Table 5.--List of Diagnosis Related Groups (DRGS), Relative Weighting Factors, Geometric Mean Length of Stay,
and Length of Stay Outlier Cutoff Points Used in the Prospective Payment System
----------------------------------------------------------------------------------------------------------------
Relative Geometric Arithmetic Outlier
weights mean LOS mean LOS threshold
----------------------------------------------------------------------------------------------------------------
1........... 01 SURG CRANIOTOMY AGE >17 3.0486 7.7 11.1 32
EXCEPT FOR TRAUMA.
2........... 01 SURG CRANIOTOMY FOR TRAUMA 3.0134 8.4 11.6 32
AGE >17.
3........... 01 SURG *CRANIOTOMY AGE 0-17... 1.9167 12.7 12.7 37
4........... 01 SURG SPINAL PROCEDURES...... 2.3399 5.9 9.1 30
5........... 01 SURG EXTRACRANIAL VASCULAR 1.5143 3.4 4.4 26
PROCEDURES.
6........... 01 SURG CARPAL TUNNEL RELEASE.. .7419 2.4 3.4 26
7........... 01 SURG PERIPH & CRANIAL NERVE 2.4886 8.1 12.6 32
& OTHER NERV SYST PROC
W CC.
8........... 01 SURG PERIPH & CRANIAL NERVE 1.0962 2.6 3.9 27
& OTHER NERV SYST PROC
W/O CC.
9........... 01 MED SPINAL DISORDERS & 1.2677 5.4 7.8 29
INJURIES.
10.......... 01 MED NERVOUS SYSTEM 1.2196 5.7 8.1 30
NEOPLASMS W CC.
11.......... 01 MED NERVOUS SYSTEM .8000 3.5 5.0 28
NEOPLASMS W/O CC.
12.......... 01 MED DEGENERATIVE NERVOUS .9457 5.4 7.7 29
SYSTEM DISORDERS.
13.......... 01 MED MULTIPLE SCLEROSIS & .7770 5.0 6.2 29
CEREBELLAR ATAXIA.
14.......... 01 MED SPECIFIC 1.1999 5.5 7.5 30
CEREBROVASCULAR
DISORDERS EXCEPT TIA.
15.......... 01 MED TRANSIENT ISCHEMIC .7231 3.5 4.5 27
ATTACK & PRECEREBRAL
OCCLUSIONS.
16.......... 01 MED NONSPECIFIC 1.0371 4.9 6.6 29
CEREBROVASCULAR
DISORDERS W CC.
17.......... 01 MED NONSPECIFIC .6331 3.0 4.0 26
CEREBROVASCULAR
DISORDERS W/O CC.
18.......... 01 MED CRANIAL & PERIPHERAL .9319 4.8 6.4 29
NERVE DISORDERS W CC.
19.......... 01 MED CRANIAL & PERIPHERAL .6230 3.4 4.5 27
NERVE DISORDERS W/O CC.
20.......... 01 MED NERVOUS SYSTEM 2.4854 8.6 11.6 33
INFECTION EXCEPT VIRAL
MENINGITIS.
21.......... 01 MED VIRAL MENINGITIS....... 1.4910 5.8 7.8 30
22.......... 01 MED HYPERTENSIVE .8353 3.8 4.9 28
ENCEPHALOPATHY.
23.......... 01 MED NONTRAUMATIC STUPOR & .8089 3.6 5.1 28
COMA.
24.......... 01 MED SEIZURE & HEADACHE AGE .9694 4.2 5.8 28
>17 W CC.
25.......... 01 MED SEIZURE & HEADACHE AGE .5793 3.0 3.9 24
>17 W/O CC.
26.......... 01 MED SEIZURE & HEADACHE AGE .7387 3.3 4.6 27
0-17.
27.......... 01 MED TRAUMATIC STUPOR & 1.3060 3.6 6.3 28
COMA, COMA >1 HR.
28.......... 01 MED TRAUMATIC STUPOR & 1.2033 4.8 7.1 29
COMA, COMA <1 HR AGE
>17 W CC.
29.......... 01 MED TRAUMATIC STUPOR & .6371 3.0 4.1 27
COMA, COMA <1 HR AGE
>17 W/O CC.
30.......... 01 MED *TRAUMATIC STUPOR & .3241 2.0 2.0 17
COMA, COMA <1 HR AGE 0-
17.
31.......... 01 MED CONCUSSION AGE >17 W CC .8412 3.7 5.4 28
32.......... 01 MED CONCUSSION AGE >17 W/O .4861 2.3 3.1 20
CC.
33.......... 01 MED *CONCUSSION AGE 0-17... .2037 1.6 1.6 9
34.......... 01 MED OTHER DISORDERS OF 1.0673 4.6 6.5 29
NERVOUS SYSTEM W CC.
35.......... 01 MED OTHER DISORDERS OF .6149 3.2 4.3 27
NERVOUS SYSTEM W/O CC.
36.......... 02 SURG RETINAL PROCEDURES..... .6134 1.3 1.6 6
37.......... 02 SURG ORBITAL PROCEDURES..... .9323 2.7 4.0 27
38.......... 02 SURG PRIMARY IRIS PROCEDURES .4282 1.9 2.6 17
39.......... 02 SURG LENS PROCEDURES WITH OR .5184 1.5 2.0 10
WITHOUT VITRECTOMY.
40.......... 02 SURG EXTRAOCULAR PROCEDURES .7072 2.2 3.4 26
EXCEPT ORBIT AGE >17.
41.......... 02 SURG *EXTRAOCULAR PROCEDURES .3299 1.6 1.6 7
EXCEPT ORBIT AGE 0-17.
[[Page 46267]]
42.......... 02 SURG INTRAOCULAR PROCEDURES .5816 1.6 2.2 13
EXCEPT RETINA, IRIS &
LENS.
43.......... 02 MED HYPHEMA................ .4520 3.3 4.2 27
44.......... 02 MED ACUTE MAJOR EYE .6237 4.7 5.7 29
INFECTIONS.
45.......... 02 MED NEUROLOGICAL EYE .6525 3.1 3.8 22
DISORDERS.
46.......... 02 MED OTHER DISORDERS OF THE .7656 4.0 5.6 28
EYE AGE >17 W CC.
47.......... 02 MED OTHER DISORDERS OF THE .4664 2.8 3.8 27
EYE AGE >17 W/O CC.
48.......... 02 MED *OTHER DISORDERS OF THE .2907 2.9 2.9 27
EYE AGE 0-17.
49.......... 03 SURG MAJOR HEAD & NECK 1.7245 4.1 5.7 28
PROCEDURES.
50.......... 03 SURG SIALOADENECTOMY........ .7686 1.7 2.1 9
51.......... 03 SURG SALIVARY GLAND .7345 1.9 2.9 20
PROCEDURES EXCEPT
SIALOADENECTOMY.
52.......... 03 SURG CLEFT LIP & PALATE 1.0271 2.1 3.4 24
REPAIR.
53.......... 03 SURG SINUS & MASTOID 1.0128 2.2 3.6 26
PROCEDURES AGE >17.
54.......... 03 SURG *SINUS & MASTOID .4712 3.2 3.2 22
PROCEDURES AGE 0-17.
55.......... 03 SURG MISCELLANEOUS EAR, .7880 2.0 3.0 22
NOSE, MOUTH & THROAT
PROCEDURES.
56.......... 03 SURG RHINOPLASTY............ .8283 2.1 2.7 18
57.......... 03 SURG T&A PROC, EXCEPT .9325 2.8 4.1 27
TONSILLECTOMY &/OR
ADENOIDECTOMY ONLY,
AGE >17.
58.......... 03 SURG *T&A PROC, EXCEPT .2676 1.5 1.5 4
TONSILLECTOMY &/OR
ADENOIDECTOMY ONLY,
AGE 0-17.
59.......... 03 SURG TONSILLECTOMY &/OR .7439 2.3 3.6 26
ADENOIDECTOMY ONLY,
AGE >17.
60.......... 03 SURG *TONSILLECTOMY &/OR .2038 1.5 1.5 4
ADENOIDECTOMY ONLY,
AGE 0-17.
61.......... 03 SURG MYRINGOTOMY W TUBE 1.1960 2.7 5.1 27
INSERTION AGE >17.
