Table 5.--List of Diagnosis Related Groups (DRGs), Relative Weighting Factors, Geometric and Arithmetic Mean
Length of Stay
----------------------------------------------------------------------------------------------------------------
Relative Geometric Arithmetic
weights mean LOS mean LOS
----------------------------------------------------------------------------------------------------------------
1............... 01 SURG CRANIOTOMY AGE >17 EXCEPT 3.0907 7.2 10.3
FOR TRAUMA.
2............... 01 SURG CRANIOTOMY FOR TRAUMA AGE 3.0511 7.9 10.6
>17.
3............... 01 SURG * CRANIOTOMY AGE 0-17...... 1.9484 12.7 12.7
4............... 01 SURG SPINAL PROCEDURES.......... 2.3858 5.5 8.5
5............... 01 SURG EXTRACRANIAL VASCULAR 1.5041 2.9 3.9
PROCEDURES.
6............... 01 SURG CARPAL TUNNEL RELEASE...... .7582 2.2 3.3
7............... 01 SURG PERIPH & CRANIAL NERVE & 2.4717 7.3 11.4
OTHER NERV SYST PROC W CC.
8............... 01 SURG PERIPH & CRANIAL NERVE & 1.2142 2.2 3.2
OTHER NERV SYST PROC W/O
CC.
9............... 01 MED SPINAL DISORDERS & INJURIES 1.2646 5.1 7.2
10.............. 01 MED NERVOUS SYSTEM NEOPLASMS W 1.2184 5.3 7.4
CC.
11.............. 01 MED NERVOUS SYSTEM NEOPLASMS W/ .7879 3.2 4.3
O CC.
12.............. 01 MED DEGENERATIVE NERVOUS SYSTEM .9370 5.0 6.8
DISORDERS.
13.............. 01 MED MULTIPLE SCLEROSIS & .7832 4.7 5.8
CEREBELLAR ATAXIA.
14.............. 01 MED SPECIFIC CEREBROVASCULAR 1.1889 5.1 6.8
DISORDERS EXCEPT TIA.
15.............. 01 MED TRANSIENT ISCHEMIC ATTACK & .7241 3.2 4.1
PRECEREBRAL OCCLUSIONS.
16.............. 01 MED NONSPECIFIC CEREBROVASCULAR 1.0452 4.6 6.1
DISORDERS W CC.
17.............. 01 MED NONSPECIFIC CEREBROVASCULAR .6161 2.8 3.7
DISORDERS W/O CC.
18.............. 01 MED CRANIAL & PERIPHERAL NERVE .9399 4.5 5.9
DISORDERS W CC.
19.............. 01 MED CRANIAL & PERIPHERAL NERVE .6293 3.2 4.1
DISORDERS W/O CC.
20.............. 01 MED NERVOUS SYSTEM INFECTION 2.5786 8.0 10.8
EXCEPT VIRAL MENINGITIS.
21.............. 01 MED VIRAL MENINGITIS........... 1.4866 5.4 7.1
22.............. 01 MED HYPERTENSIVE ENCEPHALOPATHY .8594 3.7 4.8
23.............. 01 MED NONTRAUMATIC STUPOR & COMA. .7777 3.3 4.6
24.............. 01 MED SEIZURE & HEADACHE AGE >17 .9578 3.9 5.3
W CC.
25.............. 01 MED SEIZURE & HEADACHE AGE >17 .5821 2.8 3.6
W/O CC.
26.............. 01 MED SEIZURE & HEADACHE AGE 0-17 .9601 3.6 4.9
27.............. 01 MED TRAUMATIC STUPOR & COMA, 1.2670 3.4 5.5
COMA >1 HR.
28.............. 01 MED TRAUMATIC STUPOR & COMA, 1.1707 4.4 6.4
COMA <1 HR AGE >17 W CC.
29.............. 01 MED TRAUMATIC STUPOR & COMA, .6383 2.8 3.7
COMA <1 HR AGE >17 W/O CC.
[[Page 46081]]
30.............. 01 MED * TRAUMATIC STUPOR & COMA, .3295 2.0 2.0
COMA <1 HR AGE 0-17.
31.............. 01 MED CONCUSSION AGE >17 W CC.... .8369 3.4 4.8
32.............. 01 MED CONCUSSION AGE >17 W/O CC.. .5109 2.2 3.1
33.............. 01 MED * CONCUSSION AGE 0-17...... .2071 1.6 1.6
34.............. 01 MED OTHER DISORDERS OF NERVOUS 1.0385 4.2 5.8
SYSTEM W CC.
35.............. 01 MED OTHER DISORDERS OF NERVOUS .5941 3.0 3.9
SYSTEM W/O CC.
36.............. 02 SURG RETINAL PROCEDURES......... .6265 1.3 1.5
37.............. 02 SURG ORBITAL PROCEDURES......... .9725 2.6 3.9
38.............. 02 SURG PRIMARY IRIS PROCEDURES.... .4826 1.9 2.7
39.............. 02 SURG LENS PROCEDURES WITH OR .5406 1.5 2.0
WITHOUT VITRECTOMY.
40.............. 02 SURG EXTRAOCULAR PROCEDURES .7341 2.2 3.3
EXCEPT ORBIT AGE >17.
41.............. 02 SURG * EXTRAOCULAR PROCEDURES .3354 1.6 1.6
EXCEPT ORBIT AGE 0-17.
42.............. 02 SURG INTRAOCULAR PROCEDURES .5676 1.5 2.0
EXCEPT RETINA, IRIS & LENS.
43.............. 02 MED HYPHEMA.................... .4119 2.9 4.0
44.............. 02 MED ACUTE MAJOR EYE INFECTIONS. .6072 4.3 5.3
45.............. 02 MED NEUROLOGICAL EYE DISORDERS. .6730 2.9 3.6
46.............. 02 MED OTHER DISORDERS OF THE EYE .7234 3.7 4.9
AGE >17 W CC.
47.............. 02 MED OTHER DISORDERS OF THE EYE .4623 2.7 3.6
AGE >17 W/O CC.
48.............. 02 MED * OTHER DISORDERS OF THE .2955 2.9 2.9
EYE AGE 0-17.
49.............. 03 SURG MAJOR HEAD & NECK 1.8074 3.9 5.3
PROCEDURES.
50.............. 03 SURG SIALOADENECTOMY............ .8143 1.7 2.1
51.............. 03 SURG SALIVARY GLAND PROCEDURES .8367 1.9 2.9
EXCEPT SIALOADENECTOMY.
52.............. 03 SURG CLEFT LIP & PALATE REPAIR.. 1.2768 2.2 3.2
53.............. 03 SURG SINUS & MASTOID PROCEDURES 1.0682 2.3 3.6
AGE >17.
54.............. 03 SURG * SINUS & MASTOID .4790 3.2 3.2
PROCEDURES AGE 0-17.
55.............. 03 SURG MISCELLANEOUS EAR, NOSE, .8366 2.0 2.9
MOUTH & THROAT PROCEDURES.
56.............. 03 SURG RHINOPLASTY................ .8830 2.1 2.8
57.............. 03 SURG T&A PROC, EXCEPT 1.0182 2.7 4.0
TONSILLECTOMY &/OR
ADENOIDECTOMY ONLY, AGE
>17.
58.............. 03 SURG * T&A PROC, EXCEPT .2720 1.5 1.5
TONSILLECTOMY &/OR
ADENOIDECTOMY ONLY, AGE 0-
17.
59.............. 03 SURG TONSILLECTOMY &/OR .8238 2.3 3.3
ADENOIDECTOMY ONLY, AGE
>17.
60.............. 03 SURG * TONSILLECTOMY &/OR .2072 1.5 1.5
ADENOIDECTOMY ONLY, AGE 0-
17.
61.............. 03 SURG MYRINGOTOMY W TUBE 1.1181 2.8 4.5
INSERTION AGE >17.
62.............. 03 SURG * MYRINGOTOMY W TUBE .2933 1.3 1.3
INSERTION AGE 0-17.
63.............. 03 SURG OTHER EAR, NOSE, MOUTH & 1.2444 3.1 4.6
THROAT O.R. PROCEDURES.
