DRG DRG Description DRG
Avg
Charge
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST
SYSTEM W MCC
$711,571
003 ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE,
MOUTH & NECK W MAJ O.R.
$388,042
004 TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK
W/O MAJ O.R.
$227,859
005 LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT $439,350
006 LIVER TRANSPLANT W/O MCC $334,781
008 SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT $471,534
011 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES
W MCC
$151,622
012 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES
W CC
$152,253
013 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES
W/O CC/MCC
$85,532
014 ALLOGENEIC BONE MARROW TRANSPLANT $346,311
016 AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC $196,239
017 AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC $203,954
020 INTRACRANIAL VASCULAR PROCEDURES W PDX
HEMORRHAGE W MCC
$388,135
021 INTRACRANIAL VASCULAR PROCEDURES W PDX
HEMORRHAGE W CC
$253,824
023 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W
MCC OR CHEMO IMPLANT
$163,142
024 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX
W/O MCC
$119,969
025 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL
PROCEDURES W MCC
$113,745
026 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL
PROCEDURES W CC
$91,968
027 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL
PROCEDURES W/O CC/MCC
$99,817
028 SPINAL PROCEDURES W MCC $120,860
029 SPINAL PROCEDURES W CC OR SPINAL
NEUROSTIMULATORS
$88,261
030 SPINAL PROCEDURES W/O CC/MCC $65,655
031 VENTRICULAR SHUNT PROCEDURES W MCC $124,889
032 VENTRICULAR SHUNT PROCEDURES W CC $78,351
033 VENTRICULAR SHUNT PROCEDURES W/O CC/MCC $59,939
035 CAROTID ARTERY STENT PROCEDURE W CC $142,146
037 EXTRACRANIAL PROCEDURES W MCC $84,589
038 EXTRACRANIAL PROCEDURES W CC $36,846
039 EXTRACRANIAL PROCEDURES W/O CC/MCC $32,272
040 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W
MCC
$98,330
041 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC
OR PERIPH NEUROSTIM
$85,294
042 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O
CC/MCC
$71,761
052 SPINAL DISORDERS & INJURIES W CC/MCC $74,733
054 NERVOUS SYSTEM NEOPLASMS W MCC $53,435
055 NERVOUS SYSTEM NEOPLASMS W/O MCC $52,932
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC $63,647
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC $57,593
059 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC $71,645
060 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC $68,423
061 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC
AGENT W MCC
$142,527
062 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC
AGENT W CC
$72,460
063 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC
AGENT W/O CC/MCC
$80,982
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION
W MCC
$72,804
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION
W CC OR TPA IN 24 HRS
$45,777
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION
W/O CC/MCC
$39,269
067 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O
INFARCT W MCC
$55,557
068 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O
INFARCT W/O MCC
$24,046
069 TRANSIENT ISCHEMIA $33,021
070 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC $77,746
071 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC $47,095
072 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O
CC/MCC
$32,815
073 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC $47,488
074 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC $50,655
075 VIRAL MENINGITIS W CC/MCC $35,403
078 HYPERTENSIVE ENCEPHALOPATHY W CC $55,834
080 NONTRAUMATIC STUPOR & COMA W MCC $60,102
081 NONTRAUMATIC STUPOR & COMA W/O MCC $16,890
082 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC $58,866
083 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC $41,218
084 TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC $50,129
085 TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC $69,413
086 TRAUMATIC STUPOR & COMA, COMA <1 HR W CC $42,065
087 TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC $22,706
088 CONCUSSION W MCC $59,343
089 CONCUSSION W CC $18,967
090 CONCUSSION W/O CC/MCC $34,481
091 OTHER DISORDERS OF NERVOUS SYSTEM W MCC $52,298
092 OTHER DISORDERS OF NERVOUS SYSTEM W CC $43,058
093 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC $25,461
094 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS
SYSTEM W MCC
$53,292
097 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL
MENINGITIS W MCC
$106,645
100 SEIZURES W MCC $53,513
101 SEIZURES W/O MCC $43,992
102 HEADACHES W MCC $28,995
103 HEADACHES W/O MCC $46,734
113 ORBITAL PROCEDURES W CC/MCC $80,212
114 ORBITAL PROCEDURES W/O CC/MCC $11,960
