Version 3.12 - Inpatient Facility Charge Table,,,,,,,,
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Item Code,Code Type,Description,Charge Type Indicator,Standard Room and Board Per Diem,Standard Ancillary Charge Per Diem,ICU Room and Board Per Diem,ICU Ancillary Charge Per Diem,Start Date
001,DRG,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC,S,"$3,096.42 ","$22,873.36 ","$6,143.22 ","$22,873.36 ",20130101
002,DRG,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC,S,"$2,980.82 ","$25,482.98 ","$6,326.21 ","$25,482.98 ",20130101
003,DRG,"ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R.",S,"$3,438.82 ","$12,958.27 ","$5,755.75 ","$12,958.27 ",20130101
004,DRG,"TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.",S,"$3,137.46 ","$8,951.69 ","$5,102.04 ","$8,951.69 ",20130101
005,DRG,LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT,S,"$2,956.80 ","$23,500.94 ","$6,509.04 ","$23,500.94 ",20130101
006,DRG,LIVER TRANSPLANT W/O MCC,S,"$2,237.08 ","$26,773.70 ","$5,059.83 ","$26,773.70 ",20130101
007,DRG,LUNG TRANSPLANT,S,"$3,109.48 ","$24,781.98 ","$5,473.80 ","$24,781.98 ",20130101
008,DRG,SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT,S,"$2,915.80 ","$34,879.50 ","$5,906.74 ","$34,879.50 ",20130101
010,DRG,PANCREAS TRANSPLANT,S,"$2,759.22 ","$26,785.50 ","$5,588.59 ","$26,785.50 ",20130101
011,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC",S,"$2,795.12 ","$9,566.58 ","$5,441.28 ","$9,566.58 ",20130101
012,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC",S,"$2,905.53 ","$9,764.76 ","$5,270.09 ","$9,764.76 ",20130101
013,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC",S,"$2,683.58 ","$9,565.97 ","$4,982.33 ","$9,565.97 ",20130101
014,DRG,ALLOGENEIC BONE MARROW TRANSPLANT,S,"$4,338.72 ","$12,029.57 ","$5,355.77 ","$12,029.57 ",20130101
016,DRG,AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC,S,"$3,627.68 ","$8,057.91 ","$4,557.94 ","$8,057.91 ",20130101
017,DRG,AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC,S,"$3,915.52 ","$8,268.63 ","$5,702.85 ","$8,268.63 ",20130101
020,DRG,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC,S,"$3,209.71 ","$15,923.34 ","$6,522.86 ","$15,923.34 ",20130101
021,DRG,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC,S,"$3,058.31 ","$13,880.58 ","$6,472.65 ","$13,880.58 ",20130101
022,DRG,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC,S,"$2,745.70 ","$16,230.15 ","$6,024.44 ","$16,230.15 ",20130101
023,DRG,CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT,S,"$2,721.02 ","$13,405.02 ","$5,882.45 ","$13,405.02 ",20130101
024,DRG,CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC,S,"$3,286.20 ","$16,850.35 ","$6,334.76 ","$16,850.35 ",20130101
025,DRG,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,S,"$2,861.53 ","$12,919.49 ","$6,023.33 ","$12,919.49 ",20130101
026,DRG,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,S,"$3,097.98 ","$14,213.08 ","$6,273.38 ","$14,213.08 ",20130101
027,DRG,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,S,"$2,954.52 ","$21,856.13 ","$6,045.87 ","$21,856.13 ",20130101
028,DRG,SPINAL PROCEDURES W MCC,S,"$2,519.12 ","$11,854.27 ","$5,257.29 ","$11,854.27 ",20130101
029,DRG,SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS,S,"$2,553.20 ","$14,079.95 ","$5,256.36 ","$14,079.95 ",20130101
030,DRG,SPINAL PROCEDURES W/O CC/MCC,S,"$2,515.89 ","$17,294.95 ","$4,939.77 ","$17,294.95 ",20130101
031,DRG,VENTRICULAR SHUNT PROCEDURES W MCC,S,"$2,681.62 ","$9,141.25 ","$5,725.97 ","$9,141.25 ",20130101
032,DRG,VENTRICULAR SHUNT PROCEDURES W CC,S,"$2,711.99 ","$11,599.67 ","$5,459.67 ","$11,599.67 ",20130101
033,DRG,VENTRICULAR SHUNT PROCEDURES W/O CC/MCC,S,"$2,415.81 ","$17,934.07 ","$4,792.23 ","$17,934.07 ",20130101
034,DRG,CAROTID ARTERY STENT PROCEDURE W MCC,S,"$2,367.47 ","$14,821.98 ","$4,721.90 ","$14,821.98 ",20130101
035,DRG,CAROTID ARTERY STENT PROCEDURE W CC,S,"$2,704.01 ","$24,592.73 ","$4,863.94 ","$24,592.73 ",20130101
036,DRG,CAROTID ARTERY STENT PROCEDURE W/O CC/MCC,S,"$2,481.76 ","$37,296.32 ","$4,427.83 ","$37,296.32 ",20130101
037,DRG,EXTRACRANIAL PROCEDURES W MCC,S,"$2,487.87 ","$11,629.91 ","$4,641.45 ","$11,629.91 ",20130101
038,DRG,EXTRACRANIAL PROCEDURES W CC,S,"$2,426.66 ","$14,841.05 ","$4,369.67 ","$14,841.05 ",20130101
039,DRG,EXTRACRANIAL PROCEDURES W/O CC/MCC,S,"$2,198.08 ","$21,340.81 ","$4,170.80 ","$21,340.81 ",20130101
040,DRG,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC,S,"$2,501.41 ","$8,153.65 ","$4,869.54 ","$8,153.65 ",20130101
041,DRG,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM,S,"$2,468.09 ","$9,207.93 ","$4,610.67 ","$9,207.93 ",20130101
