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Inpatient Average Charges by Diagnostic Related Grouping (DRG)

Inpatient Average Charges by Diagnostic Related Grouping (DRG)2019-01-11T09:05:39+00:00

A DRG, or diagnostic related grouping, is how Medicare and other health insurance companies categorize hospitalization acuity and determine payment for a patient’s hospital stay. The charges are almost always not the price paid. The assignment of the DRG, based on patient diagnoses, procedures and other factors, determines the fixed amount the insurer will pay.

Inpatient Charges by Diagnostic Related Grouping (DRG)
Fiscal MS DRGAvg Charge per Case
003-ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R.$371,793
004-TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.$358,642
011-TRACHEOSTOMY FOR FACE, MOUTH & NECK DIAGNOSES OR LARYNGECTOMY W MCC$109,040
023-CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX W MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY W NEUROSTIMULATOR$77,372
024-CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC$117,840
025-CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC$107,703
026-CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC$69,419
027-CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC$52,666
028-SPINAL PROCEDURES W MCC$63,492
029-SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS$54,345
030-SPINAL PROCEDURES W/O CC/MCC$51,089
033-VENTRICULAR SHUNT PROCEDURES W/O CC/MCC$30,744
037-EXTRACRANIAL PROCEDURES W MCC$77,856
038-EXTRACRANIAL PROCEDURES W CC$36,599
039-EXTRACRANIAL PROCEDURES W/O CC/MCC$30,354
040-PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC$99,383
041-PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM$72,254
042-PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC$88,241
052-SPINAL DISORDERS & INJURIES W CC/MCC$76,841
053-SPINAL DISORDERS & INJURIES W/O CC/MCC$22,563
054-NERVOUS SYSTEM NEOPLASMS W MCC$53,807
055-NERVOUS SYSTEM NEOPLASMS W/O MCC$34,922
056-DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC$46,231
057-DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC$57,392
058-MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC$57,374
059-MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC$40,915
060-MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC$30,693
061-ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W MCC$103,586
062-ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC$60,546
063-ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC$52,739
064-INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC$64,431
065-INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS$42,911
066-INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC$31,911
067-NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC$32,197
068-NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC$34,688
069-TRANSIENT ISCHEMIA W/O THROMBOLYTIC$26,159
070-NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC$65,081
071-NONSPECIFIC CEREBROVASCULAR DISORDERS W CC$39,441
072-NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC$22,769
073-CRANIAL & PERIPHERAL NERVE DISORDERS W MCC$44,028
074-CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC$34,765
076-VIRAL MENINGITIS W/O CC/MCC$36,150
077-HYPERTENSIVE ENCEPHALOPATHY W MCC$58,302
078-HYPERTENSIVE ENCEPHALOPATHY W CC$12,475
079-HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC$9,599
082-TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC$54,776
083-TRAUMATIC STUPOR & COMA, COMA >1 HR W CC$57,840
084-TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC$30,226
085-TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC$43,300
086-TRAUMATIC STUPOR & COMA, COMA <1 HR W CC$46,683
087-TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC$34,874
088-CONCUSSION W MCC$71,242
089-CONCUSSION W CC$29,568
090-CONCUSSION W/O CC/MCC$25,284
091-OTHER DISORDERS OF NERVOUS SYSTEM W MCC$58,166
092-OTHER DISORDERS OF NERVOUS SYSTEM W CC$35,892
093-OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC$21,876
094-BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC$242,846
095-BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC$102,780
096-BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC$38,031
097-NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC$96,289
098-NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC$56,450
099-NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC$23,577
100-SEIZURES W MCC$70,457
101-SEIZURES W/O MCC$28,627
102-HEADACHES W MCC$49,689