62.......... 03 SURG *MYRINGOTOMY W TUBE .2885 1.3 1.3 5
INSERTION AGE 0-17.
63.......... 03 SURG OTHER EAR, NOSE, MOUTH 1.2168 3.2 4.7 27
& THROAT O.R.
PROCEDURES.
64.......... 03 MED EAR, NOSE, MOUTH & 1.1737 4.8 7.6 29
THROAT MALIGNANCY.
65.......... 03 MED DYSEQUILIBRIUM......... .5195 2.7 3.4 20
66.......... 03 MED EPISTAXIS.............. .5366 2.9 3.6 21
67.......... 03 MED EPIGLOTTITIS........... .8397 3.4 4.2 24
68.......... 03 MED OTITIS MEDIA & URI AGE .7098 3.9 4.8 27
>17 W CC.
69.......... 03 MED OTITIS MEDIA & URI AGE .5239 3.1 3.8 20
>17 W/O CC.
70.......... 03 MED OTITIS MEDIA & URI AGE .3727 2.4 2.9 15
0-17.
71.......... 03 MED LARYNGOTRACHEITIS...... .7702 3.1 4.0 27
72.......... 03 MED NASAL TRAUMA & .6532 3.1 4.4 27
DEFORMITY.
73.......... 03 MED OTHER EAR, NOSE, MOUTH .7505 3.7 5.0 28
& THROAT DIAGNOSES AGE
>17.
74.......... 03 MED *OTHER EAR, NOSE, MOUTH .3278 2.1 2.1 20
& THROAT DIAGNOSES AGE
0-17.
75.......... 04 SURG MAJOR CHEST PROCEDURES. 3.1951 8.8 11.2 33
76.......... 04 SURG OTHER RESP SYSTEM O.R. 2.6036 9.1 12.5 33
PROCEDURES W CC.
77.......... 04 SURG OTHER RESP SYSTEM O.R. 1.1593 3.8 5.5 28
PROCEDURES W/O CC.
78.......... 04 MED PULMONARY EMBOLISM..... 1.4292 7.0 8.3 31
79.......... 04 MED RESPIRATORY INFECTIONS 1.6300 7.2 9.3 31
& INFLAMMATIONS AGE
>17 W CC.
80.......... 04 MED RESPIRATORY INFECTIONS .9436 5.3 6.6 29
& INFLAMMATIONS AGE
>17 W/O CC.
81.......... 04 MED RESPIRATORY INFECTIONS 1.4845 6.3 7.8 30
& INFLAMMATIONS AGE 0-
17.
82.......... 04 MED RESPIRATORY NEOPLASMS.. 1.3319 5.7 7.9 30
83.......... 04 MED MAJOR CHEST TRAUMA W CC .9782 4.9 6.4 29
84.......... 04 MED MAJOR CHEST TRAUMA W/O .5319 2.9 3.7 23
CC.
85.......... 04 MED PLEURAL EFFUSION W CC.. 1.2200 5.6 7.4 30
86.......... 04 MED PLEURAL EFFUSION W/O CC .7117 3.4 4.5 27
87.......... 04 MED PULMONARY EDEMA & 1.3615 5.1 6.9 29
RESPIRATORY FAILURE.
88.......... 04 MED CHRONIC OBSTRUCTIVE .9846 4.9 6.1 29
PULMONARY DISEASE.
89.......... 04 MED SIMPLE PNEUMONIA & 1.1156 5.8 7.1 30
PLEURISY AGE >17 W CC.
90.......... 04 MED SIMPLE PNEUMONIA & .6978 4.3 5.1 24
PLEURISY AGE >17 W/O
CC.
91.......... 04 MED SIMPLE PNEUMONIA & .7524 3.5 4.5 27
PLEURISY AGE 0-17.
92.......... 04 MED INTERSTITIAL LUNG 1.2029 5.6 7.3 30
DISEASE W CC.
93.......... 04 MED INTERSTITIAL LUNG .7498 4.0 4.9 28
DISEASE W/O CC.
94.......... 04 MED PNEUMOTHORAX W CC...... 1.1780 5.3 7.1 29
95.......... 04 MED PNEUMOTHORAX W/O CC.... .5996 3.3 4.1 25
96.......... 04 MED BRONCHITIS & ASTHMA AGE .8272 4.5 5.5 29
>17 W CC.
97.......... 04 MED BRONCHITIS & ASTHMA AGE .6035 3.6 4.3 22
>17 W/O CC.
98.......... 04 MED BRONCHITIS & ASTHMA AGE .7807 2.9 4.3 27
0-17.
[[Page 46268]]
99.......... 04 MED RESPIRATORY SIGNS & .6869 2.7 3.5 22
SYMPTOMS W CC.
100......... 04 MED RESPIRATORY SIGNS & .5113 2.0 2.4 12
SYMPTOMS W/O CC.
101......... 04 MED OTHER RESPIRATORY .8748 3.9 5.2 28
SYSTEM DIAGNOSES W CC.
102......... 04 MED OTHER RESPIRATORY .5335 2.4 3.1 20
SYSTEM DIAGNOSES W/O
CC.
103......... 05 SURG HEART TRANSPLANT....... 15.3358 28.4 40.0 52
104......... 05 SURG CARDIAC VALVE 7.3199 12.0 14.6 36
PROCEDURES W CARDIAC
CATH.
105......... 05 SURG CARDIAC VALVE 5.5998 9.0 11.0 33
PROCEDURES W/O CARDIAC
CATH.
106......... 05 SURG CORONARY BYPASS W 5.5564 10.3 11.7 34
CARDIAC CATH.
107......... 05 SURG CORONARY BYPASS W/O 4.0685 7.8 8.8 32
CARDIAC CATH.
108......... 05 SURG OTHER CARDIOTHORACIC 5.9135 9.8 12.6 34
PROCEDURES.
109......... ................ NO LONGER VALID........ .0000 .0 .0 0
110......... 05 SURG MAJOR CARDIOVASCULAR 4.1589 8.2 10.9 32
PROCEDURES W CC.
111......... 05 SURG MAJOR CARDIOVASCULAR 2.2875 5.9 6.7 30
PROCEDURES W/O CC.
112......... 05 SURG PERCUTANEOUS 2.0946 3.5 4.7 27
CARDIOVASCULAR
PROCEDURES.
113......... 05 SURG AMPUTATION FOR CIRC 2.6935 10.6 14.4 35
SYSTEM DISORDERS
EXCEPT UPPER LIMB &
TOE.
114......... 05 SURG UPPER LIMB & TOE 1.5152 6.8 9.5 31
AMPUTATION FOR CIRC
SYSTEM DISORDERS.
115......... 05 SURG PERM CARDIAC PACEMAKER 3.6827 9.1 11.5 33
IMPLANT W AMI, HEART
FAILURE OR SHOCK.
116......... 05 SURG OTH PERM CARDIAC 2.4150 3.9 5.4 28
PACEMAKER IMPLANT OR
AICD LEAD OR GENERATOR
PROC.
117......... 05 SURG CARDIAC PACEMAKER 1.1764 2.7 4.1 27
REVISION EXCEPT DEVICE
REPLACEMENT.
118......... 05 SURG CARDIAC PACEMAKER 1.5825 2.1 3.2 25
DEVICE REPLACEMENT.
119......... 05 SURG VEIN LIGATION & 1.1435 3.3 5.5 27
STRIPPING.
120......... 05 SURG OTHER CIRCULATORY 1.9318 5.4 9.2 29
SYSTEM O.R. PROCEDURES.
121......... 05 MED CIRCULATORY DISORDERS W 1.6482 6.4 7.8 30
AMI & C.V. COMP DISCH
ALIVE.
122......... 05 MED CIRCULATORY DISORDERS W 1.1617 4.4 5.3 28
AMI W/O C.V. COMP
DISCH ALIVE.
123......... 05 MED CIRCULATORY DISORDERS W 1.4555 2.7 4.7 27
AMI, EXPIRED.
124......... 05 MED CIRCULATORY DISORDERS 1.3258 3.8 5.0 28
EXCEPT AMI, W CARD
CATH & COMPLEX DIAG.
