | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 637 | $23991.08 | 1851430235 - JAMAICA HOSPITAL MEDICAL CENTER | 111631788 - (NY) JAMAICA HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 637 | $29126.00 | 1962403865 - DEKALB MEDICAL CENTER, INC., EMORY HILLANDALE HOSPITAL | 581966795 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | 637 | $10472.63 | 1255315305 - ROME MEMORIAL HOSPITAL, INC. | 161471634 - (NY) ROME MEMORIAL HOSPITAL INC | NY | Psychiatric Hospital Unit (273R00000X) |
United | 637 | $20111.50 | 1467129700 - VHS SAN ANTONIO PARTNERS, LLC, NORTHEAST BAPTIST HOSPITAL | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 637 | $20519.58 | 1992860910 - SAINT THOMAS WEST HOSPITAL, SAINT THOMAS WEST HOSPITAL PSYCHIATRIC UNIT | 620347580 - (TN) SAINT THOMAS WEST HOSPITAL | TN | Psychiatric Hospital (283Q00000X) |
United | 637 | $6706.00 | 1851396576 - DESERT VALLEY HOSPITAL, LLC, DESERT VALLEY HOSPITAL | 330502805 - (CA) DESERT VALLEY HOSPITAL LLC | CA | General Acute Care Hospital (282N00000X) |
United | 637 | $27750.69 | 1649867896 - NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER LLC, NOVANT HEALTH NEW HANOVER BEHAVIORAL HEALTH HOSPITAL | 853777599 | NC | Psychiatric Hospital Unit (273R00000X) |
United | 637 | $28667.26 | 1194889147 - ST. JOSEPH REGIONAL HEALTH NETWORK, ST. JOSEPH MEDICAL CENTER - SPU | 231352211 - (PA) ST JOSEPH REGIONAL HEALTH NETWORK | PA | General Acute Care Hospital (282N00000X) |
United | 637 | $24213.90 | 1942218441 - NORTH IOWA MERCY CLINICS, NORTH IOWA MERCY CLINICS-HOSPITALIST | 311373080 - MERCY HEALTH SERVICES IOWA CORP | IA | Hospitalist Physician (208M00000X) |
United | 637 | $24085.91 | 1578620449 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC, BAPTIST MEDICAL CENTER | 590747311 - SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC | FL | 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 637 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 637 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 637 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 |
|---|---|---|
| 630-APR-DRG | High | NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE |
| 630-MS-DRG | High | Other Endocrine, Nutritional and Metabolic O.R. Procedures without CC/MCC |
| 637-MS-DRG | High | Diabetes with MCC |
| 638-MS-DRG | High | Diabetes 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 637. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 637 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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