64.............. 03 MED EAR, NOSE, MOUTH & THROAT 1.1568 4.4 6.7
MALIGNANCY.
65.............. 03 MED DYSEQUILIBRIUM............. .5177 2.5 3.2
66.............. 03 MED EPISTAXIS.................. .5605 2.8 3.5
67.............. 03 MED EPIGLOTTITIS............... .7866 3.1 3.8
68.............. 03 MED OTITIS MEDIA & URI AGE >17 .6831 3.5 4.3
W CC.
69.............. 03 MED OTITIS MEDIA & URI AGE >17 .5160 2.9 3.5
W/O CC.
70.............. 03 MED OTITIS MEDIA & URI AGE 0-17 .3892 2.7 3.3
71.............. 03 MED LARYNGOTRACHEITIS.......... .6688 3.0 3.9
72.............. 03 MED NASAL TRAUMA & DEFORMITY... .6364 2.7 3.5
73.............. 03 MED OTHER EAR, NOSE, MOUTH & .7660 3.4 4.7
THROAT DIAGNOSES AGE >17.
74.............. 03 MED * OTHER EAR, NOSE, MOUTH & .3332 2.1 2.1
THROAT DIAGNOSES AGE 0-17.
75.............. 04 SURG MAJOR CHEST PROCEDURES..... 3.1958 8.3 10.6
76.............. 04 SURG OTHER RESP SYSTEM O.R. 2.6427 8.7 11.7
PROCEDURES W CC.
77.............. 04 SURG OTHER RESP SYSTEM O.R. 1.1150 3.5 5.1
PROCEDURES W/O CC.
78.............. 04 MED PULMONARY EMBOLISM......... 1.4264 6.6 7.7
79.............. 04 MED RESPIRATORY INFECTIONS & 1.6258 6.8 8.7
INFLAMMATIONS AGE >17 W CC.
80.............. 04 MED RESPIRATORY INFECTIONS & .9121 4.9 6.1
INFLAMMATIONS AGE >17 W/O
CC.
81.............. 04 MED * RESPIRATORY INFECTIONS & 1.5091 6.1 6.1
INFLAMMATIONS AGE 0-17.
82.............. 04 MED RESPIRATORY NEOPLASMS...... 1.3329 5.4 7.4
83.............. 04 MED MAJOR CHEST TRAUMA W CC.... .9716 4.6 5.9
84.............. 04 MED MAJOR CHEST TRAUMA W/O CC.. .5260 2.8 3.5
85.............. 04 MED PLEURAL EFFUSION W CC...... 1.2212 5.3 6.9
86.............. 04 MED PLEURAL EFFUSION W/O CC.... .6715 3.1 4.1
87.............. 04 MED PULMONARY EDEMA & 1.3639 4.9 6.5
RESPIRATORY FAILURE.
88.............. 04 MED CHRONIC OBSTRUCTIVE .9705 4.6 5.7
PULMONARY DISEASE.
[[Page 46082]]
89.............. 04 MED SIMPLE PNEUMONIA & PLEURISY 1.1006 5.4 6.6
AGE >17 W CC.
90.............. 04 MED SIMPLE PNEUMONIA & PLEURISY .6773 4.0 4.7
AGE >17 W/O CC.
91.............. 04 MED SIMPLE PNEUMONIA & PLEURISY .7940 3.7 4.4
AGE 0-17.
92.............. 04 MED INTERSTITIAL LUNG DISEASE W 1.1947 5.3 6.7
CC.
93.............. 04 MED INTERSTITIAL LUNG DISEASE W/ .7423 3.7 4.7
O CC.
94.............. 04 MED PNEUMOTHORAX W CC.......... 1.1857 5.1 6.7
95.............. 04 MED PNEUMOTHORAX W/O CC........ .5974 3.2 4.0
96.............. 04 MED BRONCHITIS & ASTHMA AGE >17 .8005 4.2 5.1
W CC.
97.............. 04 MED BRONCHITIS & ASTHMA AGE >17 .5887 3.3 4.0
W/O CC.
98.............. 04 MED BRONCHITIS & ASTHMA AGE 0- .6298 2.3 3.8
17.
99.............. 04 MED RESPIRATORY SIGNS & .6710 2.4 3.2
SYMPTOMS W CC.
100............. 04 MED RESPIRATORY SIGNS & .5109 1.8 2.2
SYMPTOMS W/O CC.
101............. 04 MED OTHER RESPIRATORY SYSTEM .8518 3.5 4.7
DIAGNOSES W CC.
102............. 04 MED OTHER RESPIRATORY SYSTEM .5295 2.3 2.9
DIAGNOSES W/O CC.
103............. 05 SURG HEART TRANSPLANT........... 16.5746 32.1 48.2
104............. 05 SURG CARDIAC VALVE PROCEDURES W 7.3563 10.8 13.3
CARDIAC CATH.
105............. 05 SURG CARDIAC VALVE PROCEDURES W/ 5.7109 8.3 10.2
O CARDIAC CATH.
106............. 05 SURG CORONARY BYPASS W CARDIAC 5.5843 9.8 11.1
CATH.
107............. 05 SURG CORONARY BYPASS W/O CARDIAC 4.0812 7.3 8.3
CATH.
108............. 05 SURG OTHER CARDIOTHORACIC 6.1282 9.4 12.1
PROCEDURES.
109............. ....... NO LONGER VALID............ .0000 .0 .0
110............. 05 SURG MAJOR CARDIOVASCULAR 4.1964 7.7 10.2
PROCEDURES W CC.
111............. 05 SURG MAJOR CARDIOVASCULAR 2.2409 5.4 6.2
PROCEDURES W/O CC.
112............. 05 SURG PERCUTANEOUS CARDIOVASCULAR 2.0025 3.1 4.2
PROCEDURES.
113............. 05 SURG AMPUTATION FOR CIRC SYSTEM 2.6579 9.7 13.2
DISORDERS EXCEPT UPPER
LIMB & TOE.
114............. 05 SURG UPPER LIMB & TOE AMPUTATION 1.5363 6.4 8.8
FOR CIRC SYSTEM DISORDERS.
115............. 05 SURG PERM PACE IMPLNT W AMI, HRT 3.5476 6.7 9.2
FAIL OR SHOCK OR AICD LEAD
OR GEN PROC.
116............. 05 SURG OTH PERM CARDIAC PACEMAKER 2.5321 3.5 4.7
IMPLANT OR PTCA W CORONARY
ART STENT.
117............. 05 SURG CARDIAC PACEMAKER REVISION 1.1950 2.7 4.0
EXCEPT DEVICE REPLACEMENT.
118............. 05 SURG CARDIAC PACEMAKER DEVICE 1.5889 2.0 3.0
REPLACEMENT.
119............. 05 SURG VEIN LIGATION & STRIPPING.. 1.1997 3.1 5.1
120............. 05 SURG OTHER CIRCULATORY SYSTEM 1.9158 5.0 8.5
O.R. PROCEDURES.
121............. 05 MED CIRCULATORY DISORDERS W AMI 1.6537 6.0 7.3
& MAJOR COMP DISCH ALIVE.
122............. 05 MED CIRCULATORY DISORDERS W AMI 1.1446 3.9 4.7
W/O MAJOR COMP DISCH ALIVE.
123............. 05 MED CIRCULATORY DISORDERS W 1.4695 2.7 4.5
AMI, EXPIRED.
124............. 05 MED CIRCULATORY DISORDERS 1.3565 3.6 4.6
EXCEPT AMI, W CARD CATH &
COMPLEX DIAG.
125............. 05 MED CIRCULATORY DISORDERS .9738 2.3 2.9
EXCEPT AMI, W CARD CATH W/
O COMPLEX DIAG.
126............. 05 MED ACUTE & SUBACUTE 2.4879 10.0 13.1
ENDOCARDITIS.
127............. 05 MED HEART FAILURE & SHOCK...... 1.0199 4.5 5.8
128............. 05 MED DEEP VEIN THROMBOPHLEBITIS. .7807 5.6 6.4
129............. 05 MED CARDIAC ARREST, UNEXPLAINED 1.1414 1.9 3.2
130............. 05 MED PERIPHERAL VASCULAR .9410 5.1 6.3
DISORDERS W CC.
