Per Inpatient Case - based on MS DRG 003 ECMO or trach w MV 96+ hrs or pdx exc face, mouth & neck w maj O.R. 737,213 004 Trach w MV 96+ hrs or pdx exc face, mouth & neck w/o maj O.R. 298,769 011 Tracheostomy for face,mouth & neck diagnoses w MCC 70,874 012 Tracheostomy for face,mouth & neck diagnoses w CC 59,381 023 Cranio w major dev impl/acute complex cns pdx w MCC or chemo implant 175,064 025 Craniotomy & endovascular intracranial procedures w MCC 63,872 026 Craniotomy & endovascular intracranial procedures w CC 106,386 027 Craniotomy & endovascular intracranial procedures w/o CC/MCC 60,141 028 Spinal procedures w MCC 55,265 029 Spinal procedures w CC or spinal neurostimulators 68,537 030 Spinal procedures w/o CC/MCC 60,336 032 Ventricular shunt procedures w CC 24,625 035 Carotid artery stent procedure w CC 29,648 037 Extracranial procedures w MCC 85,292 038 Extracranial procedures w CC 47,954 039 Extracranial procedures w/o CC/MCC 31,998 040 Periph/cranial nerve & other nerv syst proc w MCC 89,459 041 Periph/cranial nerve & other nerv syst proc w CC or periph neurostim 12,859 052 Spinal disorders & injuries w CC/MCC 26,042 054 Nervous system neoplasms w MCC 43,904 055 Nervous system neoplasms w/o MCC 36,262 056 Degenerative nervous system disorders w MCC 55,089 057 Degenerative nervous system disorders w/o MCC 34,302 058 Multiple sclerosis & cerebellar ataxia w MCC 25,594 059 Multiple sclerosis & cerebellar ataxia w CC 37,480 060 Multiple sclerosis & cerebellar ataxia w/o CC/MCC 17,287 061 Acute ischemic stroke w use of thrombolytic agent w MCC 117,642 062 Acute ischemic stroke w use of thrombolytic agent w CC 114,464 063 Acute ischemic stroke w use of thrombolytic agent w/o CC/MCC 43,605 064 Intracranial hemorrhage or cerebral infarction w MCC 64,879 065 Intracranial hemorrhage or cerebral infarction w CC 58,094 066 Intracranial hemorrhage or cerebral infarction w/o CC/MCC 36,597 067 Nonspecific cva & precerebral occlusion w/o infarct w MCC 32,119 068 Nonspecific cva & precerebral occlusion w/o infarct w/o MCC 28,461 069 Transient ischemia 26,540 070 Nonspecific cerebrovascular disorders w MCC 57,443 071 Nonspecific cerebrovascular disorders w CC 29,274 072 Nonspecific cerebrovascular disorders w/o CC/MCC 21,602 073 Cranial & peripheral nerve disorders w MCC 26,459 074 Cranial & peripheral nerve disorders w/o MCC 22,682 076 Viral meningitis w/o CC/MCC 20,130 077 Hypertensive encephalopathy w MCC 60,524 078 Hypertensive encephalopathy w CC 28,688 081 Nontraumatic stupor & coma w/o MCC 12,627 082 Traumatic stupor & coma, coma >1 hr w MCC 73,657 083 Traumatic stupor & coma, coma >1 hr w CC 72,856 084 Traumatic stupor & coma, coma >1 hr w/o CC/MCC 33,830 085 Traumatic stupor & coma, coma <1 hr w MCC 56,055 086 Traumatic stupor & coma, coma <1 hr w CC 45,628 087 Traumatic stupor & coma, coma <1 hr w/o CC/MCC 28,111 089 Concussion w CC 21,091 090 Concussion w/o CC/MCC 24,233 091 Other disorders of nervous system w MCC 58,971 092 Other disorders of nervous system w CC 35,143 093 Other disorders of nervous system w/o CC/MCC 27,490
Per Inpatient Case - based on MS DRG 095 Bacterial & tuberculous infections of nervous system w CC 95,630 096 Bacterial & tuberculous infections of nervous system w/o CC/MCC 71,543 097 Non-bacterial infect of nervous sys exc viral meningitis w MCC 51,867 098 Non-bacterial infect of nervous sys exc viral meningitis w CC 68,479 099 Non-bacterial infect of nervous sys exc viral meningitis w/o CC/MCC 19,340 100 Seizures w MCC 54,837 101 Seizures w/o MCC 19,042 102 Headaches w MCC 41,502 103 Headaches w/o MCC 22,856 115 Extraocular procedures except orbit 