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APPENDIX B: DRG WEIGHTS AND REVISED DRG WEIGHTS 2001 Rates

(California revisions shown in italics incorporate the DWC Revised Ratios)

DRG Number Description HCFA 2001 DRG Weights DWC Revised Ratio DWC Revised Weight Geometric Mean LOS
1 CRANIOTOMY AGE >17 EXCEPT FOR TRAUMA 3.097 1.000 3.097 6.3
2 CRANIOTOMY FOR TRAUMA AGE >17 3.1142 1.000 3.1142 7.3
3 CRANIOTOMY AGE 0-17 1.9629 1.000 1.9629 12.7
4 SPINAL PROCEDURES 2.2918 0.628 1.4399 4.8
5 EXTRACRANIAL VASCULAR PROCEDURES 1.4321 1.000 1.4321 2.3
6 CARPAL TUNNEL RELEASE 0.8246 1.000 0.8246 2.2
7 PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC 2.5919 1.000 2.5919 6.9
8 PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC 1.3948 0.808 1.1273 2.1
9 SPINAL DISORDERS & INJURIES 1.3134 1.000 1.3134 4.7
10 NERVOUS SYSTEM NEOPLASMS W CC 1.2273 1.000 1.2273 4.9
11 NERVOUS SYSTEM NEOPLASMS W/O CC 0.8345 1.000 0.8345 3.1
12 DEGENERATIVE NERVOUS SYSTEM DISORDERS 0.8925 1.000 0.8925 4.5
13 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA 0.7644 1.000 0.7644 4.1
14 SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TIA 1.207 1.000 1.2070 4.7
15 TRANSIENT ISCHEMIC ATTACK & PRECEREBRAL OCCLUSIONS 0.748 1.000 0.7480 2.9
16 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 1.1652 1.000 1.1652 4.7
17 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC 0.6539 1.000 0.6539 2.6
18 CRANIAL & PERIPHERAL NERVE DISORDERS W CC 0.96 1.000 0.9600 4.3
19 CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC 0.6963 1.000 0.6963 2.9
20 NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS 2.7744 1.000 2.7744 7.9
21 VIRAL MENINGITIS 1.4966 1.000 1.4966 5.2
22 HYPERTENSIVE ENCEPHALOPATHY 1.0082 1.000 1.0082 3.8
23 NONTRAUMATIC STUPOR & COMA 0.8027 1.000 0.8027 3.2
24 SEIZURE & HEADACHE AGE >17 W CC 0.9914 1.000 0.9914 3.7
25 SEIZURE & HEADACHE AGE >17 W/O CC 0.6043 0.749 0.4523 2.6
26 SEIZURE & HEADACHE AGE 0-17 0.6441 1.000 0.6441 2.4
27 TRAUMATIC STUPOR & COMA, COMA >1 HR 1.2912 1.000 1.2912 3.2
28 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC 1.3102 1.000 1.3102 4.5
29 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC 0.7015 1.003 0.7033 2.8
30 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17 0.332 1.000 0.3320 2
31 CONCUSSION AGE >17 W CC 0.8715 1.000 0.8715 3.1
32 CONCUSSION AGE >17 W/O CC 0.5422 0.875 0.4744 2.1
33 CONCUSSION AGE 0-17 0.2086 1.000 0.2086 1.6
34 OTHER DISORDERS OF NERVOUS SYSTEM W CC 1.0099 1.000 1.0099 3.8
35 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC 0.6027 1.000 0.6027 2.7
36 RETINAL PROCEDURES 0.6639 1.000 0.6639 1.2
37 ORBITAL PROCEDURES 1.0016 1.000 1.0016 2.6
38 PRIMARY IRIS PROCEDURES 0.4833 1.000 0.4833 1.8
39 LENS PROCEDURES WITH OR WITHOUT VITRECTOMY 0.5778 1.000 0.5778 1.5
40 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17 0.8635 1.000 0.8635 2.3
41 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17 0.338 1.000 0.3380 1.6
42 INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS 0.6478 1.066 0.6906 1.6
43 HYPHEMA 0.4977 1.000 0.4977 2.6
44 ACUTE MAJOR EYE INFECTIONS 0.6337 1.000 0.6337 4.1
45 NEUROLOGICAL EYE DISORDERS 0.7022 1.000 0.7022 2.7
46 OTHER DISORDERS OF THE EYE AGE >17 W CC 0.7749 1.000 0.7749 3.5
47 OTHER DISORDERS OF THE EYE AGE >17 W/O CC 0.5085 1.000 0.5085 2.5
48 OTHER DISORDERS OF THE EYE AGE 0-17 0.2977 1.000 0.2977 2.9
49 MAJOR HEAD & NECK PROCEDURES 1.8301 1.000 1.8301 3.5
50 SIALOADENECTOMY 0.8537 1.000 0.8537 1.6
51 SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY 0.7934 1.000 0.7934 1.8
52 CLEFT LIP & PALATE REPAIR 0.841 1.000 0.8410 1.6
53 SINUS & MASTOID PROCEDURES AGE >17 1.2118 1.000 1.2118 2.3
54 SINUS & MASTOID PROCEDURES AGE 0-17 0.4826 1.000 0.4826 3.2
55 MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES 0.9039 1.000 0.9039 1.9
56 RHINOPLASTY 0.9451 1.000 0.9451 2.1
57 T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17 1.0704 1.000 1.0704 2.5
58 T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17 0.274 1.000 0.2740 1.5
59 TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17 0.6943 1.000 0.6943 1.8
60 TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17 0.2087 1.000 0.2087 1.5
61 MYRINGOTOMY W TUBE INSERTION AGE >17 1.266 1.000 1.2660 2.8
62 MYRINGOTOMY W TUBE INSERTION AGE 0-17 0.2955 1.000 0.2955 1.3
63 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES 1.3402 0.875 1.1731 3
64 EAR, NOSE, MOUTH & THROAT MALIGNANCY 1.2288 1.000 1.2288 4.3
65 DYSEQUILIBRIUM 0.5385 1.000 0.5385 2.3
66 EPISTAXIS 0.559 1.000 0.5590 2.5
