drg list report grouper type: cms - career steptraining.careerstep.com/pdf/ms-drgsversion30.pdf ·...

4684.52Base Rate:

010001 - Test FacilityFacility:

30.0GrouperVersion:

CMSGrouper Type:

Test Facility

DRG List Report

ReimbursementWeightDescriptionDRG

$121,935.7126.0295Heart transplant or implant of heart assist system w MCC001

$65,176.2013.9131Heart transplant or implant of heart assist system w/o MCC002

$83,088.8617.7369ECMO or trach w MV 96+ hrs or PDX exc face, mouth & neck w maj O.R.003

$50,983.0410.8833Trach w MV 96+ hrs or PDX exc face, mouth & neck w/o maj O.R.004

$51,480.0610.9894Liver transplant w MCC or intestinal transplant005

$22,100.634.7178Liver transplant w/o MCC006

$45,030.899.6127Lung transplant007

$23,942.585.111Simultaneous pancreas/kidney transplant008

$18,248.083.8954Pancreas transplant010

$22,689.004.8434Tracheostomy for face,mouth & neck diagnoses w MCC011

$14,791.843.1576Tracheostomy for face,mouth & neck diagnoses w CC012

$9,165.731.9566Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC013

$49,306.9210.5255Allogeneic bone marrow transplant014

$28,543.726.0932Autologous Bone Marrow Transplant with CC/MCC016

$21,463.074.5817Autologous Bone Marrow Transplant without CC/MCC017

$42,636.639.1016Intracranial vascular procedures w PDX hemorrhage w MCC020

$31,105.216.64Intracranial vascular procedures w PDX hemorrhage w CC021

$21,106.574.5056Intracranial vascular procedures w PDX hemorrhage w/o CC/MCC022

$24,536.585.2378Cranio w major dev impl/acute complex CNS PDX w MCC or chemo implant023

$16,526.523.5279Cranio w major dev impl/acute complex CNS PDX w/o MCC024

$21,529.124.5958Craniotomy & endovascular intracranial procedures w MCC025

$13,845.102.9555Craniotomy & endovascular intracranial procedures w CC026

$10,133.092.1631Craniotomy & endovascular intracranial procedures w/o CC/MCC027

$26,246.435.6028Spinal procedures w MCC028

$13,714.872.9277Spinal procedures w CC or spinal neurostimulators029

$8,363.741.7854Spinal procedures w/o CC/MCC030

$19,977.144.2645Ventricular shunt procedures w MCC031

$9,532.062.0348Ventricular shunt procedures w CC032

$6,736.811.4381Ventricular shunt procedures w/o CC/MCC033

Printed by: Admin of 22Printed on: 1/19/2013 9:46 PM


$17,294.313.6918Carotid artery stent procedure w MCC034

$10,289.552.1965Carotid artery stent procedure w CC035

$7,780.991.661Carotid artery stent procedure w/o CC/MCC036

$14,929.573.187Extracranial procedures w MCC037

$7,373.901.5741Extracranial procedures w CC038

$4,818.031.0285Extracranial procedures w/o CC/MCC039

$18,119.723.868Periph/cranial nerve & other nerv syst proc w MCC040

$9,992.082.133Periph/cranial nerve & other nerv syst proc w CC or periph neurostim041

$8,312.211.7744Periph/cranial nerve & other nerv syst proc w/o CC/MCC042

$6,981.341.4903Spinal disorders & injuries w CC/MCC052

$4,237.620.9046Spinal disorders & injuries w/o CC/MCC053

$6,540.531.3962Nervous system neoplasms w MCC054

$4,912.191.0486Nervous system neoplasms w/o MCC055

$8,054.561.7194Degenerative nervous system disorders w MCC056

$4,534.620.968Degenerative nervous system disorders w/o MCC057

$7,716.341.6472Multiple sclerosis & cerebellar ataxia w MCC058

$4,725.741.0088Multiple sclerosis & cerebellar ataxia w CC059

$3,657.200.7807Multiple sclerosis & cerebellar ataxia w/o CC/MCC060

$13,429.582.8668Acute ischemic stroke w use of thrombolytic agent w MCC061

$9,158.711.9551Acute ischemic stroke w use of thrombolytic agent w CC062

$7,198.231.5366Acute ischemic stroke w use of thrombolytic agent w/o CC/MCC063

$8,630.761.8424Intracranial hemorrhage or cerebral infarction w MCC064

$5,314.591.1345Intracranial hemorrhage or cerebral infarction w CC065

$3,810.860.8135Intracranial hemorrhage or cerebral infarction w/o CC/MCC066

$7,061.451.5074Nonspecific cva & precerebral occlusion w/o infarct w MCC067

$4,168.750.8899Nonspecific cva & precerebral occlusion w/o infarct w/o MCC068

$3,489.500.7449Transient ischemia069

$7,989.921.7056Nonspecific cerebrovascular disorders w MCC070

$4,766.031.0174Nonspecific cerebrovascular disorders w CC071

$3,516.200.7506Nonspecific cerebrovascular disorders w/o CC/MCC072

$6,005.551.282Cranial & peripheral nerve disorders w MCC073

$4,139.710.8837Cranial & peripheral nerve disorders w/o MCC074

$8,249.911.7611Viral meningitis w CC/MCC075

$4,191.240.8947Viral meningitis w/o CC/MCC076

$7,694.791.6426Hypertensive encephalopathy w MCC077



$4,586.150.979Hypertensive encephalopathy w CC078

$3,418.290.7297Hypertensive encephalopathy w/o CC/MCC079

$5,909.991.2616Nontraumatic stupor & coma w MCC080

$3,474.040.7416Nontraumatic stupor & coma w/o MCC081

$9,017.231.9249Traumatic stupor & coma, coma >1 hr w MCC082

$6,304.431.3458Traumatic stupor & coma, coma >1 hr w CC083

$4,073.660.8696Traumatic stupor & coma, coma >1 hr w/o CC/MCC084

$9,550.332.0387Traumatic stupor & coma, coma <1 hr w MCC085

$5,562.401.1874Traumatic stupor & coma, coma <1 hr w CC086

$3,562.580.7605Traumatic stupor & coma, coma <1 hr w/o CC/MCC087

$7,348.611.5687Concussion w MCC088

$4,586.610.9791Concussion w CC089

$3,381.290.7218Concussion w/o CC/MCC090

$7,768.341.6583Other disorders of nervous system w MCC091

$4,316.320.9214Other disorders of nervous system w CC092

$3,250.120.6938Other disorders of nervous system w/o CC/MCC093

$16,703.123.5656Bacterial & tuberculous infections of nervous system w MCC094

$11,536.572.4627Bacterial & tuberculous infections of nervous system w CC095

$9,443.062.0158Bacterial & tuberculous infections of nervous system w/o CC/MCC096

$15,793.393.3714Non-bacterial infect of nervous sys exc viral meningitis w MCC097

$8,627.951.8418Non-bacterial infect of nervous sys exc viral meningitis w CC098

$5,821.451.2427Non-bacterial infect of nervous sys exc viral meningitis w/o CC/MCC099