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $38,806
117 INTRAOCULAR PROCEDURES W/O CC/MCC $47,289
123 NEUROLOGICAL EYE DISORDERS $49,845
124 OTHER DISORDERS OF THE EYE W MCC $112,258
125 OTHER DISORDERS OF THE EYE W/O MCC $28,229
129 MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR
DEVICE
$72,855
130 MAJOR HEAD & NECK PROCEDURES W/O CC/MCC $49,373
131 CRANIAL/FACIAL PROCEDURES W CC/MCC $77,813
132 CRANIAL/FACIAL PROCEDURES W/O CC/MCC $41,797
133 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES
W CC/MCC
$64,709
134 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES
W/O CC/MCC
$38,303
135 SINUS & MASTOID PROCEDURES W CC/MCC $65,853
136 SINUS & MASTOID PROCEDURES W/O CC/MCC $90,867
146 EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC $82,800
147 EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC $27,408
149 DYSEQUILIBRIUM $36,349
150 EPISTAXIS W MCC $38,002
151 EPISTAXIS W/O MCC $47,833
152 OTITIS MEDIA & URI W MCC $42,317
153 OTITIS MEDIA & URI W/O MCC $30,634
154 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC $31,065
155 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC $49,499
156 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O
CC/MCC
$30,855
157 DENTAL & ORAL DISEASES W MCC $47,087
158 DENTAL & ORAL DISEASES W CC $28,426
159 DENTAL & ORAL DISEASES W/O CC/MCC $31,280
163 MAJOR CHEST PROCEDURES W MCC $170,123
164 MAJOR CHEST PROCEDURES W CC $96,764
165 MAJOR CHEST PROCEDURES W/O CC/MCC $76,552
166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC $109,237
167 OTHER RESP SYSTEM O.R. PROCEDURES W CC $69,218
168 OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC $51,344
175 PULMONARY EMBOLISM W MCC $45,887
176 PULMONARY EMBOLISM W/O MCC $35,678
177 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC $69,682
178 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC $38,506
179 RESPIRATORY INFECTIONS & INFLAMMATIONS W/O
CC/MCC
$55,968
180 RESPIRATORY NEOPLASMS W MCC $73,417
181 RESPIRATORY NEOPLASMS W CC $45,675
182 RESPIRATORY NEOPLASMS W/O CC/MCC $60,125
183 MAJOR CHEST TRAUMA W MCC $45,148
184 MAJOR CHEST TRAUMA W CC $44,304
185 MAJOR CHEST TRAUMA W/O CC/MCC $43,014
186 PLEURAL EFFUSION W MCC $60,169
187 PLEURAL EFFUSION W CC $44,986
188 PLEURAL EFFUSION W/O CC/MCC $41,583
189 PULMONARY EDEMA & RESPIRATORY FAILURE $47,828
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC $60,093
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC $36,939
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O
CC/MCC
$24,790
193 SIMPLE PNEUMONIA & PLEURISY W MCC $54,437
194 SIMPLE PNEUMONIA & PLEURISY W CC $38,484
195 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC $32,911
196 INTERSTITIAL LUNG DISEASE W MCC $71,308
197 INTERSTITIAL LUNG DISEASE W CC $31,762
199 PNEUMOTHORAX W MCC $80,759
200 PNEUMOTHORAX W CC $44,834
201 PNEUMOTHORAX W/O CC/MCC $23,453
202 BRONCHITIS & ASTHMA W CC/MCC $36,667
203 BRONCHITIS & ASTHMA W/O CC/MCC $23,848
204 RESPIRATORY SIGNS & SYMPTOMS $31,502
205 OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC $36,129
206 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC $38,790
207 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR
SUPPORT >96 HOURS
$171,426
208 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR
SUPPORT <=96 HOURS
$83,115
215 OTHER HEART ASSIST SYSTEM IMPLANT $259,820
216 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W
CARD CATH W MCC
$318,286
217 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W
CARD CATH W CC
$291,237
219 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O
CARD CATH W MCC
$211,419
220 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O
CARD CATH W CC
$161,928
221 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O
CARD CATH W/O CC/MCC
$131,190
222 CARDIAC DEFIB IMPLANT W CARDIAC CATH W
AMI/HF/SHOCK W MCC
$183,427
223 CARDIAC DEFIB IMPLANT W CARDIAC CATH W
AMI/HF/SHOCK W/O MCC
$146,222
224 CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O
AMI/HF/SHOCK W MCC
$184,009
225 CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O
AMI/HF/SHOCK W/O MCC
$166,493
226 CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W
MCC
$200,962
227 CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH
W/O MCC
$160,154
228 OTHER CARDIOTHORACIC PROCEDURES W MCC $206,777
229 OTHER CARDIOTHORACIC PROCEDURES W/O MCC $153,629
231 CORONARY BYPASS W PTCA W MCC $217,567
233 CORONARY BYPASS W CARDIAC CATH W MCC $221,729
234 CORONARY BYPASS W CARDIAC CATH W/O MCC $203,985
235 CORONARY BYPASS W/O CARDIAC CATH W MCC $171,347
236 CORONARY BYPASS W/O CARDIAC CATH W/O MCC $141,397
239 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB
& TOE W MCC
$106,903
240 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB
& TOE W CC
$85,452
241 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB
& TOE W/O CC/MCC
$102,321
242 PERMANENT CARDIAC PACEMAKER IMPLANT W MCC $107,297
243 PERMANENT CARDIAC PACEMAKER IMPLANT W CC $83,740
244 PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC $66,354
245 AICD GENERATOR PROCEDURES $147,959
246 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W
MCC OR 4+ VESSELS/STENTS
$118,244
247 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O
MCC
$90,451
248 PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT
W MCC OR 4+ VES/STENTS
$119,831
249 PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT
W/O MCC
$77,247
250 PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT
W MCC
$61,857
251 PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT
W/O MCC
$101,906
252 OTHER VASCULAR PROCEDURES W MCC $90,100
253 OTHER VASCULAR PROCEDURES W CC $99,788
254 OTHER VASCULAR PROCEDURES W/O CC/MCC $57,073
255 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM
DISORDERS W MCC
$65,047
256 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM
DISORDERS W CC
$62,211
259 CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC $44,638
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE
REPLACEMENT W MCC
$100,420
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE
REPLACEMENT W CC
$74,901
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $110,171
265 AICD LEAD PROCEDURES $102,320
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC $211,505
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O
MCC
$188,854
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT
PULSATION BALLOON W MCC
$212,974
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT
PULSATION BALLOON W/O MCC
$137,170
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC $182,410
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC $111,478
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O
CC/MCC
$96,876
273 PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC $143,495
274 PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC $96,735
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W
MCC
$67,622
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W
CC
$44,430
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE
W/O CC/MCC
$39,849
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC $67,505
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC $73,030
286 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W
MCC
$86,311
287 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH
W/O MCC
$51,629
288 ACUTE & SUBACUTE ENDOCARDITIS W MCC $74,770
289 ACUTE & SUBACUTE ENDOCARDITIS W CC $74,910
291 HEART FAILURE & SHOCK W MCC $52,358
292 HEART FAILURE & SHOCK W CC $41,745
293 HEART FAILURE & SHOCK W/O CC/MCC $33,931
294 DEEP VEIN THROMBOPHLEBITIS W CC/MCC $26,114
296 CARDIAC ARREST, UNEXPLAINED W MCC $152,438
299 PERIPHERAL VASCULAR DISORDERS W MCC $43,910
300 PERIPHERAL VASCULAR DISORDERS W CC $32,789
301 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC $20,913
302 ATHEROSCLEROSIS W MCC $41,817
303 ATHEROSCLEROSIS W/O MCC $36,987
304 HYPERTENSION W MCC $44,085
305 HYPERTENSION W/O MCC $32,242
306 CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC $57,371
307 CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC $20,759
308 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W
MCC
$45,308
309 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC $28,715
310 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O
CC/MCC
$23,488
311 ANGINA PECTORIS $17,596
312 SYNCOPE & COLLAPSE $38,317
313 CHEST PAIN $38,473
314 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC $77,514
315 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC $39,598
316 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC $34,208
326 STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC $176,362
327 STOMACH, ESOPHAGEAL & DUODENAL PROC W CC $106,256
328 STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC $76,263
329 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC $138,208
330 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC $81,929
331 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O
CC/MCC
$59,731
335 PERITONEAL ADHESIOLYSIS W MCC $150,907
336 PERITONEAL ADHESIOLYSIS W CC $97,069
337 PERITONEAL ADHESIOLYSIS W/O CC/MCC $54,237
338 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W
MCC
$159,793
339 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC $78,941
342 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W
CC
$48,996
344 MINOR SMALL & LARGE BOWEL PROCEDURES W MCC $73,247
346 MINOR SMALL & LARGE BOWEL PROCEDURES W/O
CC/MCC
$14,136
347 ANAL & STOMAL PROCEDURES W MCC $30,537
348 ANAL & STOMAL PROCEDURES W CC $58,301
