MS-DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC
MS-DRG 640 is miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc, in MDC 10 (a medical DRG), at the with-MCC (major complication or comorbidity) level. Its FY2027 relative weight is 1.3395, so a case here pays more than the average Medicare inpatient stay (weight 1.0), with a geometric mean length of stay of 3.60 days. 130 ICD-10-CM principal diagnoses group into MS-DRGs 640–641 under the CMS definitions manual; the most-searched are listed below.
FY2027 payment factors
- Relative weight
- 1.3395
- Geometric mean LOS
- 3.60
- Arithmetic mean LOS
- 4.90
- 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 640–641
From the CMS MS-DRG definitions manual’s principal-diagnosis index: 130 ICD-10-CM codes route here, and the CC/MCC status of the secondary diagnoses decides which of 640–641 the case lands in. The 24 most-searched:
- E66.9Obesity, unspecified
- E43Unspecified severe protein-calorie malnutrition
- E46Unspecified protein-calorie malnutrition
- E55.9Vitamin D deficiency, unspecified
- R63.4Abnormal weight loss
- E66.01Morbid (severe) obesity due to excess calories
- E53.8Deficiency of other specified B group vitamins
- E87.1Hypo-osmolality and hyponatremia
- R73.03Prediabetes
- R73.9Hyperglycemia, unspecified
- R73.09Other abnormal glucose
- E66.3Overweight
- E66.813Obesity, class 3
- E87.5Hyperkalemia
- R62.51Failure to thrive (child)
- Z68.41Body mass index [BMI] 40.0-44.9, adult
- E61.1Iron deficiency
- E65Localized adiposity
- E86.0Dehydration
- E87.6Hypokalemia
- R62.50Unspecified lack of expected normal physiological development in childhood
- R62.7Adult failure to thrive
- R62.0Delayed milestone in childhood
- R63.5Abnormal weight gain
106 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 640.
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 1.3395 | |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 0.7865 | -0.5530 |
Choosing the principal diagnosis: Obesity ICD-10 codes.
All FY2027 MS-DRGs · MDC 10