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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director -Administrative Rules
Article 5.5. Application of the Official Medical Fee Schedule (Treatment)

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Appendix B. DRG Weights and Revised Drg Weights 2001 Rates (California revisions shown in italics incorporate the DWC Revised Ratios)

HCFA 2001 DRG
DWC Revised
DWC Revised
Geometric Mean
DRG Number
Description
Weights
Ratio
Weight
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
< 1HR 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
0
0
0
0
457
NO LONGER VALID
0
0
0
0
458
NO LONGER VALID
0
0
0
0
459
NO LONGER VALID
0
0
0
0
460
NO LONGER VALID
0
0
0
0
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
0
0
0
0
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 June 27,
2001, 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 June 29, 2001, 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 June 29, 2001, 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 June 29, 2001, 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
June 29, 2001, 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