14,335 121 Acute major eye infections w CC/MCC 16,649 123 Neurological eye disorders 21,265 125 Other disorders of the eye w/o MCC 29,521 129 Major head & neck procedures w CC/MCC or major device 22,913 131 Cranial/facial procedures w CC/MCC 33,560 132 Cranial/facial procedures w/o CC/MCC 24,803 134 Other ear, nose, mouth & throat O.R. procedures w/o CC/MCC 12,736 137 Mouth procedures w CC/MCC 18,325 138 Mouth procedures w/o CC/MCC 23,064 146 Ear, nose, mouth & throat malignancy w MCC 5,701 149 Dysequilibrium 23,160 151 Epistaxis w/o MCC 24,728 152 Otitis media & URI w MCC 34,469 153 Otitis media & URI w/o MCC 21,430 155 Other ear, nose, mouth & throat diagnoses w CC 24,692 156 Other ear, nose, mouth & throat diagnoses w/o CC/MCC 16,769 157 Dental & oral diseases w MCC 34,931 158 Dental & oral diseases w CC 40,233 163 Major chest procedures w MCC 113,697 164 Major chest procedures w CC 59,032 165 Major chest procedures w/o CC/MCC 46,488 166 Other resp system O.R. procedures w MCC 104,917 167 Other resp system O.R. procedures w CC 114,470 168 Other resp system O.R. procedures w/o CC/MCC 35,381 175 Pulmonary embolism w MCC 49,551 176 Pulmonary embolism w/o MCC 32,136 177 Respiratory infections & inflammations w MCC 65,572 178 Respiratory infections & inflammations w CC 62,517 179 Respiratory infections & inflammations w/o CC/MCC 40,868 180 Respiratory neoplasms w MCC 62,394 181 Respiratory neoplasms w CC 31,310 182 Respiratory neoplasms w/o CC/MCC 18,238 183 Major chest trauma w MCC 58,198 184 Major chest trauma w CC 41,451 185 Major chest trauma w/o CC/MCC 26,043 186 Pleural effusion w MCC 65,738 187 Pleural effusion w CC 53,930 188 Pleural effusion w/o CC/MCC 53,351 189 Pulmonary edema & respiratory failure 41,959 190 Chronic obstructive pulmonary disease w MCC 43,982 191 Chronic obstructive pulmonary disease w CC 39,388 192 Chronic obstructive pulmonary disease w/o CC/MCC 25,311 193 Simple pneumonia & pleurisy w MCC 48,203 194 Simple pneumonia & pleurisy w CC 32,235 195 Simple pneumonia & pleurisy w/o CC/MCC 19,593
Per Inpatient Case - based on MS DRG 196 Interstitial lung disease w MCC 57,373 198 Interstitial lung disease w/o CC/MCC 10,531 199 Pneumothorax w MCC 57,154 200 Pneumothorax w CC 32,956 201 Pneumothorax w/o CC/MCC 28,609 202 Bronchitis & asthma w CC/MCC 36,252 203 Bronchitis & asthma w/o CC/MCC 20,395 204 Respiratory signs & symptoms 21,060 205 Other respiratory system diagnoses w MCC 46,341 206 Other respiratory system diagnoses w/o MCC 30,559 207 Respiratory system diagnosis w ventilator support 96+ hours 145,284 208 Respiratory system diagnosis w ventilator support <96 hours 80,295 222 Cardiac defib implant w cardiac cath w AMI/HF/shock w MCC 199,883 223 Cardiac defib implant w cardiac cath w AMI/HF/shock w/o MCC 178,453 224 Cardiac defib implant w cardiac cath w/o AMI/HF/shock w MCC 217,400 226 Cardiac defibrillator implant w/o cardiac cath w MCC 181,551 227 Cardiac defibrillator implant w/o cardiac cath w/o MCC 162,827 237 Major cardiovasc procedures w MCC 121,658 238 Major cardiovasc procedures w/o MCC 80,934 239 Amputation for circ sys disorders exc upper limb & toe w MCC 84,438 240 Amputation for circ sys disorders exc upper limb & toe w CC 78,361 242 Permanent cardiac pacemaker implant w MCC 100,881 243 Permanent cardiac pacemaker implant w CC 79,235 244 Permanent cardiac pacemaker implant w/o CC/MCC 73,653 245 Aicd generator procedures 156,081 246 Perc cardiovasc proc w drug-eluting stent w MCC or 4+ vessels/stents 104,227 247 Perc cardiovasc proc w drug-eluting stent w/o MCC 69,357 248 Perc cardiovasc proc w non-drug-eluting stent w MCC or 4+ ves/stents 83,536 249 Perc cardiovasc proc w non-drug-eluting stent w/o MCC 66,519 250 Perc cardiovasc proc w/o coronary artery stent w MCC 97,672 251 Perc cardiovasc proc w/o coronary artery stent w/o MCC 69,282 252 Other vascular procedures w MCC 107,480 253 Other vascular procedures w CC 70,709 254 Other vascular procedures w/o CC/MCC 40,056 255 Upper limb & toe amputation for circ system disorders w MCC 228,531 257 Upper limb & toe amputation for circ system disorders w/o CC/MCC 62,930 259 Cardiac pacemaker device replacement w/o MCC 135,242 260 Cardiac pacemaker revision except device replacement w MCC 62,575 261 Cardiac pacemaker revision except device replacement w CC 58,171 262 Cardiac pacemaker revision except device replacement w/o CC/MCC 51,418 264 Other circulatory system O.R. procedures 94,183 265 Aicd lead procedures 163,641 280 Acute myocardial infarction, discharged alive w MCC 59,912 281 Acute myocardial infarction, discharged alive w CC 43,654 282 Acute myocardial infarction, discharged alive w/o CC/MCC 28,872 283 Acute myocardial infarction, expired w MCC 67,428 284 Acute myocardial infarction, expired w CC 13,749 286 Circulatory disorders except AMI, w card cath w MCC 66,685 287 Circulatory disorders except AMI, w card cath w/o MCC 33,993 288 Acute & subacute endocarditis w MCC 91,362 289 Acute & subacute endocarditis w CC 27,011 291 Heart failure & shock w MCC 52,276 292 Heart failure & shock w CC 40,068 293 Heart failure & shock w/o CC/MCC 29,790 294 Deep vein thrombophlebitis w CC/MCC 19,391
Per Inpatient Case - based on MS DRG 296 Cardiac arrest, unexplained w MCC 23,342 299 Peripheral vascular disorders w MCC 47,403 300 Peripheral vascular disorders w CC 40,061 301 Peripheral vascular disorders w/o CC/MCC 35,907 302 Atherosclerosis w MCC 40,338 303 Atherosclerosis w/o MCC 23,089 304 Hypertension w MCC 52,023 305 Hypertension w/o MCC 30,036 307 Cardiac congenital & valvular disorders w/o MCC 33,400 308 Cardiac arrhythmia & conduction disorders w MCC 54,733 309 Cardiac arrhythmia & conduction disorders w CC 32,513 310 Cardiac arrhythmia & conduction disorders w/o CC/MCC 25,762 311 Angina pectoris 21,161 312 Syncope & collapse 30,460 313 Chest pain 21,988 314 Other circulatory system diagnoses w MCC 48,412 315 Other circulatory system diagnoses w CC 35,753 316 Other circulatory system diagnoses w/o CC/MCC 24,038 326 Stomach, esophageal & duodenal proc w MCC 120,715 327 Stomach, esophageal & duodenal proc w CC 96,571 328 Stomach, esophageal & duodenal proc w/o CC/MCC 32,898 329 Major small & large bowel procedures w MCC 145,352 330 Major small & large bowel procedures w CC 65,037 331 Major small & large bowel procedures w/o CC/MCC 47,577 333 Rectal resection w CC 51,694 334 Rectal resection w/o CC/MCC 24,197 335 Peritoneal adhesiolysis w MCC 170,812 336 Peritoneal adhesiolysis w CC 79,281 337 Peritoneal adhesiolysis w/o CC/MCC 39,256 339 Appendectomy w complicated principal diag w CC 33,751 340 Appendectomy w complicated principal diag w/o CC/MCC 31,816 342 Appendectomy w/o complicated principal diag w CC 19,171 343 Appendectomy w/o complicated principal diag w/o CC/MCC 20,500 346 Minor small & large bowel procedures w/o CC/MCC 39,379 347 Anal & stomal procedures w MCC 89,137 348 Anal & stomal procedures w CC 70,273 349 Anal & stomal procedures w/o CC/MCC 8,017 350 Inguinal & femoral hernia procedures w MCC 53,988 351 Inguinal & femoral hernia procedures w CC 24,779 352 Inguinal & femoral hernia procedures w/o CC/MCC 19,373 353 Hernia procedures except inguinal & femoral w MCC 91,259 354 Hernia procedures except inguinal & femoral w CC 47,109 355 Hernia