103-HEADACHES W/O MCC$16,455
113-ORBITAL PROCEDURES W CC/MCC$41,171
121-ACUTE MAJOR EYE INFECTIONS W CC/MCC$34,932
123-NEUROLOGICAL EYE DISORDERS$20,070
125-OTHER DISORDERS OF THE EYE W/O MCC$29,057
134-OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC$42,561
137-MOUTH PROCEDURES W CC/MCC$27,627
146-EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC$124,576
147-EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC$47,433
149-DYSEQUILIBRIUM$21,100
152-OTITIS MEDIA & URI W MCC$41,373
153-OTITIS MEDIA & URI W/O MCC$18,289
154-OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC$44,772
155-OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC$22,966
156-OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC$26,266
157-DENTAL & ORAL DISEASES W MCC$58,446
158-DENTAL & ORAL DISEASES W CC$18,281
159-DENTAL & ORAL DISEASES W/O CC/MCC$29,612
163-MAJOR CHEST PROCEDURES W MCC$110,987
164-MAJOR CHEST PROCEDURES W CC$45,947
165-MAJOR CHEST PROCEDURES W/O CC/MCC$30,232
166-OTHER RESP SYSTEM O.R. PROCEDURES W MCC$119,446
167-OTHER RESP SYSTEM O.R. PROCEDURES W CC$79,145
168-OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC$35,661
175-PULMONARY EMBOLISM W MCC$77,679
176-PULMONARY EMBOLISM W/O MCC$35,985
177-RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC$74,933
178-RESPIRATORY INFECTIONS & INFLAMMATIONS W CC$52,549
179-RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC$34,231
180-RESPIRATORY NEOPLASMS W MCC$64,980
181-RESPIRATORY NEOPLASMS W CC$48,405
182-RESPIRATORY NEOPLASMS W/O CC/MCC$31,648
184-MAJOR CHEST TRAUMA W CC$36,700
185-MAJOR CHEST TRAUMA W/O CC/MCC$26,511
186-PLEURAL EFFUSION W MCC$46,463
187-PLEURAL EFFUSION W CC$54,403
188-PLEURAL EFFUSION W/O CC/MCC$28,491
189-PULMONARY EDEMA & RESPIRATORY FAILURE$58,692
190-CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC$52,297
191-CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC$40,058
192-CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC$33,053
193-SIMPLE PNEUMONIA & PLEURISY W MCC$59,549
194-SIMPLE PNEUMONIA & PLEURISY W CC$37,329
195-SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC$26,585
196-INTERSTITIAL LUNG DISEASE W MCC$63,539
197-INTERSTITIAL LUNG DISEASE W CC$32,960
198-INTERSTITIAL LUNG DISEASE W/O CC/MCC$44,014
199-PNEUMOTHORAX W MCC$67,576
200-PNEUMOTHORAX W CC$34,789
201-PNEUMOTHORAX W/O CC/MCC$26,182
202-BRONCHITIS & ASTHMA W CC/MCC$30,369
203-BRONCHITIS & ASTHMA W/O CC/MCC$27,974
204-RESPIRATORY SIGNS & SYMPTOMS$24,449
205-OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC$56,793
206-OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC$28,380
207-RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)$179,155
208-RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS$84,034
239-AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC$251,058
240-AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC$97,765
242-PERMANENT CARDIAC PACEMAKER IMPLANT W MCC$111,978
243-PERMANENT CARDIAC PACEMAKER IMPLANT W CC$67,833
244-PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC$48,172
245-AICD GENERATOR PROCEDURES$49,327
248-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS$43,552
252-OTHER VASCULAR PROCEDURES W MCC$127,991
253-OTHER VASCULAR PROCEDURES W CC$104,226
254-OTHER VASCULAR PROCEDURES W/O CC/MCC$42,328
256-UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC$59,919
258-CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC$49,880
259-CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC$61,617
260-CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC$64,436
261-CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC$66,819
262-CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC$68,228
264-OTHER CIRCULATORY SYSTEM O.R. PROCEDURES$97,368
268-AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC$169,792
269-AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC$90,140
270-OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC$153,986
271-OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC$106,112
272-OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC$63,605
280-ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC$50,823
281-ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC$31,935
282-ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC$24,378
283-ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC$68,100
284-ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC$33,969
286-CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC$79,390
287-CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC$47,274