67 EPIGLOTTITIS 0.8105 1.000 0.8105 2.8
68 OTITIS MEDIA & URI AGE >17 W CC 0.675 1.000 0.6750 3.4
69 OTITIS MEDIA & URI AGE >17 W/O CC 0.5152 1.000 0.5152 2.7
70 OTITIS MEDIA & URI AGE 0-17 0.4628 1.000 0.4628 2.4
71 LARYNGOTRACHEITIS 0.7712 1.000 0.7712 3
72 NASAL TRAUMA & DEFORMITY 0.6428 1.000 0.6428 2.6
73 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 0.7777 1.000 0.7777 3.3
74 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17 0.3358 1.000 0.3358 2.1
75 MAJOR CHEST PROCEDURES 3.1331 1.000 3.1331 7.8
76 OTHER RESP SYSTEM O.R. PROCEDURES W CC 2.7908 1.000 2.7908 8.4
77 OTHER RESP SYSTEM O.R. PROCEDURES W/O CC 1.1887 1.000 1.1887 3.5
78 PULMONARY EMBOLISM 1.3698 1.000 1.3698 6
79 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC 1.6501 1.000 1.6501 6.6
80 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC 0.9373 1.000 0.9373 4.7
81 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17 1.5204 1.000 1.5204 6.1
82 RESPIRATORY NEOPLASMS 1.3799 1.000 1.3799 5.2
83 MAJOR CHEST TRAUMA W CC 0.9808 1.000 0.9808 4.4
84 MAJOR CHEST TRAUMA W/O CC 0.5539 1.000 0.5539 2.8
85 PLEURAL EFFUSION W CC 1.2198 1.000 1.2198 4.9
86 PLEURAL EFFUSION W/O CC 0.6984 1.000 0.6984 2.9
87 PULMONARY EDEMA & RESPIRATORY FAILURE 1.3781 1.000 1.3781 4.8
88 CHRONIC OBSTRUCTIVE PULMONARY DISEASE 0.9317 1.000 0.9317 4.2
89 SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC 1.0647 1.000 1.0647 5
90 SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC 0.659 1.000 0.6590 3.6
91 SIMPLE PNEUMONIA & PLEURISY AGE 0-17 0.689 1.000 0.6890 2.8
92 INTERSTITIAL LUNG DISEASE W CC 1.1863 1.000 1.1863 5
93 INTERSTITIAL LUNG DISEASE W/O CC 0.7309 1.000 0.7309 3.3
94 PNEUMOTHORAX W CC 1.1704 1.000 1.1704 4.8
95 PNEUMOTHORAX W/O CC 0.6098 1.000 0.6098 3
96 BRONCHITIS & ASTHMA AGE >17 W CC 0.7871 1.000 0.7871 3.9
97 BRONCHITIS & ASTHMA AGE >17 W/O CC 0.5873 1.000 0.5873 3.1
98 BRONCHITIS & ASTHMA AGE 0-17 0.8768 1.000 0.8768 3.2
99 RESPIRATORY SIGNS & SYMPTOMS W CC 0.7117 1.000 0.7117 2.5
100 RESPIRATORY SIGNS & SYMPTOMS W/O CC 0.5437 1.000 0.5437 1.8
101 OTHER RESPIRATORY SYSTEM DIAGNOSES W CC 0.8563 1.000 0.8563 3.3
102 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC 0.555 1.000 0.5550 2.1
103 HEART TRANSPLANT excluded excluded excluded excluded
104 CARDIAC VALVE PROCEDURES W CARDIAC CATH 7.1843 1.000 7.1843 8.9
105 CARDIAC VALVE PROCEDURES W/O CARDIAC CATH 5.6567 1.000 5.6567 7.4
106 CORONARY BYPASS W CARDIAC CATH 7.5203 1.000 7.5203 9.3
107 CORONARY BYPASS W/O CARDIAC CATH 5.3762 1.000 5.3762 9.2
108 OTHER CARDIOTHORACIC PROCEDURES 5.6525 1.000 5.6525 8
109 CORONARY BYPASS W/O PTCA OR CARDIAC CATH 4.0198 1.000 4.0198 6.8
110 MAJOR CARDIOVASCULAR PROCEDURES W CC 4.1358 1.000 4.1358 7.1
111 MAJOR CARDIOVASCULAR PROCEDURES W/O CC 2.241 1.000 2.2410 4.7
112 PERCUTANEOUS CARDIOVASCULAR PROCEDURES 1.8677 0.841 1.5705 2.6
113 AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE 2.7806 1.000 2.7806 9.8
114 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS 1.5656 1.000 1.5656 6
115 PERM PACE IMPLNT W AMI,HRT FAIL OR SHOCK OR AICD LEAD OR GEN PROC 3.4711 1.000 3.4711 6
116 OTH PERM CARDIAC PACEMAKER IMPLANT OR PTCA W CORONARY ART STENT 2.419 1.000 2.4190 2.6
117 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT 1.2966 1.000 1.2966 2.6
118 CARDIAC PACEMAKER DEVICE REPLACEMENT 1.4939 1.000 1.4939 1.9
119 VEIN LIGATION & STRIPPING 1.26 1.000 1.2600 2.9
120 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES 2.0352 1.000 2.0352 4.9
121 CIRCULATORY DISORDERS W AMI & MAJOR COMP DISCH ALIVE 1.6194 1.000 1.6194 5.5
122 CIRCULATORY DISORDERS W AMI W/O MAJOR COMP DISCH ALIVE 1.0884 1.000 1.0884 3.3
123 CIRCULATORY DISORDERS W AMI, EXPIRED 1.5528 1.000 1.5528 2.8
124 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG 1.4134 1.000 1.4134 3.3
125 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG 1.0606 1.000 1.0606 2.2
126 ACUTE & SUBACUTE ENDOCARDITIS 2.5379 1.000 2.5379 9.3
127 HEART FAILURE & SHOCK 1.013 1.000 1.0130 4.2
128 DEEP VEIN THROMBOPHLEBITIS 0.7651 1.000 0.7651 5
129 CARDIAC ARREST, UNEXPLAINED 1.0968 1.000 1.0968 1.8
130 PERIPHERAL VASCULAR DISORDERS W CC 0.9471 1.000 0.9471 4.7
131 PERIPHERAL VASCULAR DISORDERS W/O CC 0.5898 1.000 0.5898 3.6
132 ATHEROSCLEROSIS W CC 0.6707 1.000 0.6707 2.4
133 ATHEROSCLEROSIS W/O CC 0.5663 1.000 0.5663 1.9
134 HYPERTENSION 0.5917 1.000 0.5917 2.6
135 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC 0.9083 1.000 0.9083 3.3
136 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O CC 0.6065 1.000 0.6065 2.2
