MCCG AVG CHARGE PER DRG-FY18 12/27/2018 1

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1 1 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC $762, HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC $552, ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. $561, TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. $385, TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC $183, TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC $142, TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC $54, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC $272, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC $193, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC $109, CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE CNS PDX W MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY W NEURO $194, CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC $109, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC $140, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC $90, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC $64, SPINAL PROCEDURES W MCC $193, SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS $94, SPINAL PROCEDURES W/O CC/MCC $74, VENTRICULAR SHUNT PROCEDURES W MCC $97, VENTRICULAR SHUNT PROCEDURES W CC $54, VENTRICULAR SHUNT PROCEDURES W/O CC/MCC $44, CAROTID ARTERY STENT PROCEDURE W MCC $153, CAROTID ARTERY STENT PROCEDURE W CC $52, CAROTID ARTERY STENT PROCEDURE W/O CC/MCC $33, EXTRACRANIAL PROCEDURES W MCC $169, EXTRACRANIAL PROCEDURES W CC $68, EXTRACRANIAL PROCEDURES W/O CC/MCC $34, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC $100, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM $69, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC $61, SPINAL DISORDERS & INJURIES W CC/MCC $43, SPINAL DISORDERS & INJURIES W/O CC/MCC $36, NERVOUS SYSTEM NEOPLASMS W MCC $41, NERVOUS SYSTEM NEOPLASMS W/O MCC $33, DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC $59, DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC $34, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC $82, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC $43, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC $40, ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W MCC $91, ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC $67, ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC $56, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC $68, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS $41, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC $34, NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC $43, NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC $30, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 1

2 69 TRANSIENT ISCHEMIA W/O THROMBOLYTIC $24, NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC $70, NONSPECIFIC CEREBROVASCULAR DISORDERS W CC $34, NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC $14, CRANIAL & PERIPHERAL NERVE DISORDERS W MCC $42, CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC $28, VIRAL MENINGITIS W CC/MCC $36, VIRAL MENINGITIS W/O CC/MCC $8, HYPERTENSIVE ENCEPHALOPATHY W MCC $76, HYPERTENSIVE ENCEPHALOPATHY W CC $41, NONTRAUMATIC STUPOR & COMA W MCC $31, NONTRAUMATIC STUPOR & COMA W/O MCC $18, TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC $69, TRAUMATIC STUPOR & COMA, COMA >1 HR W CC $46, TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC $30, TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC $69, TRAUMATIC STUPOR & COMA, COMA <1 HR W CC $42, TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC $22, CONCUSSION W MCC $56, CONCUSSION W CC $35, CONCUSSION W/O CC/MCC $26, OTHER DISORDERS OF NERVOUS SYSTEM W MCC $54, OTHER DISORDERS OF NERVOUS SYSTEM W CC $26, OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC $22, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC $141, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC $62, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC $66, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC $109, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC $109, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC $30, SEIZURES W MCC $58, SEIZURES W/O MCC $22, HEADACHES W MCC $26, HEADACHES W/O MCC $23, ORBITAL PROCEDURES W CC/MCC $24, ORBITAL PROCEDURES W/O CC/MCC $81, EXTRAOCULAR PROCEDURES EXCEPT ORBIT $31, INTRAOCULAR PROCEDURES W CC/MCC $47, ACUTE MAJOR EYE INFECTIONS W/O CC/MCC $37, NEUROLOGICAL EYE DISORDERS $26, OTHER DISORDERS OF THE EYE W MCC $40, OTHER DISORDERS OF THE EYE W/O MCC $23, MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE $55, MAJOR HEAD & NECK PROCEDURES W/O CC/MCC $31, CRANIAL/FACIAL PROCEDURES W CC/MCC $50, CRANIAL/FACIAL PROCEDURES W/O CC/MCC $34, OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W CC/MCC $55, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 2