131............. 05 MED PERIPHERAL VASCULAR .6040 4.1 4.9
DISORDERS W/O CC.
132............. 05 MED ATHEROSCLEROSIS W CC....... .6749 2.7 3.3
133............. 05 MED ATHEROSCLEROSIS W/O CC..... .5360 2.1 2.7
134............. 05 MED HYPERTENSION............... .5760 2.8 3.6
135............. 05 MED CARDIAC CONGENITAL & .8336 3.4 4.5
VALVULAR DISORDERS AGE >17
W CC.
136............. 05 MED CARDIAC CONGENITAL & .5709 2.4 3.1
VALVULAR DISORDERS AGE >17
W/O CC.
137............. 05 MED * CARDIAC CONGENITAL & .8131 3.3 3.3
VALVULAR DISORDERS AGE 0-
17.
138............. 05 MED CARDIAC ARRHYTHMIA & .7962 3.2 4.2
CONDUCTION DISORDERS W CC.
139............. 05 MED CARDIAC ARRHYTHMIA & .4982 2.2 2.7
CONDUCTION DISORDERS W/O
CC.
140............. 05 MED ANGINA PECTORIS............ .5993 2.6 3.2
141............. 05 MED SYNCOPE & COLLAPSE W CC.... .7005 3.1 4.1
142............. 05 MED SYNCOPE & COLLAPSE W/O CC.. .5231 2.3 2.9
143............. 05 MED CHEST PAIN................. .5200 1.9 2.4
144............. 05 MED OTHER CIRCULATORY SYSTEM 1.0904 3.9 5.4
DIAGNOSES W CC.
145............. 05 MED OTHER CIRCULATORY SYSTEM .6401 2.3 3.0
DIAGNOSES W/O CC.
146............. 06 SURG RECTAL RESECTION W CC...... 2.7356 9.3 10.5
147............. 06 SURG RECTAL RESECTION W/O CC.... 1.5885 6.3 6.9
148............. 06 SURG MAJOR SMALL & LARGE BOWEL 3.3883 10.6 12.6
PROCEDURES W CC.
149............. 06 SURG MAJOR SMALL & LARGE BOWEL 1.5495 6.5 7.1
PROCEDURES W/O CC.
150............. 06 SURG PERITONEAL ADHESIOLYSIS W 2.7109 9.1 11.1
CC.
151............. 06 SURG PERITONEAL ADHESIOLYSIS W/O 1.2645 4.9 6.1
CC.
152............. 06 SURG MINOR SMALL & LARGE BOWEL 1.9139 7.2 8.5
PROCEDURES W CC.
153............. 06 SURG MINOR SMALL & LARGE BOWEL 1.1634 5.2 5.8
PROCEDURES W/O CC.
[[Page 46083]]
154............. 06 SURG STOMACH, ESOPHAGEAL & 4.1851 10.8 14.1
DUODENAL PROCEDURES AGE
>17 W CC.
155............. 06 SURG STOMACH, ESOPHAGEAL & 1.3350 3.9 5.0
DUODENAL PROCEDURES AGE
>17 W/O CC.
156............. 06 SURG * STOMACH, ESOPHAGEAL & .8374 6.0 6.0
DUODENAL PROCEDURES AGE 0-
17.
157............. 06 SURG ANAL & STOMAL PROCEDURES W 1.1824 4.0 5.6
CC.
158............. 06 SURG ANAL & STOMAL PROCEDURES W/ .6272 2.2 2.8
O CC.
159............. 06 SURG HERNIA PROCEDURES EXCEPT 1.2548 3.8 5.1
INGUINAL & FEMORAL AGE >17
W CC.
160............. 06 SURG HERNIA PROCEDURES EXCEPT .7177 2.3 2.8
INGUINAL & FEMORAL AGE >17
W/O CC.
161............. 06 SURG INGUINAL & FEMORAL HERNIA 1.0573 3.0 4.2
PROCEDURES AGE >17 W CC.
162............. 06 SURG INGUINAL & FEMORAL HERNIA .5856 1.7 2.1
PROCEDURES AGE >17 W/O CC.
163............. 06 SURG HERNIA PROCEDURES AGE 0-17. .8660 3.1 4.7
164............. 06 SURG APPENDECTOMY W COMPLICATED 2.3412 7.5 8.7
PRINCIPAL DIAG W CC.
165............. 06 SURG APPENDECTOMY W COMPLICATED 1.2270 4.7 5.4
PRINCIPAL DIAG W/O CC.
166............. 06 SURG APPENDECTOMY W/O 1.4582 4.3 5.4
COMPLICATED PRINCIPAL DIAG
W CC.
167............. 06 SURG APPENDECTOMY W/O .8373 2.5 3.0
COMPLICATED PRINCIPAL DIAG
W/O CC.
168............. 03 SURG MOUTH PROCEDURES W CC...... 1.1187 3.2 4.7
169............. 03 SURG MOUTH PROCEDURES W/O CC.... .6903 2.0 2.6
170............. 06 SURG OTHER DIGESTIVE SYSTEM O.R. 2.7587 8.1 11.8
PROCEDURES W CC.
171............. 06 SURG OTHER DIGESTIVE SYSTEM O.R. 1.1146 3.7 5.1
PROCEDURES W/O CC.
172............. 06 MED DIGESTIVE MALIGNANCY W CC.. 1.2867 5.3 7.4
173............. 06 MED DIGESTIVE MALIGNANCY W/O CC .6744 2.9 4.0
174............. 06 MED G.I. HEMORRHAGE W CC....... .9925 4.1 5.2
175............. 06 MED G.I. HEMORRHAGE W/O CC..... .5366 2.7 3.2
176............. 06 MED COMPLICATED PEPTIC ULCER... 1.1011 4.5 5.8
177............. 06 MED UNCOMPLICATED PEPTIC ULCER .8556 3.8 4.7
W CC.
178............. 06 MED UNCOMPLICATED PEPTIC ULCER .6241 2.8 3.3
W/O CC.
179............. 06 MED INFLAMMATORY BOWEL DISEASE. 1.1100 5.2 6.7
180............. 06 MED G.I. OBSTRUCTION W CC...... .9153 4.4 5.7
181............. 06 MED G.I. OBSTRUCTION W/O CC.... .5204 3.1 3.7
182............. 06 MED ESOPHAGITIS, GASTROENT & .7664 3.5 4.6
MISC DIGEST DISORDERS AGE
>17 W CC.
183............. 06 MED ESOPHAGITIS, GASTROENT & .5496 2.6 3.2
MISC DIGEST DISORDERS AGE
>17 W/O CC.
184............. 06 MED ESOPHAGITIS, GASTROENT & .5930 2.7 3.6
MISC DIGEST DISORDERS AGE
0-17.
185............. 03 MED DENTAL & ORAL DIS EXCEPT .8424 3.5 4.8
EXTRACTIONS &
RESTORATIONS, AGE >17.
186............. 03 MED * DENTAL & ORAL DIS EXCEPT .3192 2.9 2.9
EXTRACTIONS &
RESTORATIONS, AGE 0-17.
187............. 03 MED DENTAL EXTRACTIONS & .7049 3.0 4.0
RESTORATIONS.
188............. 06 MED OTHER DIGESTIVE SYSTEM 1.0727 4.3 5.8
DIAGNOSES AGE >17 W CC.
189............. 06 MED OTHER DIGESTIVE SYSTEM .5488 2.5 3.4
DIAGNOSES AGE >17 W/O CC.
190............. 06 MED OTHER DIGESTIVE SYSTEM .8786 3.3 4.9
DIAGNOSES AGE 0-17.
191............. 07 SURG PANCREAS, LIVER & SHUNT 4.3490 11.1 14.9
PROCEDURES W CC.
192............. 07 SURG PANCREAS, LIVER & SHUNT 1.7057 5.6 7.1
PROCEDURES W/O CC.
193............. 07 SURG BILIARY TRACT PROC EXCEPT 3.2666 10.6 13.0
ONLY CHOLECYST W OR W/O
C.D.E. W CC.