137 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17 0.8192 1.000 0.8192 3.3
138 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC 0.8291 1.000 0.8291 3.1
139 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC 0.5141 1.000 0.5141 2
140 ANGINA PECTORIS 0.574 0.783 0.4497 2.2
141 SYNCOPE & COLLAPSE W CC 0.7219 1.000 0.7219 2.9
142 SYNCOPE & COLLAPSE W/O CC 0.5552 1.000 0.5552 2.2
143 CHEST PAIN 0.5402 0.842 0.4547 1.8
144 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC 1.1668 1.000 1.1668 3.8
145 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC 0.6322 1.000 0.6322 2.2
146 RECTAL RESECTION W CC 2.743 1.000 2.7430 8.9
147 RECTAL RESECTION W/O CC 1.6221 1.000 1.6221 6
148 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC 3.4347 1.000 3.4347 10.1
149 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC 1.5667 1.000 1.5667 6.1
150 PERITONEAL ADHESIOLYSIS W CC 2.8523 1.000 2.8523 9.1
151 PERITONEAL ADHESIOLYSIS W/O CC 1.3427 1.000 1.3427 4.8
152 MINOR SMALL & LARGE BOWEL PROCEDURES W CC 1.9462 1.000 1.9462 6.8
153 MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC 1.208 1.000 1.2080 4.9
154 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W CC 4.1475 1.000 4.1475 10.1
155 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC 1.3751 1.000 1.3751 3.3
156 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17 0.8436 1.000 0.8436 6
157 ANAL & STOMAL PROCEDURES W CC 1.2388 1.000 1.2388 3.9
158 ANAL & STOMAL PROCEDURES W/O CC 0.6638 1.000 0.6638 2.1
159 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC 1.3347 1.000 1.3347 3.8
160 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC 0.7837 0.902 0.7066 2.2
161 INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC 1.1017 1.000 1.1017 2.9
162 INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O CC 0.6229 0.867 0.5402 1.6
163 HERNIA PROCEDURES AGE 0-17 0.6921 1.000 0.6921 2.4
164 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC 2.376 1.000 2.3760 7.1
165 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC 1.2838 1.000 1.2838 4.3
166 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC 1.4802 1.000 1.4802 4
167 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC 0.8937 1.000 0.8937 2.3
168 MOUTH PROCEDURES W CC 1.2141 1.000 1.2141 3.2
169 MOUTH PROCEDURES W/O CC 0.7455 1.000 0.7455 1.9
170 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC 2.8686 1.000 2.8686 7.7
171 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC 1.1975 1.000 1.1975 3.6
172 DIGESTIVE MALIGNANCY W CC 1.3485 1.000 1.3485 5.1
173 DIGESTIVE MALIGNANCY W/O CC 0.77 1.000 0.7700 2.8
174 G.I. HEMORRHAGE W CC 0.9985 1.000 0.9985 3.9
175 G.I. HEMORRHAGE W/O CC 0.5501 1.000 0.5501 2.5
176 COMPLICATED PEPTIC ULCER 1.1052 1.000 1.1052 4.1
177 UNCOMPLICATED PEPTIC ULCER W CC 0.8998 1.000 0.8998 3.7
178 UNCOMPLICATED PEPTIC ULCER W/O CC 0.6604 1.000 0.6604 2.6
179 INFLAMMATORY BOWEL DISEASE 1.0576 1.000 1.0576 4.7
180 G.I. OBSTRUCTION W CC 0.9423 1.000 0.9423 4.2
181 G.I. OBSTRUCTION W/O CC 0.5304 1.000 0.5304 2.8
182 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC 0.7922 1.000 0.7922 3.4
183 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC 0.5717 1.000 0.5717 2.4
184 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17 0.5119 1.000 0.5119 2.5
185 DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17 0.8621 1.000 0.8621 3.3
186 DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17 0.3216 1.000 0.3216 2.9
187 DENTAL EXTRACTIONS & RESTORATIONS 0.7649 1.000 0.7649 2.9
188 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC 1.1005 1.000 1.1005 4.1
189 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC 0.5796 1.000 0.5796 2.4
190 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 0.9884 1.000 0.9884 4.1
191 PANCREAS, LIVER & SHUNT PROCEDURES W CC 4.3914 1.000 4.3914 10.5
192 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC 1.7916 1.000 1.7916 5.3
193 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 3.3861 1.000 3.3861 10.3
194 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC 1.6191 1.000 1.6191 5.6
195 CHOLECYSTECTOMY W C.D.E. W CC 2.9062 1.000 2.9062 8.3
196 CHOLECYSTECTOMY W C.D.E. W/O CC 1.6593 1.000 1.6593 4.9
197 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 2.4544 1.000 2.4544 7.2
198 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC 1.2339 1.000 1.2339 3.9
199 HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY 2.3584 1.000 2.3584 7.2
200 HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY 3.2262 1.000 3.2262 7
201 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES 3.4035 1.000 3.4035 10.2