288-ACUTE & SUBACUTE ENDOCARDITIS W MCC$146,512
289-ACUTE & SUBACUTE ENDOCARDITIS W CC$65,878
290-ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC$43,446
291-HEART FAILURE & SHOCK W MCC OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)$61,482
292-HEART FAILURE & SHOCK W CC$43,992
293-HEART FAILURE & SHOCK W/O CC/MCC$32,685
294-DEEP VEIN THROMBOPHLEBITIS W CC/MCC$102,848
296-CARDIAC ARREST, UNEXPLAINED W MCC OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)$24,022
299-PERIPHERAL VASCULAR DISORDERS W MCC$58,375
300-PERIPHERAL VASCULAR DISORDERS W CC$39,364
301-PERIPHERAL VASCULAR DISORDERS W/O CC/MCC$28,830
302-ATHEROSCLEROSIS W MCC$27,894
303-ATHEROSCLEROSIS W/O MCC$24,936
304-HYPERTENSION W MCC$43,730
305-HYPERTENSION W/O MCC$25,644
306-CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC$54,491
307-CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC$57,276
308-CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC$51,015
309-CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC$33,078
310-CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC$25,888
311-ANGINA PECTORIS$27,831
312-SYNCOPE & COLLAPSE$29,689
313-CHEST PAIN$18,126
314-OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC$73,661
315-OTHER CIRCULATORY SYSTEM DIAGNOSES W CC$39,701
316-OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC$19,681
326-STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC$229,113
327-STOMACH, ESOPHAGEAL & DUODENAL PROC W CC$100,695
328-STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC$30,812
329-MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC$144,081
330-MAJOR SMALL & LARGE BOWEL PROCEDURES W CC$85,757
331-MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC$41,883
333-RECTAL RESECTION W CC$50,756
335-PERITONEAL ADHESIOLYSIS W MCC$132,388
336-PERITONEAL ADHESIOLYSIS W CC$71,149
337-PERITONEAL ADHESIOLYSIS W/O CC/MCC$47,907
338-APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC$33,344
339-APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC$50,606
340-APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC$38,802
342-APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC$47,165
343-APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC$27,151
345-MINOR SMALL & LARGE BOWEL PROCEDURES W CC$56,138
346-MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC$36,300
348-ANAL & STOMAL PROCEDURES W CC$121,776
349-ANAL & STOMAL PROCEDURES W/O CC/MCC$34,745
350-INGUINAL & FEMORAL HERNIA PROCEDURES W MCC$36,132
351-INGUINAL & FEMORAL HERNIA PROCEDURES W CC$54,871
352-INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC$34,679
353-HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC$101,810
354-HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC$74,973
355-HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC$45,996
356-OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC$215,824
357-OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC$96,278
358-OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC$27,254
368-MAJOR ESOPHAGEAL DISORDERS W MCC$134,738
369-MAJOR ESOPHAGEAL DISORDERS W CC$53,921
370-MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC$20,739
371-MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC$69,378
372-MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC$47,043
373-MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC$31,431
374-DIGESTIVE MALIGNANCY W MCC$66,962
375-DIGESTIVE MALIGNANCY W CC$53,424
376-DIGESTIVE MALIGNANCY W/O CC/MCC$28,902
377-G.I. HEMORRHAGE W MCC$66,919
378-G.I. HEMORRHAGE W CC$42,803
379-G.I. HEMORRHAGE W/O CC/MCC$29,830
380-COMPLICATED PEPTIC ULCER W MCC$74,825
381-COMPLICATED PEPTIC ULCER W CC$40,669
382-COMPLICATED PEPTIC ULCER W/O CC/MCC$34,627
383-UNCOMPLICATED PEPTIC ULCER W MCC$57,299
384-UNCOMPLICATED PEPTIC ULCER W/O MCC$30,387
385-INFLAMMATORY BOWEL DISEASE W MCC$76,308
386-INFLAMMATORY BOWEL DISEASE W CC$36,368
387-INFLAMMATORY BOWEL DISEASE W/O CC/MCC$33,549
388-G.I. OBSTRUCTION W MCC$64,023
389-G.I. OBSTRUCTION W CC$37,022
390-G.I. OBSTRUCTION W/O CC/MCC$28,005
391-ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC$42,513
392-ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC$28,844
393-OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC$60,519
394-OTHER DIGESTIVE SYSTEM DIAGNOSES W CC$41,191
395-OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC$29,977
405-PANCREAS, LIVER & SHUNT PROCEDURES W MCC$120,070
406-PANCREAS, LIVER & SHUNT PROCEDURES W CC$57,930
410-BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC$61,544