3 134 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC $22, SINUS & MASTOID PROCEDURES W/O CC/MCC $45, MOUTH PROCEDURES W CC/MCC $20, MOUTH PROCEDURES W/O CC/MCC $20, EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC $42, EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC $23, EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC $7, DYSEQUILIBRIUM $21, EPISTAXIS W MCC $32, EPISTAXIS W/O MCC $12, OTITIS MEDIA & URI W MCC $30, OTITIS MEDIA & URI W/O MCC $12, OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC $34, OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC $15, OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC $13, DENTAL & ORAL DISEASES W MCC $35, DENTAL & ORAL DISEASES W CC $23, DENTAL & ORAL DISEASES W/O CC/MCC $15, MAJOR CHEST PROCEDURES W MCC $125, MAJOR CHEST PROCEDURES W CC $64, MAJOR CHEST PROCEDURES W/O CC/MCC $57, OTHER RESP SYSTEM O.R. PROCEDURES W MCC $118, OTHER RESP SYSTEM O.R. PROCEDURES W CC $65, OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC $47, PULMONARY EMBOLISM W MCC $45, PULMONARY EMBOLISM W/O MCC $26, RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC $50, RESPIRATORY INFECTIONS & INFLAMMATIONS W CC $32, RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC $20, RESPIRATORY NEOPLASMS W MCC $63, RESPIRATORY NEOPLASMS W CC $39, RESPIRATORY NEOPLASMS W/O CC/MCC $46, MAJOR CHEST TRAUMA W MCC $39, MAJOR CHEST TRAUMA W CC $41, MAJOR CHEST TRAUMA W/O CC/MCC $28, PLEURAL EFFUSION W MCC $31, PLEURAL EFFUSION W CC $33, PLEURAL EFFUSION W/O CC/MCC $17, PULMONARY EDEMA & RESPIRATORY FAILURE $44, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC $35, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC $25, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC $19, SIMPLE PNEUMONIA & PLEURISY W MCC $40, SIMPLE PNEUMONIA & PLEURISY W CC $25, SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC $14, INTERSTITIAL LUNG DISEASE W MCC $42, INTERSTITIAL LUNG DISEASE W CC $25, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 3

4 198 INTERSTITIAL LUNG DISEASE W/O CC/MCC $24, PNEUMOTHORAX W MCC $55, PNEUMOTHORAX W CC $29, PNEUMOTHORAX W/O CC/MCC $15, BRONCHITIS & ASTHMA W CC/MCC $20, BRONCHITIS & ASTHMA W/O CC/MCC $10, RESPIRATORY SIGNS & SYMPTOMS $22, OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC $28, OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC $31, RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS $167, RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS $69, OTHER HEART ASSIST SYSTEM IMPLANT $257, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC $268, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC $184, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC $274, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC $145, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC $128, CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC $168, CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC $117, CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC $150, CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC $124, CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC $127, CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC $105, OTHER CARDIOTHORACIC PROCEDURES W MCC $152, OTHER CARDIOTHORACIC PROCEDURES W/O MCC $134, CORONARY BYPASS W PTCA W MCC $204, CORONARY BYPASS W PTCA W/O MCC $179, CORONARY BYPASS W CARDIAC CATH W MCC $204, CORONARY BYPASS W CARDIAC CATH W/O MCC $150, CORONARY BYPASS W/O CARDIAC CATH W MCC $208, CORONARY BYPASS W/O CARDIAC CATH W/O MCC $112, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC $107, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC $69, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC $34, PERMANENT CARDIAC PACEMAKER IMPLANT W MCC $110, PERMANENT CARDIAC PACEMAKER IMPLANT W CC $66, PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC $45, AICD GENERATOR PROCEDURES $134, PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS $120, PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC $78, PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS $116, PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC $73, PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC $107, PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC $85, OTHER VASCULAR PROCEDURES W MCC $94, OTHER VASCULAR PROCEDURES W CC $87, OTHER VASCULAR PROCEDURES W/O CC/MCC $55, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 4

5 255 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC $106, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC $54, CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC $63, CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC $37, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC $83, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC $44, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC $39, VEIN LIGATION & STRIPPING $7, OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $104, AICD LEAD PROCEDURES $58, ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC $166, ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC $151, AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC $180, AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC $132, OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC $167, OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC $99, OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC $117, PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC $110, PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC $86, ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC $68, ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC $41, ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC $39, ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC $90, ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC $33, ACUTE MYOCARDIAL INFARCTION, EXPIRED W/O CC/MCC $24, CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC $65, CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC $46, ACUTE & SUBACUTE ENDOCARDITIS W MCC $83, HEART FAILURE & SHOCK W MCC $36, HEART FAILURE & SHOCK W CC $22, HEART FAILURE & SHOCK W/O CC/MCC $20, CARDIAC ARREST, UNEXPLAINED W MCC $38, CARDIAC ARREST, UNEXPLAINED W CC $13, CARDIAC ARREST, UNEXPLAINED W/O CC/MCC $43, PERIPHERAL VASCULAR DISORDERS W MCC $62, PERIPHERAL VASCULAR DISORDERS W CC $29, PERIPHERAL VASCULAR DISORDERS W/O CC/MCC $22, ATHEROSCLEROSIS W MCC $30, ATHEROSCLEROSIS W/O MCC $48, HYPERTENSION W MCC $27, HYPERTENSION W/O MCC $22, CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC $51, CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC $20, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC $54, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC $27, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC $24, ANGINA PECTORIS $29, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 5

