DRG Code DRG Description FY18 Average Charge

DRG Code DRG Description FY18 Average Charge 3 ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O $ 665,511 4 TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. $ 422,497 37 EXTRACRANIAL PROCEDURES W MCC $ 188,282 38 EXTRACRANIAL PROCEDURES W CC $ 119,544 54 NERVOUS SYSTEM NEOPLASMS W MCC $ 51,200 55 NERVOUS SYSTEM NEOPLASMS W/O MCC $ 48,450 56 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC $ 55,663 57 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC $ 46,052 59 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC $ 37,654 61 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC $ 114,667 62 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC $ 89,715 63 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC $ 75,155 64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC $ 160,272 65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC $ 53,812 66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC $ 46,441 69 TRANSIENT ISCHEMIA $ 36,630 70 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC $ 59,437 71 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC $ 88,495 72 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC $ 45,540 73 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC $ 90,156 74 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC $ 49,001 75 VIRAL MENINGITIS W CC/MCC $ 75,397 76 VIRAL MENINGITIS W/O CC/MCC $ 40,332 83 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC $ 39,142 86 TRAUMATIC STUPOR & COMA, COMA <1 HR W CC $ 54,436 87 TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC $ 47,934 89 CONCUSSION W CC $ 38,649 91 OTHER DISORDERS OF NERVOUS SYSTEM W MCC $ 307,545 92 OTHER DISORDERS OF NERVOUS SYSTEM W CC $ 36,941 93 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC $ 53,945 99 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/ $ 112,656 100 SEIZURES W MCC $ 116,822

101 SEIZURES W/O MCC $ 43,109 103 HEADACHES W/O MCC $ 42,224 123 NEUROLOGICAL EYE DISORDERS $ 30,438 125 OTHER DISORDERS OF THE EYE W/O MCC $ 9,016 146 EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC $ 141,672 149 DYSEQUILIBRIUM $ 113,893 153 OTITIS MEDIA & URI W/O MCC $ 28,287 156 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC $ 30,022 158 DENTAL & ORAL DISEASES W CC $ 55,906 159 DENTAL & ORAL DISEASES W/O CC/MCC $ 16,778 175 PULMONARY EMBOLISM W MCC $ 83,881 176 PULMONARY EMBOLISM W/O MCC $ 64,209 177 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC $ 91,304 178 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC $ 63,733 179 RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC $ 43,227 180 RESPIRATORY NEOPLASMS W MCC $ 71,378 181 RESPIRATORY NEOPLASMS W CC $ 40,138 183 MAJOR CHEST TRAUMA W MCC $ 43,615 184 MAJOR CHEST TRAUMA W CC $ 34,360 186 PLEURAL EFFUSION W MCC $ 92,948 187 PLEURAL EFFUSION W CC $ 66,378 189 PULMONARY EDEMA & RESPIRATORY FAILURE $ 75,146 190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC $ 50,021 191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC $ 59,569 192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC $ 40,791 193 SIMPLE PNEUMONIA & PLEURISY W MCC $ 71,815 194 SIMPLE PNEUMONIA & PLEURISY W CC $ 40,506 195 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC $ 34,371 196 INTERSTITIAL LUNG DISEASE W MCC $ 64,353 199 PNEUMOTHORAX W MCC $ 96,964 200 PNEUMOTHORAX W CC $ 47,616 202 BRONCHITIS & ASTHMA W CC/MCC $ 30,092 203 BRONCHITIS & ASTHMA W/O CC/MCC $ 17,697

204 RESPIRATORY SIGNS & SYMPTOMS $ 50,328 205 OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC $ 123,125 206 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC $ 37,923 207 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS $ 363,918 208 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <96 HOURS $ 131,110 252 OTHER VASCULAR PROCEDURES W MCC $ 42,804 264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $ 102,208 280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC $ 77,576 281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC $ 56,222 282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC $ 31,088 291 HEART FAILURE & SHOCK W MCC $ 81,211 292 HEART FAILURE & SHOCK W CC $ 52,955 293 HEART FAILURE & SHOCK W/O CC/MCC $ 37,171 299 PERIPHERAL VASCULAR DISORDERS W MCC $ 40,587 300 PERIPHERAL VASCULAR DISORDERS W CC $ 46,361 301 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC $ 21,490 302 ATHEROSCLEROSIS W MCC $ 85,386 303 ATHEROSCLEROSIS W/O MCC $ 30,835 304 HYPERTENSION W MCC $ 94,586 305 HYPERTENSION W/O MCC $ 42,096 308 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC $ 65,313 309 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC $ 44,712 310 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC $ 40,540 311 ANGINA PECTORIS $ 14,632 312 SYNCOPE & COLLAPSE $ 44,938 313 CHEST PAIN $ 32,255 314 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC $ 69,804 315 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC $ 105,337 316 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC $ 20,476 326 STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC $ 207,376 329 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC $ 245,476 330 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC $ 96,233 331 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC $ 127,633