042,DRG,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC,S,"$2,681.62 ","$19,070.19 ","$4,989.49 ","$19,070.19 ",20130101
052,DRG,SPINAL DISORDERS & INJURIES W CC/MCC,N,"$1,816.49 ","$3,871.02 ","$4,559.28 ","$3,871.02 ",20130101
053,DRG,SPINAL DISORDERS & INJURIES W/O CC/MCC,N,"$1,339.02 ","$2,911.04 ","$2,968.48 ","$2,911.04 ",20130101
054,DRG,NERVOUS SYSTEM NEOPLASMS W MCC,N,"$2,571.02 ","$5,841.62 ","$4,844.02 ","$5,841.62 ",20130101
055,DRG,NERVOUS SYSTEM NEOPLASMS W/O MCC,N,"$2,303.79 ","$5,621.50 ","$4,015.74 ","$5,621.50 ",20130101
056,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC,N,"$2,222.98 ","$3,567.72 ","$4,315.71 ","$3,567.72 ",20130101
057,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC,N,"$2,435.24 ","$2,006.50 ","$4,452.10 ","$2,006.50 ",20130101
058,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC,N,"$2,522.81 ","$5,444.08 ","$4,551.90 ","$5,444.08 ",20130101
059,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC,N,"$2,386.40 ","$4,798.81 ","$3,676.92 ","$4,798.81 ",20130101
060,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC,N,"$2,425.56 ","$4,933.33 ","$3,784.79 ","$4,933.33 ",20130101
061,DRG,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC,N,"$2,970.36 ","$10,849.70 ","$5,868.35 ","$10,849.70 ",20130101
062,DRG,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC,N,"$2,867.77 ","$10,849.75 ","$5,453.22 ","$10,849.75 ",20130101
063,DRG,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC,N,"$2,916.84 ","$13,593.44 ","$5,544.15 ","$13,593.44 ",20130101
064,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC,N,"$2,475.56 ","$6,807.43 ","$4,948.01 ","$6,807.43 ",20130101
065,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC,N,"$2,353.90 ","$6,166.51 ","$4,424.11 ","$6,166.51 ",20130101
066,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC,N,"$2,069.13 ","$6,484.57 ","$3,891.56 ","$6,484.57 ",20130101
067,DRG,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC,N,"$2,182.64 ","$6,986.03 ","$4,031.34 ","$6,986.03 ",20130101
068,DRG,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC,N,"$1,693.48 ","$5,986.05 ","$3,083.17 ","$5,986.05 ",20130101
069,DRG,TRANSIENT ISCHEMIA,N,"$2,582.36 ","$8,710.35 ","$4,540.66 ","$8,710.35 ",20130101
070,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC,N,"$2,236.02 ","$6,050.81 ","$4,209.00 ","$6,050.81 ",20130101
071,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,N,"$2,377.80 ","$5,098.84 ","$4,132.70 ","$5,098.84 ",20130101
072,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC,N,"$2,191.41 ","$6,088.76 ","$3,845.49 ","$6,088.76 ",20130101
073,DRG,CRANIAL & PERIPHERAL NERVE DISORDERS W MCC,N,"$2,204.39 ","$5,639.20 ","$3,913.45 ","$5,639.20 ",20130101
074,DRG,CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC,N,"$2,276.12 ","$5,436.75 ","$3,943.64 ","$5,436.75 ",20130101
075,DRG,VIRAL MENINGITIS W CC/MCC,N,"$2,263.56 ","$6,306.13 ","$4,191.76 ","$6,306.13 ",20130101
076,DRG,VIRAL MENINGITIS W/O CC/MCC,N,"$1,960.87 ","$5,488.12 ","$3,471.69 ","$5,488.12 ",20130101
077,DRG,HYPERTENSIVE ENCEPHALOPATHY W MCC,N,"$2,228.26 ","$6,580.31 ","$4,419.00 ","$6,580.31 ",20130101
078,DRG,HYPERTENSIVE ENCEPHALOPATHY W CC,N,"$2,251.70 ","$6,054.16 ","$4,262.39 ","$6,054.16 ",20130101
079,DRG,HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC,N,"$2,431.68 ","$6,738.68 ","$4,257.67 ","$6,738.68 ",20130101
080,DRG,NONTRAUMATIC STUPOR & COMA W MCC,N,"$2,427.49 ","$5,539.41 ","$4,694.69 ","$5,539.41 ",20130101
081,DRG,NONTRAUMATIC STUPOR & COMA W/O MCC,N,"$2,409.20 ","$5,068.55 ","$4,607.45 ","$5,068.55 ",20130101
082,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC",N,"$2,335.45 ","$7,540.29 ","$5,329.79 ","$7,540.29 ",20130101
083,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR W CC",N,"$2,604.32 ","$6,430.75 ","$5,693.04 ","$6,430.75 ",20130101
084,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC",N,"$2,410.38 ","$7,535.69 ","$5,480.43 ","$7,535.69 ",20130101
085,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC",N,"$2,115.55 ","$5,361.20 ","$4,440.23 ","$5,361.20 ",20130101
086,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR W CC",N,"$2,140.32 ","$4,730.02 ","$4,383.95 ","$4,730.02 ",20130101
087,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC",N,"$2,130.27 ","$5,336.76 ","$4,480.79 ","$5,336.76 ",20130101
088,DRG,CONCUSSION W MCC,N,"$3,134.96 ","$9,068.91 ","$6,598.11 ","$9,068.91 ",20130101
089,DRG,CONCUSSION W CC,N,"$3,269.06 ","$9,405.91 ","$6,788.33 ","$9,405.91 ",20130101