202 CIRRHOSIS & ALCOHOLIC HEPATITIS 1.3001 1.000 1.3001 4.9
203 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS 1.325 1.000 1.3250 5
204 DISORDERS OF PANCREAS EXCEPT MALIGNANCY 1.2018 1.000 1.2018 4.5
205 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC 1.2048 1.000 1.2048 4.7
206 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC 0.6751 1.000 0.6751 3
207 DISORDERS OF THE BILIARY TRACT W CC 1.1032 1.000 1.1032 4
208 DISORDERS OF THE BILIARY TRACT W/O CC 0.6538 1.000 0.6538 2.3
209 MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF LOWER EXTREMITY 2.0912 0.950 1.9866 4.6
210 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC 1.8152 1.180 2.1419 6
211 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC 1.2647 0.973 1.2300 4.5
212 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17 0.8472 1.000 0.8472 11.1
213 AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS 1.7726 1.000 1.7726 6.4
214 NO LONGER VALID 0 0.967 0.0000 0
215 NO LONGER VALID 0 0.956 0.0000 0
216 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 2.2042 1.000 2.2042 7.1
217 WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS 2.923 0.572 1.6711 8.9
218 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC 1.5337 1.030 1.5794 4.2
219 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC 1.0255 0.968 0.9928 2.7
220 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17 0.5844 1.000 0.5844 5.3
221 NO LONGER VALID 0 0.818 0.0000 0
222 NO LONGER VALID 0 1.038 0.0000 0
223 MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC 0.9585 0.885 0.8483 2
224 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC 0.7997 1.012 0.8095 1.7
225 FOOT PROCEDURES 1.0851 1.001 1.0860 3.3
226 SOFT TISSUE PROCEDURES W CC 1.477 1.000 1.4770 4.3
227 SOFT TISSUE PROCEDURES W/O CC 0.8036 0.944 0.7588 2.1
228 MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC 1.0664 0.906 0.9665 2.4
229 HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC 0.7169 1.037 0.7432 1.8
230 LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR 1.249 1.000 1.2490 3.4
231 LOCAL EXCISION & REMOVAL OF INT FIX DEVICES EXCEPT HIP & FEMUR 1.3825 0.734 1.0149 3.2
232 ARTHROSCOPY 1.0828 0.817 0.8842 2.3
233 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 2.089 1.000 2.0890 5.3
234 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC 1.2661 0.813 1.0297 2.7
235 FRACTURES OF FEMUR 0.7582 1.000 0.7582 3.8
236 FRACTURES OF HIP & PELVIS 0.7218 0.979 0.7066 4
237 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH 0.5681 1.000 0.5681 3
238 OSTEOMYELITIS 1.3496 1.000 1.3496 6.4
239 PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY 0.9745 1.000 0.9745 4.9
240 CONNECTIVE TISSUE DISORDERS W CC 1.2712 1.000 1.2712 4.9
241 CONNECTIVE TISSUE DISORDERS W/O CC 0.6177 1.000 0.6177 3.1
242 SEPTIC ARTHRITIS 1.0724 1.000 1.0724 5.1
243 MEDICAL BACK PROBLEMS 0.7262 0.761 0.5526 3.7
244 BONE DISEASES & SPECIFIC ARTHROPATHIES W CC 0.7155 1.000 0.7155 3.7
245 BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC 0.4832 1.000 0.4832 2.8
246 NON-SPECIFIC ARTHROPATHIES 0.557 1.000 0.5570 2.9
247 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE 0.5696 1.000 0.5696 2.6
248 TENDONITIS, MYOSITIS & BURSITIS 0.7864 1.000 0.7864 3.7
249 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 0.6913 1.000 0.6913 2.6
250 FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W CC 0.6929 1.000 0.6929 3.3
251 FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC 0.4995 0.901 0.4501 2.4
252 FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE 0-17 0.2538 1.000 0.2538 1.8
253 FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC 0.7253 1.000 0.7253 3.7
254 FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC 0.4413 1.003 0.4427 2.6
255 FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17 0.2956 1.000 0.2956 2.9
256 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES 0.7959 1.000 0.7959 3.8
257 TOTAL MASTECTOMY FOR MALIGNANCY W CC 0.9107 1.000 0.9107 2.3
258 TOTAL MASTECTOMY FOR MALIGNANCY W/O CC 0.7232 1.000 0.7232 1.8
259 SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC 0.9068 1.000 0.9068 1.8
260 SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC 0.6532 1.000 0.6532 1.3
261 BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION 0.9362 1.000 0.9362 1.7
262 BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY 0.8754 1.000 0.8754 2.7
263 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC 2.1219 1.000 2.1219 8.9
264 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC 1.1479 1.000 1.1479 5.4