412-CHOLECYSTECTOMY W C.D.E. W CC$83,399
414-CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC$88,102
415-CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC$52,559
416-CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC$44,305
417-LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC$62,267
418-LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC$44,587
419-LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC$38,553
432-CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC$77,828
433-CIRRHOSIS & ALCOHOLIC HEPATITIS W CC$41,504
434-CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC$31,265
435-MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC$51,974
436-MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC$45,952
437-MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC$56,183
438-DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC$51,512
439-DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC$40,217
440-DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC$28,456
441-DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC$77,491
442-DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC$35,906
443-DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC$26,658
444-DISORDERS OF THE BILIARY TRACT W MCC$57,847
445-DISORDERS OF THE BILIARY TRACT W CC$48,518
446-DISORDERS OF THE BILIARY TRACT W/O CC/MCC$32,825
454-COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC$122,190
455-COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC$98,315
457-SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC$155,128
459-SPINAL FUSION EXCEPT CERVICAL W MCC$225,623
460-SPINAL FUSION EXCEPT CERVICAL W/O MCC$88,162
462-BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC$59,947
464-WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC$75,137
466-REVISION OF HIP OR KNEE REPLACEMENT W MCC$110,897
467-REVISION OF HIP OR KNEE REPLACEMENT W CC$79,735
468-REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC$48,837
469-MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT$85,558
470-MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC$46,533
471-CERVICAL SPINAL FUSION W MCC$89,638
472-CERVICAL SPINAL FUSION W CC$56,002
473-CERVICAL SPINAL FUSION W/O CC/MCC$48,208
475-AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC$52,526
477-BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC$137,760
478-BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC$133,721
479-BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC$42,381
480-HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC$87,615
481-HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC$57,021
482-HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC$44,053
483-MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES$48,231
485-KNEE PROCEDURES W PDX OF INFECTION W MCC$47,859
486-KNEE PROCEDURES W PDX OF INFECTION W CC$83,754
487-KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC$44,924
488-KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC$59,297
489-KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC$57,354
492-LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC$63,525
493-LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC$48,495
494-LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC$38,051
496-LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC$37,289
500-SOFT TISSUE PROCEDURES W MCC$114,066
501-SOFT TISSUE PROCEDURES W CC$41,499
502-SOFT TISSUE PROCEDURES W/O CC/MCC$37,047
503-FOOT PROCEDURES W MCC$196,697
504-FOOT PROCEDURES W CC$42,045
505-FOOT PROCEDURES W/O CC/MCC$42,192
506-MAJOR THUMB OR JOINT PROCEDURES$38,120
510-SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC$65,540
511-SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC$42,149
512-SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC$30,219
515-OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC$235,716
516-OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC$58,357
517-OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC$33,616
518-BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM$39,296
519-BACK & NECK PROC EXC SPINAL FUSION W CC$40,159
520-BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC$34,294
533-FRACTURES OF FEMUR W MCC$54,119
534-FRACTURES OF FEMUR W/O MCC$43,220
535-FRACTURES OF HIP & PELVIS W MCC$56,774
536-FRACTURES OF HIP & PELVIS W/O MCC$29,415
539-OSTEOMYELITIS W MCC$64,779
540-OSTEOMYELITIS W CC$25,193
542-PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC$68,638