procedures except inguinal & femoral w/o CC/MCC 41,869 356 Other digestive system O.R. procedures w MCC 41,703 357 Other digestive system O.R. procedures w CC 50,943 358 Other digestive system O.R. procedures w/o CC/MCC 37,633 369 Major esophageal disorders w CC 33,911 370 Major esophageal disorders w/o CC/MCC 38,157 371 Major gastrointestinal disorders & peritoneal infections w MCC 46,161 372 Major gastrointestinal disorders & peritoneal infections w CC 43,007 373 Major gastrointestinal disorders & peritoneal infections w/o CC/MCC 24,626 374 Digestive malignancy w MCC 59,699 375 Digestive malignancy w CC 48,011 376 Digestive malignancy w/o CC/MCC 8,819 377 G.I. hemorrhage w MCC 49,259
Per Inpatient Case - based on MS DRG 378 G.I. hemorrhage w CC 35,978 379 G.I. hemorrhage w/o CC/MCC 27,287 381 Complicated peptic ulcer w CC 44,130 382 Complicated peptic ulcer w/o CC/MCC 46,303 383 Uncomplicated peptic ulcer w MCC 49,672 384 Uncomplicated peptic ulcer w/o MCC 25,008 386 Inflammatory bowel disease w CC 27,877 387 Inflammatory bowel disease w/o CC/MCC 28,729 388 G.I. obstruction w MCC 67,274 389 G.I. obstruction w CC 30,454 390 G.I. obstruction w/o CC/MCC 24,991 391 Esophagitis, gastroent & misc digest disorders w MCC 44,360 392 Esophagitis, gastroent & misc digest disorders w/o MCC 23,823 393 Other digestive system diagnoses w MCC 55,080 394 Other digestive system diagnoses w CC 29,870 395 Other digestive system diagnoses w/o CC/MCC 24,272 405 Pancreas, liver & shunt procedures w MCC 108,887 410 Biliary tract proc except only cholecyst w or w/o c.d.e. w/o CC/MCC 17,988 414 Cholecystectomy except by laparoscope w/o c.d.e. w MCC 134,998 415 Cholecystectomy except by laparoscope w/o c.d.e. w CC 88,238 416 Cholecystectomy except by laparoscope w/o c.d.e. w/o CC/MCC 50,724 417 Laparoscopic cholecystectomy w/o c.d.e. w MCC 45,736 418 Laparoscopic cholecystectomy w/o c.d.e. w CC 43,644 419 Laparoscopic cholecystectomy w/o c.d.e. w/o CC/MCC 27,653 423 Other hepatobiliary or pancreas O.R. procedures w MCC 103,742 424 Other hepatobiliary or pancreas O.R. procedures w CC 134,300 425 Other hepatobiliary or pancreas O.R. procedures w/o CC/MCC 26,488 432 Cirrhosis & alcoholic hepatitis w MCC 48,649 433 Cirrhosis & alcoholic hepatitis w CC 45,693 434 Cirrhosis & alcoholic hepatitis w/o CC/MCC 23,766 435 Malignancy of hepatobiliary system or pancreas w MCC 51,484 436 Malignancy of hepatobiliary system or pancreas w CC 37,801 438 Disorders of pancreas except malignancy w MCC 48,458 439 Disorders of pancreas except malignancy w CC 27,335 440 Disorders of pancreas except malignancy w/o CC/MCC 21,021 441 Disorders of liver except malig,cirr,alc hepa w MCC 49,175 442 Disorders of liver except malig,cirr,alc hepa w CC 31,339 443 Disorders of liver except malig,cirr,alc hepa w/o CC/MCC 27,925 444 Disorders of the biliary tract w MCC 39,817 445 Disorders of the biliary tract w CC 34,149 446 Disorders of the biliary tract w/o CC/MCC 23,034 457 Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w CC 187,201 458 Spinal fus exc cerv w spinal curv/malig/infec or 9+ fus w/o CC/MCC 46,348 459 Spinal fusion except cervical w MCC 131,490 460 Spinal fusion except cervical w/o MCC 94,731 462 Bilateral or multiple major joint procs of lower extremity w/o MCC 57,471 463 Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w MCC 96,474 464 Wnd debrid & skn grft exc hand, for musculo-conn tiss dis w CC 220,247 466 Revision of hip or knee replacement w MCC 62,975 467 Revision of hip or knee replacement w CC 58,605 468 Revision of hip or knee replacement w/o CC/MCC 53,692 469 Major joint replacement or reattachment of lower extremity w MCC 57,349 470 Major joint replacement or reattachment of lower extremity w/o MCC 46,099 471 Cervical spinal fusion w MCC 55,614 472 Cervical spinal fusion w CC 52,383