6 312 SYNCOPE & COLLAPSE $24, CHEST PAIN $20, OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC $56, OTHER CIRCULATORY SYSTEM DIAGNOSES W CC $30, OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC $21, STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC $170, STOMACH, ESOPHAGEAL & DUODENAL PROC W CC $61, STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC $40, MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC $134, MAJOR SMALL & LARGE BOWEL PROCEDURES W CC $70, MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC $46, RECTAL RESECTION W CC $49, RECTAL RESECTION W/O CC/MCC $42, PERITONEAL ADHESIOLYSIS W MCC $215, PERITONEAL ADHESIOLYSIS W CC $54, PERITONEAL ADHESIOLYSIS W/O CC/MCC $38, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC $96, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC $66, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC $33, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC $35, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC $20, MINOR SMALL & LARGE BOWEL PROCEDURES W MCC $55, MINOR SMALL & LARGE BOWEL PROCEDURES W CC $51, MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC $31, ANAL & STOMAL PROCEDURES W CC $28, ANAL & STOMAL PROCEDURES W/O CC/MCC $22, INGUINAL & FEMORAL HERNIA PROCEDURES W MCC $55, INGUINAL & FEMORAL HERNIA PROCEDURES W CC $36, INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC $15, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC $76, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC $52, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC $33, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC $120, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC $60, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC $30, MAJOR ESOPHAGEAL DISORDERS W MCC $118, MAJOR ESOPHAGEAL DISORDERS W CC $40, MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC $30, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC $45, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC $34, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC $23, DIGESTIVE MALIGNANCY W MCC $58, DIGESTIVE MALIGNANCY W CC $37, DIGESTIVE MALIGNANCY W/O CC/MCC $39, G.I. HEMORRHAGE W MCC $73, G.I. HEMORRHAGE W CC $32, G.I. HEMORRHAGE W/O CC/MCC $19, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 6

7 380 COMPLICATED PEPTIC ULCER W MCC $72, COMPLICATED PEPTIC ULCER W CC $35, COMPLICATED PEPTIC ULCER W/O CC/MCC $20, UNCOMPLICATED PEPTIC ULCER W MCC $61, UNCOMPLICATED PEPTIC ULCER W/O MCC $27, INFLAMMATORY BOWEL DISEASE W MCC $52, INFLAMMATORY BOWEL DISEASE W CC $36, INFLAMMATORY BOWEL DISEASE W/O CC/MCC $40, G.I. OBSTRUCTION W MCC $56, G.I. OBSTRUCTION W CC $24, G.I. OBSTRUCTION W/O CC/MCC $20, ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC $31, ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC $24, OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC $56, OTHER DIGESTIVE SYSTEM DIAGNOSES W CC $30, OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC $21, PANCREAS, LIVER & SHUNT PROCEDURES W MCC $164, PANCREAS, LIVER & SHUNT PROCEDURES W CC $87, PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC $68, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC $163, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC $95, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC $49, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC $85, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC $102, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC $23, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC $55, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC $50, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC $38, HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC $114, HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC $74, HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC $48, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC $189, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC $24, CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC $57, CIRRHOSIS & ALCOHOLIC HEPATITIS W CC $31, CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC $15, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC $67, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC $36, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC $9, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC $60, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC $28, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC $18, DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC $88, DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC $27, DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC $29, DISORDERS OF THE BILIARY TRACT W MCC $45, DISORDERS OF THE BILIARY TRACT W CC $36, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 7