194............. 07 SURG BILIARY TRACT PROC EXCEPT 1.6688 5.9 7.5
ONLY CHOLECYST W OR W/O
C.D.E. W/O CC.
195............. 07 SURG CHOLECYSTECTOMY W C.D.E. W 2.7112 8.2 9.8
CC.
196............. 07 SURG CHOLECYSTECTOMY W C.D.E. W/ 1.6075 5.5 6.3
O CC.
197............. 07 SURG CHOLECYSTECTOMY EXCEPT BY 2.3085 7.2 8.7
LAPAROSCOPE W/O C.D.E. W
CC.
198............. 07 SURG CHOLECYSTECTOMY EXCEPT BY 1.1693 4.1 4.7
LAPAROSCOPE W/O C.D.E. W/O
CC.
199............. 07 SURG HEPATOBILIARY DIAGNOSTIC 2.3523 7.9 10.7
PROCEDURE FOR MALIGNANCY.
200............. 07 SURG HEPATOBILIARY DIAGNOSTIC 3.0210 7.5 11.3
PROCEDURE FOR NON-
MALIGNANCY.
201............. 07 SURG OTHER HEPATOBILIARY OR 3.4752 11.1 15.2
PANCREAS O.R. PROCEDURES.
202............. 07 MED CIRRHOSIS & ALCOHOLIC 1.3255 5.3 7.2
HEPATITIS.
203............. 07 MED MALIGNANCY OF HEPATOBILIARY 1.2605 5.2 7.2
SYSTEM OR PANCREAS.
204............. 07 MED DISORDERS OF PANCREAS 1.2117 4.9 6.4
EXCEPT MALIGNANCY.
205............. 07 MED DISORDERS OF LIVER EXCEPT 1.2144 5.0 6.8
MALIG, CIRR, ALC HEPA W CC.
206............. 07 MED DISORDERS OF LIVER EXCEPT .6543 3.2 4.2
MALIG, CIRR, ALC HEPA W/O
CC.
207............. 07 MED DISORDERS OF THE BILIARY 1.0507 4.1 5.3
TRACT W CC.
208............. 07 MED DISORDERS OF THE BILIARY .6039 2.4 3.0
TRACT W/O CC.
209............. 08 SURG MAJOR JOINT & LIMB 2.2337 5.3 5.9
REATTACHMENT PROCEDURES OF
LOWER EXTREMITY.
210............. 08 SURG HIP & FEMUR PROCEDURES 1.8265 6.5 7.6
EXCEPT MAJOR JOINT AGE >17
W CC.
[[Page 46084]]
211............. 08 SURG HIP & FEMUR PROCEDURES 1.2541 5.0 5.6
EXCEPT MAJOR JOINT AGE >17
W/O CC.
212............. 08 SURG HIP & FEMUR PROCEDURES 1.1311 3.9 5.2
EXCEPT MAJOR JOINT AGE 0-
17.
213............. 08 SURG AMPUTATION FOR 1.6513 6.4 8.8
MUSCULOSKELETAL SYSTEM &
CONN TISSUE DISORDERS.
214............. 08 SURG NO LONGER VALID............ .0000 .0 .0
215............. 08 SURG NO LONGER VALID............ .0000 .0 .0
216............. 08 SURG BIOPSIES OF MUSCULOSKELETAL 2.1082 7.4 10.3
SYSTEM & CONNECTIVE TISSUE.
217............. 08 SURG WND DEBRID & SKN GRFT 2.8033 9.2 13.8
EXCEPT HAND, FOR
MUSCSKELET & CONN TISS DIS.
218............. 08 SURG LOWER EXTREM & HUMER PROC 1.4576 4.4 5.6
EXCEPT HIP, FOOT, FEMUR
AGE >17 W CC.
219............. 08 SURG LOWER EXTREM & HUMER PROC .9631 2.9 3.4
EXCEPT HIP, FOOT, FEMUR
AGE >17 W/O CC.
220............. 08 SURG * LOWER EXTREM & HUMER PROC .5800 5.3 5.3
EXCEPT HIP, FOOT, FEMUR
AGE 0-17.
221............. 08 SURG NO LONGER VALID............ .0000 .0 .0
222............. 08 SURG NO LONGER VALID............ .0000 .0 .0
223............. 08 SURG MAJOR SHOULDER/ELBOW PROC, .9007 2.1 2.7
OR OTHER UPPER EXTREMITY
PROC W CC.
224............. 08 SURG SHOULDER, ELBOW OR FOREARM .7466 1.8 2.1
PROC, EXC MAJOR JOINT
PROC, W/O CC.
225............. 08 SURG FOOT PROCEDURES............ 1.0124 3.1 4.6
226............. 08 SURG SOFT TISSUE PROCEDURES W CC 1.4095 4.1 6.3
227............. 08 SURG SOFT TISSUE PROCEDURES W/O .7729 2.2 2.9
CC.
228............. 08 SURG MAJOR THUMB OR JOINT PROC, .9542 2.3 3.5
OR OTH HAND OR WRIST PROC
W CC.
229............. 08 SURG HAND OR WRIST PROC, EXCEPT .6706 1.8 2.4
MAJOR JOINT PROC, W/O CC.
230............. 08 SURG LOCAL EXCISION & REMOVAL OF 1.1296 3.3 5.0
INT FIX DEVICES OF HIP &
FEMUR.
231............. 08 SURG LOCAL EXCISION & REMOVAL OF 1.2727 3.1 4.8
INT FIX DEVICES EXCEPT HIP
& FEMUR.
232............. 08 SURG ARTHROSCOPY................ 1.0629 2.5 4.2
233............. 08 SURG OTHER MUSCULOSKELET SYS & 2.0329 5.7 8.3
CONN TISS O.R. PROC W CC.
234............. 08 SURG OTHER MUSCULOSKELET SYS & 1.1126 2.9 3.9
CONN TISS O.R. PROC W/O CC.
235............. 08 MED FRACTURES OF FEMUR......... .7710 4.2 5.9
236............. 08 MED FRACTURES OF HIP & PELVIS.. .7338 4.3 5.7
237............. 08 MED SPRAINS, STRAINS, & .5952 3.2 4.2
DISLOCATIONS OF HIP,
PELVIS & THIGH.
238............. 08 MED OSTEOMYELITIS.............. 1.3250 7.0 9.5
239............. 08 MED PATHOLOGICAL FRACTURES & .9865 5.3 7.0
MUSCULOSKELETAL & CONN
TISS MALIGNANCY.
240............. 08 MED CONNECTIVE TISSUE DISORDERS 1.2098 5.1 7.0
W CC.
241............. 08 MED CONNECTIVE TISSUE DISORDERS .5862 3.3 4.2
W/O CC.
242............. 08 MED SEPTIC ARTHRITIS........... 1.0501 5.5 7.2
243............. 08 MED MEDICAL BACK PROBLEMS...... .7158 4.0 5.1
244............. 08 MED BONE DISEASES & SPECIFIC .7199 4.0 5.4
ARTHROPATHIES W CC.
245............. 08 MED BONE DISEASES & SPECIFIC .5002 3.0 4.0
ARTHROPATHIES W/O CC.
246............. 08 MED NON-SPECIFIC ARTHROPATHIES. .5713 3.3 4.2
247............. 08 MED SIGNS & SYMPTOMS OF .5587 2.8 3.7
MUSCULOSKELETAL SYSTEM &
CONN TISSUE.
248............. 08 MED TENDONITIS, MYOSITIS & .7428 3.7 5.0
BURSITIS.
249............. 08 MED AFTERCARE, MUSCULOSKELETAL .6559 2.7 4.0
SYSTEM & CONNECTIVE TISSUE.
250............. 08 MED FX, SPRN, STRN & DISL OF .6995 3.4 4.7
FOREARM, HAND, FOOT AGE
>17 W CC.
251............. 08 MED FX, SPRN, STRN & DISL OF .4517 2.3 3.0
FOREARM, HAND, FOOT AGE
>17 W/O CC.
252............. 08 MED * FX, SPRN, STRN & DISL OF .2520 1.8 1.8
FOREARM, HAND, FOOT AGE 0-
17.