335 PERITONEAL ADHESIOLYSIS W MCC $ 127,074 336 PERITONEAL ADHESIOLYSIS W CC $ 109,096 339 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC $ 68,741 340 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC $ 56,913 342 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC $ 45,749 343 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC $ 45,302 345 MINOR SMALL & LARGE BOWEL PROCEDURES W CC $ 99,076 350 INGUINAL & FEMORAL HERNIA PROCEDURES W MCC $ 196,952 352 INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC $ 70,498 354 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC $ 71,440 355 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC $ 69,745 356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC $ 165,479 368 MAJOR ESOPHAGEAL DISORDERS W MCC $ 122,514 369 MAJOR ESOPHAGEAL DISORDERS W CC $ 34,904 371 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC $ 137,452 372 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC $ 39,215 374 DIGESTIVE MALIGNANCY W MCC $ 83,647 375 DIGESTIVE MALIGNANCY W CC $ 107,759 377 G.I. HEMORRHAGE W MCC $ 90,243 378 G.I. HEMORRHAGE W CC $ 68,147 379 G.I. HEMORRHAGE W/O CC/MCC $ 34,857 380 COMPLICATED PEPTIC ULCER W MCC $ 58,837 381 COMPLICATED PEPTIC ULCER W CC $ 60,321 384 UNCOMPLICATED PEPTIC ULCER W/O MCC $ 40,872 385 INFLAMMATORY BOWEL DISEASE W MCC $ 22,902 386 INFLAMMATORY BOWEL DISEASE W CC $ 92,345 387 INFLAMMATORY BOWEL DISEASE W/O CC/MCC $ 70,696 388 G.I. OBSTRUCTION W MCC $ 112,423 389 G.I. OBSTRUCTION W CC $ 67,474 390 G.I. OBSTRUCTION W/O CC/MCC $ 32,901 391 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC $ 104,834 392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC $ 37,921 393 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC $ 108,897

394 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC $ 48,548 395 OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC $ 33,918 416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC $ 92,770 417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC $ 100,447 418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC $ 77,399 419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC $ 54,665 421 HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC $ 283,771 424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC $ 127,959 432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC $ 100,007 433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC $ 77,673 435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC $ 117,343 436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC $ 51,041 438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC $ 125,496 439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC $ 55,129 440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC $ 43,585 441 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC $ 70,047 442 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC $ 89,977 444 DISORDERS OF THE BILIARY TRACT W MCC $ 120,543 445 DISORDERS OF THE BILIARY TRACT W CC $ 49,188 446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC $ 44,019 460 SPINAL FUSION EXCEPT CERVICAL W/O MCC $ 145,691 463 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC $ 436,567 469 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC $ 101,930 470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O M $ 96,429 472 CERVICAL SPINAL FUSION W CC $ 415,425 473 CERVICAL SPINAL FUSION W/O CC/MCC $ 95,004 478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC $ 52,061 480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC $ 176,826 481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC $ 96,066 482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC $ 74,088 483 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC $ 103,681 488 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC $ 137,945 493 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC $ 39,825

494 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC $ 99,272 501 SOFT TISSUE PROCEDURES W CC $ 191,803 504 FOOT PROCEDURES W CC $ 93,510 511 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC $ 80,101 512 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC $ 87,393 518 NO LONGER VALID $ 240,813 519 NO LONGER VALID $ 107,224 520 NO LONGER VALID $ 72,967 535 FRACTURES OF HIP & PELVIS W MCC $ 50,892 536 FRACTURES OF HIP & PELVIS W/O MCC $ 47,844 540 OSTEOMYELITIS W CC $ 27,140 542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC $ 147,209 543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC $ 128,467 545 CONNECTIVE TISSUE DISORDERS W MCC $ 66,990 546 CONNECTIVE TISSUE DISORDERS W CC $ 44,306 551 MEDICAL BACK PROBLEMS W MCC $ 35,198 552 MEDICAL BACK PROBLEMS W/O MCC $ 54,296 554 BONE DISEASES & ARTHROPATHIES W/O MCC $ 45,186 556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC $ 55,350 558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC $ 31,193 559 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC $ 171,353 560 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC $ 29,512 562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC $ 122,115 563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC $ 47,221 564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC $ 103,364 565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC $ 46,133 566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/M $ 42,297 571 NO LONGER VALID $ 80,307 572 NO LONGER VALID $ 52,018 580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC $ 67,114 581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC $ 65,347 592 SKIN ULCERS W MCC $ 94,300 597 MALIGNANT BREAST DISORDERS W MCC $ 69,639

