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637

MS-DRG 637: DIABETES WITH MCC

DRGMedicalMDC 10

MS-DRG 637 is diabetes with mcc, in MDC 10 (a medical DRG), at the with-MCC (major complication or comorbidity) level. Its FY2027 relative weight is 1.4129, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 3.90 days. 88 ICD-10-CM principal diagnoses group into MS-DRGs 637–639 under the CMS definitions manual; the most-searched are listed below.

FY2027 payment factors

Relative weight
1.4129
Geometric mean LOS
3.90
Arithmetic mean LOS
5.20
Post-acute transfer
Yes

This DRG is subject to the post-acute care transfer policy: a discharge to a qualifying setting below the mean length of stay is paid per diem rather than in full.

Principal diagnoses that group to MS-DRGs 637–639

From the CMS MS-DRG definitions manual’s principal-diagnosis index: 88 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 637–639 the case lands in. The 24 most-searched:

  • E11.9Type 2 diabetes mellitus without complications
  • E11.65Type 2 diabetes mellitus with hyperglycemia
  • E11.621Type 2 diabetes mellitus with foot ulcer
  • E11.69Type 2 diabetes mellitus with other specified complication
  • E10.9Type 1 diabetes mellitus without complications
  • E11.8Type 2 diabetes mellitus with unspecified complications
  • E11.AType 2 diabetes mellitus without complications in remission
  • E10.65Type 1 diabetes mellitus with hyperglycemia
  • E11.622Type 2 diabetes mellitus with other skin ulcer
  • E11.628Type 2 diabetes mellitus with other skin complications
  • E13.9Other specified diabetes mellitus without complications
  • E11.00Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
  • E11.10Type 2 diabetes mellitus with ketoacidosis without coma
  • E11.649Type 2 diabetes mellitus with hypoglycemia without coma
  • E10.10Type 1 diabetes mellitus with ketoacidosis without coma
  • E08.9Diabetes mellitus due to underlying condition without complications
  • R81Glycosuria
  • E08.00Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
  • E08.621Diabetes mellitus due to underlying condition with foot ulcer
  • E08.65Diabetes mellitus due to underlying condition with hyperglycemia
  • E09.9Drug or chemical induced diabetes mellitus without complications
  • E10.11Type 1 diabetes mellitus with ketoacidosis with coma
  • E10.621Type 1 diabetes mellitus with foot ulcer
  • E10.649Type 1 diabetes mellitus with hypoglycemia without coma

64 more codes group here. Open any code above for its full hierarchy, or check a whole claim in the free DRG calculator.

The severity splits

Same base DRG, split by whether a secondary diagnosis is a CC or MCC. The last column is the weight change from MS-DRG 637.

637DIABETES WITH MCC1.4129
638DIABETES WITH CC0.9019-0.5110
639DIABETES WITHOUT CC/MCC0.6376-0.7753

Choosing the principal diagnosis: Type 2 diabetes ICD-10 codes.

All FY2027 MS-DRGs · MDC 10

MS-DRG (IPPS Table 5)FY2027