Per Inpatient Case - based on MS DRG 473 Cervical spinal fusion w/o CC/MCC 48,671 474 Amputation for musculoskeletal sys & conn tissue dis w MCC 126,220 475 Amputation for musculoskeletal sys & conn tissue dis w CC 89,587 477 Biopsies of musculoskeletal system & connective tissue w MCC 94,276 478 Biopsies of musculoskeletal system & connective tissue w CC 78,774 479 Biopsies of musculoskeletal system & connective tissue w/o CC/MCC 46,173 480 Hip & femur procedures except major joint w MCC 85,328 481 Hip & femur procedures except major joint w CC 59,097 482 Hip & femur procedures except major joint w/o CC/MCC 39,546 483 Major joint & limb reattachment proc of upper extremity w CC/MCC 67,176 484 Major joint & limb reattachment proc of upper extremity w/o CC/MCC 52,852 485 Knee procedures w pdx of infection w MCC 59,178 486 Knee procedures w pdx of infection w CC 37,509 488 Knee procedures w/o pdx of infection w CC/MCC 55,036 489 Knee procedures w/o pdx of infection w/o CC/MCC 40,005 490 Back & neck proc exc spinal fusion w CC/MCC or disc device/neurostim 49,941 491 Back & neck proc exc spinal fusion w/o CC/MCC 30,107 493 Lower extrem & humer proc except hip,foot,femur w CC 52,970 494 Lower extrem & humer proc except hip,foot,femur w/o CC/MCC 40,798 496 Local excision & removal int fix devices exc hip & femur w CC 31,794 497 Local excision & removal int fix devices exc hip & femur w/o CC/MCC 57,210 498 Local excision & removal int fix devices of hip & femur w CC/MCC 50,732 501 Soft tissue procedures w CC 33,879 502 Soft tissue procedures w/o CC/MCC 19,345 506 Major thumb or joint procedures 31,847 508 Major shoulder or elbow joint procedures w/o CC/MCC 18,757 511 Shoulder,elbow or forearm proc,exc major joint proc w CC 71,014 512 Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC 27,931 513 Hand or wrist proc, except major thumb or joint proc w CC/MCC 17,097 514 Hand or wrist proc, except major thumb or joint proc w/o CC/MCC 21,503 515 Other musculoskelet sys & conn tiss O.R. proc w MCC 114,585 516 Other musculoskelet sys & conn tiss O.R. proc w CC 60,498 517 Other musculoskelet sys & conn tiss O.R. proc w/o CC/MCC 39,673 533 Fractures of femur w MCC 44,554 535 Fractures of hip & pelvis w MCC 39,619 536 Fractures of hip & pelvis w/o MCC 21,128 539 Osteomyelitis w MCC 22,078 540 Osteomyelitis w CC 29,291 541 Osteomyelitis w/o CC/MCC 7,503 542 Pathological fractures & musculoskelet & conn tiss malig w MCC 38,653 543 Pathological fractures & musculoskelet & conn tiss malig w CC 47,091 544 Pathological fractures & musculoskelet & conn tiss malig w/o CC/MCC 19,510 546 Connective tissue disorders w CC 41,283 547 Connective tissue disorders w/o CC/MCC 22,563 551 Medical back problems w MCC 45,133 552 Medical back problems w/o MCC 27,682 553 Bone diseases & arthropathies w MCC 24,435 554 Bone diseases & arthropathies w/o MCC 23,737 555 Signs & symptoms of musculoskeletal system & conn tissue w MCC 54,052 556 Signs & symptoms of musculoskeletal system & conn tissue w/o MCC 29,653 557 Tendonitis, myositis & bursitis w MCC 67,798 558 Tendonitis, myositis & bursitis w/o MCC 24,956 559 Aftercare, musculoskeletal system & connective tissue w MCC 110,561 560 Aftercare, musculoskeletal system & connective tissue w CC 51,496 562 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC 36,954