$7,293.801.557Seizures w MCC100

$3,580.380.7643Seizures w/o MCC101

$4,782.431.0209Headaches w MCC102

$3,229.040.6893Headaches w/o MCC103

$8,707.121.8587Orbital procedures w CC/MCC113

$4,491.990.9589Orbital procedures w/o CC/MCC114

$5,812.081.2407Extraocular procedures except orbit115

$7,037.091.5022Intraocular procedures w CC/MCC116

$3,388.780.7234Intraocular procedures w/o CC/MCC117

$4,491.990.9589Acute major eye infections w CC/MCC121

$3,060.400.6533Acute major eye infections w/o CC/MCC122

$3,533.060.7542Neurological eye disorders123

$5,567.551.1885Other disorders of the eye w MCC124



$3,208.900.685Other disorders of the eye w/o MCC125

$10,071.722.15Major head & neck procedures w CC/MCC or major device129

$5,651.871.2065Major head & neck procedures w/o CC/MCC130

$10,981.922.3443Cranial/facial procedures w CC/MCC131

$5,791.001.2362Cranial/facial procedures w/o CC/MCC132

$8,346.881.7818Other ear, nose, mouth & throat O.R. procedures w CC/MCC133

$4,298.980.9177Other ear, nose, mouth & throat O.R. procedures w/o CC/MCC134

$9,369.982.0002Sinus & mastoid procedures w CC/MCC135

$5,011.031.0697Sinus & mastoid procedures w/o CC/MCC136

$6,179.821.3192Mouth procedures w CC/MCC137

$3,460.920.7388Mouth procedures w/o CC/MCC138

$4,179.530.8922Salivary gland procedures139

$10,468.502.2347Ear, nose, mouth & throat malignancy w MCC146

$5,849.091.2486Ear, nose, mouth & throat malignancy w CC147

$3,507.770.7488Ear, nose, mouth & throat malignancy w/o CC/MCC148

$3,027.140.6462Dysequilibrium149

$6,506.801.389Epistaxis w MCC150

$3,025.260.6458Epistaxis w/o MCC151

$4,762.281.0166Otitis media & URI w MCC152

$3,094.130.6605Otitis media & URI w/o MCC153

$6,622.971.4138Other ear, nose, mouth & throat diagnoses w MCC154

$4,280.250.9137Other ear, nose, mouth & throat diagnoses w CC155

$2,974.200.6349Other ear, nose, mouth & throat diagnoses w/o CC/MCC156

$7,499.921.601Dental & Oral Diseases w MCC157

$4,210.450.8988Dental & Oral Diseases w CC158

$2,796.190.5969Dental & Oral Diseases w/o CC/MCC159

$23,981.465.1193Major chest procedures w MCC163

$12,269.232.6191Major chest procedures w CC164

$8,395.601.7922Major chest procedures w/o CC/MCC165

$17,573.043.7513Other resp system O.R. procedures w MCC166

$9,389.182.0043Other resp system O.R. procedures w CC167

$6,161.551.3153Other resp system O.R. procedures w/o CC/MCC168

$7,434.331.587Pulmonary embolism w MCC175

$4,862.061.0379Pulmonary embolism w/o MCC176

$9,626.222.0549Respiratory infections & inflammations w MCC177



$6,747.111.4403Respiratory infections & inflammations w CC178

$4,590.360.9799Respiratory infections & inflammations w/o CC/MCC179

$8,229.301.7567Respiratory neoplasms w MCC180

$5,672.021.2108Respiratory neoplasms w CC181

$3,876.440.8275Respiratory neoplasms w/o CC/MCC182

$6,934.961.4804Major chest trauma w MCC183

$4,764.631.0171Major chest trauma w CC184

$3,260.890.6961Major chest trauma w/o CC/MCC185

$7,376.251.5746Pleural effusion w MCC186

$5,232.141.1169Pleural effusion w CC187

$3,534.000.7544Pleural effusion w/o CC/MCC188

$5,837.381.2461Pulmonary edema & respiratory failure189

$5,555.841.186Chronic obstructive pulmonary disease w MCC190

$4,460.130.9521Chronic obstructive pulmonary disease w CC191

$3,312.890.7072Chronic obstructive pulmonary disease w/o CC/MCC192

$6,976.661.4893Simple pneumonia & pleurisy w MCC193

$4,682.650.9996Simple pneumonia & pleurisy w CC194

$3,315.700.7078Simple pneumonia & pleurisy w/o CC/MCC195

$7,879.361.682Interstitial lung disease w MCC196

$5,250.881.1209Interstitial lung disease w CC197

$3,690.930.7879Interstitial lung disease w/o CC/MCC198

$8,860.771.8915Pneumothorax w MCC199

$4,797.891.0242Pneumothorax w CC200

$3,181.730.6792Pneumothorax w/o CC/MCC201

$4,077.410.8704Bronchitis & asthma w CC/MCC202

$2,917.520.6228Bronchitis & asthma w/o CC/MCC203

$3,195.780.6822Respiratory signs & symptoms204

$6,468.851.3809Other respiratory system diagnoses w MCC205

$3,636.590.7763Other respiratory system diagnoses w/o MCC206

$25,117.935.3619Respiratory system diagnosis w ventilator support 96+ hours207

$10,727.082.2899Respiratory system diagnosis w ventilator support <96 hours208

$66,068.6014.1036Other heart assist system implant215

$44,591.959.519Cardiac valve & oth maj cardiothoracic proc w card cath w MCC216

$29,744.366.3495Cardiac valve & oth maj cardiothoracic proc w card cath w CC217

$25,028.925.3429Cardiac valve & oth maj cardiothoracic proc w card cath w/o CC/MCC218



$36,721.957.839Cardiac valve & oth maj cardiothoracic proc w/o card cath w MCC219

$24,564.695.2438Cardiac valve & oth maj cardiothoracic proc w/o card cath w CC220

$20,720.574.4232Cardiac valve & oth maj cardiothoracic proc w/o card cath w/o CC/MCC221

$40,055.468.5506Cardiac defib implant w cardiac cath w AMI/HF/shock w MCC222

$28,606.026.1065Cardiac defib implant w cardiac cath w AMI/HF/shock w/o MCC223

$35,957.447.6758Cardiac defib implant w cardiac cath w/o AMI/HF/shock w MCC224

$26,985.185.7605Cardiac defib implant w cardiac cath w/o AMI/HF/shock w/o MCC225

$31,552.126.7354Cardiac defibrillator implant w/o cardiac cath w MCC226

$24,306.105.1886Cardiac defibrillator implant w/o cardiac cath w/o MCC227

$33,173.437.0815Other cardiothoracic procedures w MCC228

$21,679.494.6279Other cardiothoracic procedures w CC229

$17,853.173.8111Other cardiothoracic procedures w/o CC/MCC230

$35,273.037.5297Coronary bypass w PTCA w MCC231

$26,772.505.7151Coronary bypass w PTCA w/o MCC232

$33,865.337.2292Coronary bypass w cardiac cath w MCC233

$22,679.174.8413Coronary bypass w cardiac cath w/o MCC234

$27,176.775.8014Coronary bypass w/o cardiac cath w MCC235

$17,696.713.7777Coronary bypass w/o cardiac cath w/o MCC236

$23,970.695.117Major Cardiovascular Procedures with MCC237

$14,926.293.1863Major cardiovasc procedures w/o MCC238

$21,639.674.6194Amputation for circ sys disorders exc upper limb & toe w MCC239

$12,428.502.6531Amputation for circ sys disorders exc upper limb & toe w CC240

$6,944.801.4825Amputation for circ sys disorders exc upper limb & toe w/o CC/MCC241

