MS-DRG 640 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 640 by major payers:
$14,628.49
$17,707.58
$20,859.14
$21,299.70
| 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 640 | ||||||
United | 640 | $25152.32 | 1154764819 - ST. CATHERINE OF SIENA MEDICAL CENTER | 61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 640 | $21986.36 | 1730172057 - APPALACHIAN REGIONAL HEALTHCARE, INC., HAZARD ARH REGIONAL MEDICAL CENTER | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | KY | Psychiatric Hospital Unit (273R00000X) |
United | 640 | $4158.00 | 1568649697 - MOUNTAIN STATES HEALTH ALLIANCE, RUSSELL COUNTY PSYCHIATRIC UNIT | 620476282 - MOUNTAIN STATES HEALTH ALLIANCE | VA | Psychiatric Hospital Unit (273R00000X) |
United | 640 | $23983.67 | 1740368851 - MERCY HEALTH, MERCY HEALTH - WEST HOSPITAL (REHABILITATION UNIT) | 311091597 | OH | Rehabilitation Hospital Unit (273Y00000X) |
United | 640 | $21675.61 | 1699065136 - DUKE UNIVERSITY HOSPITAL | 562070036 - DUKE UNIVERSITY HEALTH SYSTEM INC | NC | General Acute Care Hospital (282N00000X) |
United | 640 | $39996.00 | 1164497533 - THE HOSPITAL SERVICE DISTRICT OF WEST FELICIANA PARISH LOUISIANA | 720683078 | LA | Critical Access Hospital (282NC0060X) |
United | 640 | $35703.28 | 1326229279 - GREENWICH HOSPITAL | 60646659 - (CT) GREENWICH HOSPITAL | CT | General Acute Care Hospital (282N00000X) |
United | 640 | $10345.00 | 1609855139 - TEXAS HEART HOSPITAL OF THE SOUTHWEST, LLC, BAYLOR SCOTT & WHITE HEART AND VASCULAR HOSPITAL - DALLAS | 412101361 - (TX) TEXAS HEART HOSPITAL OF THE SOUTHWEST, L.L.P | TX | General Acute Care Hospital (282N00000X) |
United | 640 | $15876.24 | 1730115940 - HILLSDALE COMMUNITY HEALTH CENTER, HILLSDALE HOSPITAL | 386005550 - HILLSDALE COMMUNITY HEALTH CENTER | MI | General Acute Care Hospital (282N00000X) |
United | 640 | $26832.24 | 1992131734 - DIGNITY HEALTH, ST. JOSEPH'S WESTGATE MEDICAL CENTER | 463533638 - (AZ) DIGNITY HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | 640 | $18516.40 | 1750661534 - AHS SOUTHCREST HOSPITAL, LLC., HILLCREST HOSPITAL SOUTH | 452711804 | OK | General Acute Care Hospital (282N00000X) |
United | 640 | $16080.63 | 1053384776 - AHS HOSPITAL CORP., MORRISTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 640 | $22420.61 | 1609834001 - LEHIGH VALLEY HOSPITAL | 231689692 - LEHIGH VALLEY HOSPITAL | PA | Psychiatric Hospital Unit (273R00000X) |
United | 640 | $44440.19 | 1841277704 - SCRIPPS HEALTH, SCRIPPS MEMORIAL HOSPITAL LA JOLLA | 951684089 - SCRIPPS HEALTH | CA | General Acute Care Hospital (282N00000X) |
United | 640 | $23457.78 | 1417032145 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
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 640 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 640 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 640 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 |
|---|---|---|
| 639-APR-DRG | High | NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION |
| 639-MS-DRG | High | Diabetes without CC/MCC |
| 640-MS-DRG | High | Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC |
| 641-MS-DRG | High | Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes 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 640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 640 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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