543-PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC$47,838
544-PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC$28,830
545-CONNECTIVE TISSUE DISORDERS W MCC$69,038
546-CONNECTIVE TISSUE DISORDERS W CC$50,597
549-SEPTIC ARTHRITIS W CC$39,607
550-SEPTIC ARTHRITIS W/O CC/MCC$11,970
551-MEDICAL BACK PROBLEMS W MCC$78,136
552-MEDICAL BACK PROBLEMS W/O MCC$30,502
553-BONE DISEASES & ARTHROPATHIES W MCC$44,240
554-BONE DISEASES & ARTHROPATHIES W/O MCC$22,315
556-SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC$19,632
557-TENDONITIS, MYOSITIS & BURSITIS W MCC$51,550
558-TENDONITIS, MYOSITIS & BURSITIS W/O MCC$34,376
559-AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC$48,692
560-AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC$37,382
561-AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC$33,456
562-FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC$33,405
563-FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC$20,151
564-OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC$51,125
565-OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC$37,349
566-OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC$45,023
570-SKIN DEBRIDEMENT W MCC$83,059
571-SKIN DEBRIDEMENT W CC$49,485
572-SKIN DEBRIDEMENT W/O CC/MCC$43,964
574-SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC$59,934
576-SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC$18,332
577-SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC$25,207
578-SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC$35,634
579-OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC$81,042
580-OTHER SKIN, SUBCUT TISS & BREAST PROC W CC$41,677
581-OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC$39,484
592-SKIN ULCERS W MCC$72,333
593-SKIN ULCERS W CC$60,791
594-SKIN ULCERS W/O CC/MCC$22,591
596-MAJOR SKIN DISORDERS W/O MCC$34,235
597-MALIGNANT BREAST DISORDERS W MCC$79,179
598-MALIGNANT BREAST DISORDERS W CC$43,944
599-MALIGNANT BREAST DISORDERS W/O CC/MCC$24,412
600-NON-MALIGNANT BREAST DISORDERS W CC/MCC$38,433
601-NON-MALIGNANT BREAST DISORDERS W/O CC/MCC$7,335
602-CELLULITIS W MCC$73,673
603-CELLULITIS W/O MCC$33,417
604-TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC$44,698
605-TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC$35,018
606-MINOR SKIN DISORDERS W MCC$65,579
607-MINOR SKIN DISORDERS W/O MCC$20,380
616-AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC$135,863
617-AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC$62,405
619-O.R. PROCEDURES FOR OBESITY W MCC$75,834
620-O.R. PROCEDURES FOR OBESITY W CC$31,709
621-O.R. PROCEDURES FOR OBESITY W/O CC/MCC$29,540
622-SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC$102,023
623-SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC$57,723
627-THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC$37,274
628-OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC$92,124
629-OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC$100,655
637-DIABETES W MCC$69,917
638-DIABETES W CC$31,671
639-DIABETES W/O CC/MCC$26,299
640-MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC$51,101
641-MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC$23,041
643-ENDOCRINE DISORDERS W MCC$56,442
644-ENDOCRINE DISORDERS W CC$43,053
645-ENDOCRINE DISORDERS W/O CC/MCC$38,729
654-MAJOR BLADDER PROCEDURES W CC$63,899
655-MAJOR BLADDER PROCEDURES W/O CC/MCC$32,943
656-KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC$134,929
657-KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC$52,578
658-KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC$30,273
659-KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC$89,610
660-KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC$50,269
661-KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC$27,817
662-MINOR BLADDER PROCEDURES W MCC$83,022
663-MINOR BLADDER PROCEDURES W CC$103,365
664-MINOR BLADDER PROCEDURES W/O CC/MCC$21,419
666-PROSTATECTOMY W CC$95,448
668-TRANSURETHRAL PROCEDURES W MCC$120,291
669-TRANSURETHRAL PROCEDURES W CC$43,325
670-TRANSURETHRAL PROCEDURES W/O CC/MCC$32,213
671-URETHRAL PROCEDURES W CC/MCC$33,166
672-URETHRAL PROCEDURES W/O CC/MCC$10,048
673-OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC$190,355
674-OTHER KIDNEY & URINARY TRACT PROCEDURES W CC$77,573
675-OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC$95,899
682-RENAL FAILURE W MCC$65,684
683-RENAL FAILURE W CC$42,539
684-RENAL FAILURE W/O CC/MCC$23,627
686-KIDNEY & URINARY TRACT NEOPLASMS W MCC$76,598
687-KIDNEY & URINARY TRACT NEOPLASMS W CC$58,609