$17,479.823.7314Permanent cardiac pacemaker implant w MCC242

$12,275.322.6204Permanent cardiac pacemaker implant w CC243

$9,661.352.0624Permanent cardiac pacemaker implant w/o CC/MCC244

$19,927.954.254AICD generator procedures245

$14,787.163.1566Perc cardiovasc proc w drug-eluting stent w MCC or 4+ vessels/stents246

$9,327.351.9911Perc cardiovasc proc w drug-eluting stent w/o MCC247

$14,054.973.0003Perc cardiovasc proc w non-drug-eluting stent w MCC or 4+ ves/stents248

$8,413.871.7961Perc cardiovasc proc w non-drug-eluting stent w/o MCC249

$14,047.942.9988Perc cardiovasc proc w/o coronary artery stent w MCC250

$9,011.611.9237Perc cardiovasc proc w/o coronary artery stent w/o MCC251

$14,158.493.0224Other vascular procedures w MCC252

$11,589.032.4739Other vascular procedures w CC253



$7,780.521.6609Other vascular procedures w/o CC/MCC254

$11,421.332.4381Upper limb & toe amputation for circ system disorders w MCC255

$7,464.311.5934Upper limb & toe amputation for circ system disorders w CC256

$4,466.690.9535Upper limb & toe amputation for circ system disorders w/o CC/MCC257

$12,622.442.6945Cardiac pacemaker device replacement w MCC258

$8,708.521.859Cardiac pacemaker device replacement w/o MCC259

$17,156.593.6624Cardiac pacemaker revision except device replacement w MCC260

$7,855.471.6769Cardiac pacemaker revision except device replacement w CC261

$5,782.101.2343Cardiac pacemaker revision except device replacement w/o CC/MCC262

$8,943.221.9091Vein ligation & stripping263

$12,495.492.6674Other circulatory system O.R. procedures264

$11,427.422.4394AICD lead procedures265

$8,431.671.7999Acute myocardial infarction, discharged alive w MCC280

$5,134.701.0961Acute myocardial infarction, discharged alive w CC281

$3,623.940.7736Acute myocardial infarction, discharged alive w/o CC/MCC282

$8,216.181.7539Acute myocardial infarction, expired w MCC283

$3,767.290.8042Acute myocardial infarction, expired w CC284

$2,507.620.5353Acute myocardial infarction, expired w/o CC/MCC285

$9,658.072.0617Circulatory disorders except AMI, w card cath w MCC286

$5,016.651.0709Circulatory disorders except AMI, w card cath w/o MCC287

$13,223.932.8229Acute & subacute endocarditis w MCC288

$8,500.061.8145Acute & subacute endocarditis w CC289

$5,664.521.2092Acute & subacute endocarditis w/o CC/MCC290

$7,108.291.5174Heart failure & shock w MCC291

$4,700.451.0034Heart failure & shock w CC292

$3,162.520.6751Heart failure & shock w/o CC/MCC293

$4,791.801.0229Deep vein thrombophlebitis w CC/MCC294

$3,033.700.6476Deep vein thrombophlebitis w/o CC/MCC295

$6,032.721.2878Cardiac arrest, unexplained w MCC296

$3,023.860.6455Cardiac arrest, unexplained w CC297

$2,141.290.4571Cardiac arrest, unexplained w/o CC/MCC298

$6,645.461.4186Peripheral vascular disorders w MCC299

$4,534.150.9679Peripheral vascular disorders w CC300

$3,128.790.6679Peripheral vascular disorders w/o CC/MCC301

$4,751.041.0142Atherosclerosis w MCC302



$2,704.370.5773Atherosclerosis w/o MCC303

$4,920.151.0503Hypertension w MCC304

$2,898.310.6187Hypertension w/o MCC305

$6,147.031.3122Cardiac congenital & valvular disorders w MCC306

$3,672.660.784Cardiac congenital & valvular disorders w/o MCC307

$5,754.931.2285Cardiac arrhythmia & conduction disorders w MCC308

$3,793.520.8098Cardiac arrhythmia & conduction disorders w CC309

$2,595.690.5541Cardiac arrhythmia & conduction disorders w/o CC/MCC310

$2,439.230.5207Angina pectoris311

$3,437.970.7339Syncope & collapse312

$2,631.290.5617Chest pain313

$8,670.111.8508Other circulatory system diagnoses w MCC314

$4,462.940.9527Other circulatory system diagnoses w CC315

$2,915.650.6224Other circulatory system diagnoses w/o CC/MCC316

$26,288.595.6118Stomach, esophageal & duodenal proc w MCC326

$12,559.672.6811Stomach, esophageal & duodenal proc w CC327

$6,751.801.4413Stomach, esophageal & duodenal proc w/o CC/MCC328

$24,640.115.2599Major small & large bowel procedures w MCC329

$12,053.742.5731Major small & large bowel procedures w CC330

$7,664.341.6361Major small & large bowel procedures w/o CC/MCC331

$21,615.784.6143Rectal resection w MCC332

$11,624.172.4814Rectal resection w CC333

$7,580.021.6181Rectal resection w/o CC/MCC334

$20,211.834.3146Peritoneal adhesiolysis w MCC335

$11,022.212.3529Peritoneal adhesiolysis w CC336

$7,278.811.5538Peritoneal adhesiolysis w/o CC/MCC337

$14,994.213.2008Appendectomy w complicated principal diag w MCC338

$8,748.341.8675Appendectomy w complicated principal diag w CC339

$5,632.671.2024Appendectomy w complicated principal diag w/o CC/MCC340

$10,828.742.3116Appendectomy w/o complicated principal diag w MCC341

$6,331.601.3516Appendectomy w/o complicated principal diag w CC342

$4,472.310.9547Appendectomy w/o complicated principal diag w/o CC/MCC343

$15,971.403.4094Minor small & large bowel procedures w MCC344

$8,021.301.7123Minor small & large bowel procedures w CC345

$5,437.791.1608Minor small & large bowel procedures w/o CC/MCC346



$11,790.472.5169Anal & stomal procedures w MCC347

$6,511.481.39Anal & stomal procedures w CC348

$3,908.300.8343Anal & stomal procedures w/o CC/MCC349

$11,749.712.5082Inguinal & femoral hernia procedures w MCC350

$6,443.561.3755Inguinal & femoral hernia procedures w CC351

$4,236.210.9043Inguinal & femoral hernia procedures w/o CC/MCC352

$13,206.602.8192Hernia procedures except inguinal & femoral w MCC353

$7,483.991.5976Hernia procedures except inguinal & femoral w CC354

$5,233.551.1172Hernia procedures except inguinal & femoral w/o CC/MCC355

$18,486.523.9463Other digestive system O.R. procedures w MCC356

$10,187.432.1747Other digestive system O.R. procedures w CC357

$6,384.531.3629Other digestive system O.R. procedures w/o CC/MCC358

$8,585.321.8327Major esophageal disorders w MCC368

$4,995.571.0664Major esophageal disorders w CC369

$3,556.960.7593Major esophageal disorders w/o CC/MCC370

$9,462.732.02Major gastrointestinal disorders & peritoneal infections w MCC371

$5,750.251.2275Major gastrointestinal disorders & peritoneal infections w CC372

$3,935.470.8401Major gastrointestinal disorders & peritoneal infections w/o CC/MCC373