8 446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC $30, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC $367, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC $177, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC $107, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC $220, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC $163, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC $154, SPINAL FUSION EXCEPT CERVICAL W MCC $220, SPINAL FUSION EXCEPT CERVICAL W/O MCC $104, BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC $79, WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC $151, WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC $115, WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC $63, REVISION OF HIP OR KNEE REPLACEMENT W MCC $98, REVISION OF HIP OR KNEE REPLACEMENT W CC $87, REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC $67, MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACE $91, MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC $55, CERVICAL SPINAL FUSION W MCC $200, CERVICAL SPINAL FUSION W CC $83, CERVICAL SPINAL FUSION W/O CC/MCC $65, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC $118, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC $36, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC $27, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC $96, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC $72, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC $66, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC $92, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC $66, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC $48, MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $50, KNEE PROCEDURES W PDX OF INFECTION W MCC $223, KNEE PROCEDURES W PDX OF INFECTION W CC $55, KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC $41, KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC $76, KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC $53, LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC $96, LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC $72, LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC $45, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC $66, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC $44, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC $34, LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC $41, LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC $26, SOFT TISSUE PROCEDURES W MCC $167, SOFT TISSUE PROCEDURES W CC $52, SOFT TISSUE PROCEDURES W/O CC/MCC $39, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 8

9 503 FOOT PROCEDURES W MCC $124, FOOT PROCEDURES W CC $64, FOOT PROCEDURES W/O CC/MCC $46, MAJOR THUMB OR JOINT PROCEDURES $31, MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC $77, SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC $66, SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC $57, SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC $42, HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC $81, HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC $22, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC $95, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC $63, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC $53, BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM $119, BACK & NECK PROC EXC SPINAL FUSION W CC $69, BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC $53, FRACTURES OF FEMUR W MCC $38, FRACTURES OF FEMUR W/O MCC $15, FRACTURES OF HIP & PELVIS W MCC $46, FRACTURES OF HIP & PELVIS W/O MCC $30, SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC $33, OSTEOMYELITIS W MCC $123, OSTEOMYELITIS W CC $97, OSTEOMYELITIS W/O CC/MCC $36, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC $74, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC $51, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC $22, CONNECTIVE TISSUE DISORDERS W MCC $67, CONNECTIVE TISSUE DISORDERS W CC $93, CONNECTIVE TISSUE DISORDERS W/O CC/MCC $24, SEPTIC ARTHRITIS W MCC $33, SEPTIC ARTHRITIS W CC $39, SEPTIC ARTHRITIS W/O CC/MCC $17, MEDICAL BACK PROBLEMS W MCC $70, MEDICAL BACK PROBLEMS W/O MCC $34, BONE DISEASES & ARTHROPATHIES W MCC $38, BONE DISEASES & ARTHROPATHIES W/O MCC $45, SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC $5, SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC $23, TENDONITIS, MYOSITIS & BURSITIS W MCC $60, TENDONITIS, MYOSITIS & BURSITIS W/O MCC $18, AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC $91, AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC $34, AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC $32, FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC $34, FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC $29, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC $41, MCCG AVG CHARGE PER DRG-FY18 12/27/2018 9

10 565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC $33, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC $18, SKIN DEBRIDEMENT W MCC $120, SKIN DEBRIDEMENT W CC $42, SKIN DEBRIDEMENT W/O CC/MCC $63, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC $143, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC $181, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC $121, OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC $79, OTHER SKIN, SUBCUT TISS & BREAST PROC W CC $42, OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC $42, MASTECTOMY FOR MALIGNANCY W CC/MCC $52, MASTECTOMY FOR MALIGNANCY W/O CC/MCC $74, BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC $147, BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC $125, SKIN ULCERS W MCC $29, SKIN ULCERS W CC $16, SKIN ULCERS W/O CC/MCC $11, MAJOR SKIN DISORDERS W MCC $32, MAJOR SKIN DISORDERS W/O MCC $17, MALIGNANT BREAST DISORDERS W MCC $36, MALIGNANT BREAST DISORDERS W CC $85, MALIGNANT BREAST DISORDERS W/O CC/MCC $67, NON-MALIGNANT BREAST DISORDERS W CC/MCC $20, NON-MALIGNANT BREAST DISORDERS W/O CC/MCC $4, CELLULITIS W MCC $37, CELLULITIS W/O MCC $18, TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC $57, TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC $27, MINOR SKIN DISORDERS W MCC $19, MINOR SKIN DISORDERS W/O MCC $13, ADRENAL & PITUITARY PROCEDURES W CC/MCC $141, ADRENAL & PITUITARY PROCEDURES W/O CC/MCC $41, AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC $128, AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC $51, AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W/O CC/MCC $38, O.R. PROCEDURES FOR OBESITY W MCC $66, O.R. PROCEDURES FOR OBESITY W CC $53, O.R. PROCEDURES FOR OBESITY W/O CC/MCC $42, SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC $100, SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC $42, THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W MCC $83, THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W CC $49, THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC $34, OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC $147, OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC $49, OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC/MCC $81, MCCG AVG CHARGE PER DRG-FY18 12/27/