265 SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC 1.5309 1.000 1.5309 4.3
266 SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC 0.8707 1.131 0.9844 2.4
267 PERIANAL & PILONIDAL PROCEDURES 1.0792 1.000 1.0792 3.1
268 SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES 1.1405 1.000 1.1405 2.4
269 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 1.7004 1.000 1.7004 5.8
270 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC 0.767 1.000 0.7670 2.3
271 SKIN ULCERS 1.0104 1.000 1.0104 5.5
272 MAJOR SKIN DISORDERS W CC 0.9994 1.000 0.9994 4.8
273 MAJOR SKIN DISORDERS W/O CC 0.6179 1.000 0.6179 3.2
274 MALIGNANT BREAST DISORDERS W CC 1.2061 1.000 1.2061 4.9
275 MALIGNANT BREAST DISORDERS W/O CC 0.5301 1.000 0.5301 2.4
276 NON-MALIGANT BREAST DISORDERS 0.6899 1.000 0.6899 3.6
277 CELLULITIS AGE >17 W CC 0.8396 0.791 0.6641 4.7
278 CELLULITIS AGE >17 W/O CC 0.5522 0.865 0.4779 3.6
279 CELLULITIS AGE 0-17 0.6644 1.000 0.6644 4.2
280 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC 0.6788 1.000 0.6788 3.2
281 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC 0.4729 0.971 0.4591 2.4
282 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17 0.257 1.000 0.2570 2.2
283 MINOR SKIN DISORDERS W CC 0.6917 1.000 0.6917 3.5
284 MINOR SKIN DISORDERS W/O CC 0.4336 1.000 0.4336 2.5
285 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS 1.9961 1.000 1.9961 7.7
286 ADRENAL & PITUITARY PROCEDURES 2.1299 1.000 2.1299 4.9
287 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS 1.8283 1.000 1.8283 7.8
288 O.R. PROCEDURES FOR OBESITY 2.1607 1.000 2.1607 4.5
289 PARATHYROID PROCEDURES 0.9914 1.000 0.9914 2
290 THYROID PROCEDURES 0.9193 1.000 0.9193 1.8
291 THYROGLOSSAL PROCEDURES 0.5487 1.000 0.5487 1.4
292 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC 2.4538 1.000 2.4538 6.9
293 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC 1.2289 1.000 1.2289 3.6
294 DIABETES AGE >35 0.7589 1.000 0.7589 3.6
295 DIABETES AGE 0-35 0.7587 1.000 0.7587 2.9
296 NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC 0.8594 1.000 0.8594 4
297 NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC 0.5179 1.000 0.5179 2.8
298 NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17 0.5269 1.000 0.5269 2.5
299 INBORN ERRORS OF METABOLISM 0.9632 1.000 0.9632 4
300 ENDOCRINE DISORDERS W CC 1.0829 1.000 1.0829 4.7
301 ENDOCRINE DISORDERS W/O CC 0.6133 1.000 0.6133 2.9
302 KIDNEY TRANSPLANT excluded excluded excluded excluded
303 KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM 2.4602 1.000 2.4602 7
304 KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC 2.3407 1.000 2.3407 6.4
305 KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC 1.1825 1.000 1.1825 3.1
306 PROSTATECTOMY W CC 1.2489 1.000 1.2489 3.7
307 PROSTATECTOMY W/O CC 0.646 1.000 0.6460 1.9
308 MINOR BLADDER PROCEDURES W CC 1.6449 1.000 1.6449 4.2
309 MINOR BLADDER PROCEDURES W/O CC 0.9339 1.000 0.9339 2
310 TRANSURETHRAL PROCEDURES W CC 1.1172 1.000 1.1172 3
311 TRANSURETHRAL PROCEDURES W/O CC 0.6174 1.000 0.6174 1.6
312 URETHRAL PROCEDURES, AGE >17 W CC 1.0173 1.000 1.0173 3
313 URETHRAL PROCEDURES, AGE >17 W/O CC 0.6444 1.000 0.6444 1.7
314 URETHRAL PROCEDURES, AGE 0-17 0.4953 1.000 0.4953 2.3
315 OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES 2.0474 1.000 2.0474 4.2
316 RENAL FAILURE 1.3424 1.000 1.3424 4.9
317 ADMIT FOR RENAL DIALYSIS 0.7395 1.000 0.7395 2.1
318 KIDNEY & URINARY TRACT NEOPLASMS W CC 1.1313 1.000 1.1313 4.3
319 KIDNEY & URINARY TRACT NEOPLASMS W/O CC 0.604 1.000 0.6040 2.2
320 KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC 0.8621 1.000 0.8621 4.3
321 KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC 0.5686 1.000 0.5686 3.2
322 KIDNEY & URINARY TRACT INFECTIONS AGE 0-17 0.4939 1.000 0.4939 3.3
323 URINARY STONES W CC, &/OR ESW LITHOTRIPSY 0.7996 1.000 0.7996 2.4
324 URINARY STONES W/O CC 0.4509 1.000 0.4509 1.6
325 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC 0.646 1.000 0.6460 3
326 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC 0.4297 1.000 0.4297 2.1
327 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17 0.3543 1.000 0.3543 3.1
328 URETHRAL STRICTURE AGE >17 W CC 0.7455 1.000 0.7455 2.8
329 URETHRAL STRICTURE AGE >17 W/O CC 0.5253 1.000 0.5253 1.7
330 URETHRAL STRICTURE AGE 0-17 0.3191 1.000 0.3191 1.6
331 OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC 1.0221 1.000 1.0221 4.1
332 OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC 0.5997 1.000 0.5997 2.5
333 OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17 0.8247 1.000 0.8247 3.5
