MS‑DRG 640: Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with MCC

What Medicare paid hospitals for MS‑DRG 640 in 2024: nationally, state by state and across hospitals.

Paid per case$10,6420.7× the all-DRG average

Discharges73,5141.48% of all Medicare discharges

Total paid$782.4M22nd largest MS‑DRG by spending

Hospitals1,869in 50 states and DC

Charges ÷ paid5.8×$61,341 average charge

Relative weight1.3395FY2027, 3.6-day geometric mean stay; FY2026 1.3356 (+0.3%)

In 2024 Medicare paid hospitals an average of $10,642 per discharge for MS‑DRG 640, across 73,514 fee-for-service discharges at 1,869 hospitals: 1.48% of all Medicare inpatient discharges and $782.4M in total, the 22nd largest MS‑DRG by Medicare spending.

By state, the average ran from $5,695 in Vermont to $14,086 in New York. Across hospitals, half were paid between $8,467 and $11,266 per case, and the median hospital $9,524; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $61,341 on average for these stays, 5.8 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 640 on the interactive map Price an MS‑DRG 640 claim at any hospital Every MS‑DRG

What changed in FY2027

The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.

MS‑DRG 640, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	1.3356	1.3395	+0.3%
Geometric mean stay (days)	3.6	3.6	0.0
Average stay (days)	5.0	4.9	−0.1

Not capped: the +0.3% is CMS’s yearly recalibration of every weight from recent claims and cost data.
Name, MDC and transfer status are unchanged.

FY2027 national base payment (illustration)

$9,896.16

The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.

FY2027 national base payment across the severity levels of MS‑DRG 640
MS‑DRG	Severity	Payment ($)	Step ($)
640	with MCC	9,896.16	—
641	without MCC	5,810.62	−4,085.54

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 640 at a hospital

Paid per case, by state

MS‑DRG 640 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$16,404	1,619	38	1.2×
New York	$14,086	4,328	93	6.1×
Alaska	$13,867	126	4	7.2×
California	$13,642	9,630	198	6.5×
Hawaii	$12,824	234	7	4.5×
District of Columbia	$12,598	304	5	6.3×
Connecticut	$12,191	778	20	4.2×
Oregon	$12,094	578	19	3.8×
Wyoming	$12,030	76	2	3.6×
Massachusetts	$11,451	2,094	45	2.9×
New Jersey	$11,082	2,449	54	8.7×
Rhode Island	$10,948	194	7	3.7×
Minnesota	$10,749	902	22	4.2×
Nevada	$10,648	857	18	9.9×
Washington	$10,436	1,225	35	5.6×
Texas	$10,390	6,342	148	6.7×
Delaware	$10,221	315	5	4.4×
Arizona	$10,200	1,209	38	6.0×
Georgia	$10,168	2,499	63	5.6×
Maine	$10,147	130	4	4.4×
Colorado	$10,058	680	27	8.6×
New Mexico	$10,021	369	11	4.3×
Illinois	$10,019	3,212	82	4.7×
Utah	$10,006	270	8	4.2×
Nebraska	$9,861	363	14	4.3×
Pennsylvania	$9,716	2,682	81	7.0×
New Hampshire	$9,706	270	12	4.4×
Michigan	$9,564	2,061	52	3.9×
North Carolina	$9,537	2,268	55	4.2×
Idaho	$9,500	255	10	5.2×
Wisconsin	$9,396	800	27	4.7×
South Dakota	$9,377	216	6	4.7×
Missouri	$9,270	1,528	43	5.3×
Florida	$9,253	5,862	138	7.8×
North Dakota	$9,252	229	6	3.4×
Indiana	$9,183	1,435	44	4.9×
Virginia	$8,938	2,041	52	5.3×
Oklahoma	$8,898	1,039	25	5.6×
Montana	$8,853	185	7	3.1×
Ohio	$8,829	2,342	75	5.0×
South Carolina	$8,760	1,451	37	5.2×
Kansas	$8,622	649	18	7.2×
Mississippi	$8,486	1,070	26	4.8×
Louisiana	$8,446	1,071	29	5.3×
Tennessee	$8,444	1,554	42	5.9×
West Virginia	$8,335	419	14	4.6×
Iowa	$8,332	536	18	5.0×
Arkansas	$8,218	708	20	4.6×
Alabama	$8,182	1,047	34	6.2×
Kentucky	$8,167	937	28	5.1×
Vermont	$5,695	76	3	7.2×
United States	$10,642	73,514	1,869	5.8×

* Maryland hospitals are paid under the state’s all-payer model, not the IPPS, so Maryland is left out of the state range above.

How much hospitals vary

Each hospital’s own average Medicare payment for MS‑DRG 640.

10th percentile	$7,770
25th percentile	$8,467
Median hospital	$9,524
75th percentile	$11,266
90th percentile	$13,408

Related analysis

Transfers and the per-diem rule: when a short stay pays less than the full DRG · Inpatient DRG
DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity

The same condition at other severities

641Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without MCC · $5,830

Questions

What did Medicare pay for MS‑DRG 640 in 2024?

An average of $10,642 per discharge across 73,514 fee-for-service discharges at 1,869 hospitals, $782.4M in total.

Which state paid the most for MS‑DRG 640?

New York, at $14,086 per case; Vermont paid the least, $5,695.

Where do these figures come from?

From the Medicare Inpatient Hospitals - by Provider and Service (data year 2024): the published hospital-by-DRG averages of Medicare fee-for-service inpatient discharges in 2024. Cells with fewer than 11 discharges are not published, so a hospital with a handful of cases is not counted. Average Medicare payment excludes the patient’s deductible and coinsurance.