090,DRG,CONCUSSION W/O CC/MCC,N,"$3,097.72 ","$10,780.29 ","$6,408.49 ","$10,780.29 ",20130101
091,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W MCC,N,"$2,288.69 ","$5,698.11 ","$4,526.45 ","$5,698.11 ",20130101
092,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W CC,N,"$2,468.39 ","$5,137.14 ","$4,256.49 ","$5,137.14 ",20130101
093,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,N,"$2,377.42 ","$6,026.21 ","$4,112.46 ","$6,026.21 ",20130101
094,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC,N,"$2,242.04 ","$6,902.96 ","$4,487.85 ","$6,902.96 ",20130101
095,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,N,"$2,370.70 ","$7,893.60 ","$4,313.09 ","$7,893.60 ",20130101
096,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC,N,"$2,289.21 ","$9,368.32 ","$4,039.98 ","$9,368.32 ",20130101
097,DRG,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC,N,"$2,597.54 ","$7,531.61 ","$4,742.79 ","$7,531.61 ",20130101
098,DRG,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC,N,"$2,546.75 ","$6,566.22 ","$4,455.62 ","$6,566.22 ",20130101
099,DRG,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC,N,"$2,169.60 ","$5,761.32 ","$3,358.27 ","$5,761.32 ",20130101
100,DRG,SEIZURES W MCC,N,"$2,575.40 ","$6,588.58 ","$4,795.62 ","$6,588.58 ",20130101
101,DRG,SEIZURES W/O MCC,N,"$2,612.23 ","$5,950.41 ","$4,288.16 ","$5,950.41 ",20130101
102,DRG,HEADACHES W MCC,N,"$2,468.21 ","$6,898.36 ","$4,344.19 ","$6,898.36 ",20130101
103,DRG,HEADACHES W/O MCC,N,"$2,080.65 ","$5,867.30 ","$3,598.11 ","$5,867.30 ",20130101
113,DRG,ORBITAL PROCEDURES W CC/MCC,S,"$3,020.09 ","$11,281.18 ","$6,705.82 ","$11,281.18 ",20130101
114,DRG,ORBITAL PROCEDURES W/O CC/MCC,S,"$2,507.71 ","$12,157.68 ","$5,719.57 ","$12,157.68 ",20130101
115,DRG,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,S,"$2,713.30 ","$8,987.79 ","$5,120.10 ","$8,987.79 ",20130101
116,DRG,INTRAOCULAR PROCEDURES W CC/MCC,S,"$2,826.04 ","$9,199.61 ","$5,404.21 ","$9,199.61 ",20130101
117,DRG,INTRAOCULAR PROCEDURES W/O CC/MCC,S,"$2,863.65 ","$12,269.32 ","$5,307.52 ","$12,269.32 ",20130101
121,DRG,ACUTE MAJOR EYE INFECTIONS W CC/MCC,N,"$2,333.62 ","$3,822.00 ","$3,855.61 ","$3,822.00 ",20130101
122,DRG,ACUTE MAJOR EYE INFECTIONS W/O CC/MCC,N,"$2,226.48 ","$3,148.53 ","$4,373.91 ","$3,148.53 ",20130101
123,DRG,NEUROLOGICAL EYE DISORDERS,N,"$2,552.16 ","$8,263.35 ","$4,221.58 ","$8,263.35 ",20130101
124,DRG,OTHER DISORDERS OF THE EYE W MCC,N,"$2,489.69 ","$5,381.64 ","$4,162.04 ","$5,381.64 ",20130101
125,DRG,OTHER DISORDERS OF THE EYE W/O MCC,N,"$2,502.03 ","$4,900.44 ","$4,120.27 ","$4,900.44 ",20130101
129,DRG,MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE,S,"$3,004.14 ","$15,630.37 ","$5,647.78 ","$15,630.37 ",20130101
130,DRG,MAJOR HEAD & NECK PROCEDURES W/O CC/MCC,S,"$2,696.51 ","$17,569.71 ","$5,144.14 ","$17,569.71 ",20130101
131,DRG,CRANIAL/FACIAL PROCEDURES W CC/MCC,S,"$2,988.72 ","$14,853.25 ","$6,221.63 ","$14,853.25 ",20130101
132,DRG,CRANIAL/FACIAL PROCEDURES W/O CC/MCC,S,"$3,794.97 ","$22,784.32 ","$7,189.36 ","$22,784.32 ",20130101
133,DRG,"OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W CC/MCC",S,"$2,567.76 ","$9,907.44 ","$5,045.76 ","$9,907.44 ",20130101
134,DRG,"OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC",S,"$2,564.72 ","$14,125.29 ","$4,786.60 ","$14,125.29 ",20130101
135,DRG,SINUS & MASTOID PROCEDURES W CC/MCC,S,"$2,645.86 ","$11,181.72 ","$4,894.76 ","$11,181.72 ",20130101
136,DRG,SINUS & MASTOID PROCEDURES W/O CC/MCC,S,"$2,731.30 ","$17,039.98 ","$4,688.83 ","$17,039.98 ",20130101
137,DRG,MOUTH PROCEDURES W CC/MCC,S,"$2,265.56 ","$7,003.37 ","$4,379.51 ","$7,003.37 ",20130101
138,DRG,MOUTH PROCEDURES W/O CC/MCC,S,"$2,563.15 ","$10,712.47 ","$4,745.23 ","$10,712.47 ",20130101
139,DRG,SALIVARY GLAND PROCEDURES,S,"$2,781.57 ","$19,581.52 ","$4,699.72 ","$19,581.52 ",20130101
146,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC",N,"$2,456.89 ","$5,391.93 ","$4,659.89 ","$5,391.93 ",20130101
147,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC",N,"$2,497.95 ","$5,298.48 ","$4,399.20 ","$5,298.48 ",20130101
148,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC",N,"$2,504.11 ","$5,872.25 ","$4,600.08 ","$5,872.25 ",20130101
149,DRG,DYSEQUILIBRIUM,N,"$2,597.62 ","$6,962.37 ","$4,294.48 ","$6,962.37 ",20130101
150,DRG,EPISTAXIS W MCC,N,"$2,390.02 ","$5,750.20 ","$4,479.50 ","$5,750.20 ",20130101
151,DRG,EPISTAXIS W/O MCC,N,"$2,460.29 ","$4,435.06 ","$4,466.54 ","$4,435.06 ",20130101
152,DRG,OTITIS MEDIA & URI W MCC,N,"$2,398.17 ","$5,382.67 ","$4,231.14 ","$5,382.67 ",20130101
153,DRG,OTITIS MEDIA & URI W/O MCC,N,"$2,084.96 ","$4,522.57 ","$3,648.12 ","$4,522.57 ",20130101