$9,970.532.1284Digestive malignancy w MCC374

$5,967.141.2738Digestive malignancy w CC375

$4,126.590.8809Digestive malignancy w/o CC/MCC376

$8,346.411.7817G.I. hemorrhage w MCC377

$4,763.221.0168G.I. hemorrhage w CC378

$3,286.190.7015G.I. hemorrhage w/o CC/MCC379

$9,046.281.9311Complicated peptic ulcer w MCC380

$5,213.871.113Complicated peptic ulcer w CC381

$3,708.730.7917Complicated peptic ulcer w/o CC/MCC382

$6,269.761.3384Uncomplicated peptic ulcer w MCC383

$3,918.600.8365Uncomplicated peptic ulcer w/o MCC384

$8,937.131.9078Inflammatory bowel disease w MCC385

$4,921.091.0505Inflammatory bowel disease w CC386

$3,690.460.7878Inflammatory bowel disease w/o CC/MCC387

$7,759.441.6564G.I. obstruction w MCC388

$4,317.720.9217G.I. obstruction w CC389

$2,984.980.6372G.I. obstruction w/o CC/MCC390



$5,573.171.1897Esophagitis, gastroent & misc digest disorders w MCC391

$3,454.830.7375Esophagitis, gastroent & misc digest disorders w/o MCC392

$7,807.221.6666Other digestive system diagnoses w MCC393

$4,608.160.9837Other digestive system diagnoses w CC394

$3,181.260.6791Other digestive system diagnoses w/o CC/MCC395

$26,034.225.5575Pancreas, liver & shunt procedures w MCC405

$12,790.142.7303Pancreas, liver & shunt procedures w CC406

$8,563.301.828Pancreas, liver & shunt procedures w/o CC/MCC407

$17,976.853.8375Biliary tract proc except only cholecyst w or w/o c.d.e. w MCC408

$10,624.492.268Biliary tract proc except only cholecyst w or w/o c.d.e. w CC409

$7,905.131.6875Biliary tract proc except only cholecyst w or w/o c.d.e. w/o CC/MCC410

$17,819.913.804Cholecystectomy w c.d.e. w MCC411

$12,174.602.5989Cholecystectomy w c.d.e. w CC412

$8,704.781.8582Cholecystectomy w c.d.e. w/o CC/MCC413

$16,697.033.5643Cholecystectomy except by laparoscope w/o c.d.e. w MCC414

$9,710.072.0728Cholecystectomy except by laparoscope w/o c.d.e. w CC415

$6,255.711.3354Cholecystectomy except by laparoscope w/o c.d.e. w/o CC/MCC416

$11,799.842.5189Laparoscopic cholecystectomy w/o c.d.e. w MCC417

$7,966.961.7007Laparoscopic cholecystectomy w/o c.d.e. w CC418

$5,644.851.205Laparoscopic cholecystectomy w/o c.d.e. w/o CC/MCC419

$18,039.623.8509Hepatobiliary diagnostic procedures w MCC420

$8,142.161.7381Hepatobiliary diagnostic procedures w CC421

$6,092.691.3006Hepatobiliary diagnostic procedures w/o CC/MCC422

$20,287.724.3308Other hepatobiliary or pancreas O.R. procedures w MCC423

$11,280.792.4081Other hepatobiliary or pancreas O.R. procedures w CC424

$7,380.931.5756Other hepatobiliary or pancreas O.R. procedures w/o CC/MCC425

$7,866.251.6792Cirrhosis & alcoholic hepatitis w MCC432

$4,364.100.9316Cirrhosis & alcoholic hepatitis w CC433

$2,971.390.6343Cirrhosis & alcoholic hepatitis w/o CC/MCC434

$8,345.941.7816Malignancy of hepatobiliary system or pancreas w MCC435

$5,590.511.1934Malignancy of hepatobiliary system or pancreas w CC436

$4,467.630.9537Malignancy of hepatobiliary system or pancreas w/o CC/MCC437

$8,359.061.7844Disorders of pancreas except malignancy w MCC438

$4,498.540.9603Disorders of pancreas except malignancy w CC439

$3,180.790.679Disorders of pancreas except malignancy w/o CC/MCC440



$8,791.441.8767Disorders of liver except malig,cirr,alc hepa w MCC441

$4,471.370.9545Disorders of liver except malig,cirr,alc hepa w CC442

$3,032.290.6473Disorders of liver except malig,cirr,alc hepa w/o CC/MCC443

$7,513.501.6039Disorders of the biliary tract w MCC444

$5,021.811.072Disorders of the biliary tract w CC445

$3,552.270.7583Disorders of the biliary tract w/o CC/MCC446

$49,633.4310.5952Combined anterior/posterior spinal fusion w MCC453

$36,529.427.7979Combined anterior/posterior spinal fusion w CC454

$27,500.475.8705Combined anterior/posterior spinal fusion w/o CC/MCC455

$44,598.509.5204Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w MCC456

$30,061.036.4171Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w CC457

$23,184.164.9491Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w/o CC/MCC458

$30,632.086.539Spinal fusion except cervical w MCC459

$18,167.973.8783Spinal fusion except cervical w/o MCC460

$22,983.194.9062Bilateral or multiple major joint procs of lower extremity w MCC461

$15,807.913.3745Bilateral or multiple major joint procs of lower extremity w/o MCC462

$25,503.935.4443Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w MCC463

$13,775.302.9406Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w CC464

$8,807.831.8802Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w/o CC/MCC465

$23,459.145.0078Revision of hip or knee replacement w MCC466

$15,232.193.2516Revision of hip or knee replacement w CC467

$12,212.542.607Revision of hip or knee replacement w/o CC/MCC468

$16,019.183.4196Major joint replacement or reattachment of lower extremity w MCC469

$9,815.472.0953Major joint replacement or reattachment of lower extremity w/o MCC470

$22,052.384.7075Cervical spinal fusion w MCC471

$13,135.862.8041Cervical spinal fusion w CC472

$9,956.482.1254Cervical spinal fusion w/o CC/MCC473

$16,712.493.5676Amputation for musculoskeletal sys & conn tissue dis w MCC474

$9,402.302.0071Amputation for musculoskeletal sys & conn tissue dis w CC475

$4,764.631.0171Amputation for musculoskeletal sys & conn tissue dis w/o CC/MCC476

$15,309.483.2681Biopsies of musculoskeletal system & connective tissue w MCC477

$10,616.532.2663Biopsies of musculoskeletal system & connective tissue w CC478

$7,927.141.6922Biopsies of musculoskeletal system & connective tissue w/o CC/MCC479