349 ANAL & STOMAL PROCEDURES W/O CC/MCC $42,283
350 INGUINAL & FEMORAL HERNIA PROCEDURES W MCC $122,502
351 INGUINAL & FEMORAL HERNIA PROCEDURES W CC $51,067
352 INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC $36,695
353 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W
MCC
$57,615
354 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W
CC
$63,354
355 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O
CC/MCC
$51,913
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC $133,061
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC $74,332
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O
CC/MCC
$59,138
368 MAJOR ESOPHAGEAL DISORDERS W MCC $53,241
369 MAJOR ESOPHAGEAL DISORDERS W CC $54,034
371 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL
INFECTIONS W MCC
$57,646
372 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL
INFECTIONS W CC
$39,303
373 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL
INFECTIONS W/O CC/MCC
$31,798
374 DIGESTIVE MALIGNANCY W MCC $65,664
375 DIGESTIVE MALIGNANCY W CC $48,257
376 DIGESTIVE MALIGNANCY W/O CC/MCC $48,894
377 G.I. HEMORRHAGE W MCC $70,537
378 G.I. HEMORRHAGE W CC $41,363
379 G.I. HEMORRHAGE W/O CC/MCC $29,775
380 COMPLICATED PEPTIC ULCER W MCC $97,479
381 COMPLICATED PEPTIC ULCER W CC $52,746
383 UNCOMPLICATED PEPTIC ULCER W MCC $37,152
384 UNCOMPLICATED PEPTIC ULCER W/O MCC $28,780
385 INFLAMMATORY BOWEL DISEASE W MCC $89,776
386 INFLAMMATORY BOWEL DISEASE W CC $34,773
387 INFLAMMATORY BOWEL DISEASE W/O CC/MCC $44,651
388 G.I. OBSTRUCTION W MCC $51,719
389 G.I. OBSTRUCTION W CC $42,204
390 G.I. OBSTRUCTION W/O CC/MCC $23,907
391 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W
MCC
$41,953
392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS
W/O MCC
$35,545
393 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC $55,500
394 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC $33,169
395 OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC $24,769
405 PANCREAS, LIVER & SHUNT PROCEDURES W MCC $137,360
406 PANCREAS, LIVER & SHUNT PROCEDURES W CC $82,840
407 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC $61,834
408 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR
W/O C.D.E. W MCC
$88,192
410 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR
W/O C.D.E. W/O CC/MCC
$38,937
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O
C.D.E. W MCC
$89,305
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O
C.D.E. W CC
$75,932
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O
C.D.E. W/O CC/MCC
$63,778
417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC $58,671
418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC $87,342
419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O
CC/MCC
$50,825
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC $91,216
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC $84,671
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC $65,872
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES
W MCC
$97,430
432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC $57,145
433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC $38,843
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS
W MCC
$61,541
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS
W CC
$53,780
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS
W/O CC/MCC
$35,864
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC $49,372
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC $35,751
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O
CC/MCC
$23,799
441 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W
MCC
$64,757
442 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W
CC
$39,347
443 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O
CC/MCC
$29,804
444 DISORDERS OF THE BILIARY TRACT W MCC $58,207
445 DISORDERS OF THE BILIARY TRACT W CC $50,369
446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC $41,855
453 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC $354,442
454 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC $197,160
455 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O
CC/MCC
$145,651
456 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR
EXT FUS W MCC
$330,287
457 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR
EXT FUS W CC
$210,119
458 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR
EXT FUS W/O CC/MCC
$105,953
459 SPINAL FUSION EXCEPT CERVICAL W MCC $220,803
460 SPINAL FUSION EXCEPT CERVICAL W/O MCC $122,755
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER
EXTREMITY W/O MCC
$101,138
463 WND DEBRID & SKN GRFT EXC HAND, FOR
MUSCULO-CONN TISS DIS W MCC
$149,090
464 WND DEBRID & SKN GRFT EXC HAND, FOR
MUSCULO-CONN TISS DIS W CC
$114,187