125......... 05 MED CIRCULATORY DISORDERS .9246 2.3 3.1 20
EXCEPT AMI, W CARD
CATH W/O COMPLEX DIAG.
126......... 05 MED ACUTE & SUBACUTE 2.5379 11.0 14.3 35
ENDOCARDITIS.
127......... 05 MED HEART FAILURE & SHOCK.. 1.0265 4.8 6.2 29
128......... 05 MED DEEP VEIN .7861 5.9 6.7 27
THROMBOPHLEBITIS.
129......... 05 MED CARDIAC ARREST, 1.1316 2.0 3.5 26
UNEXPLAINED.
130......... 05 MED PERIPHERAL VASCULAR .9352 5.3 6.7 29
DISORDERS W CC.
131......... 05 MED PERIPHERAL VASCULAR .6038 4.3 5.2 28
DISORDERS W/O CC.
132......... 05 MED ATHEROSCLEROSIS W CC... .6840 2.9 3.6 20
133......... 05 MED ATHEROSCLEROSIS W/O CC. .5537 2.3 2.9 16
134......... 05 MED HYPERTENSION........... .5787 3.0 3.9 23
135......... 05 MED CARDIAC CONGENITAL & .8838 3.7 5.0 28
VALVULAR DISORDERS AGE
>17 W CC.
136......... 05 MED CARDIAC CONGENITAL & .5629 2.6 3.3 18
VALVULAR DISORDERS AGE
>17 W/O CC.
137......... 05 MED *CARDIAC CONGENITAL & .7999 3.3 3.3 27
VALVULAR DISORDERS AGE
0-17.
138......... 05 MED CARDIAC ARRHYTHMIA & .8008 3.5 4.6 27
CONDUCTION DISORDERS W
CC.
139......... 05 MED CARDIAC ARRHYTHMIA & .4971 2.4 2.9 16
CONDUCTION DISORDERS W/
O CC.
140......... 05 MED ANGINA PECTORIS........ .6205 2.8 3.5 20
141......... 05 MED SYNCOPE & COLLAPSE W CC .7128 3.4 4.5 27
142......... 05 MED SYNCOPE & COLLAPSE W/O .5288 2.5 3.2 18
CC.
143......... 05 MED CHEST PAIN............. .5223 2.1 2.6 14
144......... 05 MED OTHER CIRCULATORY 1.0857 4.1 5.7 28
SYSTEM DIAGNOSES W CC.
145......... 05 MED OTHER CIRCULATORY .6208 2.5 3.2 20
SYSTEM DIAGNOSES W/O
CC.
146......... 06 SURG RECTAL RESECTION W CC.. 2.6363 9.8 11.2 34
147......... 06 SURG RECTAL RESECTION W/O CC 1.6018 6.7 7.3 27
148......... 06 SURG MAJOR SMALL & LARGE 3.3710 11.2 13.5 35
BOWEL PROCEDURES W CC.
149......... 06 SURG MAJOR SMALL & LARGE 1.5999 7.0 7.7 25
BOWEL PROCEDURES W/O
CC.
150......... 06 SURG PERITONEAL ADHESIOLYSIS 2.6828 9.5 11.7 34
W CC.
151......... 06 SURG PERITONEAL ADHESIOLYSIS 1.2910 5.2 6.5 29
W/O CC.
152......... 06 SURG MINOR SMALL & LARGE 1.9311 7.6 9.0 32
BOWEL PROCEDURES W CC.
[[Page 46269]]
153......... 06 SURG MINOR SMALL & LARGE 1.1568 5.6 6.2 24
BOWEL PROCEDURES W/O
CC.
154......... 06 SURG *STOMACH, ESOPHAGEAL & 4.1817 11.6 15.0 36
DUODENAL PROCEDURES
AGE >17 W CC.
155......... 06 SURG STOMACH, ESOPHAGEAL & 1.4059 4.5 5.9 29
DUODENAL PROCEDURES
AGE >17 W/O CC.
156......... 06 SURG *STOMACH, ESOPHAGEAL & .8238 6.0 6.0 30
DUODENAL PROCEDURES
AGE 0-17.
157......... 06 SURG ANAL & STOMAL 1.1352 4.2 5.8 28
PROCEDURES W CC.
158......... 06 SURG ANAL & STOMAL .6077 2.3 2.9 18
PROCEDURES W/O CC.
159......... 06 SURG HERNIA PROCEDURES 1.2268 4.0 5.3 28
EXCEPT INGUINAL &
FEMORAL AGE >17 W CC.
160......... 06 SURG HERNIA PROCEDURES .7026 2.4 3.0 16
EXCEPT INGUINAL &
FEMORAL AGE >17 W/O CC.
161......... 06 SURG INGUINAL & FEMORAL 1.0066 3.0 4.4 27
HERNIA PROCEDURES AGE
>17 W CC.
162......... 06 SURG INGUINAL & FEMORAL .5707 1.7 2.2 11
HERNIA PROCEDURES AGE
>17 W/O CC.
163......... 06 SURG *HERNIA PROCEDURES AGE .7706 2.1 2.1 11
0-17.
164......... 06 SURG APPENDECTOMY W 2.3386 8.0 9.4 32
COMPLICATED PRINCIPAL
DIAG W CC.
165......... 06 SURG APPENDECTOMY W 1.2582 5.1 5.8 24
COMPLICATED PRINCIPAL
DIAG W/O CC.
166......... 06 SURG APPENDECTOMY W/O 1.4497 4.5 5.7 29
COMPLICATED PRINCIPAL
DIAG W CC.
167......... 06 SURG APPENDECTOMY W/O .8431 2.8 3.2 15
COMPLICATED PRINCIPAL
DIAG W/O CC.
168......... 03 SURG MOUTH PROCEDURES W CC.. 1.0929 3.2 5.0 27
169......... 03 SURG MOUTH PROCEDURES W/O CC .6717 2.0 2.5 15
170......... 06 SURG OTHER DIGESTIVE SYSTEM 2.7453 8.5 12.5 33
O.R. PROCEDURES W CC.
171......... 06 SURG OTHER DIGESTIVE SYSTEM 1.1202 4.0 5.4 28
O.R. PROCEDURES W/O CC.
172......... 06 MED DIGESTIVE MALIGNANCY W 1.2920 5.7 8.2 30
CC.
173......... 06 MED DIGESTIVE MALIGNANCY W/ .6769 3.0 4.4 27
O CC.
174......... 06 MED G.I. HEMORRHAGE W CC... .9952 4.4 5.6 28
175......... 06 MED G.I. HEMORRHAGE W/O CC. .5485 2.9 3.5 17
176......... 06 MED COMPLICATED PEPTIC 1.0856 4.7 6.2 29
ULCER.
177......... 06 MED UNCOMPLICATED PEPTIC .8335 4.0 5.0 28
ULCER W CC.
178......... 06 MED UNCOMPLICATED PEPTIC .6091 3.0 3.6 19
ULCER W/O CC.
179......... 06 MED INFLAMMATORY BOWEL 1.1188 5.5 7.2 30
DISEASE.
180......... 06 MED G.I. OBSTRUCTION W CC.. .9194 4.7 6.1 29
181......... 06 MED G.I. OBSTRUCTION W/O CC .5338 3.3 4.0 22
182......... 06 MED ESOPHAGITIS, GASTROENT .7789 3.8 5.0 28
& MISC DIGEST
DISORDERS AGE >17 W CC.
183......... 06 MED ESOPHAGITIS, GASTROENT .5553 2.8 3.4 20
& MISC DIGEST
DISORDERS AGE >17 W/O
CC.
184......... 06 MED ESOPHAGITIS, GASTROENT .5414 2.8 3.9 27
& MISC DIGEST
DISORDERS AGE 0-17.
185......... 03 MED DENTAL & ORAL DIS .8424 3.7 5.2 28
EXCEPT EXTRACTIONS &
RESTORATIONS, AGE >17.
186......... 03 MED *DENTAL & ORAL DIS .3140 2.9 2.9 23
EXCEPT EXTRACTIONS &
RESTORATIONS, AGE 0-17.
187......... 03 MED DENTAL EXTRACTIONS & .7104 3.1 4.2 27
RESTORATIONS.
188......... 06 MED OTHER DIGESTIVE SYSTEM 1.0591 4.5 6.1 28
DIAGNOSES AGE >17 W CC.