253............. 08 MED FX, SPRN, STRN & DISL OF .7265 3.9 5.3
UPARM, LOWLEG EX FOOT AGE
>17 W CC.
254............. 08 MED FX, SPRN, STRN & DISL OF .4350 2.8 3.5
UPARM, LOWLEG EX FOOT AGE
>17 W/O CC.
255............. 08 MED * FX, SPRN, STRN & DISL OF .2934 2.9 2.9
UPARM, LOWLEG EX FOOT AGE
0-17.
256............. 08 MED OTHER MUSCULOSKELETAL .7826 4.0 5.7
SYSTEM & CONNECTIVE TISSUE
DIAGNOSES.
257............. 09 SURG TOTAL MASTECTOMY FOR .9276 2.6 3.2
MALIGNANCY W CC.
258............. 09 SURG TOTAL MASTECTOMY FOR .7162 2.0 2.3
MALIGNANCY W/O CC.
259............. 09 SURG SUBTOTAL MASTECTOMY FOR .8874 2.1 3.2
MALIGNANCY W CC.
260............. 09 SURG SUBTOTAL MASTECTOMY FOR .6092 1.4 1.7
MALIGNANCY W/O CC.
261............. 09 SURG BREAST PROC FOR NON- .8961 1.8 2.2
MALIGNANCY EXCEPT BIOPSY &
LOCAL EXCISION.
[[Page 46085]]
262............. 09 SURG BREAST BIOPSY & LOCAL .7820 2.6 4.0
EXCISION FOR NON-
MALIGNANCY.
263............. 09 SURG SKIN GRAFT &/OR DEBRID FOR 2.0221 8.9 12.6
SKN ULCER OR CELLULITIS W
CC.
264............. 09 SURG SKIN GRAFT &/OR DEBRID FOR 1.0773 5.4 7.3
SKN ULCER OR CELLULITIS W/
O CC.
265............. 09 SURG SKIN GRAFT &/OR DEBRID 1.5166 4.6 7.3
EXCEPT FOR SKIN ULCER OR
CELLULITIS W CC.
266............. 09 SURG SKIN GRAFT &/OR DEBRID .7909 2.6 3.6
EXCEPT FOR SKIN ULCER OR
CELLULITIS W/O CC.
267............. 09 SURG PERIANAL & PILONIDAL .8424 2.7 4.1
PROCEDURES.
268............. 09 SURG SKIN, SUBCUTANEOUS TISSUE & 1.0090 2.4 3.5
BREAST PLASTIC PROCEDURES.
269............. 09 SURG OTHER SKIN, SUBCUT TISS & 1.5733 5.9 8.5
BREAST PROC W CC.
270............. 09 SURG OTHER SKIN, SUBCUT TISS & .7061 2.2 3.2
BREAST PROC W/O CC.
271............. 09 MED SKIN ULCERS................ 1.0259 6.0 7.8
272............. 09 MED MAJOR SKIN DISORDERS W CC.. .9950 5.1 6.7
273............. 09 MED MAJOR SKIN DISORDERS W/O CC .6618 4.0 5.4
274............. 09 MED MALIGNANT BREAST DISORDERS 1.1229 5.0 7.2
W CC.
275............. 09 MED MALIGNANT BREAST DISORDERS .5882 2.5 3.9
W/O CC.
276............. 09 MED NON-MALIGANT BREAST .6122 3.8 4.7
DISORDERS.
277............. 09 MED CELLULITIS AGE >17 W CC.... .8322 5.1 6.2
278............. 09 MED CELLULITIS AGE >17 W/O CC.. .5574 4.0 4.8
279............. 09 MED * CELLULITIS AGE 0-17...... .7309 4.2 4.2
280............. 09 MED TRAUMA TO THE SKIN, SUBCUT .6757 3.4 4.7
TISS & BREAST AGE >17 W CC.
281............. 09 MED TRAUMA TO THE SKIN, SUBCUT .4558 2.5 3.4
TISS & BREAST AGE >17 W/O
CC.
282............. 09 MED * TRAUMA TO THE SKIN, .2551 2.2 2.2
SUBCUT TISS & BREAST AGE 0-
17.
283............. 09 MED MINOR SKIN DISORDERS W CC.. .6936 3.8 5.0
284............. 09 MED MINOR SKIN DISORDERS W/O CC .4371 2.7 3.6
285............. 10 SURG AMPUTAT OF LOWER LIMB FOR 2.1556 8.8 12.1
ENDOCRINE, NUTRIT, &
METABOL DISORDERS.
286............. 10 SURG ADRENAL & PITUITARY 2.2671 5.8 7.3
PROCEDURES.
287............. 10 SURG SKIN GRAFTS & WOUND DEBRID 1.8727 8.6 12.1
FOR ENDOC, NUTRIT & METAB
DISORDERS.
288............. 10 SURG O.R. PROCEDURES FOR OBESITY 2.0255 4.9 6.2
289............. 10 SURG PARATHYROID PROCEDURES..... .9827 2.4 3.5
290............. 10 SURG THYROID PROCEDURES......... .8970 2.0 2.6
291............. 10 SURG THYROGLOSSAL PROCEDURES.... .7372 1.7 2.2
292............. 10 SURG OTHER ENDOCRINE, NUTRIT & 2.5483 7.6 11.2
METAB O.R. PROC W CC.
293............. 10 SURG OTHER ENDOCRINE, NUTRIT & 1.2297 3.8 5.6
METAB O.R. PROC W/O CC.
294............. 10 MED DIABETES AGE >35........... .7546 4.0 5.3
295............. 10 MED DIABETES AGE 0-35.......... .7359 3.2 4.1
296............. 10 MED NUTRITIONAL & MISC .8657 4.3 5.8
METABOLIC DISORDERS AGE
>17 W CC.
297............. 10 MED NUTRITIONAL & MISC .5188 3.0 3.9
METABOLIC DISORDERS AGE
>17 W/O CC.
298............. 10 MED NUTRITIONAL & MISC .4207 2.0 2.5
METABOLIC DISORDERS AGE 0-
17.
299............. 10 MED INBORN ERRORS OF METABOLISM .8716 3.9 5.5
300............. 10 MED ENDOCRINE DISORDERS W CC... 1.0810 5.1 6.6
301............. 10 MED ENDOCRINE DISORDERS W/O CC. .5941 3.1 4.4
302............. 11 SURG KIDNEY TRANSPLANT.......... 3.7570 9.2 10.9
303............. 11 SURG KIDNEY, URETER & MAJOR 2.6139 7.8 9.5
BLADDER PROCEDURES FOR
NEOPLASM.
304............. 11 SURG KIDNEY, URETER & MAJOR 2.3982 6.9 9.6
BLADDER PROC FOR NON-NEOPL
W CC.
305............. 11 SURG KIDNEY, URETER & MAJOR 1.1695 3.4 4.3
BLADDER PROC FOR NON-NEOPL
W/O CC.
306............. 11 SURG PROSTATECTOMY W CC......... 1.2168 4.0 5.8
307............. 11 SURG PROSTATECTOMY W/O CC....... .6455 2.1 2.5
308............. 11 SURG MINOR BLADDER PROCEDURES W 1.5120 4.3 6.4
CC.
309............. 11 SURG MINOR BLADDER PROCEDURES W/ .8760 2.1 2.6
O CC.
310............. 11 SURG TRANSURETHRAL PROCEDURES W 1.0248 3.0 4.3
CC.
311............. 11 SURG TRANSURETHRAL PROCEDURES W/ .5866 1.7 2.1
O CC.
312............. 11 SURG URETHRAL PROCEDURES, AGE .9732 3.1 4.7
>17 W CC.
313............. 11 SURG URETHRAL PROCEDURES, AGE .5783 1.8 2.3
>17 W/O CC.
314............. 11 SURG * URETHRAL PROCEDURES, AGE .4916 2.3 2.3
0-17.
315............. 11 SURG OTHER KIDNEY & URINARY 2.0601 4.9 8.5
TRACT O.R. PROCEDURES.
316............. 11 MED RENAL FAILURE.............. 1.3089 5.1 7.1
317............. 11 MED ADMIT FOR RENAL DIALYSIS... .5489 2.0 2.9
318............. 11 MED KIDNEY & URINARY TRACT 1.1594 4.7 6.7
NEOPLASMS W CC.