$14,225.483.0367Hip & femur procedures except major joint w MCC480

$9,062.201.9345Hip & femur procedures except major joint w CC481



$7,335.961.566Hip & femur procedures except major joint w/o CC/MCC482

$11,858.392.5314Major joint & limb reattachment proc of upper extremity w CC/MCC483

$9,814.072.095Major joint & limb reattachment proc of upper extremity w/o CC/MCC484

$14,326.673.0583Knee procedures w pdx of infection w MCC485

$9,747.552.0808Knee procedures w pdx of infection w CC486

$6,962.601.4863Knee procedures w pdx of infection w/o CC/MCC487

$7,900.441.6865Knee procedures w/o pdx of infection w CC/MCC488

$5,849.091.2486Knee procedures w/o pdx of infection w/o CC/MCC489

$8,504.281.8154Back & neck proc exc spinal fusion w CC/MCC or disc device/neurostim490

$4,850.351.0354Back & neck proc exc spinal fusion w/o CC/MCC491

$14,540.283.1039Lower extrem & humer proc except hip,foot,femur w MCC492

$9,045.811.931Lower extrem & humer proc except hip,foot,femur w CC493

$6,529.281.3938Lower extrem & humer proc except hip,foot,femur w/o CC/MCC494

$14,042.792.9977Local excision & removal int fix devices exc hip & femur w MCC495

$7,638.581.6306Local excision & removal int fix devices exc hip & femur w CC496

$5,247.601.1202Local excision & removal int fix devices exc hip & femur w/o CC/MCC497

$9,979.902.1304Local excision & removal int fix devices of hip & femur w CC/MCC498

$4,734.181.0106Local excision & removal int fix devices of hip & femur w/o CC/MCC499

$14,694.403.1368Soft tissue procedures w MCC500

$7,467.121.594Soft tissue procedures w CC501

$4,998.381.067Soft tissue procedures w/o CC/MCC502

$10,777.212.3006Foot procedures w MCC503

$7,327.061.5641Foot procedures w CC504

$5,376.891.1478Foot procedures w/o CC/MCC505

$6,091.281.3003Major thumb or joint procedures506

$8,754.901.8689Major shoulder or elbow joint procedures w CC/MCC507

$5,654.681.2071Major shoulder or elbow joint procedures w/o CC/MCC508

$6,321.291.3494Arthroscopy509

$10,757.062.2963Shoulder,elbow or forearm proc,exc major joint proc w MCC510

$7,130.781.5222Shoulder,elbow or forearm proc,exc major joint proc w CC511

$5,247.131.1201Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC512

$6,281.471.3409Hand or wrist proc, except major thumb or joint proc w CC/MCC513

$4,054.450.8655Hand or wrist proc, except major thumb or joint proc w/o CC/MCC514

$15,379.753.2831Other musculoskelet sys & conn tiss O.R. proc w MCC515

$9,249.121.9744Other musculoskelet sys & conn tiss O.R. proc w CC516



$7,386.081.5767Other musculoskelet sys & conn tiss O.R. proc w/o CC/MCC517

$6,897.961.4725Fractures of femur w MCC533

$3,450.620.7366Fractures of femur w/o MCC534

$5,991.501.279Fractures of hip & pelvis w MCC535

$3,347.560.7146Fractures of hip & pelvis w/o MCC536

$4,046.490.8638Sprains, strains, & dislocations of hip, pelvis & thigh w CC/MCC537

$3,000.440.6405Sprains, strains, & dislocations of hip, pelvis & thigh w/o CC/MCC538

$9,360.611.9982Osteomyelitis w MCC539

$5,945.591.2692Osteomyelitis w CC540

$4,576.780.977Osteomyelitis w/o CC/MCC541

$9,506.302.0293Pathological fractures & musculoskelet & conn tiss malig w MCC542

$5,503.841.1749Pathological fractures & musculoskelet & conn tiss malig w CC543

$3,753.240.8012Pathological fractures & musculoskelet & conn tiss malig w/o CC/MCC544

$11,610.582.4785Connective tissue disorders w MCC545

$5,512.271.1767Connective tissue disorders w CC546

$3,551.330.7581Connective tissue disorders w/o CC/MCC547

$8,181.511.7465Septic arthritis w MCC548

$5,472.921.1683Septic arthritis w CC549

$3,617.850.7723Septic arthritis w/o CC/MCC550

$7,656.851.6345Medical back problems w MCC551

$3,997.300.8533Medical back problems w/o MCC552

$5,662.181.2087Bone diseases & arthropathies w MCC553

$3,239.810.6916Bone diseases & arthropathies w/o MCC554

$5,784.451.2348Signs & symptoms of musculoskeletal system & conn tissue w MCC555

$3,297.430.7039Signs & symptoms of musculoskeletal system & conn tissue w/o MCC556

$7,313.941.5613Tendonitis, myositis & bursitis w MCC557

$4,025.880.8594Tendonitis, myositis & bursitis w/o MCC558

$8,779.261.8741Aftercare, musculoskeletal system & connective tissue w MCC559

$4,825.061.03Aftercare, musculoskeletal system & connective tissue w CC560

$2,864.580.6115Aftercare, musculoskeletal system & connective tissue w/o CC/MCC561

$6,553.181.3989Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC562

$3,496.060.7463Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC563

$6,773.351.4459Other musculoskeletal sys & connective tissue diagnoses w MCC564

$4,396.890.9386Other musculoskeletal sys & connective tissue diagnoses w CC565

$3,178.920.6786Other musculoskeletal sys & connective tissue diagnoses w/o CC/MCC566



$11,565.142.4688Skin Debridement with MCC570

$7,012.261.4969Skin debridement with CC571

$4,701.381.0036Skin Debridement without CC/MCC572

$16,694.223.5637Skin Graft for Skin Ulcer or Cellulitis with MCC573

$11,462.552.4469Skin Graft for Skin Ulcer or Cellulitis with CC574

$6,214.481.3266Skin Graft for Skin Ulcer or Cellulitis without CC/MCC575

$19,889.074.2457Skin Graft Except for Skin Ulcer or Cellulitis with MCC576

$8,883.261.8963Skin Graft except for Skin Ulcer or Cellulitis with CC577

$5,299.131.1312Skin Graft Except for Skin Ulcer or Cellulitis without CC/MCC578

$12,735.342.7186Other skin, subcut tiss & breast proc w MCC579

$6,968.221.4875Other skin, subcut tiss & breast proc w CC580

$4,645.170.9916Other skin, subcut tiss & breast proc w/o CC/MCC581

$5,285.541.1283Mastectomy for malignancy w CC/MCC582

$4,212.320.8992Mastectomy for malignancy w/o CC/MCC583

$7,752.881.655Breast biopsy, local excision & other breast procedures w CC/MCC584

$5,331.451.1381Breast biopsy, local excision & other breast procedures w/o CC/MCC585

