MS-DRG 638: DIABETES WITH CC
MS-DRG 638 is diabetes with cc, in MDC 10 (a medical DRG), at the with-CC (complication or comorbidity) level. Its FY2027 relative weight is 0.9019, so a case here pays less than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 2.90 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
- 0.9019
- Geometric mean LOS
- 2.90
- Arithmetic mean LOS
- 3.70
- 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 638.
| 637 | DIABETES WITH MCC | 1.4129 | +0.5110 |
| 638 | DIABETES WITH CC | 0.9019 | |
| 639 | DIABETES WITHOUT CC/MCC | 0.6376 | -0.2643 |
Choosing the principal diagnosis: Type 2 diabetes ICD-10 codes.
All FY2027 MS-DRGs · MDC 10