334 MAJOR MALE PELVIC PROCEDURES W CC 1.5591 1.000 1.5591 4.2
335 MAJOR MALE PELVIC PROCEDURES W/O CC 1.1697 1.000 1.1697 3.2
336 TRANSURETHRAL PROSTATECTOMY W CC 0.888 1.000 0.8880 2.7
337 TRANSURETHRAL PROSTATECTOMY W/O CC 0.6152 1.000 0.6152 1.9
338 TESTES PROCEDURES, FOR MALIGNANCY 1.19 1.000 1.1900 3.5
339 TESTES PROCEDURES, NON-MALIGNANCY AGE >17 1.0769 1.000 1.0769 3
340 TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17 0.2835 1.000 0.2835 2.4
341 PENIS PROCEDURES 1.1709 1.000 1.1709 2.1
342 CIRCUMCISION AGE >17 0.824 1.000 0.8240 2.5
343 CIRCUMCISION AGE 0-17 0.1541 1.000 0.1541 1.7
344 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY 1.1519 1.000 1.1519 1.6
345 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXCEPT FOR MALIGNANCY 0.88 1.000 0.8800 2.6
346 MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC 0.9756 1.000 0.9756 4.3
347 MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W/O CC 0.5922 1.000 0.5922 2.4
348 BENIGN PROSTATIC HYPERTROPHY W CC 0.7142 1.000 0.7142 3.2
349 BENIGN PROSTATIC HYPERTROPHY W/O CC 0.438 1.000 0.4380 2
350 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM 0.6992 1.000 0.6992 3.6
351 STERILIZATION, MALE 0.2364 1.000 0.2364 1.3
352 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES 0.6858 1.000 0.6858 2.8
353 PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY 1.9292 1.000 1.9292 5.3
354 UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC 1.5284 1.000 1.5284 4.9
355 UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC 0.9278 1.000 0.9278 3.1
356 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES 0.7846 1.000 0.7846 2.1
357 UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY 2.3628 1.000 2.3628 6.9
358 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC 1.2263 1.000 1.2263 3.7
359 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC 0.8593 1.000 0.8593 2.6
360 VAGINA, CERVIX & VULVA PROCEDURES 0.886 1.000 0.8860 2.4
361 LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION 1.2318 1.000 1.2318 2.2
362 ENDOSCOPIC TUBAL INTERRUPTION 0.3022 1.000 0.3022 1.4
363 D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY 0.8136 1.000 0.8136 2.5
364 D&C, CONIZATION EXCEPT FOR MALIGNANCY 0.753 1.000 0.7530 2.6
365 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES 1.8425 1.000 1.8425 4.9
366 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC 1.2467 1.000 1.2467 4.8
367 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC 0.5676 1.000 0.5676 2.4
368 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM 1.1205 1.000 1.1205 5
369 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS 0.5704 1.000 0.5704 2.4
370 CESAREAN SECTION W CC 1.0631 1.000 1.0631 4.4
371 CESAREAN SECTION W/O CC 0.7157 1.000 0.7157 3.3
372 VAGINAL DELIVERY W COMPLICATING DIAGNOSES 0.6077 1.000 0.6077 2.7
373 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 0.4169 1.000 0.4169 2
374 VAGINAL DELIVERY W STERILIZATION &/OR D&C 0.7565 1.000 0.7565 2.6
375 VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C 0.686 1.000 0.6860 4.4
376 POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE 0.5224 1.000 0.5224 2.6
377 POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE 0.8899 1.000 0.8899 2.6
378 ECTOPIC PREGNANCY 0.7664 1.000 0.7664 2
379 THREATENED ABORTION 0.3959 1.000 0.3959 2
380 ABORTION W/O D&C 0.4843 1.000 0.4843 1.8
381 ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY 0.5331 1.000 0.5331 1.5
382 FALSE LABOR 0.2127 1.000 0.2127 1.3
383 OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS 0.5137 1.000 0.5137 2.7
384 OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS 0.3161 1.000 0.3161 1.6
385 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 1.3767 1.000 1.3767 1.8
386 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE 4.54 1.000 4.5400 17.9
387 PREMATURITY W MAJOR PROBLEMS 3.1007 1.000 3.1007 13.3
388 PREMATURITY W/O MAJOR PROBLEMS 1.8709 1.000 1.8709 8.6
389 FULL TERM NEONATE W MAJOR PROBLEMS 1.8408 1.000 1.8408 4.7
390 NEONATE W OTHER SIGNIFICANT PROBLEMS 0.9471 1.000 0.9471 3
391 NORMAL NEWBORN 0.1527 1.000 0.1527 3.1
392 SPLENECTOMY AGE >17 3.1739 1.000 3.1739 7.1
393 SPLENECTOMY AGE 0-17 1.3486 1.000 1.3486 9.1
394 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS 1.5969 1.000 1.5969 4.1
395 RED BLOOD CELL DISORDERS AGE >17 0.8257 1.000 0.8257 3.3
396 RED BLOOD CELL DISORDERS AGE 0-17 1.1573 1.000 1.1573 2.5
397 COAGULATION DISORDERS 1.2278 1.000 1.2278 3.8
398 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC 1.275 1.000 1.2750 4.7