154,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC",N,"$2,327.69 ","$5,609.24 ","$4,560.33 ","$5,609.24 ",20130101
155,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC",N,"$2,276.08 ","$5,011.37 ","$3,998.18 ","$5,011.37 ",20130101
156,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC",N,"$2,418.97 ","$5,369.88 ","$4,377.12 ","$5,369.88 ",20130101
157,DRG,DENTAL & ORAL DISEASES W MCC,N,"$2,400.86 ","$5,924.11 ","$4,902.46 ","$5,924.11 ",20130101
158,DRG,DENTAL & ORAL DISEASES W CC,N,"$2,404.26 ","$5,141.47 ","$4,062.06 ","$5,141.47 ",20130101
159,DRG,DENTAL & ORAL DISEASES W/O CC/MCC,N,"$2,584.51 ","$5,769.52 ","$4,526.36 ","$5,769.52 ",20130101
163,DRG,MAJOR CHEST PROCEDURES W MCC,S,"$2,435.38 ","$9,415.07 ","$4,457.01 ","$9,415.07 ",20130101
164,DRG,MAJOR CHEST PROCEDURES W CC,S,"$2,731.29 ","$10,448.60 ","$4,360.24 ","$10,448.60 ",20130101
165,DRG,MAJOR CHEST PROCEDURES W/O CC/MCC,S,"$2,550.67 ","$11,987.38 ","$3,980.57 ","$11,987.38 ",20130101
166,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W MCC,S,"$2,312.38 ","$7,786.18 ","$4,208.81 ","$7,786.18 ",20130101
167,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W CC,S,"$2,389.08 ","$7,837.19 ","$4,093.29 ","$7,837.19 ",20130101
168,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC,S,"$2,249.48 ","$9,041.31 ","$3,883.30 ","$9,041.31 ",20130101
175,DRG,PULMONARY EMBOLISM W MCC,N,"$2,137.29 ","$5,712.60 ","$3,712.90 ","$5,712.60 ",20130101
176,DRG,PULMONARY EMBOLISM W/O MCC,N,"$2,089.74 ","$5,017.79 ","$3,551.85 ","$5,017.79 ",20130101
177,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,N,"$2,306.35 ","$5,739.39 ","$4,118.74 ","$5,739.39 ",20130101
178,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,N,"$2,276.02 ","$5,084.75 ","$4,015.74 ","$5,084.75 ",20130101
179,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC,N,"$2,178.59 ","$4,698.27 ","$4,002.02 ","$4,698.27 ",20130101
180,DRG,RESPIRATORY NEOPLASMS W MCC,N,"$2,376.04 ","$6,229.81 ","$4,154.65 ","$6,229.81 ",20130101
181,DRG,RESPIRATORY NEOPLASMS W CC,N,"$2,402.68 ","$5,849.68 ","$3,989.42 ","$5,849.68 ",20130101
182,DRG,RESPIRATORY NEOPLASMS W/O CC/MCC,N,"$1,475.97 ","$4,001.46 ","$2,641.07 ","$4,001.46 ",20130101
183,DRG,MAJOR CHEST TRAUMA W MCC,N,"$2,400.28 ","$5,706.56 ","$4,747.16 ","$5,706.56 ",20130101
184,DRG,MAJOR CHEST TRAUMA W CC,N,"$2,638.34 ","$6,266.75 ","$5,268.02 ","$6,266.75 ",20130101
185,DRG,MAJOR CHEST TRAUMA W/O CC/MCC,N,"$2,633.15 ","$5,997.70 ","$5,195.94 ","$5,997.70 ",20130101
186,DRG,PLEURAL EFFUSION W MCC,N,"$2,181.69 ","$5,745.00 ","$3,714.37 ","$5,745.00 ",20130101
187,DRG,PLEURAL EFFUSION W CC,N,"$2,361.50 ","$5,627.44 ","$3,943.39 ","$5,627.44 ",20130101
188,DRG,PLEURAL EFFUSION W/O CC/MCC,N,"$2,257.35 ","$5,615.97 ","$3,770.94 ","$5,615.97 ",20130101
189,DRG,PULMONARY EDEMA & RESPIRATORY FAILURE,N,"$2,001.18 ","$5,167.54 ","$3,727.74 ","$5,167.54 ",20130101
190,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,N,"$1,999.65 ","$4,914.08 ","$3,605.00 ","$4,914.08 ",20130101
191,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC,N,"$1,979.29 ","$4,692.32 ","$3,517.34 ","$4,692.32 ",20130101
192,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,N,"$1,746.92 ","$4,167.50 ","$3,240.51 ","$4,167.50 ",20130101
193,DRG,SIMPLE PNEUMONIA & PLEURISY W MCC,N,"$2,140.69 ","$5,518.07 ","$3,838.06 ","$5,518.07 ",20130101
194,DRG,SIMPLE PNEUMONIA & PLEURISY W CC,N,"$2,037.61 ","$4,636.83 ","$3,607.07 ","$4,636.83 ",20130101
195,DRG,SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,N,"$1,779.44 ","$4,026.56 ","$3,293.86 ","$4,026.56 ",20130101
196,DRG,INTERSTITIAL LUNG DISEASE W MCC,N,"$2,294.61 ","$5,382.73 ","$4,120.21 ","$5,382.73 ",20130101
197,DRG,INTERSTITIAL LUNG DISEASE W CC,N,"$2,408.84 ","$5,433.94 ","$4,094.55 ","$5,433.94 ",20130101
198,DRG,INTERSTITIAL LUNG DISEASE W/O CC/MCC,N,"$2,248.08 ","$5,348.33 ","$3,956.88 ","$5,348.33 ",20130101
199,DRG,PNEUMOTHORAX W MCC,N,"$2,169.43 ","$5,172.89 ","$3,865.46 ","$5,172.89 ",20130101
200,DRG,PNEUMOTHORAX W CC,N,"$2,155.92 ","$5,113.10 ","$3,873.66 ","$5,113.10 ",20130101
201,DRG,PNEUMOTHORAX W/O CC/MCC,N,"$1,850.92 ","$4,037.51 ","$3,152.48 ","$4,037.51 ",20130101
202,DRG,BRONCHITIS & ASTHMA W CC/MCC,N,"$2,117.04 ","$4,759.39 ","$3,784.93 ","$4,759.39 ",20130101
203,DRG,BRONCHITIS & ASTHMA W/O CC/MCC,N,"$1,901.18 ","$4,071.59 ","$3,454.65 ","$4,071.59 ",20130101
204,DRG,RESPIRATORY SIGNS & SYMPTOMS,N,"$2,205.35 ","$6,336.41 ","$3,718.27 ","$6,336.41 ",20130101
205,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC,N,"$2,508.03 ","$6,456.25 ","$4,604.61 ","$6,456.25 ",20130101