319............. 11 MED KIDNEY & URINARY TRACT .5808 2.0 2.8
NEOPLASMS W/O CC.
320............. 11 MED KIDNEY & URINARY TRACT .8782 4.7 5.9
INFECTIONS AGE >17 W CC.
321............. 11 MED KIDNEY & URINARY TRACT .5838 3.6 4.3
INFECTIONS AGE >17 W/O CC.
322............. 11 MED KIDNEY & URINARY TRACT .5342 3.4 4.3
INFECTIONS AGE 0-17.
323............. 11 MED URINARY STONES W CC, &/OR .7555 2.5 3.4
ESW LITHOTRIPSY.
[[Page 46086]]
324............. 11 MED URINARY STONES W/O CC...... .4298 1.7 2.0
325............. 11 MED KIDNEY & URINARY TRACT .6207 3.1 4.2
SIGNS & SYMPTOMS AGE >17 W
CC.
326............. 11 MED KIDNEY & URINARY TRACT .4188 2.3 2.9
SIGNS & SYMPTOMS AGE >17 W/
O CC.
327............. 11 MED KIDNEY & URINARY TRACT .3516 2.3 3.5
SIGNS & SYMPTOMS AGE 0-17.
328............. 11 MED URETHRAL STRICTURE AGE >17 .6878 2.9 3.9
W CC.
329............. 11 MED URETHRAL STRICTURE AGE >17 .5080 1.9 2.3
W/O CC.
330............. 11 MED * URETHRAL STRICTURE AGE 0- .3167 1.6 1.6
17.
331............. 11 MED OTHER KIDNEY & URINARY 1.0009 4.4 5.9
TRACT DIAGNOSES AGE >17 W
CC.
332............. 11 MED OTHER KIDNEY & URINARY .5964 2.7 3.7
TRACT DIAGNOSES AGE >17 W/
O CC.
333............. 11 MED OTHER KIDNEY & URINARY .8389 4.0 5.7
TRACT DIAGNOSES AGE 0-17.
334............. 12 SURG MAJOR MALE PELVIC 1.6359 4.8 5.4
PROCEDURES W CC.
335............. 12 SURG MAJOR MALE PELVIC 1.2190 3.7 4.1
PROCEDURES W/O CC.
336............. 12 SURG TRANSURETHRAL PROSTATECTOMY .8870 2.9 3.8
W CC.
337............. 12 SURG TRANSURETHRAL PROSTATECTOMY .6129 2.1 2.4
W/O CC.
338............. 12 SURG TESTES PROCEDURES, FOR 1.0950 3.3 5.1
MALIGNANCY.
339............. 12 SURG TESTES PROCEDURES, NON- 1.0038 3.1 4.6
MALIGNANCY AGE >17.
340............. 12 SURG * TESTES PROCEDURES, NON- .2815 2.4 2.4
MALIGNANCY AGE 0-17.
341............. 12 SURG PENIS PROCEDURES........... 1.1089 2.2 3.1
342............. 12 SURG CIRCUMCISION AGE >17....... .8511 2.9 3.6
343............. 12 SURG * CIRCUMCISION AGE 0-17.... .1529 1.7 1.7
344............. 12 SURG OTHER MALE REPRODUCTIVE 1.0298 2.1 3.1
SYSTEM O.R. PROCEDURES FOR
MALIGNANCY.
345............. 12 SURG OTHER MALE REPRODUCTIVE .8552 2.7 3.8
SYSTEM O.R. PROC EXCEPT
FOR MALIGNANCY.
346............. 12 MED MALIGNANCY, MALE .9573 4.5 6.3
REPRODUCTIVE SYSTEM, W CC.
347............. 12 MED MALIGNANCY, MALE .4603 2.2 3.0
REPRODUCTIVE SYSTEM, W/O
CC.
348............. 12 MED BENIGN PROSTATIC .6958 3.3 4.5
HYPERTROPHY W CC.
349............. 12 MED BENIGN PROSTATIC .4154 2.1 2.7
HYPERTROPHY W/O CC.
350............. 12 MED INFLAMMATION OF THE MALE .6797 3.8 4.6
REPRODUCTIVE SYSTEM.
351............. 12 MED * STERILIZATION, MALE...... .2347 1.3 1.3
352............. 12 MED OTHER MALE REPRODUCTIVE .6263 2.9 4.0
SYSTEM DIAGNOSES.
353............. 13 SURG PELVIC EVISCERATION, 2.1179 6.4 8.3
RADICAL HYSTERECTOMY &
RADICAL VULVECTOMY.
354............. 13 SURG UTERINE, ADNEXA PROC FOR 1.4963 5.0 6.0
NON-OVARIAN/ADNEXAL MALIG
W CC.
355............. 13 SURG UTERINE, ADNEXA PROC FOR .9180 3.4 3.6
NON-OVARIAN/ADNEXAL MALIG
W/O CC.
356............. 13 SURG FEMALE REPRODUCTIVE SYSTEM .7701 2.5 2.8
RECONSTRUCTIVE PROCEDURES.
357............. 13 SURG UTERINE & ADNEXA PROC FOR 2.4309 7.6 9.3
OVARIAN OR ADNEXAL
MALIGNANCY.
358............. 13 SURG UTERINE & ADNEXA PROC FOR 1.2021 3.8 4.5
NON-MALIGNANCY W CC.
359............. 13 SURG UTERINE & ADNEXA PROC FOR .8452 2.9 3.1
NON-MALIGNANCY W/O CC.
360............. 13 SURG VAGINA, CERVIX & VULVA .8708 2.7 3.3
PROCEDURES.
361............. 13 SURG LAPAROSCOPY & INCISIONAL 1.1872 2.6 3.7
TUBAL INTERRUPTION.
362............. 13 SURG * ENDOSCOPIC TUBAL .3000 1.4 1.4
INTERRUPTION.
363............. 13 SURG D&C, CONIZATION & RADIO- .7485 2.6 3.5
IMPLANT, FOR MALIGNANCY.
364............. 13 SURG D&C, CONIZATION EXCEPT FOR .6985 2.5 3.5
MALIGNANCY.
365............. 13 SURG OTHER FEMALE REPRODUCTIVE 1.7085 4.7 7.2
SYSTEM O.R. PROCEDURES.
366............. 13 MED MALIGNANCY, FEMALE 1.1857 4.9 7.1
REPRODUCTIVE SYSTEM W CC.
367............. 13 MED MALIGNANCY, FEMALE .5309 2.1 2.9
REPRODUCTIVE SYSTEM W/O CC.
368............. 13 MED INFECTIONS, FEMALE .9698 4.9 6.2
REPRODUCTIVE SYSTEM.
369............. 13 MED MENSTRUAL & OTHER FEMALE .5367 2.5 3.4
REPRODUCTIVE SYSTEM
DISORDERS.
370............. 14 SURG CESAREAN SECTION W CC...... 1.0587 4.3 5.5
371............. 14 SURG CESAREAN SECTION W/O CC.... .7054 3.3 3.6
372............. 14 MED VAGINAL DELIVERY W .5590 2.4 3.1
COMPLICATING DIAGNOSES.
373............. 14 MED VAGINAL DELIVERY W/O .3987 1.7 2.0
COMPLICATING DIAGNOSES.
374............. 14 SURG VAGINAL DELIVERY W .7625 2.3 2.9
STERILIZATION &/OR D&C.
375............. 14 SURG * VAGINAL DELIVERY W O.R. .6809 4.4 4.4
PROC EXCEPT STERIL &/OR
D&C.
376............. 14 MED POSTPARTUM & POST ABORTION .4822 2.3 3.2
DIAGNOSES W/O O.R.
PROCEDURE.
377............. 14 SURG POSTPARTUM & POST ABORTION 1.0517 2.5 4.0
DIAGNOSES W O.R. PROCEDURE.
378............. 14 MED ECTOPIC PREGNANCY.......... .8126 2.3 2.6
379............. 14 MED THREATENED ABORTION........ .4028 2.1 2.9
380............. 14 MED ABORTION W/O D&C........... .3501 1.5 1.8
381............. 14 SURG ABORTION W D&C, ASPIRATION .4809 1.7 2.3
CURETTAGE OR HYSTEROTOMY.