11 637 DIABETES W MCC $41, DIABETES W CC $21, DIABETES W/O CC/MCC $14, MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC $28, MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC $22, INBORN AND OTHER DISORDERS OF METABOLISM $27, ENDOCRINE DISORDERS W MCC $61, ENDOCRINE DISORDERS W CC $30, ENDOCRINE DISORDERS W/O CC/MCC $19, MAJOR BLADDER PROCEDURES W CC $90, KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC $56, KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC $54, KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC $48, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC $99, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC $49, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC $42, MINOR BLADDER PROCEDURES W MCC $29, MINOR BLADDER PROCEDURES W CC $35, MINOR BLADDER PROCEDURES W/O CC/MCC $25, PROSTATECTOMY W CC $34, PROSTATECTOMY W/O CC/MCC $16, TRANSURETHRAL PROCEDURES W MCC $75, TRANSURETHRAL PROCEDURES W CC $24, TRANSURETHRAL PROCEDURES W/O CC/MCC $24, OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC $79, OTHER KIDNEY & URINARY TRACT PROCEDURES W CC $58, OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC $60, RENAL FAILURE W MCC $42, RENAL FAILURE W CC $27, RENAL FAILURE W/O CC/MCC $19, ADMIT FOR RENAL DIALYSIS $39, KIDNEY & URINARY TRACT NEOPLASMS W MCC $57, KIDNEY & URINARY TRACT NEOPLASMS W CC $30, KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC $33, KIDNEY & URINARY TRACT INFECTIONS W MCC $33, KIDNEY & URINARY TRACT INFECTIONS W/O MCC $20, URINARY STONES W/O ESW LITHOTRIPSY W MCC $26, URINARY STONES W/O ESW LITHOTRIPSY W/O MCC $24, KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC $15, URETHRAL STRICTURE $23, OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC $51, OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC $31, OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC $24, MAJOR MALE PELVIC PROCEDURES W CC/MCC $53, MAJOR MALE PELVIC PROCEDURES W/O CC/MCC $49, PENIS PROCEDURES W CC/MCC $99, PENIS PROCEDURES W/O CC/MCC $24, MCCG AVG CHARGE PER DRG-FY18 12/27/

12 711 TESTES PROCEDURES W CC/MCC $172, TESTES PROCEDURES W/O CC/MCC $21, TRANSURETHRAL PROSTATECTOMY W CC/MCC $69, TRANSURETHRAL PROSTATECTOMY W/O CC/MCC $17, OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC $57, OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC $65, MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC $88, MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC $44, MALIGNANCY, MALE REPRODUCTIVE SYSTEM W/O CC/MCC $47, BENIGN PROSTATIC HYPERTROPHY W MCC $16, BENIGN PROSTATIC HYPERTROPHY W/O MCC $22, INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC $78, INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC $27, OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC $93, OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC $28, PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W CC/MCC $54, PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W/O CC/MCC $45, UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC $180, UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC $75, UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC $65, UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC $183, UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC $75, UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC $41, UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC $50, UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC $29, D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC $65, D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC $22, VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC $94, VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC $24, FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $28, OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC $95, OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC $44, MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC $48, MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC $59, MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC $36, INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC $42, INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC $23, INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC $15, MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC $39, MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC $18, CESAREAN SECTION W CC/MCC $31, CESAREAN SECTION W/O CC/MCC $23, VAGINAL DELIVERY W STERILIZATION &/OR D&C $31, VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C $62, POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE $7, ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $19, VAGINAL DELIVERY W COMPLICATING DIAGNOSES $22, MCCG AVG CHARGE PER DRG-FY18 12/27/

