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See a sample rate comparisonMS-DRG 637 Fee Schedule
Last Verified: October 2026
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.
DIABETES WITH MCC
| 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
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MS-DRG 637
5 of 25 sample ratesHigher to lower in this preview
Dekalb Medical Center, Inc., Emory Hillandale Hospital
Emory University
$29,126.00Published rateJamaica Hospital Medical Center
$23,991.08Published rateHackensack University Medical Center
Hackensack Meridian Health Inc
$18,764.00Published rateJefferson County Hma, LLC, Tennova Healthcare-Jefferson Memorial Hospital
$12,430.98Published rateCleveland Tennessee Hospital Company LLC, Skyridge Medical Center
$2,772.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-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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