$6,854.391.4632Skin ulcers w MCC592

$4,643.300.9912Skin ulcers w CC593

$3,177.040.6782Skin ulcers w/o CC/MCC594

$8,808.301.8803Major skin disorders w MCC595

$4,159.850.888Major skin disorders w/o MCC596

$7,507.411.6026Malignant breast disorders w MCC597

$5,752.591.228Malignant breast disorders w CC598

$3,115.210.665Malignant breast disorders w/o CC/MCC599

$4,669.530.9968Non-malignant breast disorders w CC/MCC600

$2,926.420.6247Non-malignant breast disorders w/o CC/MCC601

$6,971.971.4883Cellulitis w MCC602

$3,931.250.8392Cellulitis w/o MCC603

$6,229.011.3297Trauma to the skin, subcut tiss & breast w MCC604

$3,537.750.7552Trauma to the skin, subcut tiss & breast w/o MCC605

$6,528.351.3936Minor skin disorders w MCC606

$3,228.570.6892Minor skin disorders w/o MCC607

$11,241.912.3998Adrenal & pituitary procedures w CC/MCC614

$6,575.191.4036Adrenal & pituitary procedures w/o CC/MCC615

$20,389.374.3525Amputat of lower limb for endocrine,nutrit,& metabol dis w MCC616



$9,236.001.9716Amputat of lower limb for endocrine,nutrit,& metabol dis w CC617

$5,287.421.1287Amputat of lower limb for endocrine,nutrit,& metabol dis w/o CC/MCC618

$16,337.733.4876O.R. procedures for obesity w MCC619

$8,713.681.8601O.R. procedures for obesity w CC620

$7,038.961.5026O.R. procedures for obesity w/o CC/MCC621

$16,708.753.5668Skin grafts & wound debrid for endoc, nutrit & metab dis w MCC622

$8,535.661.8221Skin grafts & wound debrid for endoc, nutrit & metab dis w CC623

$4,526.180.9662Skin grafts & wound debrid for endoc, nutrit & metab dis w/o CC/MCC624

$11,058.282.3606Thyroid, parathyroid & thyroglossal procedures w MCC625

$5,697.781.2163Thyroid, parathyroid & thyroglossal procedures w CC626

$3,849.270.8217Thyroid, parathyroid & thyroglossal procedures w/o CC/MCC627

$15,428.943.2936Other endocrine, nutrit & metab O.R. proc w MCC628

$10,043.612.144Other endocrine, nutrit & metab O.R. proc w CC629

$5,746.031.2266Other endocrine, nutrit & metab O.R. proc w/o CC/MCC630

$6,591.121.407Diabetes w MCC637

$3,849.740.8218Diabetes w CC638

$2,603.660.5558Diabetes w/o CC/MCC639

$5,188.571.1076Miscellaneous Disorders of Nutrition, Metabolism, and Fluids and Electrolytes with MCC640

$3,241.690.692Miscellaneous Disorders of Nutrition, Metabolism, and Fluids and Electrolytes withoutMCC

641

$5,262.121.1233Inborn and Other Disorders of Metabolism642

$8,007.721.7094Endocrine disorders w MCC643

$4,922.491.0508Endocrine disorders w CC644

$3,388.310.7233Endocrine disorders w/o CC/MCC645

$14,440.033.0825Kidney transplant652

$28,879.606.1649Major bladder procedures w MCC653

$14,652.713.1279Major bladder procedures w CC654

$9,796.742.0913Major bladder procedures w/o CC/MCC655

$16,459.533.5136Kidney & ureter procedures for neoplasm w MCC656

$9,324.071.9904Kidney & ureter procedures for neoplasm w CC657

$6,949.951.4836Kidney & ureter procedures for neoplasm w/o CC/MCC658

$16,485.763.5192Kidney & ureter procedures for non-neoplasm w MCC659

$8,820.481.8829Kidney & ureter procedures for non-neoplasm w CC660

$6,246.811.3335Kidney & ureter procedures for non-neoplasm w/o CC/MCC661

$14,025.922.9941Minor bladder procedures w MCC662



$7,164.971.5295Minor bladder procedures w CC663

$5,274.771.126Minor bladder procedures w/o CC/MCC664

$14,398.813.0737Prostatectomy w MCC665

$7,777.241.6602Prostatectomy w CC666

$4,103.640.876Prostatectomy w/o CC/MCC667

$11,585.292.4731Transurethral procedures w MCC668

$6,096.901.3015Transurethral procedures w CC669

$3,900.330.8326Transurethral procedures w/o CC/MCC670

$6,798.641.4513Urethral procedures w CC/MCC671

$3,927.030.8383Urethral procedures w/o CC/MCC672

$14,330.423.0591Other kidney & urinary tract procedures w MCC673

$10,253.012.1887Other kidney & urinary tract procedures w CC674

$6,351.271.3558Other kidney & urinary tract procedures w/o CC/MCC675

$7,430.591.5862Renal failure w MCC682

$4,664.850.9958Renal failure w CC683

$3,013.080.6432Renal failure w/o CC/MCC684

$4,168.750.8899Admit for renal dialysis685

$7,880.771.6823Kidney & urinary tract neoplasms w MCC686

$4,918.281.0499Kidney & urinary tract neoplasms w CC687

$3,187.820.6805Kidney & urinary tract neoplasms w/o CC/MCC688

$5,520.241.1784Kidney & urinary tract infections w MCC689

$3,658.610.781Kidney & urinary tract infections w/o MCC690

$7,322.841.5632Urinary stones w esw lithotripsy w CC/MCC691

$4,948.261.0563Urinary stones w esw lithotripsy w/o CC/MCC692

$6,637.501.4169Urinary stones w/o esw lithotripsy w MCC693

$3,287.130.7017Urinary stones w/o esw lithotripsy w/o MCC694

$6,063.641.2944Kidney & urinary tract signs & symptoms w MCC695

$3,110.050.6639Kidney & urinary tract signs & symptoms w/o MCC696

$3,862.860.8246Urethral stricture697

$7,492.891.5995Other kidney & urinary tract diagnoses w MCC698

$4,683.580.9998Other kidney & urinary tract diagnoses w CC699

$3,210.770.6854Other kidney & urinary tract diagnoses w/o CC/MCC700

$8,494.911.8134Major male pelvic procedures w CC/MCC707

$6,059.901.2936Major male pelvic procedures w/o CC/MCC708

$9,409.802.0087Penis procedures w CC/MCC709



$6,085.661.2991Penis procedures w/o CC/MCC710

$9,196.181.9631Testes procedures w CC/MCC711

$3,943.430.8418Testes procedures w/o CC/MCC712

$6,199.491.3234Transurethral prostatectomy w CC/MCC713

$3,271.200.6983Transurethral prostatectomy w/o CC/MCC714

$8,970.391.9149Other male reproductive system O.R. proc for malignancy w CC/MCC715

$4,523.370.9656Other male reproductive system O.R. proc for malignancy w/o CC/MCC716

$8,085.951.7261Other male reproductive system O.R. proc exc malignancy w CC/MCC717

$4,055.390.8657Other male reproductive system O.R. proc exc malignancy w/o CC/MCC718