382............. 14 MED FALSE LABOR................ .2086 1.2 1.3
383............. 14 MED OTHER ANTEPARTUM DIAGNOSES .4636 2.8 3.8
W MEDICAL COMPLICATIONS.
[[Page 46087]]
384............. 14 MED OTHER ANTEPARTUM DIAGNOSES .3539 2.0 2.8
W/O MEDICAL COMPLICATIONS.
385............. 15 * NEONATES, DIED OR 1.3665 1.8 1.8
TRANSFERRED TO ANOTHER
ACUTE CARE FACILITY.
386............. 15 * EXTREME IMMATURITY OR 4.5063 17.9 17.9
RESPIRATORY DISTRESS
SYNDROME, NEONATE.
387............. 15 * PREMATURITY W MAJOR 3.0777 13.3 13.3
PROBLEMS.
388............. 15 * PREMATURITY W/O MAJOR 1.8570 8.6 8.6
PROBLEMS.
389............. 15 FULL TERM NEONATE W MAJOR 1.4862 5.1 6.3
PROBLEMS.
390............. 15 * NEONATE W OTHER 1.3058 3.4 3.4
SIGNIFICANT PROBLEMS.
391............. 15 * NORMAL NEWBORN........... .1515 3.1 3.1
392............. 16 SURG SPLENECTOMY AGE >17........ 3.1695 8.1 10.6
393............. 16 SURG * SPLENECTOMY AGE 0-17..... 1.3386 9.1 9.1
394............. 16 SURG OTHER O.R. PROCEDURES OF 1.6479 4.5 7.5
THE BLOOD AND BLOOD
FORMING ORGANS.
395............. 16 MED RED BLOOD CELL DISORDERS .8181 3.6 5.0
AGE >17.
396............. 16 MED RED BLOOD CELL DISORDERS .6284 2.7 4.0
AGE 0-17.
397............. 16 MED COAGULATION DISORDERS...... 1.2679 4.2 5.8
398............. 16 MED RETICULOENDOTHELIAL & 1.2242 4.9 6.3
IMMUNITY DISORDERS W CC.
399............. 16 MED RETICULOENDOTHELIAL & .6836 3.2 4.0
IMMUNITY DISORDERS W/O CC.
400............. 17 SURG LYMPHOMA & LEUKEMIA W MAJOR 2.6402 6.3 9.7
O.R. PROCEDURE.
401............. 17 SURG LYMPHOMA & NON-ACUTE 2.5653 8.1 11.7
LEUKEMIA W OTHER O.R. PROC
W CC.
402............. 17 SURG LYMPHOMA & NON-ACUTE 1.0145 2.9 4.2
LEUKEMIA W OTHER O.R. PROC
W/O CC.
403............. 17 MED LYMPHOMA & NON-ACUTE 1.6964 6.0 8.6
LEUKEMIA W CC.
404............. 17 MED LYMPHOMA & NON-ACUTE .7917 3.3 4.6
LEUKEMIA W/O CC.
405............. 17 * ACUTE LEUKEMIA W/O MAJOR 1.8978 4.9 4.9
O.R. PROCEDURE AGE 0-17.
406............. 17 SURG MYELOPROLIF DISORD OR 2.6147 7.3 10.1
POORLY DIFF NEOPL W MAJ
O.R.PROC W CC.
407............. 17 SURG MYELOPROLIF DISORD OR 1.1516 3.5 4.4
POORLY DIFF NEOPL W MAJ
O.R. PROC W/O CC.
408............. 17 SURG MYELOPROLIF DISORD OR 1.7294 4.7 7.6
POORLY DIFF NEOPL W OTHER
O.R.PROC.
409............. 17 MED RADIOTHERAPY............... .9534 4.3 5.9
410............. 17 MED CHEMOTHERAPY W/O ACUTE .7968 2.6 3.4
LEUKEMIA AS SECONDARY
DIAGNOSIS.
411............. 17 MED HISTORY OF MALIGNANCY W/O .4214 1.8 2.3
ENDOSCOPY.
412............. 17 MED HISTORY OF MALIGNANCY W .5175 2.4 3.4
ENDOSCOPY.
413............. 17 MED OTHER MYELOPROLIF DIS OR 1.3777 5.7 8.1
POORLY DIFF NEOPL DIAG W
CC.
414............. 17 MED OTHER MYELOPROLIF DIS OR .7041 3.2 4.6
POORLY DIFF NEOPL DIAG W/O
CC.
415............. 18 SURG O.R. PROCEDURE FOR 3.5166 10.8 14.9
INFECTIOUS & PARASITIC
DISEASES.
416............. 18 MED SEPTICEMIA AGE >17......... 1.4797 5.8 7.7
417............. 18 MED SEPTICEMIA AGE 0-17........ .7688 3.3 4.3
418............. 18 MED POSTOPERATIVE & POST- .9679 5.0 6.3
TRAUMATIC INFECTIONS.
419............. 18 MED FEVER OF UNKNOWN ORIGIN AGE .8831 4.1 5.2
>17 W CC.
420............. 18 MED FEVER OF UNKNOWN ORIGIN AGE .6064 3.2 4.0
>17 W/O CC.
421............. 18 MED VIRAL ILLNESS AGE >17...... .7069 3.3 4.2
422............. 18 MED VIRAL ILLNESS & FEVER OF .5347 2.7 3.8
UNKNOWN ORIGIN AGE 0-17.
423............. 18 MED OTHER INFECTIOUS & 1.5690 5.8 8.0
PARASITIC DISEASES
DIAGNOSES.
424............. 19 SURG O.R. PROCEDURE W PRINCIPAL 2.4581 9.9 16.8
DIAGNOSES OF MENTAL
ILLNESS.
425............. 19 MED ACUTE ADJUST REACT & .6857 3.2 4.4
DISTURBANCES OF
PSYCHOSOCIAL DYSFUNCTION.
426............. 19 MED DEPRESSIVE NEUROSES........ .5648 3.7 5.2
427............. 19 MED NEUROSES EXCEPT DEPRESSIVE. .5818 3.6 5.3
428............. 19 MED DISORDERS OF PERSONALITY & .6975 4.9 7.7
IMPULSE CONTROL.
429............. 19 MED ORGANIC DISTURBANCES & .8728 5.4 7.9
MENTAL RETARDATION.
430............. 19 MED PSYCHOSES.................. .8073 6.5 9.1
431............. 19 MED CHILDHOOD MENTAL DISORDERS. .8371 5.5 8.9
432............. 19 MED OTHER MENTAL DISORDER .7647 3.7 5.9
DIAGNOSES.
433............. 20 ALCOHOL/DRUG ABUSE OR .3053 2.4 3.3
DEPENDENCE, LEFT AMA.
434............. 20 ALC/DRUG ABUSE OR DEPEND, .6865 4.0 5.3
DETOX OR OTH SYMPT TREAT W
CC.
435............. 20 ALC/DRUG ABUSE OR DEPEND, .4015 3.6 4.5
DETOX OR OTH SYMPT TREAT W/
O CC.
436............. 20 ALC/DRUG DEPENDENCE W .8110 11.5 14.1
REHABILITATION THERAPY.
437............. 20 ALC/DRUG DEPENDENCE, .7343 8.3 9.9
COMBINED REHAB & DETOX
THERAPY.
438............. ....... NO LONGER VALID............ .0000 .0 .0
439............. 21 SURG SKIN GRAFTS FOR INJURIES... 1.6391 5.4 8.5
440............. 21 SURG WOUND DEBRIDEMENTS FOR 1.8456 6.0 9.6
INJURIES.
441............. 21 SURG HAND PROCEDURES FOR .9298 2.2 3.4
INJURIES.
442............. 21 SURG OTHER O.R. PROCEDURES FOR 2.1818 5.4 8.3
INJURIES W CC.
[[Page 46088]]
443............. 21 SURG OTHER O.R. PROCEDURES FOR .9116 2.5 3.4
INJURIES W/O CC.