688-KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC$20,735
689-KIDNEY & URINARY TRACT INFECTIONS W MCC$48,232
690-KIDNEY & URINARY TRACT INFECTIONS W/O MCC$33,521
693-URINARY STONES W/O ESW LITHOTRIPSY W MCC$97,890
694-URINARY STONES W/O ESW LITHOTRIPSY W/O MCC$33,851
696-KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC$26,850
697-URETHRAL STRICTURE$39,081
698-OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC$64,936
699-OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC$38,867
700-OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC$22,033
707-MAJOR MALE PELVIC PROCEDURES W CC/MCC$23,107
708-MAJOR MALE PELVIC PROCEDURES W/O CC/MCC$26,334
713-TRANSURETHRAL PROSTATECTOMY W CC/MCC$39,617
714-TRANSURETHRAL PROSTATECTOMY W/O CC/MCC$25,289
715-OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC$42,907
717-OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC$35,768
718-OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC$29,140
722-MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC$75,532
723-MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC$39,712
724-MALIGNANCY, MALE REPRODUCTIVE SYSTEM W/O CC/MCC$26,294
725-BENIGN PROSTATIC HYPERTROPHY W MCC$55,787
726-BENIGN PROSTATIC HYPERTROPHY W/O MCC$32,129
727-INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC$64,669
728-INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC$33,519
730-OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC$18,282
742-UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC$46,937
743-UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC$26,706
744-D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC$66,993
747-VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC$20,000
749-OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC$83,283
754-MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC$38,907
755-MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC$35,414
757-INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC$137,044
758-INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC$33,419
759-INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC$21,078
760-MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC$22,521
761-MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC$13,376
765-CESAREAN SECTION W CC/MCC$32,457
766-CESAREAN SECTION W/O CC/MCC$26,458
767-VAGINAL DELIVERY W STERILIZATION &/OR D&C$16,721
768-VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C$17,014
769-POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE$22,014
770-ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY$22,727
774-VAGINAL DELIVERY W COMPLICATING DIAGNOSES$17,835
775-VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES$15,525
776-POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE$15,074
777-ECTOPIC PREGNANCY$23,525
778-THREATENED ABORTION$11,270
779-ABORTION W/O D&C$99,449
780-FALSE LABOR$1,929
781-OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS$16,063
782-OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS$29,634
783-CESAREAN SECTION W STERILIZATION W MCC$29,038
784-CESAREAN SECTION W STERILIZATION W CC$27,377
785-CESAREAN SECTION W STERILIZATION W/O CC/MCC$27,354
787-CESAREAN SECTION W/O STERILIZATION W CC$30,466
788-CESAREAN SECTION W/O STERILIZATION W/O CC/MCC$25,520
789-NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY$18,090
790-EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE$47,728
791-PREMATURITY W MAJOR PROBLEMS$66,558
792-PREMATURITY W/O MAJOR PROBLEMS$25,128
793-FULL TERM NEONATE W MAJOR PROBLEMS$19,694
794-NEONATE W OTHER SIGNIFICANT PROBLEMS$6,970
795-NORMAL NEWBORN$4,900
799-SPLENECTOMY W MCC$93,218
803-OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC$25,012
805-VAGINAL DELIVERY W/O STERILIZATION/D&C W MCC$17,728
806-VAGINAL DELIVERY W/O STERILIZATION/D&C W CC$18,755
807-VAGINAL DELIVERY W/O STERILIZATION/D&C W/O CC/MCC$15,825
808-MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC$61,446
809-MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC$36,727
810-MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC$26,351
811-RED BLOOD CELL DISORDERS W MCC$66,404
812-RED BLOOD CELL DISORDERS W/O MCC$39,701
813-COAGULATION DISORDERS$41,873
814-RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC$65,936
815-RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC$26,904
816-RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC$18,242
818-OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W CC$17,952
820-LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC$194,955