189......... 06 MED OTHER DIGESTIVE SYSTEM .5640 2.7 3.7 27
DIAGNOSES AGE >17 W/O
CC.
190......... 06 MED OTHER DIGESTIVE SYSTEM .8769 3.9 5.1 28
DIAGNOSES AGE 0-17.
191......... 07 SURG PANCREAS, LIVER & SHUNT 4.4543 12.1 16.3 36
PROCEDURES W CC.
192......... 07 SURG PANCREAS, LIVER & SHUNT 1.7889 6.2 7.9 30
PROCEDURES W/O CC.
193......... 07 SURG BILIARY TRACT PROC 3.2878 11.4 13.9 35
EXCEPT ONLY CHOLECYST
W OR W/O C.D.E. W CC.
194......... 07 SURG BILIARY TRACT PROC 1.7549 6.8 8.5 31
EXCEPT ONLY CHOLECYST
W OR W/O C.D.E. W/O CC.
195......... 07 SURG CHOLECYSTECTOMY W 2.6894 8.8 10.5 33
C.D.E. W CC.
196......... 07 SURG CHOLECYSTECTOMY W 1.6127 5.8 6.7 30
C.D.E. W/O CC.
197......... 07 SURG CHOLECYSTECTOMY EXCEPT 2.2679 7.5 9.2 31
BY LAPAROSCOPE W/O
C.D.E. W CC.
198......... 07 SURG CHOLECYSTECTOMY EXCEPT 1.1738 4.3 4.9 23
BY LAPAROSCOPE W/O
C.D.E. W/O CC.
[[Page 46270]]
199......... 07 SURG HEPATOBILIARY 2.3728 8.4 11.2 32
DIAGNOSTIC PROCEDURE
FOR MALIGNANCY.
200......... 07 SURG HEPATOBILIARY 3.1772 7.9 12.4 32
DIAGNOSTIC PROCEDURE
FOR NON-MALIGNANCY.
201......... 07 SURG OTHER HEPATOBILIARY OR 3.7669 12.1 16.8 36
PANCREAS O.R.
PROCEDURES.
202......... 07 MED CIRRHOSIS & ALCOHOLIC 1.3675 5.7 7.8 30
HEPATITIS.
203......... 07 MED MALIGNANCY OF 1.2486 5.5 7.7 30
HEPATOBILIARY SYSTEM
OR PANCREAS.
204......... 07 MED DISORDERS OF PANCREAS 1.2004 5.1 6.8 29
EXCEPT MALIGNANCY.
205......... 07 MED DISORDERS OF LIVER 1.2194 5.3 7.3 29
EXCEPT MALIG, CIRR,
ALC HEPA W CC.
206......... 07 MED DISORDERS OF LIVER .7159 3.6 4.7 28
EXCEPT MALIG, CIRR,
ALC HEPA W/O CC.
207......... 07 MED DISORDERS OF THE 1.0508 4.4 5.8 28
BILIARY TRACT W CC.
208......... 07 MED DISORDERS OF THE .6045 2.6 3.5 21
BILIARY TRACT W/O CC.
209......... 08 SURG MAJOR JOINT & LIMB 2.2606 5.9 6.7 23
REATTACHMENT
PROCEDURES OF LOWER
EXTREMITY.
210......... 08 SURG HIP & FEMUR PROCEDURES 1.8460 7.2 8.6 31
EXCEPT MAJOR JOINT AGE
>17 W CC.
211......... 08 SURG HIP & FEMUR PROCEDURES 1.2740 5.6 6.3 23
EXCEPT MAJOR JOINT AGE
>17 W/O CC.
212......... 08 SURG *HIP & FEMUR PROCEDURES 1.1487 11.1 11.1 35
EXCEPT MAJOR JOINT AGE
0-17.
213......... 08 SURG AMPUTATION FOR 1.7049 7.0 9.7 31
MUSCULOSKELETAL SYSTEM
& CONN TISSUE
DISORDERS.
214......... 08 SURG BACK & NECK PROCEDURES 1.9255 4.9 6.5 29
W CC.
215......... 08 SURG BACK & NECK PROCEDURES 1.1119 3.0 3.7 20
W/O CC.
216......... 08 SURG BIOPSIES OF 2.0784 7.9 11.1 32
MUSCULOSKELETAL SYSTEM
& CONNECTIVE TISSUE.
217......... 08 SURG WND DEBRID & SKN GRFT 2.8812 10.2 15.4 34
EXCEPT HAND, FOR
MUSCSKELET & CONN TISS
DIS.
218......... 08 SURG LOWER EXTREM & HUMER 1.4574 4.8 6.2 29
PROC EXCEPT HIP, FOOT,
FEMUR AGE >17 W CC.
219......... 08 SURG LOWER EXTREM & HUMER .9553 3.1 3.8 19
PROC EXCEPT HIP, FOOT,
FEMUR AGE >17 W/O CC.
220......... 08 SURG *LOWER EXTREM & HUMER .5706 5.3 5.3 29
PROC EXCEPT HIP, FOOT,
FEMUR AGE 0-17.
221......... 08 SURG KNEE PROCEDURES W CC... 1.8340 5.8 8.1 30
222......... 08 SURG KNEE PROCEDURES W/O CC. 1.0177 3.1 4.0 27
223......... 08 SURG MAJOR SHOULDER/ELBOW .8720 2.2 2.9 16
PROC, OR OTHER UPPER
EXTREMITY PROC W CC.
224......... 08 SURG SHOULDER, ELBOW OR .7417 1.9 2.3 10
FOREARM PROC, EXC
MAJOR JOINT PROC, W/O
CC.
225......... 08 SURG FOOT PROCEDURES........ 1.0020 3.3 5.0 27
226......... 08 SURG SOFT TISSUE PROCEDURES 1.3831 4.4 6.7 28
W CC.
227......... 08 SURG SOFT TISSUE PROCEDURES .7449 2.3 3.0 18
W/O CC.
228......... 08 SURG MAJOR THUMB OR JOINT .9349 2.3 3.5 26
PROC, OR OTH HAND OR
WRIST PROC W CC.
229......... 08 SURG HAND OR WRIST PROC, .6512 1.8 2.4 13
EXCEPT MAJOR JOINT
PROC, W/O CC.
230......... 08 SURG LOCAL EXCISION & 1.0567 3.3 5.2 27
REMOVAL OF INT FIX
DEVICES OF HIP & FEMUR.
231......... 08 SURG LOCAL EXCISION & 1.2263 3.3 5.1 27
REMOVAL OF INT FIX
DEVICES EXCEPT HIP &
FEMUR.
232......... 08 SURG ARTHROSCOPY............ 1.0884 2.6 4.5 27
233......... 08 SURG OTHER MUSCULOSKELET SYS 2.0170 6.4 9.1 30
& CONN TISS O.R. PROC
W CC.
234......... 08 SURG OTHER MUSCULOSKELET SYS 1.0675 3.1 4.1 27
& CONN TISS O.R. PROC
W/O CC.
235......... 08 MED FRACTURES OF FEMUR..... .8395 4.7 6.9 29
236......... 08 MED FRACTURES OF HIP & .7620 4.7 6.4 29
PELVIS.
237......... 08 MED SPRAINS, STRAINS, & .5637 3.3 4.4 27
DISLOCATIONS OF HIP,
PELVIS & THIGH.
238......... 08 MED OSTEOMYELITIS.......... 1.3796 7.6 10.1 32
239......... 08 MED PATHOLOGICAL FRACTURES 1.0115 5.8 7.6 30
& MUSCULOSKELETAL &
CONN TISS MALIGNANCY.
240......... 08 MED CONNECTIVE TISSUE 1.2112 5.5 7.5 30
DISORDERS W CC.
241......... 08 MED CONNECTIVE TISSUE .6029 3.5 4.6 28
DISORDERS W/O CC.
242......... 08 MED SEPTIC ARTHRITIS....... 1.0492 5.8 7.7 30
[[Page 46271]]
243......... 08 MED MEDICAL BACK PROBLEMS.. .7241 4.3 5.6 28
244......... 08 MED BONE DISEASES & .7279 4.3 5.8 28
SPECIFIC ARTHROPATHIES
W CC.