465 WND DEBRID & SKN GRFT EXC HAND, FOR
MUSCULO-CONN TISS DIS W/O CC/MCC
$90,183
466 REVISION OF HIP OR KNEE REPLACEMENT W MCC $170,709
467 REVISION OF HIP OR KNEE REPLACEMENT W CC $131,075
468 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC $124,490
469 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF
LOWER EXTREMITY W MCC
$123,734
470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF
LOWER EXTREMITY W/O MCC
$74,006
471 CERVICAL SPINAL FUSION W MCC $165,457
472 CERVICAL SPINAL FUSION W CC $107,522
473 CERVICAL SPINAL FUSION W/O CC/MCC $95,533
474 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN
TISSUE DIS W MCC
$112,083
475 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN
TISSUE DIS W CC
$78,972
476 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN
TISSUE DIS W/O CC/MCC
$48,559
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE
TISSUE W MCC
$112,384
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE
TISSUE W CC
$86,695
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE
TISSUE W/O CC/MCC
$55,657
480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC $98,185
481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC $77,255
482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O
CC/MCC
$60,042
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF
UPPER EXTREMITIES
$77,481
485 KNEE PROCEDURES W PDX OF INFECTION W MCC $74,759
487 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC $49,562
488 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC $72,950
489 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC $42,948
492 LOWER EXTREM & HUMER PROC EXCEPT
HIP,FOOT,FEMUR W MCC
$89,593
493 LOWER EXTREM & HUMER PROC EXCEPT
HIP,FOOT,FEMUR W CC
$74,967
494 LOWER EXTREM & HUMER PROC EXCEPT
HIP,FOOT,FEMUR W/O CC/MCC
$60,325
495 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP &
FEMUR W MCC
$67,691
496 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP &
FEMUR W CC
$62,832
497 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP &
FEMUR W/O CC/MCC
$56,891
498 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP &
FEMUR W CC/MCC
$81,280
499 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP &
FEMUR W/O CC/MCC
$16,578
500 SOFT TISSUE PROCEDURES W MCC $104,210
501 SOFT TISSUE PROCEDURES W CC $60,623
502 SOFT TISSUE PROCEDURES W/O CC/MCC $57,845
503 FOOT PROCEDURES W MCC $109,487
504 FOOT PROCEDURES W CC $69,456
505 FOOT PROCEDURES W/O CC/MCC $59,785
506 MAJOR THUMB OR JOINT PROCEDURES $61,803
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W
CC/MCC
$49,917
510 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT
PROC W MCC
$76,415
511 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT
PROC W CC
$44,214
512 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT
PROC W/O CC/MCC
$54,793
513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT
PROC W CC/MCC
$59,296
514 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT
PROC W/O CC/MCC
$38,722
515 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W
MCC
$71,453
516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W
CC
$68,562
517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC
W/O CC/MCC
$50,094
518 BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC
DEVICE/NEUROSTIM
$85,356
519 BACK & NECK PROC EXC SPINAL FUSION W CC $73,186
520 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC $42,345
533 FRACTURES OF FEMUR W MCC $96,413
534 FRACTURES OF FEMUR W/O MCC $25,793
535 FRACTURES OF HIP & PELVIS W MCC $71,560
536 FRACTURES OF HIP & PELVIS W/O MCC $36,267
539 OSTEOMYELITIS W MCC $69,699
540 OSTEOMYELITIS W CC $70,312
541 OSTEOMYELITIS W/O CC/MCC $46,722
542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN
TISS MALIG W MCC
$71,637
543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN
TISS MALIG W CC
$42,930
544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN
TISS MALIG W/O CC/MCC
$64,771
545 CONNECTIVE TISSUE DISORDERS W MCC $101,909
546 CONNECTIVE TISSUE DISORDERS W CC $42,270
547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC $32,717
549 SEPTIC ARTHRITIS W CC $36,400
550 SEPTIC ARTHRITIS W/O CC/MCC $111,681
551 MEDICAL BACK PROBLEMS W MCC $64,999
552 MEDICAL BACK PROBLEMS W/O MCC $37,669
553 BONE DISEASES & ARTHROPATHIES W MCC $54,284
554 BONE DISEASES & ARTHROPATHIES W/O MCC $25,437
555 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM &
CONN TISSUE W MCC
$25,962
556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM &
CONN TISSUE W/O MCC
$31,963
557 TENDONITIS, MYOSITIS & BURSITIS W MCC $54,963
558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC $19,786
559 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE
TISSUE W MCC
$109,269
560 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE
TISSUE W CC
$29,546
561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE
TISSUE W/O CC/MCC
$27,866
562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS &
THIGH W MCC
$80,058
563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS &
THIGH W/O MCC
$30,401
564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE
DIAGNOSES W MCC
$35,193
565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE
DIAGNOSES W CC
$43,925
566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE
DIAGNOSES W/O CC/MCC
$41,532
570 SKIN DEBRIDEMENT W MCC $80,504
571 SKIN DEBRIDEMENT W CC $68,729
572 SKIN DEBRIDEMENT W/O CC/MCC $81,540
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC $100,098
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC $30,923
576 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC $189,771
577 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC $97,369
578 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O
CC/MCC
$36,173
579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC $140,505
580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC $73,313
581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC $56,639
584 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST
PROCEDURES W CC/MCC
$100,256
585 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST
PROCEDURES W/O CC/MCC
$89,468
592 SKIN ULCERS W MCC $52,389
593 SKIN ULCERS W CC $73,672
595 MAJOR SKIN DISORDERS W MCC $44,862
596 MAJOR SKIN DISORDERS W/O MCC $29,162
598 MALIGNANT BREAST DISORDERS W CC $58,626
602 CELLULITIS W MCC $45,588
603 CELLULITIS W/O MCC $37,219
604 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC $48,076
605 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC $29,270
606 MINOR SKIN DISORDERS W MCC $51,569
607 MINOR SKIN DISORDERS W/O MCC $46,359
614 ADRENAL & PITUITARY PROCEDURES W CC/MCC $83,094
615 ADRENAL & PITUITARY PROCEDURES W/O CC/MCC $68,803
616 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,&
METABOL DIS W MCC
$142,615
617 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,&
METABOL DIS W CC
$74,117
622 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT &
METAB DIS W MCC
$63,840
624 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT &
METAB DIS W/O CC/MCC
$44,890
625 THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES
W MCC
$99,483
626 THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES
W CC
$68,856
627 THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES
W/O CC/MCC
$39,205
628 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC $124,092
629 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC $82,250
630 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O
CC/MCC
$46,289
637 DIABETES W MCC $47,293
638 DIABETES W CC $33,016
639 DIABETES W/O CC/MCC $24,693
640 MISC DISORDERS OF
NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC
$45,416
641 MISC DISORDERS OF
NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC
$29,667
642 INBORN AND OTHER DISORDERS OF METABOLISM $33,064
643 ENDOCRINE DISORDERS W MCC $53,528
644 ENDOCRINE DISORDERS W CC $38,973
645 ENDOCRINE DISORDERS W/O CC/MCC $26,120
652 KIDNEY TRANSPLANT $282,995
653 MAJOR BLADDER PROCEDURES W MCC $130,084
654 MAJOR BLADDER PROCEDURES W CC $98,739
655 MAJOR BLADDER PROCEDURES W/O CC/MCC $89,751
656 KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC $85,061
657 KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC $76,207
658 KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O
CC/MCC
$66,724
659 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W
MCC
$77,427
660 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W
CC
$77,062
661 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM
W/O CC/MCC
$52,985
663 MINOR BLADDER PROCEDURES W CC $62,714
664 MINOR BLADDER PROCEDURES W/O CC/MCC $43,560
666 PROSTATECTOMY W CC $63,148
667 PROSTATECTOMY W/O CC/MCC $39,127
668 TRANSURETHRAL PROCEDURES W MCC $84,430
669 TRANSURETHRAL PROCEDURES W CC $40,481
670 TRANSURETHRAL PROCEDURES W/O CC/MCC $30,170
673 OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC $130,071
674 OTHER KIDNEY & URINARY TRACT PROCEDURES W CC $97,116
682 RENAL FAILURE W MCC $58,524
683 RENAL FAILURE W CC $39,764
684 RENAL FAILURE W/O CC/MCC $25,050
686 KIDNEY & URINARY TRACT NEOPLASMS W MCC $43,058
687 KIDNEY & URINARY TRACT NEOPLASMS W CC $16,291
689 KIDNEY & URINARY TRACT INFECTIONS W MCC $42,790
690 KIDNEY & URINARY TRACT INFECTIONS W/O MCC $32,976
693 URINARY STONES W/O ESW LITHOTRIPSY W MCC $32,902
694 URINARY STONES W/O ESW LITHOTRIPSY W/O MCC $41,286
695 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC $37,153
696 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC $27,396
698 OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC $57,629