Per Inpatient Case - based on MS DRG 563 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC 30,592 564 Other musculoskeletal sys & connective tissue diagnoses w MCC 51,713 565 Other musculoskeletal sys & connective tissue diagnoses w CC 49,836 571 Skin debridement w CC 65,470 572 Skin debridement w/o CC/MCC 28,587 573 Skin graft for skin ulcer or cellulitis w MCC 31,188 575 Skin graft for skin ulcer or cellulitis w/o CC/MCC 115,625 577 Skin graft exc for skin ulcer or cellulitis w CC 58,235 578 Skin graft exc for skin ulcer or cellulitis w/o CC/MCC 28,369 579 Other skin, subcut tiss & breast proc w MCC 34,110 580 Other skin, subcut tiss & breast proc w CC 70,298 581 Other skin, subcut tiss & breast proc w/o CC/MCC 32,455 582 Mastectomy for malignancy w CC/MCC 21,312 585 Breast biopsy, local excision & other breast procedures w/o CC/MCC 56,310 592 Skin ulcers w MCC 34,000 593 Skin ulcers w CC 31,172 594 Skin ulcers w/o CC/MCC 14,014 595 Major skin disorders w MCC 48,692 596 Major skin disorders w/o MCC 27,783 598 Malignant breast disorders w CC 70,977 599 Malignant breast disorders w/o CC/MCC 47,283 600 Non-malignant breast disorders w CC/MCC 18,909 601 Non-malignant breast disorders w/o CC/MCC 24,788 602 Cellulitis w MCC 33,113 603 Cellulitis w/o MCC 26,565 604 Trauma to the skin, subcut tiss & breast w MCC 25,725 605 Trauma to the skin, subcut tiss & breast w/o MCC 26,588 607 Minor skin disorders w/o MCC 23,073 616 Amputat of lower limb for endocrine,nutrit,& metabol dis w MCC 86,691 617 Amputat of lower limb for endocrine,nutrit,& metabol dis w CC 127,483 619 O.R. procedures for obesity w MCC 25,627 620 O.R. procedures for obesity w CC 18,640 621 O.R. procedures for obesity w/o CC/MCC 19,353 622 Skin grafts & wound debrid for endoc, nutrit & metab dis w MCC 35,653 626 Thyroid, parathyroid & thyroglossal procedures w CC 46,690 627 Thyroid, parathyroid & thyroglossal procedures w/o CC/MCC 29,265 628 Other endocrine, nutrit & metab O.R. proc w MCC 52,125 629 Other endocrine, nutrit & metab O.R. proc w CC 102,282 637 Diabetes w MCC 43,912 638 Diabetes w CC 28,102 639 Diabetes w/o CC/MCC 19,298 640 Misc disorders of nutrition,metabolism,fluids/electrolytes w MCC 38,181 641 Misc disorders of nutrition,metabolism,fluids/electrolytes w/o MCC 21,062 642 Inborn and other disorders of metabolism 15,998 643 Endocrine disorders w MCC 36,585 644 Endocrine disorders w CC 27,536 645 Endocrine disorders w/o CC/MCC 31,698 654 Major bladder procedures w CC 74,126 655 Major bladder procedures w/o CC/MCC 92,417 656 Kidney & ureter procedures for neoplasm w MCC 105,290 657 Kidney & ureter procedures for neoplasm w CC 42,565 658 Kidney & ureter procedures for neoplasm w/o CC/MCC 32,294 660 Kidney & ureter procedures for non-neoplasm w CC 42,884 661 Kidney & ureter procedures for non-neoplasm w/o CC/MCC 30,559 664 Minor bladder procedures w/o CC/MCC 28,402
Per Inpatient Case - based on MS DRG 668 Transurethral procedures w MCC 43,850 669 Transurethral procedures w CC 34,625 670 Transurethral procedures w/o CC/MCC 19,663 673 Other kidney & urinary tract procedures w MCC 96,056 674 Other kidney & urinary tract procedures w CC 100,708 675 Other kidney & urinary tract procedures w/o CC/MCC 45,953 682 Renal failure w MCC 49,878 683 Renal failure w CC 35,428 684 Renal failure w/o CC/MCC 21,451 685 Admit for renal dialysis 16,990 687 Kidney & urinary tract neoplasms w CC 17,959 689 Kidney & urinary tract infections w MCC 37,471 690 Kidney & urinary tract infections w/o MCC 23,927 693 Urinary stones w/o esw lithotripsy w MCC 24,608 694 Urinary stones w/o esw lithotripsy w/o MCC 18,278 695 Kidney & urinary tract signs & symptoms w MCC 54,155 696 Kidney & urinary tract signs & symptoms w/o MCC 24,836 698 Other