245......... 08 MED BONE DISEASES & .4954 3.2 4.3 27
SPECIFIC ARTHROPATHIES
W/O CC.
246......... 08 MED NON-SPECIFIC .5887 3.6 4.6 28
ARTHROPATHIES.
247......... 08 MED SIGNS & SYMPTOMS OF .5523 2.9 4.0 27
MUSCULOSKELETAL SYSTEM
& CONN TISSUE.
248......... 08 MED TENDONITIS, MYOSITIS & .7325 3.9 5.3 28
BURSITIS.
249......... 08 MED AFTERCARE, .6522 2.9 4.3 27
MUSCULOSKELETAL SYSTEM
& CONNECTIVE TISSUE.
250......... 08 MED FX, SPRN, STRN & DISL .6915 3.6 5.1 28
OF FOREARM, HAND, FOOT
AGE >17 W CC.
251......... 08 MED FX, SPRN, STRN & DISL .4640 2.5 3.3 22
OF FOREARM, HAND, FOOT
AGE >17 W/O CC.
252......... 08 MED *FX, SPRN, STRN & DISL .2479 1.8 1.8 15
OF FOREARM, HAND, FOOT
AGE 0-17.
253......... 08 MED FX, SPRN, STRN & DISL .7438 4.3 5.8 28
OF UPARM, LOWLEG EX
FOOT AGE >17 W CC.
254......... 08 MED FX, SPRN, STRN & DISL .4451 2.9 3.9 25
OF UPARM, LOWLEG EX
FOOT AGE >17 W/O CC.
255......... 08 MED *FX, SPRN, STRN & DISL .2886 2.9 2.9 27
OF UPARM, LOWLEG EX
FOOT AGE 0-17.
256......... 08 MED OTHER MUSCULOSKELETAL .7651 4.0 5.7 28
SYSTEM & CONNECTIVE
TISSUE DIAGNOSES.
257......... 09 SURG TOTAL MASTECTOMY FOR .9015 2.8 3.4 17
MALIGNANCY W CC.
258......... 09 SURG TOTAL MASTECTOMY FOR .7087 2.2 2.5 10
MALIGNANCY W/O CC.
259......... 09 SURG SUBTOTAL MASTECTOMY FOR .8640 2.3 3.5 26
MALIGNANCY W CC.
260......... 09 SURG SUBTOTAL MASTECTOMY FOR .6083 1.6 1.9 8
MALIGNANCY W/O CC.
261......... 09 SURG BREAST PROC FOR NON- .8286 1.9 2.3 12
MALIGNANCY EXCEPT
BIOPSY & LOCAL
EXCISION.
262......... 09 SURG BREAST BIOPSY & LOCAL .7695 2.7 3.9 27
EXCISION FOR NON-
MALIGNANCY.
263......... 09 SURG SKIN GRAFT &/OR DEBRID 2.1226 9.9 13.9 34
FOR SKIN ULCER OR
CELLULITIS W CC.
264......... 09 SURG SKIN GRAFT &/OR DEBRID 1.1270 6.0 8.3 30
FOR SKIN ULCER OR
CELLULITIS W/O CC.
265......... 09 SURG SKIN GRAFT &/OR DEBRID 1.4993 4.8 7.7 29
EXCEPT FOR SKIN ULCER
OR CELLULITIS W CC.
266......... 09 SURG SKIN GRAFT &/OR DEBRID .7629 2.7 3.7 27
EXCEPT FOR SKIN ULCER
OR CELLULITIS W/O CC.
267......... 09 SURG PERIANAL & PILONIDAL .8330 2.8 4.3 27
PROCEDURES.
268......... 09 SURG SKIN, SUBCUTANEOUS .9916 2.5 4.1 27
TISSUE & BREAST
PLASTIC PROCEDURES.
269......... 09 SURG OTHER SKIN, SUBCUT TISS 1.6416 6.3 9.3 30
& BREAST PROC W CC.
270......... 09 SURG OTHER SKIN, SUBCUT TISS .7003 2.4 3.4 26
& BREAST PROC W/O CC.
271......... 09 MED SKIN ULCERS............ 1.0816 6.6 8.5 31
272......... 09 MED MAJOR SKIN DISORDERS W 1.0158 5.6 7.5 30
CC.
273......... 09 MED MAJOR SKIN DISORDERS W/ .6346 4.1 5.5 28
O CC.
274......... 09 MED MALIGNANT BREAST 1.0760 5.3 7.9 29
DISORDERS W CC.
275......... 09 MED MALIGNANT BREAST .5085 2.5 3.7 27
DISORDERS W/O CC.
276......... 09 MED NON-MALIGNANT BREAST .6374 3.9 5.0 28
DISORDERS.
277......... 09 MED CELLULITIS AGE >17 W CC .8526 5.5 6.7 29
278......... 09 MED CELLULITIS AGE >17 W/O .5774 4.3 5.2 25
CC.
279......... 09 MED *CELLULITIS AGE 0-17... .7190 4.2 4.2 24
280......... 09 MED TRAUMA TO THE SKIN, .6750 3.7 5.1 28
SUBCUT TISS & BREAST
AGE >17 W CC.
281......... 09 MED TRAUMA TO THE SKIN, .4560 2.7 3.6 24
SUBCUT TISS & BREAST
AGE >17 W/O CC.
282......... 09 MED *TRAUMA TO THE SKIN, .2509 2.2 2.2 19
SUBCUT TISS & BREAST
AGE 0-17.
283......... 09 MED MINOR SKIN DISORDERS W .6990 4.1 5.5 28
CC.
284......... 09 MED MINOR SKIN DISORDERS W/ .4340 2.9 3.8 26
O CC.
285......... 10 SURG AMPUTAT OF LOWER LIMB 2.2015 9.5 13.7 34
FOR ENDOCRINE, NUTRIT,
& METABOL DISORDERS.
286......... 10 SURG ADRENAL & PITUITARY 2.3775 6.6 8.7 31
PROCEDURES.
287......... 10 SURG SKIN GRAFTS & WOUND 1.9765 9.4 13.4 33
DEBRID FOR ENDOC,
NUTRIT & METAB
DISORDERS.
288......... 10 SURG O.R. PROCEDURES FOR 2.0104 5.2 6.9 29
OBESITY.
289......... 10 SURG PARATHYROID PROCEDURES. 1.0198 2.7 4.0 27
290......... 10 SURG THYROID PROCEDURES..... .8798 2.1 2.8 15
[[Page 46272]]
291......... 10 SURG THYROGLOSSAL PROCEDURES .5189 1.4 1.8 8
292......... 10 SURG OTHER ENDOCRINE, NUTRIT 2.6450 8.4 12.8 32
& METAB O.R. PROC W CC.
293......... 10 SURG OTHER ENDOCRINE, NUTRIT 1.2671 4.6 6.8 29
& METAB O.R. PROC W/O
CC.
294......... 10 MED DIABETES AGE >35....... .7594 4.3 5.7 28
295......... 10 MED DIABETES AGE 0-35...... .7159 3.3 4.3 27
296......... 10 MED NUTRITIONAL & MISC .8929 4.7 6.4 29
METABOLIC DISORDERS
AGE >17 W CC.
297......... 10 MED NUTRITIONAL & MISC .5364 3.3 4.3 26
METABOLIC DISORDERS
AGE >17 W/O CC.
298......... 10 MED NUTRITIONAL & MISC .5221 2.5 3.4 23
METABOLIC DISORDERS
AGE 0-17.
299......... 10 MED INBORN ERRORS OF .8330 3.9 5.4 28
METABOLISM.
300......... 10 MED ENDOCRINE DISORDERS W 1.0950 5.5 7.3 30
CC.
301......... 10 MED ENDOCRINE DISORDERS W/O .6182 3.4 4.4 27
CC.
302......... 11 SURG KIDNEY TRANSPLANT...... 3.9047 10.4 12.3 34
303......... 11 SURG KIDNEY, URETER & MAJOR 2.6409 8.4 10.2 32
BLADDER PROCEDURES FOR
NEOPLASM.
304......... 11 SURG KIDNEY, URETER & MAJOR 2.3716 7.5 10.3 31
BLADDER PROC FOR NON-
NEOPL W CC.