$7,818.461.669Malignancy, male reproductive system w MCC722

$5,183.891.1066Malignancy, male reproductive system w CC723

$3,049.150.6509Malignancy, male reproductive system w/o CC/MCC724

$6,078.631.2976Benign prostatic hypertrophy w MCC725

$3,318.980.7085Benign prostatic hypertrophy w/o MCC726

$6,564.891.4014Inflammation of the male reproductive system w MCC727

$3,616.920.7721Inflammation of the male reproductive system w/o MCC728

$4,851.761.0357Other male reproductive system diagnoses w CC/MCC729

$2,863.650.6113Other male reproductive system diagnoses w/o CC/MCC730

$12,485.182.6652Pelvic evisceration, rad hysterectomy & rad vulvectomy w CC/MCC734

$5,472.461.1682Pelvic evisceration, rad hysterectomy & rad vulvectomy w/o CC/MCC735

$20,677.474.414Uterine & adnexa proc for ovarian or adnexal malignancy w MCC736

$9,391.992.0049Uterine & adnexa proc for ovarian or adnexal malignancy w CC737

$6,021.011.2853Uterine & adnexa proc for ovarian or adnexal malignancy w/o CC/MCC738

$15,561.513.3219Uterine,adnexa proc for non-ovarian/adnexal malig w MCC739

$7,349.071.5688Uterine,adnexa proc for non-ovarian/adnexal malig w CC740

$5,386.731.1499Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC741

$6,631.871.4157Uterine & adnexa proc for non-malignancy w CC/MCC742

$4,521.970.9653Uterine & adnexa proc for non-malignancy w/o CC/MCC743

$7,295.201.5573D&C, conization, laparoscopy & tubal interruption w CC/MCC744

$3,798.680.8109D&C, conization, laparoscopy & tubal interruption w/o CC/MCC745

$6,488.061.385Vagina, cervix & vulva procedures w CC/MCC746

$4,130.810.8818Vagina, cervix & vulva procedures w/o CC/MCC747

$4,578.180.9773Female reproductive system reconstructive procedures748

$12,064.982.5755Other female reproductive system O.R. procedures w CC/MCC749

$5,000.731.0675Other female reproductive system O.R. procedures w/o CC/MCC750



$9,290.811.9833Malignancy, female reproductive system w MCC754

$5,148.291.099Malignancy, female reproductive system w CC755

$2,706.250.5777Malignancy, female reproductive system w/o CC/MCC756

$7,937.921.6945Infections, female reproductive system w MCC757

$5,054.601.079Infections, female reproductive system w CC758

$3,360.210.7173Infections, female reproductive system w/o CC/MCC759

$3,776.660.8062Menstrual & other female reproductive system disorders w CC/MCC760

$2,319.310.4951Menstrual & other female reproductive system disorders w/o CC/MCC761

$5,712.301.2194Cesarean section w CC/MCC765

$4,022.130.8586Cesarean section w/o CC/MCC766

$4,321.470.9225Vaginal delivery w sterilization &/or D&C767

$8,574.551.8304Vaginal delivery w O.R. proc except steril &/or D&C768

$6,871.251.4668Postpartum & post abortion diagnoses w O.R. procedure769

$3,039.790.6489Abortion w D&C, aspiration curettage or hysterotomy770

$3,380.820.7217Vaginal delivery w complicating diagnoses774

$2,695.940.5755Vaginal delivery w/o complicating diagnoses775

$3,075.390.6565Postpartum & post abortion diagnoses w/o O.R. procedure776

$4,111.600.8777Ectopic pregnancy777

$2,365.210.5049Threatened abortion778

$2,324.460.4962Abortion w/o D&C779

$888.180.1896False labor780

$3,132.540.6687Other antepartum diagnoses w medical complications781

$1,897.230.405Other antepartum diagnoses w/o medical complications782

$7,043.181.5035Neonates, died or transferred to another acute care facility789

$23,225.384.9579Extreme immaturity or respiratory distress syndrome, neonate790

$15,862.253.3861Prematurity w major problems791

$9,570.942.0431Prematurity w/o major problems792

$16,294.173.4783Full term neonate w major problems793

$5,767.111.2311Neonate w other significant problems794

$780.910.1667Normal newborn795

$24,123.405.1496Splenectomy w MCC799

$12,354.022.6372Splenectomy w CC800

$7,371.561.5736Splenectomy w/o CC/MCC801

$17,076.013.6452Other O.R. proc of the blood & blood forming organs w MCC802

$8,233.511.7576Other O.R. proc of the blood & blood forming organs w CC803



$5,251.821.1211Other O.R. proc of the blood & blood forming organs w/o CC/MCC804

$9,791.582.0902Major hematol/immun diag exc sickle cell crisis & coagul w MCC808

$5,512.271.1767Major hematol/immun diag exc sickle cell crisis & coagul w CC809

$3,977.160.849Major hematol/immun diag exc sickle cell crisis & coagul w/o CC/MCC810

$5,881.881.2556Red blood cell disorders w MCC811

$3,687.650.7872Red blood cell disorders w/o MCC812

$7,420.751.5841Coagulation disorders813

$7,867.181.6794Reticuloendothelial & immunity disorders w MCC814

$4,732.301.0102Reticuloendothelial & immunity disorders w CC815

$3,240.750.6918Reticuloendothelial & immunity disorders w/o CC/MCC816

$26,808.575.7228Lymphoma & leukemia w major O.R. procedure w MCC820

$10,805.312.3066Lymphoma & leukemia w major O.R. procedure w CC821

$5,590.971.1935Lymphoma & leukemia w major O.R. procedure w/o CC/MCC822

$21,266.324.5397Lymphoma & non-acute leukemia w other O.R. proc w MCC823

$10,588.422.2603Lymphoma & non-acute leukemia w other O.R. proc w CC824

$5,954.961.2712Lymphoma & non-acute leukemia w other O.R. proc w/o CC/MCC825

$22,804.244.868Myeloprolif disord or poorly diff neopl w maj O.R. proc w MCC826

$10,195.862.1765Myeloprolif disord or poorly diff neopl w maj O.R. proc w CC827

$6,281.471.3409Myeloprolif disord or poorly diff neopl w maj O.R. proc w/o CC/MCC828

$14,210.493.0335Myeloprolif disord or poorly diff neopl w other O.R. proc w CC/MCC829

$5,529.611.1804Myeloprolif disord or poorly diff neopl w other O.R. proc w/o CC/MCC830

$24,182.435.1622Acute leukemia w/o major O.R. procedure w MCC834

$10,368.252.2133Acute leukemia w/o major O.R. procedure w CC835

$5,149.221.0992Acute leukemia w/o major O.R. procedure w/o CC/MCC836

$30,393.636.4881Chemo w acute leukemia as sdx or w high dose chemo agent w MCC837

$12,899.762.7537Chemo w acute leukemia as sdx w CC or high dose chemo agent838

$5,814.431.2412Chemo w acute leukemia as sdx w/o CC/MCC839

$14,101.813.0103Lymphoma & non-acute leukemia w MCC840

$7,585.171.6192Lymphoma & non-acute leukemia w CC841

$4,895.321.045Lymphoma & non-acute leukemia w/o CC/MCC842

$8,768.951.8719Other myeloprolif dis or poorly diff neopl diag w MCC843

$5,722.611.2216Other myeloprolif dis or poorly diff neopl diag w CC844

$4,034.310.8612Other myeloprolif dis or poorly diff neopl diag w/o CC/MCC845

$11,418.052.4374Chemotherapy w/o acute leukemia as secondary diagnosis w MCC846

$4,893.921.0447Chemotherapy w/o acute leukemia as secondary diagnosis w CC847



$3,690.460.7878Chemotherapy w/o acute leukemia as secondary diagnosis w/o CC/MCC848