399 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC 0.6881 1.000 0.6881 2.8
400 LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE 2.6309 1.000 2.6309 5.8
401 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC 2.7198 1.000 2.7198 7.8
402 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC 1.0985 1.000 1.0985 2.8
403 LYMPHOMA & NON-ACUTE LEUKEMIA W CC 1.7594 1.000 1.7594 5.7
404 LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC 0.848 1.000 0.8480 3.1
405 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17 1.912 1.000 1.9120 4.9
406 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC 2.8275 1.000 2.8275 7.6
407 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC 1.3179 1.000 1.3179 3.6
408 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC 2.0008 1.000 2.0008 4.8
409 RADIOTHERAPY 1.1215 1.000 1.1215 4.4
410 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 0.9468 1.000 0.9468 2.9
411 HISTORY OF MALIGNANCY W/O ENDOSCOPY 0.3305 1.000 0.3305 2
412 HISTORY OF MALIGNANCY W ENDOSCOPY 0.4841 1.000 0.4841 2
413 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC 1.3645 1.000 1.3645 5.3
414 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC 0.7548 1.000 0.7548 3
415 O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES 3.5925 0.491 1.7628 10.4
416 SEPTICEMIA AGE >17 1.5278 1.000 1.5278 5.5
417 SEPTICEMIA AGE 0-17 1.1717 1.000 1.1717 3.7
418 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS 1.0074 0.680 0.6851 4.8
419 FEVER OF UNKNOWN ORIGIN AGE >17 W CC 0.8709 1.000 0.8709 3.7
420 FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC 0.6057 1.000 0.6057 3
421 VIRAL ILLNESS AGE >17 0.6796 1.000 0.6796 3.1
422 VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17 0.7854 1.000 0.7854 2.8
423 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES 1.725 1.000 1.7250 5.9
424 O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS excluded excluded excluded excluded
425 ACUTE ADJUST REACT & DISTURBANCES OF PSYCHOSOCIAL DYSFUNCTION excluded excluded excluded excluded
426 DEPRESSIVE NEUROSES excluded excluded excluded excluded
427 NEUROSES EXCEPT DEPRESSIVE excluded excluded excluded excluded
428 DISORDERS OF PERSONALITY & IMPULSE CONTROL excluded excluded excluded excluded
429 ORGANIC DISTURBANCES & MENTAL RETARDATION excluded excluded excluded excluded
430 PSYCHOSES excluded excluded excluded excluded
431 CHILDHOOD MENTAL DISORDERS excluded excluded excluded excluded
432 OTHER MENTAL DISORDER DIAGNOSES excluded excluded excluded excluded
433 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA excluded excluded excluded excluded
434 ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W CC excluded excluded excluded excluded
435 ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W/O CC excluded excluded excluded excluded
436 ALC/DRUG DEPENDENCE W REHABILITATION THERAPY excluded excluded excluded excluded
437 ALC/DRUG DEPENDENCE, COMBINED REHAB & DETOX THERAPY excluded excluded excluded excluded
438 NO LONGER VALID 0 1.000 0.0000 0
439 SKIN GRAFTS FOR INJURIES 1.7092 1.000 1.7092 5.3
440 WOUND DEBRIDEMENTS FOR INJURIES 1.9096 0.774 1.4776 5.8
441 HAND PROCEDURES FOR INJURIES 0.9463 0.991 0.9382 2.2
442 OTHER O.R. PROCEDURES FOR INJURIES W CC 2.3403 1.000 2.3403 5.4
443 OTHER O.R. PROCEDURES FOR INJURIES W/O CC 0.9978 1.002 1.0002 2.5
444 TRAUMATIC INJURY AGE >17 W CC 0.7243 1.000 0.7243 3.2
445 TRAUMATIC INJURY AGE >17 W/O CC 0.5076 0.811 0.4118 2.4
446 TRAUMATIC INJURY AGE 0-17 0.2964 1.000 0.2964 2.4
447 ALLERGIC REACTIONS AGE >17 0.5166 1.000 0.5166 1.9
448 ALLERGIC REACTIONS AGE 0-17 0.0975 1.000 0.0975 2.9
449 POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC 0.8076 1.000 0.8076 2.6
450 POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC 0.4406 0.666 0.2933 1.6
451 POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17 0.2632 1.000 0.2632 2.1
452 COMPLICATIONS OF TREATMENT W CC 1.0152 1.000 1.0152 3.5
453 COMPLICATIONS OF TREATMENT W/O CC 0.4987 1.000 0.4987 2.2
454 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC 0.8593 1.000 0.8593 3.2
455 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC 0.4672 0.748 0.3496 2
456 NO LONGER VALID BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 0 excluded 0 excluded 0 excluded 0 excluded
457 NO LONGER VALID EXTENSIVE BURNS W/O O.R. PROCEDURE 0 excluded 0 excluded 0 excluded 0 excluded
458 NO LONGER VALID NON-EXTENSIVE BURNS W SKIN GRAFT 0 excluded 0 excluded 0 excluded 0 excluded
459 NO LONGER VALID NON-EXTENSIVE BURNS W WOUND DEBRIDEMENT OR OTHER O.R. PROC 0 excluded 0 excluded 0 excluded 0 excluded