602 CELLULITIS W MCC $ 68,065 603 CELLULITIS W/O MCC $ 40,781 605 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC $ 39,896 607 MINOR SKIN DISORDERS W/O MCC $ 73,545 617 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC $ 101,740 622 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC $ 242,676 624 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W/O CC/ $ 38,455 629 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC $ 105,169 637 DIABETES W MCC $ 88,986 638 DIABETES W CC $ 47,415 639 DIABETES W/O CC/MCC $ 34,085 640 NUTRITIONAL & MISC METABOLIC DISORDERS W MCC $ 73,383 641 NUTRITIONAL & MISC METABOLIC DISORDERS W/O MCC $ 42,014 642 INBORN ERRORS OF METABOLISM $ 21,706 643 ENDOCRINE DISORDERS W MCC $ 32,179 644 ENDOCRINE DISORDERS W CC $ 30,559 673 OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC $ 260,845 674 OTHER KIDNEY & URINARY TRACT PROCEDURES W CC $ 207,192 682 RENAL FAILURE W MCC $ 100,301 683 RENAL FAILURE W CC $ 43,274 684 RENAL FAILURE W/O CC/MCC $ 23,217 687 KIDNEY & URINARY TRACT NEOPLASMS W CC $ 56,482 689 KIDNEY & URINARY TRACT INFECTIONS W MCC $ 55,051 690 KIDNEY & URINARY TRACT INFECTIONS W/O MCC $ 43,518 694 URINARY STONES W/O ESW LITHOTRIPSY W/O MCC $ 29,145 698 OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC $ 66,877 699 OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC $ 71,163 723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC $ 53,232 727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC $ 29,246 728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC $ 41,193 742 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC $ 66,394 743 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC $ 60,208 746 VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC $ 53,361

757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC $ 9,625 759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC $ 43,168 776 POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE $ 42,364 781 OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS $ 24,907 809 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC $ 49,833 811 RED BLOOD CELL DISORDERS W MCC $ 85,246 812 RED BLOOD CELL DISORDERS W/O MCC $ 42,142 813 COAGULATION DISORDERS $ 40,812 834 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC $ 31,518 840 LYMPHOMA & NON-ACUTE LEUKEMIA W MCC $ 169,998 853 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC $ 267,917 854 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC $ 156,447 856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC $ 972,524 857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC $ 55,509 858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MC $ 34,566 862 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC $ 199,885 863 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC $ 41,191 864 FEVER $ 80,880 865 VIRAL ILLNESS W MCC $ 19,157 866 VIRAL ILLNESS W/O MCC $ 55,035 870 SEPTICEMIA OR SEVERE SEPSIS W MV 96+ HOURS $ 273,998 871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC $ 98,990 872 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC $ 49,021 880 ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION $ 17,172 884 ORGANIC DISTURBANCES & MENTAL RETARDATION $ 51,870 894 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA $ 29,885 896 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MC $ 50,404 897 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O $ 50,836 902 WOUND DEBRIDEMENTS FOR INJURIES W CC $ 86,352 907 OTHER O.R. PROCEDURES FOR INJURIES W MCC $ 158,140 909 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC $ 71,899 913 TRAUMATIC INJURY W MCC $ 261,733 917 POISONING & TOXIC EFFECTS OF DRUGS W MCC $ 99,850

918 POISONING & TOXIC EFFECTS OF DRUGS W/O MCC $ 44,725 919 COMPLICATIONS OF TREATMENT W MCC $ 70,741 920 COMPLICATIONS OF TREATMENT W CC $ 61,609 947 SIGNS & SYMPTOMS W MCC $ 84,227 948 SIGNS & SYMPTOMS W/O MCC $ 46,288 949 AFTERCARE W CC/MCC $ 45,147 950 AFTERCARE W/O CC/MCC $ 38,694 964 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC $ 132,307 974 HIV W MAJOR RELATED CONDITION W MCC $ 120,465 975 HIV W MAJOR RELATED CONDITION W CC $ 95,070 977 HIV W OR W/O OTHER RELATED CONDITION $ 9,699 981 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $ 279,202 982 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC $ 135,906 983 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC $ 56,872 988 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC $ 99,944 989 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/ $ 66,505