$6,275.381.3396Radiotherapy849

$25,029.865.3431Infectious & parasitic diseases w O.R. procedure w MCC853

$11,984.412.5583Infectious & parasitic diseases w O.R. procedure w CC854

$7,181.841.5331Infectious & parasitic diseases w O.R. procedure w/o CC/MCC855

$22,544.254.8125Postoperative or post-traumatic infections w O.R. proc w MCC856

$9,673.072.0649Postoperative or post-traumatic infections w O.R. proc w CC857

$5,871.581.2534Postoperative or post-traumatic infections w O.R. proc w/o CC/MCC858

$9,415.422.0099Postoperative & post-traumatic infections w MCC862

$4,601.140.9822Postoperative & post-traumatic infections w/o MCC863

$3,955.140.8443Fever864

$7,111.571.5181Viral illness w MCC865

$3,557.420.7594Viral illness w/o MCC866

$12,114.642.5861Other infectious & parasitic diseases diagnoses w MCC867

$5,041.481.0762Other infectious & parasitic diseases diagnoses w CC868

$3,473.570.7415Other infectious & parasitic diseases diagnoses w/o CC/MCC869

$27,357.135.8399Septicemia or severe sepsis w MV 96+ hours870

$8,808.301.8803Septicemia or severe sepsis w/o MV 96+ hours w MCC871

$5,147.351.0988Septicemia or severe sepsis w/o MV 96+ hours w/o MCC872

$12,693.642.7097O.R. procedure w principal diagnoses of mental illness876

$3,032.760.6474Acute adjustment reaction & psychosocial dysfunction880

$2,977.480.6356Depressive neuroses881

$2,937.660.6271Neuroses except depressive882

$6,377.041.3613Disorders of personality & impulse control883

$4,614.250.985Organic disturbances & mental retardation884

$4,468.560.9539Psychoses885

$3,659.550.7812Behavioral & developmental disorders886

$4,437.650.9473Other mental disorder diagnoses887

$2,004.040.4278Alcohol/drug abuse or dependence, left ama894

$5,135.641.0963Alcohol/drug abuse or dependence w rehabilitation therapy895

$7,153.731.5271Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC896

$3,179.850.6788Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC897

$20,366.894.3477Wound debridements for injuries w MCC901

$8,000.691.7079Wound debridements for injuries w CC902

$4,632.990.989Wound debridements for injuries w/o CC/MCC903



$13,653.032.9145Skin grafts for injuries w CC/MCC904

$5,916.551.263Skin grafts for injuries w/o CC/MCC905

$5,432.171.1596Hand procedures for injuries906

$18,065.853.8565Other O.R. procedures for injuries w MCC907

$9,143.711.9519Other O.R. procedures for injuries w CC908

$5,645.321.2051Other O.R. procedures for injuries w/o CC/MCC909

$5,749.311.2273Traumatic injury w MCC913

$3,278.230.6998Traumatic injury w/o MCC914

$7,105.481.5168Allergic reactions w MCC915

$2,361.930.5042Allergic reactions w/o MCC916

$6,812.231.4542Poisoning & toxic effects of drugs w MCC917

$2,953.120.6304Poisoning & toxic effects of drugs w/o MCC918

$7,783.331.6615Complications of treatment w MCC919

$4,540.710.9693Complications of treatment w CC920

$3,109.120.6637Complications of treatment w/o CC/MCC921

$6,701.211.4305Other injury, poisoning & toxic effect diag w MCC922

$3,015.890.6438Other injury, poisoning & toxic effect diag w/o MCC923

$76,838.3116.4026Extensive burns or full thickness burns w MV 96+ hrs w skin graft927

$22,447.754.7919Full thickness burn w skin graft or inhal inj w CC/MCC928

$10,502.692.242Full thickness burn w skin graft or inhal inj w/o CC/MCC929

$11,121.052.374Extensive burns or full thickness burns w MV 96+ hrs w/o skin graft933

$7,084.401.5123Full thickness burn w/o skin grft or inhal inj934

$6,281.941.341Non-extensive burns935

$13,008.442.7769O.R. proc w diagnoses of other contact w health services w MCC939

$8,482.731.8108O.R. proc w diagnoses of other contact w health services w CC940

$5,516.491.1776O.R. proc w diagnoses of other contact w health services w/o CC/MCC941

$6,185.441.3204Rehabilitation w CC/MCC945

$5,869.701.253Rehabilitation w/o CC/MCC946

$5,214.341.1131Signs & symptoms w MCC947

$3,283.850.701Signs & symptoms w/o MCC948

$4,390.330.9372Aftercare w CC/MCC949

$2,666.900.5693Aftercare w/o CC/MCC950

$3,796.800.8105Other factors influencing health status951

$25,376.045.417Craniotomy for multiple significant trauma955

$17,038.543.6372Limb reattachment, hip & femur proc for multiple significant trauma956



$30,066.196.4182Other O.R. procedures for multiple significant trauma w MCC957

$18,271.503.9004Other O.R. procedures for multiple significant trauma w CC958

$12,013.922.5646Other O.R. procedures for multiple significant trauma w/o CC/MCC959

$13,342.922.8483Other multiple significant trauma w MCC963

$7,015.071.4975Other multiple significant trauma w CC964

$4,497.140.96Other multiple significant trauma w/o CC/MCC965

$25,678.205.4815HIV w extensive O.R. procedure w MCC969

$12,475.352.6631HIV w extensive O.R. procedure w/o MCC970

$12,153.052.5943HIV w major related condition w MCC974

$6,156.401.3142HIV w major related condition w CC975

$3,942.490.8416HIV w major related condition w/o CC/MCC976

$4,926.711.0517HIV w or w/o other related condition977

$23,549.085.027Extensive O.R. procedure unrelated to principal diagnosis w MCC981

$13,245.952.8276Extensive O.R. procedure unrelated to principal diagnosis w CC982

$8,045.661.7175Extensive O.R. procedure unrelated to principal diagnosis w/o CC/MCC983

$16,965.933.6217Prostatic O.R. procedure unrelated to principal diagnosis w MCC984

$9,788.302.0895Prostatic O.R. procedure unrelated to principal diagnosis w CC985

$5,017.121.071Prostatic O.R. procedure unrelated to principal diagnosis w/o CC/MCC986

$15,634.123.3374Non-extensive O.R. proc unrelated to principal diagnosis w MCC987

$8,498.191.8141Non-extensive O.R. proc unrelated to principal diagnosis w CC988

$4,754.791.015Non-extensive O.R. proc unrelated to principal diagnosis w/o CC/MCC989

$0.000Principal diagnosis invalid as discharge diagnosis998

$0.000Ungroupable999


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