206,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC,N,"$2,458.62 ","$6,284.26 ","$4,254.23 ","$6,284.26 ",20130101
207,DRG,RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS,N,"$2,267.70 ","$7,407.00 ","$4,519.49 ","$7,407.00 ",20130101
208,DRG,RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <96 HOURS,N,"$2,270.03 ","$7,975.32 ","$4,454.86 ","$7,975.32 ",20130101
215,DRG,OTHER HEART ASSIST SYSTEM IMPLANT,S,"$2,901.76 ","$30,201.24 ","$5,577.14 ","$30,201.24 ",20130101
216,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,S,"$3,310.62 ","$18,080.49 ","$5,490.35 ","$18,080.49 ",20130101
217,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC,S,"$3,409.74 ","$20,312.40 ","$5,438.18 ","$20,312.40 ",20130101
218,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC,S,"$2,962.51 ","$21,903.08 ","$4,727.34 ","$21,903.08 ",20130101
219,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC,S,"$3,127.34 ","$19,520.19 ","$5,491.64 ","$19,520.19 ",20130101
220,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC,S,"$3,077.43 ","$22,293.22 ","$5,328.11 ","$22,293.22 ",20130101
221,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC,S,"$2,947.91 ","$26,410.86 ","$5,099.64 ","$26,410.86 ",20130101
222,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC,S,"$2,810.00 ","$21,795.33 ","$4,712.31 ","$21,795.33 ",20130101
223,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC,S,"$2,458.84 ","$30,522.46 ","$3,744.57 ","$30,522.46 ",20130101
224,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC,S,"$2,729.74 ","$24,361.29 ","$4,617.47 ","$24,361.29 ",20130101
225,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC,S,"$2,670.54 ","$39,013.32 ","$4,238.54 ","$39,013.32 ",20130101
226,DRG,CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC,S,"$2,693.05 ","$24,049.95 ","$4,473.09 ","$24,049.95 ",20130101
227,DRG,CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC,S,"$2,685.51 ","$55,516.21 ","$4,025.36 ","$55,516.21 ",20130101
228,DRG,OTHER CARDIOTHORACIC PROCEDURES W MCC,S,"$2,485.95 ","$17,096.80 ","$4,771.44 ","$17,096.80 ",20130101
229,DRG,OTHER CARDIOTHORACIC PROCEDURES W CC,S,"$2,516.00 ","$19,668.69 ","$4,499.03 ","$19,668.69 ",20130101
230,DRG,OTHER CARDIOTHORACIC PROCEDURES W/O CC/MCC,S,"$2,652.41 ","$26,389.66 ","$4,779.15 ","$26,389.66 ",20130101
231,DRG,CORONARY BYPASS W PTCA W MCC,S,"$2,579.19 ","$21,863.27 ","$4,811.53 ","$21,863.27 ",20130101
232,DRG,CORONARY BYPASS W PTCA W/O MCC,S,"$2,187.67 ","$21,373.30 ","$4,218.90 ","$21,373.30 ",20130101
233,DRG,CORONARY BYPASS W CARDIAC CATH W MCC,S,"$2,507.51 ","$16,245.65 ","$4,620.04 ","$16,245.65 ",20130101
234,DRG,CORONARY BYPASS W CARDIAC CATH W/O MCC,S,"$2,444.08 ","$17,398.94 ","$4,180.77 ","$17,398.94 ",20130101
235,DRG,CORONARY BYPASS W/O CARDIAC CATH W MCC,S,"$2,497.21 ","$16,205.68 ","$4,805.81 ","$16,205.68 ",20130101
236,DRG,CORONARY BYPASS W/O CARDIAC CATH W/O MCC,S,"$2,347.23 ","$17,704.45 ","$4,281.73 ","$17,704.45 ",20130101
237,DRG,MAJOR CARDIOVASC PROCEDURES W MCC,S,"$2,609.60 ","$15,016.91 ","$4,882.14 ","$15,016.91 ",20130101
238,DRG,MAJOR CARDIOVASC PROCEDURES W/O MCC,S,"$2,219.75 ","$22,597.19 ","$3,941.43 ","$22,597.19 ",20130101
239,DRG,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC,S,"$2,374.38 ","$7,558.81 ","$4,253.79 ","$7,558.81 ",20130101
240,DRG,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC,S,"$2,304.01 ","$6,811.32 ","$3,845.53 ","$6,811.32 ",20130101
241,DRG,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC,S,"$1,844.67 ","$6,196.60 ","$3,032.95 ","$6,196.60 ",20130101
242,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT W MCC,S,"$2,853.63 ","$14,269.41 ","$4,893.66 ","$14,269.41 ",20130101
243,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT W CC,S,"$2,612.79 ","$17,099.18 ","$4,245.89 ","$17,099.18 ",20130101
244,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC,S,"$2,572.95 ","$23,770.09 ","$4,100.69 ","$23,770.09 ",20130101
245,DRG,AICD GENERATOR PROCEDURES,S,"$2,533.87 ","$30,418.85 ","$3,773.33 ","$30,418.85 ",20130101
246,DRG,PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS,S,"$2,805.66 ","$24,137.90 ","$4,844.34 ","$24,137.90 ",20130101
247,DRG,PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC,S,"$2,578.70 ","$33,309.53 ","$4,013.54 ","$33,309.53 ",20130101
248,DRG,PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W MCC OR 4+ VES/STENTS,S,"$2,871.97 ","$17,733.93 ","$4,882.45 ","$17,733.93 ",20130101
249,DRG,PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC,S,"$2,700.45 ","$26,567.44 ","$4,385.32 ","$26,567.44 ",20130101