kidney & urinary tract diagnoses w MCC 39,181 699 Other kidney & urinary tract diagnoses w CC 36,049 700 Other kidney & urinary tract diagnoses w/o CC/MCC 30,167 707 Major male pelvic procedures w CC/MCC 40,445 708 Major male pelvic procedures w/o CC/MCC 34,480 713 Transurethral prostatectomy w CC/MCC 52,104 714 Transurethral prostatectomy w/o CC/MCC 17,064 717 Other male reproductive system O.R. proc exc malignancy w CC/MCC 32,088 726 Benign prostatic hypertrophy w/o MCC 21,684 728 Inflammation of the male reproductive system w/o MCC 21,020 742 Uterine & adnexa proc for non-malignancy w CC/MCC 49,981 743 Uterine & adnexa proc for non-malignancy w/o CC/MCC 25,699 744 D&C, conization, laparoscopy & tubal interruption w CC/MCC 47,682 749 Other female reproductive system O.R. procedures w CC/MCC 114,077 754 Malignancy, female reproductive system w MCC 503 755 Malignancy, female reproductive system w CC 8,562 757 Infections, female reproductive system w MCC 23,688 759 Infections, female reproductive system w/o CC/MCC 21,078 760 Menstrual & other female reproductive system disorders w CC/MCC 23,133 761 Menstrual & other female reproductive system disorders w/o CC/MCC 27,321 765 Cesarean section w CC/MCC 38,610 766 Cesarean section w/o CC/MCC 31,049 767 Vaginal delivery w sterilization &/or D&C 30,585 768 Vaginal delivery w O.R. proc except steril &/or D&C 21,393 769 Postpartum & post abortion diagnoses w O.R. procedure 46,246 770 Abortion w D&C, aspiration curettage or hysterotomy 19,005 774 Vaginal delivery w complicating diagnoses 23,864 775 Vaginal delivery w/o complicating diagnoses 20,780 776 Postpartum & post abortion diagnoses w/o O.R. procedure 19,261 777 Ectopic pregnancy 28,889 778 Threatened abortion 9,600 779 Abortion w/o D&C 13,161 780 False labor 8,875 781 Other antepartum diagnoses w medical complications 16,025 782 Other antepartum diagnoses w/o medical complications 11,281 789 Neonates, died or transferred to another acute care facility 14,062 790 Extreme immaturity or respiratory distress syndrome, neonate 47,727 791 Prematurity w major problems 55,885
Per Inpatient Case - based on MS DRG 792 Prematurity w/o major problems 19,703 793 Full term neonate w major problems 21,650 794 Neonate w other significant problems 8,628 795 Normal newborn 6,603 801 Splenectomy w/o CC/MCC 26,954 802 Other O.R. proc of the blood & blood forming organs w MCC 121,388 804 Other O.R. proc of the blood & blood forming organs w/o CC/MCC 49,247 808 Major hematol/immun diag exc sickle cell crisis & coagul w MCC 102,226 809 Major hematol/immun diag exc sickle cell crisis & coagul w CC 34,342 810 Major hematol/immun diag exc sickle cell crisis & coagul w/o CC/MCC 31,067 811 Red blood cell disorders w MCC 40,858 812 Red blood cell disorders w/o MCC 33,232 813 Coagulation disorders 44,970 814 Reticuloendothelial & immunity disorders w MCC 32,738 815 Reticuloendothelial & immunity disorders w CC 28,214 816 Reticuloendothelial & immunity disorders w/o CC/MCC 15,668 820 Lymphoma & leukemia w major O.R. procedure w MCC 141,958 821 Lymphoma & leukemia w major O.R. procedure w CC 60,017 823 Lymphoma & non-acute leukemia w other O.R. proc w MCC 63,297 824 Lymphoma & non-acute leukemia w other O.R. proc w CC 129,529 828 Myeloprolif disord or poorly diff neopl w maj O.R. proc w/o CC/MCC 32,266 834 Acute leukemia w/o major O.R. procedure w MCC 58,035 835 Acute leukemia w/o major O.R. procedure w CC 56,152 836 Acute leukemia w/o major O.R. procedure w/o CC/MCC 29,320 838 Chemo w acute leukemia as sdx w CC or high dose chemo agent 60,274 840 Lymphoma & non-acute leukemia w MCC 80,452 841 Lymphoma & non-acute leukemia w CC 62,356 842 Lymphoma & non-acute leukemia w/o CC/MCC 56,519 843 Other myeloprolif dis or poorly diff neopl diag w MCC 59,929 844 Other myeloprolif dis or poorly diff neopl diag w CC 46,042 845 Other myeloprolif dis or poorly diff neopl diag w/o CC/MCC 21,652 846 Chemotherapy w/o acute leukemia as secondary diagnosis w MCC 78,120 847 Chemotherapy w/o acute leukemia as secondary diagnosis w CC 32,584 849 Radiotherapy 74,690 853 Infectious & parasitic diseases w O.R. procedure w MCC 131,176 854 Infectious & parasitic diseases w O.R. procedure w CC 71,337 855 Infectious & parasitic diseases w O.R. procedure w/o CC/MCC 32,608 856 Postoperative or post-traumatic infections w O.R. proc w MCC 72,517 857 Postoperative or post-traumatic infections w O.R. proc w CC 55,077 862 Postoperative & post-traumatic infections w MCC 74,587 863 Postoperative & post-traumatic infections w/o MCC 30,399 864 Fever 23,083 865 Viral illness w MCC 28,485 866 Viral illness w/o MCC 18,932 867 Other infectious & parasitic diseases diagnoses w MCC 23,840 868 Other infectious & parasitic diseases diagnoses w CC 36,718 869 Other infectious & parasitic diseases diagnoses w/o CC/MCC 15,877 870 Septicemia or severe sepsis w MV 96+ hours 180,649 871 Septicemia or severe sepsis w/o MV 96+ hours w MCC 60,505 872 Septicemia or severe sepsis w/o MV 96+ hours w/o MCC 37,250 880 Acute adjustment reaction & psychosocial dysfunction 23,835 881 Depressive neuroses 21,443 882 Neuroses except depressive 18,523 883 Disorders of personality & impulse control 31,578 884 Organic disturbances & mental retardation 32,060
Per Inpatient Case - based on MS DRG 885 Psychoses 37,443 886 Behavioral & developmental disorders 24,917 894 Alcohol/drug abuse or dependence, left ama 21,372 896 Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC 59,071 897 Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC 23,207 906 Hand procedures for injuries 13,262 907 Other O.R. procedures for injuries w MCC 124,507 908 Other O.R. procedures for injuries w CC 80,988 909 Other O.R. procedures for injuries w/o CC/MCC 31,082 913 Traumatic injury w MCC 39,204 914 Traumatic injury w/o MCC 14,846 915 Allergic reactions w MCC 90,361 916 Allergic reactions w/o MCC 18,702 917 Poisoning & toxic effects of drugs w MCC 42,174 918 Poisoning & toxic effects of drugs w/o MCC 24,002 919 Complications of treatment w MCC 87,967 920 Complications of treatment w CC 27,493 921 Complications of treatment w/o CC/MCC 25,293 923 Other injury, poisoning & toxic effect diag w/o MCC 25,012 935 Non-extensive burns 19,904 939 O.R. proc w diagnoses of other contact w health services w MCC 47,605 945 Rehabilitation w CC/MCC 63,911 946 Rehabilitation w/o CC/MCC 52,946 947 Signs & symptoms w MCC 20,837 948 Signs & symptoms w/o MCC 25,207 949 Aftercare w CC/MCC 81,716 963 Other multiple significant trauma w MCC 45,520 964 Other multiple significant trauma w CC 50,204 965 Other multiple significant trauma w/o CC/MCC 69,804 974 HIV w major related condition w MCC 71,981 975 HIV w major related condition w CC 157,249 976 HIV w major related condition w/o CC/MCC 66,923 977 HIV w or w/o other related condition 26,496 981 Extensive O.R. procedure unrelated to principal diagnosis w MCC 210,979 982 Extensive O.R. procedure unrelated to principal diagnosis w CC 85,091 983 Extensive O.R. procedure unrelated to principal diagnosis w/o CC/MCC 41,895 987 Non-extensive O.R. proc unrelated to principal diagnosis w MCC 87,209 988 Non-extensive O.R. proc unrelated to principal diagnosis w CC 44,344 989 Non-extensive O.R. proc unrelated to principal diagnosis w/o CC/MCC 26,948