305......... 11 SURG KIDNEY, URETER & MAJOR 1.1776 3.9 4.9 28
BLADDER PROC FOR NON-
NEOPL W/O CC.
306......... 11 SURG PROSTATECTOMY W CC..... 1.2258 4.3 6.2 28
307......... 11 SURG PROSTATECTOMY W/O CC... .6708 2.4 3.0 15
308......... 11 SURG MINOR BLADDER 1.5252 4.7 7.0 29
PROCEDURES W CC.
309......... 11 SURG MINOR BLADDER .8860 2.3 3.0 18
PROCEDURES W/O CC.
310......... 11 SURG TRANSURETHRAL 1.0015 3.2 4.6 27
PROCEDURES W CC.
311......... 11 SURG TRANSURETHRAL .5670 1.8 2.2 11
PROCEDURES W/O CC.
312......... 11 SURG URETHRAL PROCEDURES, .9124 3.2 4.8 27
AGE >17 W CC.
313......... 11 SURG URETHRAL PROCEDURES, .5223 1.8 2.3 13
AGE >17 W/O CC.
314......... 11 SURG *URETHRAL PROCEDURES, .4836 2.3 2.3 26
AGE 0-17.
315......... 11 SURG OTHER KIDNEY & URINARY 2.0574 5.3 9.3 29
TRACT O.R. PROCEDURES.
316......... 11 MED RENAL FAILURE.......... 1.3034 5.4 7.6 29
317......... 11 MED ADMIT FOR RENAL .4845 1.9 2.9 20
DIALYSIS.
318......... 11 MED KIDNEY & URINARY TRACT 1.1296 5.0 7.2 29
NEOPLASMS W CC.
319......... 11 MED KIDNEY & URINARY TRACT .5772 2.3 3.2 24
NEOPLASMS W/O CC.
320......... 11 MED KIDNEY & URINARY TRACT .9048 5.1 6.4 29
INFECTIONS AGE >17 W
CC.
321......... 11 MED KIDNEY & URINARY TRACT .6077 3.9 4.7 24
INFECTIONS AGE >17 W/O
CC.
322......... 11 MED KIDNEY & URINARY TRACT .5133 3.6 4.4 23
INFECTIONS AGE 0-17.
323......... 11 MED URINARY STONES W CC, &/ .7496 2.7 3.6 24
OR ESW LITHOTRIPSY.
324......... 11 MED URINARY STONES W/O CC.. .4159 1.7 2.1 10
325......... 11 MED KIDNEY & URINARY TRACT .6377 3.4 4.6 27
SIGNS & SYMPTOMS AGE
>17 W CC.
326......... 11 MED KIDNEY & URINARY TRACT .4320 2.4 3.4 19
SIGNS & SYMPTOMS AGE
>17 W/O CC.
327......... 11 MED *KIDNEY & URINARY TRACT .2341 3.1 3.1 27
SIGNS & SYMPTOMS AGE 0-
17.
328......... 11 MED URETHRAL STRICTURE AGE .6886 3.1 4.3 27
>17 W CC.
329......... 11 MED URETHRAL STRICTURE AGE .4567 2.1 2.8 17
>17 W/O CC.
330......... 11 MED *URETHRAL STRICTURE AGE .3115 1.6 1.6 9
0-17.
331......... 11 MED OTHER KIDNEY & URINARY .9914 4.6 6.2 29
TRACT DIAGNOSES AGE
>17 W CC.
332......... 11 MED OTHER KIDNEY & URINARY .6070 2.8 3.9 27
TRACT DIAGNOSES AGE
>17 W/O CC.
333......... 11 MED OTHER KIDNEY & URINARY .8562 4.3 5.8 28
TRACT DIAGNOSES AGE 0-
17.
334......... 12 SURG MAJOR MALE PELVIC 1.6653 5.3 6.1 23
PROCEDURES W CC.
335......... 12 SURG MAJOR MALE PELVIC 1.2610 4.2 4.6 17
PROCEDURES W/O CC.
336......... 12 SURG TRANSURETHRAL .8848 3.2 4.1 24
PROSTATECTOMY W CC.
337......... 12 SURG TRANSURETHRAL .6147 2.3 2.7 11
PROSTATECTOMY W/O CC.
338......... 12 SURG TESTES PROCEDURES, FOR 1.0499 3.5 5.3 27
MALIGNANCY.
339......... 12 SURG TESTES PROCEDURES, NON- 1.0194 3.1 5.3 27
MALIGNANCY AGE >17.
340......... 12 SURG *TESTES PROCEDURES, NON- .2769 2.4 2.4 13
MALIGNANCY AGE 0-17.
341......... 12 SURG PENIS PROCEDURES....... 1.0745 2.3 3.3 21
342......... 12 SURG CIRCUMCISION AGE >17... .7578 2.7 4.0 27
343......... 12 SURG *CIRCUMCISION AGE 0-17. .1504 1.7 1.7 6
[[Page 46273]]
344......... 12 SURG OTHER MALE REPRODUCTIVE 1.0083 2.3 3.5 25
SYSTEM O.R. PROCEDURES
FOR MALIGNANCY.
345......... 12 SURG OTHER MALE REPRODUCTIVE .8422 2.8 4.0 27
SYSTEM O.R. PROC
EXCEPT FOR MALIGNANCY.
346......... 12 MED MALIGNANCY, MALE .9559 4.8 6.8 29
REPRODUCTIVE SYSTEM, W
CC.
347......... 12 MED MALIGNANCY, MALE .5096 2.4 3.3 25
REPRODUCTIVE SYSTEM, W/
O CC.
348......... 12 MED BENIGN PROSTATIC .7107 3.6 4.9 28
HYPERTROPHY W CC.
349......... 12 MED BENIGN PROSTATIC .3974 2.2 3.0 20
HYPERTROPHY W/O CC.
350......... 12 MED INFLAMMATION OF THE .6611 3.9 4.8 24
MALE REPRODUCTIVE
SYSTEM.
351......... 12 MED *STERILIZATION, MALE... .2309 1.3 1.3 5
352......... 12 MED OTHER MALE REPRODUCTIVE .5877 2.8 3.9 27
SYSTEM DIAGNOSES.
353......... 13 SURG PELVIC EVISCERATION, 1.9174 6.7 8.3 31
RADICAL HYSTERECTOMY &
RADICAL VULVECTOMY.
354......... 13 SURG UTERINE, ADNEXA PROC 1.4643 5.2 6.3 28
FOR NON-OVARIAN/
ADNEXAL MALIG W CC.
355......... 13 SURG UTERINE, ADNEXA PROC .9056 3.6 3.9 11
FOR NON-OVARIAN/
ADNEXAL MALIG W/O CC.
356......... 13 SURG FEMALE REPRODUCTIVE .7376 2.6 3.0 12
SYSTEM RECONSTRUCTIVE
PROCEDURES.
357......... 13 SURG UTERINE & ADNEXA PROC 2.3824 8.0 9.8 32
FOR OVARIAN OR ADNEXAL
MALIGNANCY.
358......... 13 SURG UTERINE & ADNEXA PROC 1.1713 4.1 4.8 19
FOR NON-MALIGNANCY W
CC.
359......... 13 SURG UTERINE & ADNEXA PROC .8285 3.0 3.3 10
FOR NON-MALIGNANCY W/O
CC.
360......... 13 SURG VAGINA, CERVIX & VULVA .8459 2.9 3.5 17
PROCEDURES.
361......... 13 SURG LAPAROSCOPY & 1.1148 2.5 3.5 23
INCISIONAL TUBAL
INTERRUPTION.
362......... 13 SURG *ENDOSCOPIC TUBAL .2951 1.4 1.4 5
INTERRUPTION.
363......... 13 SURG D&C, CONIZATION & RADIO- .6911 2.6 3.5 21
IMPLANT, FOR
MALIGNANCY.
364......... 13 SURG D&C, CONIZATION EXCEPT .6739 2.6 3.6 27
FOR MALIGNANCY.
365......... 13 SURG OTHER FEMALE 1.7237 5.3 8.1 29
REPRODUCTIVE SYSTEM
O.R. PROCEDURES.
366......... 13 MED MALIGNANCY, FEMALE 1.1941 5.3 7.8 29
REPRODUCTIVE SYSTEM W
CC.
