MS-DRG 643 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 643 by major payers:
$18,999.48
$21,898.30
$26,041.97
$26,497.09
| 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 643 | ||||||
United | 643 | $20784.19 | 1659511988 - SSM SELECT REHAB ST LOUIS LLC | 263694972 | MO | Rehabilitation Hospital (283X00000X) |
United | 643 | $30147.93 | 1821187758 - EAST BATON ROUGE MEDICAL CENTER REHAB, OCHSNER MEDICAL CENTER BATON ROUGE REHAB | 201729674 | LA | Rehabilitation Hospital Unit (273Y00000X) |
United | 643 | $19815.23 | 1518945799 - FORT SANDERS REGIONAL MEDICAL CENTER, PATRICIA NEAL REHABILITATION CENTER | 620528340 - (TN) FORT SANDERS REGIONAL MEDICAL CENTER | TN | Rehabilitation Hospital Unit (273Y00000X) |
United | 643 | $15899.88 | 1730103250 - | 751301362 - LUBBOCK COUNTY HOSPITAL DISTRICT | TX | Rehabilitation Hospital Unit (273Y00000X) |
United | 643 | $27438.25 | 1891792495 - APPALACHIAN REGIONAL HEALTHCARE, INC., MIDDLESBORO ARH HOSPITAL | 520795508 - APPALACHIAN REGIONAL HEALTHCARE INC | KY | General Acute Care Hospital (282N00000X) |
United | 643 | $33808.92 | 1760599344 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., THE WESTERN PENNSYLVANIA HOSPITAL - REHAB | 250969492 - (PA) HIGHMARK HEALTH | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 643 | $13830.45 | 1326061730 - GRANVILLE HEALTH SYSTEM, GRANVILLE HEALTH SYSTEM | 560593547 - (NC) GRANVILLE HEALTH SYSTEM | NC | General Acute Care Hospital (282N00000X) |
United | 643 | $17350.90 | 1386188068 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatric Hospital Unit (273R00000X) |
United | 643 | $13081.07 | 1477509859 - PHYSICIANS MEDICAL CENTER, LLC | 721275428 - (LA) PHYSICIANS MEDICAL CENTER, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 643 | $21522.05 | 1457452898 - NESS COUNTY HOSPITAL DISTRICT #2, NESS COUNTY HOSPITAL | 480579743 | KS | Critical Access Hospital (282NC0060X) |
United | 643 | $25119.01 | 1396769782 - WVHCS-HOSPITAL, WILKES-BARRE GENERAL HOSPITAL | 263632648 | PA | General Acute Care Hospital (282N00000X) |
United | 643 | $43136.17 | 1821091059 - WAYNESBORO HOSPITAL, WELLSPAN WAYNESBORO HOSPITAL | 231360854 - (PA) WAYNESBORO HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 643 | $28378.48 | 1679833008 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY, UNIVERSITY OF KANSAS HOSPITAL AT INDIAN CREEK CAMPUS | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | General Acute Care Hospital (282N00000X) |
United | 643 | $33298.46 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 643 | $17232.55 | 1902870132 - ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE, LLC, ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SCOTTSDALE | 631184846 | AZ | Rehabilitation Hospital (283X00000X) |
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 643 vs. Other Endocrine, Nutritional & Metabolic Diseases & Disorders Codes
The MS-DRG 643 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 643 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 |
|---|---|---|
| 642-MS-DRG | High | Inborn and Other Disorders of Metabolism |
| 643-MS-DRG | High | Endocrine Disorders with MCC |
| 644-MS-DRG | High | Endocrine Disorders 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 643. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 643 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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