444............. 21 MED TRAUMATIC INJURY AGE >17 W .7007 3.7 4.8
CC.
445............. 21 MED TRAUMATIC INJURY AGE >17 W/ .4842 2.6 3.7
O CC.
446............. 21 MED * TRAUMATIC INJURY AGE 0-17 .2942 2.4 2.4
447............. 21 MED ALLERGIC REACTIONS AGE >17. .4927 2.0 2.6
448............. 21 MED ALLERGIC REACTIONS AGE 0-17 .0968 1.0 1.0
449............. 21 MED POISONING & TOXIC EFFECTS .7860 2.8 4.1
OF DRUGS AGE >17 W CC.
450............. 21 MED POISONING & TOXIC EFFECTS .4406 1.7 2.2
OF DRUGS AGE >17 W/O CC.
451............. 21 MED * POISONING & TOXIC EFFECTS .2613 2.1 2.1
OF DRUGS AGE 0-17.
452............. 21 MED COMPLICATIONS OF TREATMENT .9476 3.7 5.2
W CC.
453............. 21 MED COMPLICATIONS OF TREATMENT .4960 2.3 3.1
W/O CC.
454............. 21 MED OTHER INJURY, POISONING & .9035 3.3 5.2
TOXIC EFFECT DIAG W CC.
455............. 21 MED OTHER INJURY, POISONING & .4453 2.0 2.7
TOXIC EFFECT DIAG W/O CC.
456............. 22 BURNS, TRANSFERRED TO 1.7396 3.7 7.3
ANOTHER ACUTE CARE
FACILITY.
457............. 22 MED EXTENSIVE BURNS W/O O.R. 1.5860 2.5 4.9
PROCEDURE.
458............. 22 SURG NON-EXTENSIVE BURNS W SKIN 3.5746 11.1 16.0
GRAFT.
459............. 22 SURG NON-EXTENSIVE BURNS W WOUND 1.5588 6.5 9.3
DEBRIDEMENT OR OTHER O.R.
PROC.
460............. 22 MED NON-EXTENSIVE BURNS W/O .9421 4.4 6.3
O.R. PROCEDURE.
461............. 23 SURG O.R. PROC W DIAGNOSES OF 1.0123 2.5 4.6
OTHER CONTACT W HEALTH
SERVICES.
462............. 23 MED REHABILITATION............. 1.4041 10.5 13.1
463............. 23 MED SIGNS & SYMPTOMS W CC...... .6907 3.6 4.8
464............. 23 MED SIGNS & SYMPTOMS W/O CC.... .4872 2.7 3.4
465............. 23 MED AFTERCARE W HISTORY OF .5858 2.2 3.8
MALIGNANCY AS SECONDARY
DIAGNOSIS.
466............. 23 MED AFTERCARE W/O HISTORY OF .6336 2.6 4.7
MALIGNANCY AS SECONDARY
DIAGNOSIS.
467............. 23 MED OTHER FACTORS INFLUENCING .4669 2.3 4.2
HEALTH STATUS.
468............. ....... EXTENSIVE O.R. PROCEDURE 3.6202 9.9 14.2
UNRELATED TO PRINCIPAL
DIAGNOSIS.
469............. ....... ** PRINCIPAL DIAGNOSIS .0000 .0 .0
INVALID AS DISCHARGE
DIAGNOSIS.
470............. ....... ** UNGROUPABLE............. .0000 .0 .0
471............. 08 SURG BILATERAL OR MULTIPLE MAJOR 3.4771 5.8 6.7
JOINT PROCS OF LOWER
EXTREMITY.
472............. 22 SURG EXTENSIVE BURNS W O.R. 10.2429 11.8 24.2
PROCEDURE.
473............. 17 ACUTE LEUKEMIA W/O MAJOR 3.4853 7.9 13.6
O.R. PROCEDURE AGE >17.
474............. ....... NO LONGER VALID............ .0000 .0 .0
475............. 04 MED RESPIRATORY SYSTEM 3.7291 8.2 11.6
DIAGNOSIS WITH VENTILATOR
SUPPORT.
476............. ....... SURG PROSTATIC O.R. PROCEDURE 2.2234 9.5 12.7
UNRELATED TO PRINCIPAL
DIAGNOSIS.
477............. ....... SURG NON-EXTENSIVE O.R. 1.7461 5.5 8.6
PROCEDURE UNRELATED TO
PRINCIPAL DIAGNOSIS.
478............. 05 SURG OTHER VASCULAR PROCEDURES W 2.2981 5.2 7.7
CC.
479............. 05 SURG OTHER VASCULAR PROCEDURES W/ 1.4113 3.2 4.2
O CC.
480............. ....... SURG LIVER TRANSPLANT........... 11.4672 19.0 25.3
481............. ....... SURG BONE MARROW TRANSPLANT..... 11.2821 26.5 30.2
482............. ....... SURG TRACHEOSTOMY FOR FACE, 3.5999 10.5 13.5
MOUTH & NECK DIAGNOSES.
483............. ....... SURG TRACHEOSTOMY EXCEPT FOR 16.0451 33.8 43.5
FACE, MOUTH & NECK
DIAGNOSES.
484............. 24 SURG CRANIOTOMY FOR MULTIPLE 5.7762 10.6 15.4
SIGNIFICANT TRAUMA.
485............. 24 SURG LIMB REATTACHMENT, HIP AND 3.1562 8.3 10.6
FEMUR PROC FOR MULTIPLE
SIGNIFICANT TR.
486............. 24 SURG OTHER O.R. PROCEDURES FOR 4.8882 8.8 13.5
MULTIPLE SIGNIFICANT
TRAUMA.
487............. 24 MED OTHER MULTIPLE SIGNIFICANT 2.0229 5.9 8.3
TRAUMA.
488............. 25 SURG HIV W EXTENSIVE O.R. 4.5078 12.1 18.0
PROCEDURE.
489............. 25 MED HIV W MAJOR RELATED 1.8009 6.7 9.8
CONDITION.
490............. 25 MED HIV W OR W/O OTHER RELATED .9952 4.2 6.1
CONDITION.
491............. 08 SURG MAJOR JOINT & LIMB 1.6579 3.3 3.9
REATTACHMENT PROCEDURES OF
UPPER EXTREMITY.
492............. 17 MED CHEMOTHERAPY W ACUTE 4.6393 11.9 18.0
LEUKEMIA AS SECONDARY
DIAGNOSIS.
493............. 07 SURG LAPAROSCOPIC 1.7561 4.1 5.7
CHOLECYSTECTOMY W/O C.D.E.
W CC.
494............. 07 SURG LAPAROSCOPIC .9400 1.8 2.4
CHOLECYSTECTOMY W/O C.D.E.
W/O CC.
495............. ....... SURG LUNG TRANSPLANT............ 9.5171 14.8 17.9
496............. 08 SURG COMBINED ANTERIOR/POSTERIOR 5.5214 9.2 11.6
SPINAL FUSION.
497............. 08 SURG SPINAL FUSION W CC......... 2.7692 5.3 6.8
498............. 08 SURG SPINAL FUSION W/O CC....... 1.6171 3.1 3.8
499............. 08 SURG BACK & NECK PROCS EXCEPT 1.4827 4.1 5.3
SPINAL FUSION W CC.
500............. 08 SURG BACK & NECK PROCS EXCEPT .9708 2.6 3.1
SPINAL FUSION W/O CC.
501............. 08 SURG KNEE PROC W PDX OF 2.5660 8.7 11.3
INFECTION W CC.
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502............. 08 SURG KNEE PROC W PDX OF 1.6004 5.9 7.1
INFECTION W/O CC.
503............. 08 SURG KNEE PROCEDURES W/O PDX OF 1.2380 3.4 4.4
INFECTION.
----------------------------------------------------------------------------------------------------------------
* Medicare data have been supplemented by data from 19 states for low volume DRGs.
** DRGs 469 and 470 contain cases which could not be assigned to valid DRGs.
Note: Geometric mean is used only to determine payment for transfer cases.
Note: Arithmetic mean is used only to determine payment for outlier cases.
Note: Relative weights are based on medicare patient data and may not be appropriate for other patients.
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