250,DRG,PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC,S,"$3,065.62 ","$14,824.90 ","$5,123.55 ","$14,824.90 ",20130101
251,DRG,PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC,S,"$3,265.43 ","$29,345.32 ","$4,985.33 ","$29,345.32 ",20130101
252,DRG,OTHER VASCULAR PROCEDURES W MCC,S,"$2,537.49 ","$11,404.12 ","$4,419.58 ","$11,404.12 ",20130101
253,DRG,OTHER VASCULAR PROCEDURES W CC,S,"$2,673.03 ","$13,599.21 ","$4,373.07 ","$13,599.21 ",20130101
254,DRG,OTHER VASCULAR PROCEDURES W/O CC/MCC,S,"$2,350.66 ","$21,178.70 ","$3,872.20 ","$21,178.70 ",20130101
255,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC,S,"$2,499.35 ","$6,732.37 ","$4,219.24 ","$6,732.37 ",20130101
256,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC,S,"$2,268.48 ","$5,514.37 ","$3,624.08 ","$5,514.37 ",20130101
257,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC,S,"$2,098.61 ","$5,916.75 ","$3,216.51 ","$5,916.75 ",20130101
258,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC,S,"$2,651.79 ","$11,571.92 ","$4,461.38 ","$11,571.92 ",20130101
259,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC,S,"$2,662.09 ","$16,580.74 ","$3,859.41 ","$16,580.74 ",20130101
260,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC,S,"$2,941.12 ","$9,901.28 ","$5,012.00 ","$9,901.28 ",20130101
261,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC,S,"$2,478.51 ","$11,532.86 ","$4,129.39 ","$11,532.86 ",20130101
262,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC,S,"$2,486.47 ","$14,741.75 ","$3,926.45 ","$14,741.75 ",20130101
263,DRG,VEIN LIGATION & STRIPPING,S,"$2,694.19 ","$9,621.19 ","$4,382.94 ","$9,621.19 ",20130101
264,DRG,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,S,"$2,410.98 ","$7,792.68 ","$4,361.18 ","$7,792.68 ",20130101
265,DRG,AICD LEAD PROCEDURES,S,"$2,401.34 ","$20,624.58 ","$3,992.50 ","$20,624.58 ",20130101
280,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC",N,"$2,844.29 ","$7,454.46 ","$4,989.85 ","$7,454.46 ",20130101
281,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC",N,"$3,101.98 ","$8,864.00 ","$5,363.09 ","$8,864.00 ",20130101
282,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC",N,"$3,112.02 ","$11,304.25 ","$5,494.52 ","$11,304.25 ",20130101
283,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC",N,"$2,861.71 ","$9,793.64 ","$5,535.17 ","$9,793.64 ",20130101
284,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC",N,"$2,294.13 ","$8,082.25 ","$4,727.83 ","$8,082.25 ",20130101
285,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W/O CC/MCC",N,"$2,223.28 ","$9,144.61 ","$4,736.66 ","$9,144.61 ",20130101
286,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC",N,"$2,620.14 ","$9,236.84 ","$4,599.64 ","$9,236.84 ",20130101
287,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC",N,"$2,584.47 ","$12,675.85 ","$4,188.40 ","$12,675.85 ",20130101
288,DRG,ACUTE & SUBACUTE ENDOCARDITIS W MCC,N,"$2,318.65 ","$5,360.67 ","$4,328.51 ","$5,360.67 ",20130101
289,DRG,ACUTE & SUBACUTE ENDOCARDITIS W CC,N,"$2,344.53 ","$4,367.84 ","$4,105.18 ","$4,367.84 ",20130101
290,DRG,ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC,N,"$2,374.84 ","$4,503.61 ","$3,966.77 ","$4,503.61 ",20130101
291,DRG,HEART FAILURE & SHOCK W MCC,N,"$2,259.76 ","$5,330.24 ","$4,004.16 ","$5,330.24 ",20130101
292,DRG,HEART FAILURE & SHOCK W CC,N,"$2,212.08 ","$4,313.19 ","$3,795.69 ","$4,313.19 ",20130101
293,DRG,HEART FAILURE & SHOCK W/O CC/MCC,N,"$2,113.51 ","$4,328.47 ","$3,791.02 ","$4,328.47 ",20130101
294,DRG,DEEP VEIN THROMBOPHLEBITIS W CC/MCC,N,"$2,172.65 ","$4,098.87 ","$3,948.55 ","$4,098.87 ",20130101
295,DRG,DEEP VEIN THROMBOPHLEBITIS W/O CC/MCC,N,"$1,756.83 ","$2,565.76 ","$3,272.03 ","$2,565.76 ",20130101
296,DRG,"CARDIAC ARREST, UNEXPLAINED W MCC",N,"$2,549.13 ","$12,936.24 ","$5,237.12 ","$12,936.24 ",20130101
297,DRG,"CARDIAC ARREST, UNEXPLAINED W CC",N,"$2,280.27 ","$10,422.04 ","$4,720.94 ","$10,422.04 ",20130101
298,DRG,"CARDIAC ARREST, UNEXPLAINED W/O CC/MCC",N,"$1,701.01 ","$6,429.92 ","$3,670.55 ","$6,429.92 ",20130101
299,DRG,PERIPHERAL VASCULAR DISORDERS W MCC,N,"$2,274.80 ","$5,148.13 ","$4,087.67 ","$5,148.13 ",20130101
300,DRG,PERIPHERAL VASCULAR DISORDERS W CC,N,"$2,253.32 ","$4,198.82 ","$3,922.53 ","$4,198.82 ",20130101
301,DRG,PERIPHERAL VASCULAR DISORDERS W/O CC/MCC,N,"$2,049.60 ","$3,963.13 ","$3,772.01 ","$3,963.13 ",20130101
302,DRG,ATHEROSCLEROSIS W MCC,N,"$2,628.22 ","$6,429.20 ","$4,800.62 ","$6,429.20 ",20130101
303,DRG,ATHEROSCLEROSIS W/O MCC,N,"$2,979.94 ","$7,724.13 ","$5,290.41 ","$7,724.13 ",20130101