460 NO LONGER VALID NON-EXTENSIVE BURNS W/O O.R. PROCEDURE 0 excluded 0 excluded 0 excluded 0 excluded
461 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES 1.2101 0.921 1.1141 2.4
462 REHABILITATION excluded excluded excluded excluded
463 SIGNS & SYMPTOMS W CC 0.6936 1.000 0.6936 3.3
464 SIGNS & SYMPTOMS W/O CC 0.4775 1.000 0.4775 2.4
465 AFTERCARE W HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS 0.5756 1.000 0.5756 2.1
466 AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS 0.684 1.000 0.6840 2.3
467 OTHER FACTORS INFLUENCING HEALTH STATUS 0.5112 1.000 0.5112 2.3
468 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 3.6399 1.000 3.6399 9.2
469 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS 0 1.000 0.0000 0
470 UNGROUPABLE 0 1.000 0.0000 0
471 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY 3.1957 1.000 3.1957 5
472 NO LONGER VALID EXTENSIVE BURNS W O.R. PROCEDURE 0 excluded 0 excluded 0 excluded 0 excluded
473 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17 3.5822 1.000 3.5822 7.6
474 NO LONGER VALID 0 1.000 0.0000 0
475 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT excluded excluded excluded excluded
476 PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 2.2547 1.000 2.2547 8.4
477 NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS 1.8204 1.000 1.8204 5.4
478 OTHER VASCULAR PROCEDURES W CC 2.3333 1.000 2.3333 4.9
479 OTHER VASCULAR PROCEDURES W/O CC 1.4326 1.000 1.4326 2.8
480 LIVER TRANSPLANT excluded excluded excluded excluded
481 BONE MARROW TRANSPLANT excluded excluded excluded excluded
482 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES excluded excluded excluded excluded
483 TRACHEOSTOMY EXCEPT FOR FACE,MOUTH & NECK DIAGNOSES excluded excluded excluded excluded
484 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA 5.5606 1.000 5.5606 8.8
485 LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TR 3.0998 1.000 3.0998 7.7
486 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA 4.9048 1.000 4.9048 8.1
487 OTHER MULTIPLE SIGNIFICANT TRAUMA 2.0604 1.000 2.0604 5.6
488 HIV W EXTENSIVE O.R. PROCEDURE 4.5574 1.000 4.5574 11.5
489 HIV W MAJOR RELATED CONDITION 1.7414 1.000 1.7414 6
490 HIV W OR W/O OTHER RELATED CONDITION 0.968 1.000 0.9680 3.7
491 MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY 1.6685 1.000 1.6685 2.9
492 CHEMOTHERAPY W ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS 4.2467 1.000 4.2467 10.9
493 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 1.818 1.000 1.8180 4.3
494 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC 1.0388 1.000 1.0388 2
495 LUNG TRANSPLANT excluded excluded excluded excluded
496 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION Note – For admissions on or after * , 2000, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). 5.5532 1.000 5.5532 7.8
497 SPINAL FUSION W CC Note – For admissions on or after * , 2000, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). 2.9441 1.000 2.9441 4.9
498 SPINAL FUSION W/O CC Note – For admissions on or after * , 2000, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). 1.9057 1.000 1.9057 2.8
499 BACK & NECK PROCS EXCEPT SPINAL FUSION W CC Note – For admissions on or after * , 2000, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). 1.4572 1.000 1.4572 3.6
500 BACK & NECK PROCS EXCEPT SPINAL FUSION W/O CC Note – For admissions on or after * , 2000, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). 0.9805 1.000 0.9805 2.2
501 KNEE PROC W PDX OF INFECTION W CC 2.6283 1.000 2.6283 8.4
502 KNEE PROC W PDX OF INFECTION W/O CC 1.4434 1.000 1.4434 4.9
503 KNEE PROCEDURES W/O PDX OF INFECTION 1.2156 1.000 1.2156 3.1
504 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT excluded excluded excluded excluded
505 EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT. excluded excluded excluded excluded
506 FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA. excluded excluded excluded excluded
507 FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W/O CC OR SIG TRAUMA. excluded excluded excluded excluded
508 FULL THICKNESS BURN W/O SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA. excluded excluded excluded excluded
509 FULL THICKNESS BURN W/O SKIN GRAFT OR INHAL INJ W/O CC OR SIG TRAUMA. excluded excluded excluded excluded
510 NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA excluded excluded excluded excluded
511 NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA. excluded excluded excluded excluded