699 OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC $44,432
700 OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O
CC/MCC
$24,603
707 MAJOR MALE PELVIC PROCEDURES W CC/MCC $56,491
708 MAJOR MALE PELVIC PROCEDURES W/O CC/MCC $56,249
709 PENIS PROCEDURES W CC/MCC $34,482
710 PENIS PROCEDURES W/O CC/MCC $68,234
713 TRANSURETHRAL PROSTATECTOMY W CC/MCC $50,081
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR
MALIGNANCY W CC/MCC
$41,747
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR
MALIGNANCY W/O CC/MCC
$49,570
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC
MALIGNANCY W/O CC/MCC
$50,185
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC $30,964
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W/O CC/MCC $32,037
725 BENIGN PROSTATIC HYPERTROPHY W MCC $50,582
726 BENIGN PROSTATIC HYPERTROPHY W/O MCC $17,476
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W
MCC
$88,892
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM
W/O MCC
$42,088
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W
CC/MCC
$34,609
734 PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD
VULVECTOMY W CC/MCC
$92,261
735 PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD
VULVECTOMY W/O CC/MCC
$52,839
736 UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL
MALIGNANCY W MCC
$125,229
737 UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL
MALIGNANCY W CC
$86,261
738 UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL
MALIGNANCY W/O CC/MCC
$56,344
739 UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL
MALIG W MCC
$62,716
740 UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL
MALIG W CC
$77,742
741 UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL
MALIG W/O CC/MCC
$60,284
742 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W
CC/MCC
$55,048
743 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O
CC/MCC
$46,136
745 D&C, CONIZATION, LAPAROSCOPY & TUBAL
INTERRUPTION W/O CC/MCC
$18,587
746 VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC $27,493
747 VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC $54,628
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE
PROCEDURES
$46,974
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R.
PROCEDURES W/O CC/MCC
$62,942
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC $72,919
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC $39,257
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC $57,315
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O
CC/MCC
$33,220
760 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM
DISORDERS W CC/MCC
$27,376
761 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM
DISORDERS W/O CC/MCC
$35,423
765 CESAREAN SECTION W CC/MCC $41,285
769 POSTPARTUM & POST ABORTION DIAGNOSES W O.R.
PROCEDURE
$14,694
774 VAGINAL DELIVERY W COMPLICATING DIAGNOSES $21,758
775 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES $21,329
781 OTHER ANTEPARTUM DIAGNOSES W MEDICAL
COMPLICATIONS
$32,336
782 OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL
COMPLICATIONS
$16,206
804 OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING
ORGANS W/O CC/MCC
$25,582
808 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS &
COAGUL W MCC
$69,897
809 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS &
COAGUL W CC
$55,744
810 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS &
COAGUL W/O CC/MCC
$28,151
811 RED BLOOD CELL DISORDERS W MCC $53,580
812 RED BLOOD CELL DISORDERS W/O MCC $35,252
813 COAGULATION DISORDERS $60,785
814 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC $25,393
815 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC $13,564
820 LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W
MCC
$186,422
821 LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC $47,256
822 LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O
CC/MCC
$35,852
823 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC
W MCC
$138,919
824 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC
W CC
$44,080
825 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC
W/O CC/MCC
$41,970
826 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ
O.R. PROC W MCC
$104,490
827 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ
O.R. PROC W CC
$83,760
828 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ
O.R. PROC W/O CC/MCC
$64,891
829 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER
O.R. PROC W CC/MCC
$84,484
830 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER
O.R. PROC W/O CC/MCC
$54,730
834 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC $150,792
835 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC $81,542
837 CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE
CHEMO AGENT W MCC
$142,799
838 CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE
CHEMO AGENT
$79,165
839 CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC $19,041
840 LYMPHOMA & NON-ACUTE LEUKEMIA W MCC $87,294
841 LYMPHOMA & NON-ACUTE LEUKEMIA W CC $94,289
842 LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC $57,973
843 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG
W MCC
$56,619
846 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY
DIAGNOSIS W MCC
$90,559
847 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY
DIAGNOSIS W CC
$58,739
848 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY
DIAGNOSIS W/O CC/MCC
$19,745
853 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE
W MCC
$141,232
854 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE
W CC
$89,037
855 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE
W/O CC/MCC
$95,328
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W
O.R. PROC W MCC
$119,757
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W
O.R. PROC W CC
$66,742
862 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC $62,562
863 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O
MCC
$39,416
864 FEVER $52,987
865 VIRAL ILLNESS W MCC $58,585
866 VIRAL ILLNESS W/O MCC $67,327
867 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W
MCC
$61,435
868 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W
CC
$41,588
870 SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS $175,140
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W
MCC
$73,275
872 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O
MCC
$46,911
880 ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL
DYSFUNCTION
$25,068
881 DEPRESSIVE NEUROSES $32,565
882 NEUROSES EXCEPT DEPRESSIVE $45,314
884 ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY $42,045
885 PSYCHOSES $23,565
894 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA $28,251
896 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O
REHABILITATION THERAPY W MCC
$49,292
897 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O
REHABILITATION THERAPY W/O MCC
$41,102
901 WOUND DEBRIDEMENTS FOR INJURIES W MCC $95,711
902 WOUND DEBRIDEMENTS FOR INJURIES W CC $67,286
904 SKIN GRAFTS FOR INJURIES W CC/MCC $87,326
906 HAND PROCEDURES FOR INJURIES $73,738
907 OTHER O.R. PROCEDURES FOR INJURIES W MCC $107,837
908 OTHER O.R. PROCEDURES FOR INJURIES W CC $64,335
909 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC $53,362
914 TRAUMATIC INJURY W/O MCC $38,753
915 ALLERGIC REACTIONS W MCC $34,957
916 ALLERGIC REACTIONS W/O MCC $42,977
917 POISONING & TOXIC EFFECTS OF DRUGS W MCC $55,143
918 POISONING & TOXIC EFFECTS OF DRUGS W/O MCC $32,183
919 COMPLICATIONS OF TREATMENT W MCC $70,538
920 COMPLICATIONS OF TREATMENT W CC $36,250
921 COMPLICATIONS OF TREATMENT W/O CC/MCC $59,315
922 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC $32,236
923 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O
MCC
$16,451
928 FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W
CC/MCC
$131,002
929 FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W/O
CC/MCC
$45,692
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV >96
HRS W/O SKIN GRAFT
$32,905
934 FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ $34,290
935 NON-EXTENSIVE BURNS $45,369
939 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH
SERVICES W MCC
$100,732
940 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH
SERVICES W CC
$79,036
941 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH
SERVICES W/O CC/MCC
$71,990
947 SIGNS & SYMPTOMS W MCC $37,047
948 SIGNS & SYMPTOMS W/O MCC $34,051
949 AFTERCARE W CC/MCC $47,756
951 OTHER FACTORS INFLUENCING HEALTH STATUS $5,800
956 LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE
SIGNIFICANT TRAUMA
$154,886
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT
TRAUMA W MCC
$209,593
963 OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC $93,137
964 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC $49,803
974 HIV W MAJOR RELATED CONDITION W MCC $44,962
975 HIV W MAJOR RELATED CONDITION W CC $45,299
976 HIV W MAJOR RELATED CONDITION W/O CC/MCC $16,755
977 HIV W OR W/O OTHER RELATED CONDITION $65,944
981 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL
DIAGNOSIS W MCC
$137,015
982 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL
DIAGNOSIS W CC
$81,419
983 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL
DIAGNOSIS W/O CC/MCC
$62,321
987 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL
DIAGNOSIS W MCC
$99,826
988 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL
DIAGNOSIS W CC
$56,742
989 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL
DIAGNOSIS W/O CC/MCC
$91,718