304,DRG,HYPERTENSION W MCC,N,"$2,427.46 ","$5,771.47 ","$4,223.10 ","$5,771.47 ",20130101
305,DRG,HYPERTENSION W/O MCC,N,"$2,345.65 ","$5,625.32 ","$3,863.73 ","$5,625.32 ",20130101
306,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC,N,"$2,841.27 ","$5,561.30 ","$4,895.64 ","$5,561.30 ",20130101
307,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,N,"$2,610.78 ","$5,039.77 ","$4,505.79 ","$5,039.77 ",20130101
308,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,N,"$2,433.54 ","$5,473.32 ","$4,090.90 ","$5,473.32 ",20130101
309,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,N,"$2,427.44 ","$5,191.15 ","$3,962.59 ","$5,191.15 ",20130101
310,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,N,"$2,353.42 ","$5,372.41 ","$3,822.29 ","$5,372.41 ",20130101
311,DRG,ANGINA PECTORIS,N,"$2,216.82 ","$6,331.08 ","$4,006.39 ","$6,331.08 ",20130101
312,DRG,SYNCOPE & COLLAPSE,N,"$2,608.80 ","$6,562.86 ","$4,326.28 ","$6,562.86 ",20130101
313,DRG,CHEST PAIN,N,"$2,530.77 ","$7,908.36 ","$4,093.31 ","$7,908.36 ",20130101
314,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC,N,"$2,310.73 ","$6,468.37 ","$4,262.56 ","$6,468.37 ",20130101
315,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,N,"$2,364.66 ","$5,644.46 ","$4,130.39 ","$5,644.46 ",20130101
316,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC,N,"$2,274.04 ","$6,001.72 ","$3,922.15 ","$6,001.72 ",20130101
326,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC",S,"$2,375.68 ","$9,698.01 ","$4,670.47 ","$9,698.01 ",20130101
327,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC W CC",S,"$2,528.73 ","$9,498.06 ","$4,786.76 ","$9,498.06 ",20130101
328,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC",S,"$2,430.93 ","$14,120.50 ","$4,794.34 ","$14,120.50 ",20130101
329,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,S,"$2,192.25 ","$8,735.62 ","$4,340.01 ","$8,735.62 ",20130101
330,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,S,"$2,280.14 ","$7,982.11 ","$4,144.23 ","$7,982.11 ",20130101
331,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,S,"$2,239.36 ","$9,436.19 ","$3,980.37 ","$9,436.19 ",20130101
332,DRG,RECTAL RESECTION W MCC,S,"$2,174.64 ","$8,777.63 ","$4,341.72 ","$8,777.63 ",20130101
333,DRG,RECTAL RESECTION W CC,S,"$2,384.52 ","$8,807.30 ","$4,196.13 ","$8,807.30 ",20130101
334,DRG,RECTAL RESECTION W/O CC/MCC,S,"$2,388.68 ","$10,377.40 ","$4,291.01 ","$10,377.40 ",20130101
335,DRG,PERITONEAL ADHESIOLYSIS W MCC,S,"$2,224.70 ","$8,352.50 ","$4,398.36 ","$8,352.50 ",20130101
336,DRG,PERITONEAL ADHESIOLYSIS W CC,S,"$2,242.38 ","$7,467.86 ","$4,060.11 ","$7,467.86 ",20130101
337,DRG,PERITONEAL ADHESIOLYSIS W/O CC/MCC,S,"$2,314.71 ","$9,193.58 ","$4,170.84 ","$9,193.58 ",20130101
338,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC,S,"$2,047.26 ","$8,304.38 ","$3,970.47 ","$8,304.38 ",20130101
339,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC,S,"$2,094.26 ","$7,946.44 ","$3,847.36 ","$7,946.44 ",20130101
340,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,S,"$2,194.94 ","$9,814.42 ","$3,778.47 ","$9,814.42 ",20130101
341,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC,S,"$2,228.04 ","$10,367.87 ","$4,325.04 ","$10,367.87 ",20130101
342,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC,S,"$2,308.22 ","$12,015.13 ","$4,228.68 ","$12,015.13 ",20130101
343,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC,S,"$2,406.60 ","$17,427.64 ","$4,043.99 ","$17,427.64 ",20130101
344,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W MCC,S,"$2,240.39 ","$7,732.37 ","$4,310.04 ","$7,732.37 ",20130101
345,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W CC,S,"$2,279.12 ","$6,948.54 ","$4,065.50 ","$6,948.54 ",20130101
346,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,S,"$2,129.27 ","$7,214.76 ","$3,620.51 ","$7,214.76 ",20130101
347,DRG,ANAL & STOMAL PROCEDURES W MCC,S,"$2,216.10 ","$7,439.98 ","$4,263.25 ","$7,439.98 ",20130101
348,DRG,ANAL & STOMAL PROCEDURES W CC,S,"$2,237.14 ","$7,020.55 ","$4,219.34 ","$7,020.55 ",20130101
349,DRG,ANAL & STOMAL PROCEDURES W/O CC/MCC,S,"$2,120.49 ","$8,514.80 ","$3,714.34 ","$8,514.80 ",20130101
350,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES W MCC,S,"$2,419.18 ","$8,825.77 ","$4,492.74 ","$8,825.77 ",20130101
351,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES W CC,S,"$2,607.42 ","$9,616.29 ","$4,456.79 ","$9,616.29 ",20130101
352,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC,S,"$2,625.86 ","$12,751.67 ","$4,305.01 ","$12,751.67 ",20130101
353,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC,S,"$2,209.59 ","$9,652.17 ","$4,371.75 ","$9,652.17 ",20130101