13 775 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES $18, POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE $13, ECTOPIC PREGNANCY $32, THREATENED ABORTION $9, ABORTION W/O D&C $13, FALSE LABOR $7, OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS $18, OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS $15, NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $140, EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $182, PREMATURITY W MAJOR PROBLEMS $110, PREMATURITY W/O MAJOR PROBLEMS $14, FULL TERM NEONATE W MAJOR PROBLEMS $30, NEONATE W OTHER SIGNIFICANT PROBLEMS $7, NORMAL NEWBORN $3, SPLENECTOMY W MCC $121, SPLENECTOMY W/O CC/MCC $39, OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC $83, OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W/O CC/MCC $37, MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC $76, MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC $29, MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC $17, RED BLOOD CELL DISORDERS W MCC $35, RED BLOOD CELL DISORDERS W/O MCC $20, COAGULATION DISORDERS $34, RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC $51, RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC $17, RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC $15, LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC $237, LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC $79, LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC $43, LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W MCC $134, LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W CC $83, LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC $37, MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC $136, MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC $91, MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC $49, MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC $120, MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W/O CC/MCC $70, ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC $189, ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC $102, ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC $33, CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC $183, CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT $227, CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC $54, LYMPHOMA & NON-ACUTE LEUKEMIA W MCC $64, LYMPHOMA & NON-ACUTE LEUKEMIA W CC $39, MCCG AVG CHARGE PER DRG-FY18 12/27/

14 842 LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC $33, OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC $287, OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC $30, OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC/MCC $36, CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC $40, CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC $26, CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W/O CC/MCC $25, INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC $181, INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC $91, POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC $123, POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC $78, POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC $32, POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC $49, POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC $29, FEVER $20, VIRAL ILLNESS W MCC $27, VIRAL ILLNESS W/O MCC $11, OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC $93, OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC $14, OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC $43, SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS $196, SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC $67, SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC $30, O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS $94, ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION $20, DEPRESSIVE NEUROSES $18, NEUROSES EXCEPT DEPRESSIVE $10, DISORDERS OF PERSONALITY & IMPULSE CONTROL $64, ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY $38, PSYCHOSES $24, OTHER MENTAL DISORDER DIAGNOSES $28, ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA $12, ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC $68, ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC $17, WOUND DEBRIDEMENTS FOR INJURIES W MCC $89, WOUND DEBRIDEMENTS FOR INJURIES W CC $50, WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC $23, SKIN GRAFTS FOR INJURIES W CC/MCC $117, SKIN GRAFTS FOR INJURIES W/O CC/MCC $16, HAND PROCEDURES FOR INJURIES $33, OTHER O.R. PROCEDURES FOR INJURIES W MCC $86, OTHER O.R. PROCEDURES FOR INJURIES W CC $69, OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC $50, TRAUMATIC INJURY W MCC $46, TRAUMATIC INJURY W/O MCC $26, ALLERGIC REACTIONS W MCC $50, ALLERGIC REACTIONS W/O MCC $16, MCCG AVG CHARGE PER DRG-FY18 12/27/

15 917 POISONING & TOXIC EFFECTS OF DRUGS W MCC $52, POISONING & TOXIC EFFECTS OF DRUGS W/O MCC $17, COMPLICATIONS OF TREATMENT W MCC $46, COMPLICATIONS OF TREATMENT W CC $22, COMPLICATIONS OF TREATMENT W/O CC/MCC $24, OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC $49, OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC $14, FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC $70, NON-EXTENSIVE BURNS $44, O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC $337, O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC $122, O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC $108, SIGNS & SYMPTOMS W MCC $30, SIGNS & SYMPTOMS W/O MCC $24, AFTERCARE W CC/MCC $40, AFTERCARE W/O CC/MCC $13, OTHER FACTORS INFLUENCING HEALTH STATUS $11, CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $187, LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA $220, OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC $214, OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC $138, OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC $94, OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC $151, OTHER MULTIPLE SIGNIFICANT TRAUMA W CC $56, OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC $29, HIV W EXTENSIVE O.R. PROCEDURE W MCC $163, HIV W EXTENSIVE O.R. PROCEDURE W/O MCC $41, HIV W MAJOR RELATED CONDITION W MCC $72, HIV W MAJOR RELATED CONDITION W CC $60, HIV W MAJOR RELATED CONDITION W/O CC/MCC $39, HIV W OR W/O OTHER RELATED CONDITION $39, EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $141, EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC $76, EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC $47, NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $105, NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC $50, NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC $40, UNGROUPABLE $72, MCCG AVG CHARGE PER DRG-FY18 12/27/