821-LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC$50,835
823-LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W MCC$433,834
824-LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W CC$58,793
825-LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC$66,529
828-MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC$29,749
829-MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC$156,033
830-MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W/O CC/MCC$26,806
832-OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC$23,433
833-OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC$25,297
834-ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC$112,944
835-ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC$57,647
838-CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT$155,583
840-LYMPHOMA & NON-ACUTE LEUKEMIA W MCC$86,735
841-LYMPHOMA & NON-ACUTE LEUKEMIA W CC$63,539
842-LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC$40,794
843-OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC$85,126
846-CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC$34,242
847-CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC$29,484
853-INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC$181,884
854-INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC$96,241
856-POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC$124,132
857-POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC$68,569
858-POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC$23,370
862-POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC$79,735
863-POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC$41,760
864-FEVER AND INFLAMMATORY CONDITIONS$39,927
865-VIRAL ILLNESS W MCC$48,732
866-VIRAL ILLNESS W/O MCC$24,316
867-OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC$84,015
868-OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC$63,511
869-OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC$30,340
870-SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)$211,932
871-SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC$77,447
872-SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC$46,519
876-O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS$57,776
880-ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION$24,296
881-DEPRESSIVE NEUROSES$25,770
882-NEUROSES EXCEPT DEPRESSIVE$19,404
883-DISORDERS OF PERSONALITY & IMPULSE CONTROL$13,153
884-ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY$26,143
885-PSYCHOSES$35,912
894-ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA$20,102
896-ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC$54,687
897-ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC$33,414
902-WOUND DEBRIDEMENTS FOR INJURIES W CC$73,582
903-WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC$29,753
904-SKIN GRAFTS FOR INJURIES W CC/MCC$17,699
907-OTHER O.R. PROCEDURES FOR INJURIES W MCC$133,692
908-OTHER O.R. PROCEDURES FOR INJURIES W CC$58,333
909-OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC$21,051
914-TRAUMATIC INJURY W/O MCC$24,043
916-ALLERGIC REACTIONS W/O MCC$21,984
917-POISONING & TOXIC EFFECTS OF DRUGS W MCC$67,021
918-POISONING & TOXIC EFFECTS OF DRUGS W/O MCC$25,556
919-COMPLICATIONS OF TREATMENT W MCC$63,246
920-COMPLICATIONS OF TREATMENT W CC$49,825
921-COMPLICATIONS OF TREATMENT W/O CC/MCC$17,421
922-OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC$34,430
923-OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC$23,074
935-NON-EXTENSIVE BURNS$34,864
940-O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC$78,113
947-SIGNS & SYMPTOMS W MCC$52,411
948-SIGNS & SYMPTOMS W/O MCC$39,468
950-AFTERCARE W/O CC/MCC$22,047
951-OTHER FACTORS INFLUENCING HEALTH STATUS$9,161
956-LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA$90,540
963-OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC$66,489
964-OTHER MULTIPLE SIGNIFICANT TRAUMA W CC$58,506
965-OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC$32,680
974-HIV W MAJOR RELATED CONDITION W MCC$58,261
977-HIV W OR W/O OTHER RELATED CONDITION$40,475
981-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC$170,988
982-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC$87,978
983-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC$27,911
987-NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC$111,128
988-NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC$54,463
989-NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC$36,193
NO FISCAL MS DRG$59,475
TOTAL$44,977