367......... 13 MED MALIGNANCY, FEMALE .5216 2.3 3.2 24
REPRODUCTIVE SYSTEM W/
O CC.
368......... 13 MED INFECTIONS, FEMALE 1.0230 5.3 6.9 29
REPRODUCTIVE SYSTEM.
369......... 13 MED MENSTRUAL & OTHER .5454 2.6 3.7 27
FEMALE REPRODUCTIVE
SYSTEM DISORDERS.
370......... 14 SURG CESAREAN SECTION W CC.. 1.0401 4.3 5.6 26
371......... 14 SURG CESAREAN SECTION W/O CC .6838 3.2 3.6 11
372......... 14 MED VAGINAL DELIVERY W .5439 2.4 3.4 20
COMPLICATING DIAGNOSES.
373......... 14 MED VAGINAL DELIVERY W/O .3602 1.7 1.9 7
COMPLICATING DIAGNOSES.
374......... 14 SURG VAGINAL DELIVERY W .6775 2.0 2.6 11
STERILIZATION &/OR D&C.
375......... 14 SURG *VAGINAL DELIVERY W .6698 4.4 4.4 28
O.R. PROC EXCEPT
STERIL &/OR D&C.
376......... 14 MED POSTPARTUM & POST .5638 2.3 3.4 25
ABORTION DIAGNOSES W/O
O.R. PROCEDURE.
377......... 14 SURG POSTPARTUM & POST .8188 2.1 3.3 26
ABORTION DIAGNOSES W
O.R. PROCEDURE.
378......... 14 MED ECTOPIC PREGNANCY...... .8054 2.4 2.9 15
379......... 14 MED THREATENED ABORTION.... .3591 2.0 3.0 21
380......... 14 MED ABORTION W/O D&C....... .4775 1.7 2.3 12
381......... 14 SURG ABORTION W D&C, .5151 1.7 2.3 14
ASPIRATION CURETTAGE
OR HYSTEROTOMY.
382......... 14 MED FALSE LABOR............ .2013 1.3 1.6 6
383......... 14 MED OTHER ANTEPARTUM .4655 2.8 4.1 27
DIAGNOSES W MEDICAL
COMPLICATIONS.
384......... 14 MED OTHER ANTEPARTUM .3921 1.8 3.1 22
DIAGNOSES W/O MEDICAL
COMPLICATIONS.
385......... 15 ................ *NEONATES, DIED OR 1.3443 1.8 1.8 26
TRANSFERRED TO ANOTHER
ACUTE CARE FACILITY.
386......... 15 ................ *EXTREME IMMATURITY OR 4.4329 17.9 17.9 42
RESPIRATORY DISTRESS
SYNDROME, NEONATE.
387......... 15 ................ *PREMATURITY W MAJOR 3.0276 13.3 13.3 37
PROBLEMS.
388......... 15 ................ *PREMATURITY W/O MAJOR 1.8268 8.6 8.6 33
PROBLEMS.
389......... 15 ................ FULL TERM NEONATE W 2.2451 7.9 10.7 32
MAJOR PROBLEMS.
390......... 15 ................ NEONATE W OTHER 1.2845 3.6 4.7 28
SIGNIFICANT PROBLEMS.
[[Page 46274]]
391......... 15 ................ *NORMAL NEWBORN........ .1490 3.1 3.1 11
392......... 16 SURG SPLENECTOMY AGE >17.... 3.2443 8.9 11.7 33
393......... 16 SURG *SPLENECTOMY AGE 0-17.. 1.3168 9.1 9.1 33
394......... 16 SURG OTHER O.R. PROCEDURES 1.5994 4.5 8.0 28
OF THE BLOOD AND BLOOD
FORMING ORGANS.
395......... 16 MED RED BLOOD CELL .8362 3.9 5.4 28
DISORDERS AGE >17.
396......... 16 MED RED BLOOD CELL .6966 2.7 3.8 27
DISORDERS AGE 0-17.
397......... 16 MED COAGULATION DISORDERS.. 1.2612 4.4 6.1 28
398......... 16 MED RETICULOENDOTHELIAL & 1.2106 5.2 6.6 29
IMMUNITY DISORDERS W
CC.
399......... 16 MED RETICULOENDOTHELIAL & .7030 3.5 4.4 27
IMMUNITY DISORDERS W/O
CC.
400......... 17 SURG LYMPHOMA & LEUKEMIA W 2.5572 6.7 10.4 31
MAJOR O.R. PROCEDURE.
401......... 17 SURG LYMPHOMA & NON-ACUTE 2.4834 8.5 12.4 32
LEUKEMIA W OTHER O.R.
PROC W CC.
402......... 17 SURG LYMPHOMA & NON-ACUTE 1.0255 3.1 4.7 27
LEUKEMIA W OTHER O.R.
PROC W/O CC.
403......... 17 MED LYMPHOMA & NON-ACUTE 1.6925 6.5 9.3 30
LEUKEMIA W CC.
404......... 17 MED LYMPHOMA & NON-ACUTE .8059 3.7 5.1 28
LEUKEMIA W/O CC.
405......... 17 ................ *ACUTE LEUKEMIA W/O 1.8669 4.9 4.9 29
MAJOR O.R. PROCEDURE
AGE 0-17.
406......... 17 SURG MYELOPROLIF DISORD OR 2.6841 8.1 11.3 32
POORLY DIFF NEOPL W
MAJ O.R. PROC W CC.
407......... 17 SURG MYELOPROLIF DISORD OR 1.1787 3.8 4.9 28
POORLY DIFF NEOPL W
MAJ O.R. PROC W/O CC.
408......... 17 SURG MYELOPROLIF DISORD OR 1.7393 5.0 8.2 29
POORLY DIFF NEOPL W
OTHER O.R. PROC.
409......... 17 MED RADIOTHERAPY........... .9763 4.7 6.7 29
410......... 17 MED CHEMOTHERAPY W/O ACUTE .7514 2.6 3.4 20
LEUKEMIA AS SECONDARY
DIAGNOSIS.
411......... 17 MED HISTORY OF MALIGNANCY W/ .3837 2.1 2.7 16
O ENDOSCOPY.
412......... 17 MED HISTORY OF MALIGNANCY W .4080 2.1 3.0 23
ENDOSCOPY.
413......... 17 MED OTHER MYELOPROLIF DIS 1.3257 6.0 8.4 30
OR POORLY DIFF NEOPL
DIAG W CC.
414......... 17 MED OTHER MYELOPROLIF DIS .7337 3.7 5.2 28
OR POORLY DIFF NEOPL
DIAG W/O CC.
415......... 18 SURG O.R. PROCEDURE FOR 3.4430 11.4 15.8 35
INFECTIOUS & PARASITIC
DISEASES.
416......... 18 MED SEPTICEMIA AGE >17..... 1.4838 6.2 8.3 30
417......... 18 MED SEPTICEMIA AGE 0-17.... .8089 3.7 4.6 28
418......... 18 MED POSTOPERATIVE & POST- .9697 5.4 6.8 29
TRAUMATIC INFECTIONS.
419......... 18 MED FEVER OF UNKNOWN ORIGIN .8991 4.4 5.7 28
AGE >17 W CC.
420......... 18 MED FEVER OF UNKNOWN ORIGIN .6264 3.5 4.3 24
AGE >17 W/O CC.
421......... 18 MED VIRAL ILLNESS AGE >17.. .7153 3.6 4.7 28
422......... 18 MED VIRAL ILLNESS & FEVER .5347 2.9 3.8 25
OF UNKNOWN ORIGIN AGE
0-17.
423......... 18 MED OTHER INFECTIOUS & 1.5947 6.3 8.8 30
PARASITIC DISEASES
DIAGNOSES.
424......... 19 SURG O.R. PROCEDURE W 2.3637 10.9 18.0 35
PRINCIPAL DIAGNOSES OF
MENTAL ILLNESS.
425......... 19 MED ACUTE ADJUST REACT & .7051 3.5 4.9 27
DISTURBANCES OF
PSYCHOSOCIAL
DYSFUNCTION.
426......... 19 MED DEPRESSIVE NEUROSES.... .5680 3.9 5.5 28
427......... 19 MED NEUROSES EXCEPT .5495 3.7 5.2 28
DEPRESSIVE.
428......... 19 MED DISORDERS OF .7303 5.2 8.4 29
PERSONALITY & IMPULSE
CONTROL.
429......... 19 MED ORGANIC DISTURBANCES & .9075 5.9 9.0 30
MENTAL RETARDATION.
430......... 19 MED PSYCHOSES.............. .8391 6.9 9.8 31
431......... 19 MED CHILDHOOD MENTAL .6556 4.9 7.2 29
DISORDERS.
432......... 19 MED OTHER MENTAL DISORDER .7363 3.9 6.5 28
DIAGNOSES.
433......... 20 ................ ALCOHOL/DRUG ABUSE OR .2986 2.5 3.4 25
DEPENDENCE, LEFT AMA.
434......... 20 ................ ALC/DRUG ABUSE OR .7141 4.3 5.8 28
DEPEND, DETOX OR OTH
SYMPT TREAT W CC.
435......... 20 ................ ALC/DRUG ABUSE OR .4164 3.8 4.8 28
DEPEND, DETOX OR OTH
SYMPT TREAT W/O CC.
436......... 20 ................ ALC/DRUG DEPENDENCE W .8183 12.1 14.8 36
REHABILITATION THERAPY.
437......... 20 ................ ALC/DRUG DEPENDENCE, .7657 9.2 10.9 33
COMBINED REHAB & DETOX
THERAPY.
438......... NO LONGER VALID........ .0000 .0 .0 0
439......... 21 SURG SKIN GRAFTS FOR 1.6144 5.9 8.9 30
INJURIES.
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440......... 21 SURG W/OUND DEBRIDEMENTS FOR 1.7725 6.3 9.9 30
INJURIES.
441......... 21 SURG HAND PROCEDURES FOR .9294 2.4 4.4 26
INJURIES.
442......... 21 SURG OTHER O.R. PROCEDURES 2.1653 5.6 8.7 30
FOR INJURIES W CC.
443......... 21 SURG OTHER O.R. PROCEDURES .8849 2.5 3.6 26
FOR INJURIES W/O CC.
444......... 21 MED TRAUMATIC INJURY AGE .7312 4.0 5.3 28
>17 W CC.
445......... 21 MED TRAUMATIC INJURY AGE .4845 2.9 3.9 25
>17 W/O CC.
446......... 21 MED *TRAUMATIC INJURY AGE 0- .2894 2.4 2.4 22
17.
447......... 21 MED ALLERGIC REACTIONS AGE .4918 2.1 2.8 17
>17.
448......... 21 MED ALLERGIC REACTIONS AGE .0777 1.0 1.0 1
0-17.
449......... 21 MED POISONING & TOXIC .7902 3.0 4.5 27
EFFECTS OF DRUGS AGE
>17 W CC.
450......... 21 MED POISONING & TOXIC .4274 1.8 2.3 13
EFFECTS OF DRUGS AGE
>17 W/O CC.
451......... 21 MED *POISONING & TOXIC .2570 2.1 2.1 17
EFFECTS OF DRUGS AGE 0-
17.
452......... 21 MED COMPLICATIONS OF .9473 3.8 5.4 28
TREATMENT W CC.
453......... 21 MED COMPLICATIONS OF .4822 2.4 3.2 20
TREATMENT W/O CC.
454......... 21 MED OTHER INJURY, POISONING .8575 3.4 5.1 27
& TOXIC EFFECT DIAG W
CC.
455......... 21 MED OTHER INJURY, POISONING .4467 2.1 2.8 18
& TOXIC EFFECT DIAG W/
O CC.
456......... 22 MED BURNS, TRANSFERRED TO 1.8327 4.1 8.4 28
ANOTHER ACUTE CARE
FACILITY.
457......... 22 MED EXTENSIVE BURNS W/O 1.4657 2.4 4.8 26
O.R. PROCEDURE.
458......... 22 SURG NON-EXTENSIVE BURNS W 3.4991 11.9 16.9 36
SKIN GRAFT.
459......... 22 SURG NON-EXTENSIVE BURNS W W/ 1.6538 6.7 10.3 31
OUND DEBRIDEMENT OR
OTHER O.R. PROC.
460......... 22 MED NON-EXTENSIVE BURNS W/O .9547 4.6 6.6 29
O.R. PROCEDURE.
461......... 23 SURG O.R. PROC W DIAGNOSES .9963 2.5 4.9 27
OF OTHER CONTACT W
HEALTH SERVICES.
462......... 23 MED REHABILITATION......... 1.4298 11.0 13.9 35
463......... 23 MED SIGNS & SYMPTOMS W CC.. .7101 3.8 5.2 28
464......... 23 MED SIGNS & SYMPTOMS W/O CC .5028 2.8 3.8 24
465......... 23 MED AFTERCARE W HISTORY OF .5571 2.3 3.9 26
MALIGNANCY AS
SECONDARY DIAGNOSIS.
466......... 23 MED AFTERCARE W/O HISTORY .5905 2.5 4.8 27
OF MALIGNANCY AS
SECONDARY DIAGNOSIS.
467......... 23 MED OTHER FACTORS .4588 2.4 4.1 26
INFLUENCING HEALTH
STATUS.
468......... ................ EXTENSIVE O.R. 3.6028 10.6 15.3 35
PROCEDURE UNRELATED TO
PRINCIPAL DIAGNOSIS.
469......... ................ **PRINCIPAL DIAGNOSIS .0000 .0 .0 0
INVALID AS DISCHARGE
DIAGNOSIS.
470......... ................ **UNGROUPABLE.......... .0000 .0 .0 0
471......... 08 SURG BILATERAL OR MULTIPLE 3.5980 6.8 8.1 31
MAJOR JOINT PROCS OF
LOWER EXTREMITY.
472......... 22 SURG EXTENSIVE BURNS W O.R. 10.9989 17.0 30.2 41
PROCEDURE.
473......... 17 ................ ACUTE LEUKEMIA W/O 3.5740 8.5 14.7 33
MAJOR O.R. PROCEDURE
AGE >17.
474......... ................ NO LONGER VALID........ .0000 .0 .0 0
475......... 04 MED RESPIRATORY SYSTEM 3.6765 8.6 12.3 33
DIAGNOSIS WITH
VENTILATOR SUPPORT.
476......... SURG PROSTATIC O.R. 2.2479 10.3 13.9 34
PROCEDURE UNRELATED TO
PRINCIPAL DIAGNOSIS.
477......... SURG NON-EXTENSIVE O.R. 1.7266 5.9 9.3 30
PROCEDURE UNRELATED TO
PRINCIPAL DIAGNOSIS.
478......... 05 SURG OTHER VASCULAR 2.2883 5.6 8.3 30
PROCEDURES W CC.
479......... 05 SURG OTHER VASCULAR 1.4080 3.5 4.6 27
PROCEDURES W/O CC.
480......... SURG LIVER TRANSPLANT....... 13.9424 26.4 32.6 50
481......... SURG BONE MARROW TRANSPLANT. 11.2299 29.7 32.6 54
482......... SURG TRACHEOSTOMY FOR FACE, 3.6578 11.4 14.9 35
MOUTH & NECK DIAGNOSES.
483......... SURG TRACHEOSTOMY EXCEPT FOR 16.0413 36.0 46.4 60
FACE, MOUTH & NECK
DIAGNOSES.
484......... 24 SURG CRANIOTOMY FOR MULTIPLE 5.6821 10.6 15.9 35
SIGNIFICANT TRAUMA.
485......... 24 SURG LIMB REATTACHMENT, HIP 3.2058 9.2 11.7 33
AND FEMUR PROC FOR
MULTIPLE SIGNIFICANT
TR.
486......... 24 SURG OTHER O.R. PROCEDURES 4.7915 9.0 13.6 33
FOR MULTIPLE
SIGNIFICANT TRAUMA.
487......... 24 MED OTHER MULTIPLE 2.0305 6.2 9.1 30
SIGNIFICANT TRAUMA.
488......... 25 SURG HIV W EXTENSIVE O.R. 4.7905 14.3 20.5 38
PROCEDURE.
489......... 25 MED HIV W MAJOR RELATED 1.8141 7.2 10.7 31
CONDITION.
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490......... 25 MED HIV