354,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC,S,"$2,256.75 ","$9,813.85 ","$4,087.85 ","$9,813.85 ",20130101
355,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC,S,"$2,285.53 ","$12,586.46 ","$4,028.95 ","$12,586.46 ",20130101
356,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC,S,"$2,513.56 ","$8,246.95 ","$4,566.70 ","$8,246.95 ",20130101
357,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC,S,"$2,320.31 ","$8,012.51 ","$4,132.77 ","$8,012.51 ",20130101
358,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC,S,"$2,235.07 ","$10,418.80 ","$4,130.65 ","$10,418.80 ",20130101
368,DRG,MAJOR ESOPHAGEAL DISORDERS W MCC,N,"$2,282.69 ","$6,864.64 ","$4,355.99 ","$6,864.64 ",20130101
369,DRG,MAJOR ESOPHAGEAL DISORDERS W CC,N,"$2,331.69 ","$6,325.50 ","$4,260.12 ","$6,325.50 ",20130101
370,DRG,MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC,N,"$2,226.88 ","$6,470.92 ","$4,107.70 ","$6,470.92 ",20130101
371,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC,N,"$2,477.68 ","$5,131.11 ","$4,219.16 ","$5,131.11 ",20130101
372,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,N,"$2,452.49 ","$4,196.40 ","$3,986.07 ","$4,196.40 ",20130101
373,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC,N,"$2,353.69 ","$3,932.93 ","$3,785.95 ","$3,932.93 ",20130101
374,DRG,DIGESTIVE MALIGNANCY W MCC,N,"$2,605.52 ","$5,976.85 ","$4,650.00 ","$5,976.85 ",20130101
375,DRG,DIGESTIVE MALIGNANCY W CC,N,"$2,581.02 ","$5,535.01 ","$4,255.77 ","$5,535.01 ",20130101
376,DRG,DIGESTIVE MALIGNANCY W/O CC/MCC,N,"$1,896.64 ","$4,774.55 ","$3,129.20 ","$4,774.55 ",20130101
377,DRG,G.I. HEMORRHAGE W MCC,N,"$2,416.34 ","$6,733.97 ","$4,524.93 ","$6,733.97 ",20130101
378,DRG,G.I. HEMORRHAGE W CC,N,"$2,301.99 ","$5,949.02 ","$4,217.13 ","$5,949.02 ",20130101
379,DRG,G.I. HEMORRHAGE W/O CC/MCC,N,"$2,269.35 ","$5,667.24 ","$4,116.94 ","$5,667.24 ",20130101
380,DRG,COMPLICATED PEPTIC ULCER W MCC,N,"$2,250.23 ","$6,371.86 ","$4,373.35 ","$6,371.86 ",20130101
381,DRG,COMPLICATED PEPTIC ULCER W CC,N,"$2,179.40 ","$5,854.79 ","$4,080.51 ","$5,854.79 ",20130101
382,DRG,COMPLICATED PEPTIC ULCER W/O CC/MCC,N,"$2,224.59 ","$6,176.07 ","$3,961.81 ","$6,176.07 ",20130101
383,DRG,UNCOMPLICATED PEPTIC ULCER W MCC,N,"$2,200.04 ","$6,394.82 ","$3,811.14 ","$6,394.82 ",20130101
384,DRG,UNCOMPLICATED PEPTIC ULCER W/O MCC,N,"$2,151.93 ","$6,638.01 ","$3,649.46 ","$6,638.01 ",20130101
385,DRG,INFLAMMATORY BOWEL DISEASE W MCC,N,"$2,330.29 ","$5,328.77 ","$4,164.28 ","$5,328.77 ",20130101
386,DRG,INFLAMMATORY BOWEL DISEASE W CC,N,"$2,235.28 ","$4,928.73 ","$3,885.08 ","$4,928.73 ",20130101
387,DRG,INFLAMMATORY BOWEL DISEASE W/O CC/MCC,N,"$2,199.92 ","$4,784.76 ","$3,727.18 ","$4,784.76 ",20130101
388,DRG,G.I. OBSTRUCTION W MCC,N,"$2,317.90 ","$5,619.69 ","$4,202.60 ","$5,619.69 ",20130101
389,DRG,G.I. OBSTRUCTION W CC,N,"$2,174.87 ","$4,549.21 ","$3,738.31 ","$4,549.21 ",20130101
390,DRG,G.I. OBSTRUCTION W/O CC/MCC,N,"$2,121.79 ","$4,408.54 ","$3,580.07 ","$4,408.54 ",20130101
391,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC",N,"$2,202.35 ","$5,547.42 ","$3,931.69 ","$5,547.42 ",20130101
392,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",N,"$2,140.69 ","$5,261.57 ","$3,660.75 ","$5,261.57 ",20130101
393,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC,N,"$2,353.33 ","$5,723.41 ","$4,244.00 ","$5,723.41 ",20130101
394,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,N,"$2,336.91 ","$5,172.14 ","$3,990.96 ","$5,172.14 ",20130101
395,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC,N,"$2,665.85 ","$6,198.24 ","$4,462.94 ","$6,198.24 ",20130101
405,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W MCC",S,"$2,599.19 ","$10,533.58 ","$5,174.78 ","$10,533.58 ",20130101
406,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W CC",S,"$2,828.51 ","$10,875.95 ","$5,213.70 ","$10,875.95 ",20130101
407,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC",S,"$2,773.06 ","$11,882.59 ","$5,211.55 ","$11,882.59 ",20130101
408,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC,S,"$2,413.53 ","$8,766.35 ","$4,654.31 ","$8,766.35 ",20130101
409,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC,S,"$2,406.80 ","$7,972.40 ","$4,253.68 ","$7,972.40 ",20130101
410,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC,S,"$2,427.80 ","$8,904.46 ","$4,237.88 ","$8,904.46 ",20130101
411,DRG,CHOLECYSTECTOMY W C.D.E. W MCC,S,"$2,262.98 ","$9,177.38 ","$4,481.81 ","$9,177.38 ",20130101
412,DRG,CHOLECYSTECTOMY W C.D.E. W CC,S,"$2,195.00 ","$9,151.37 ","$4,180.89 ","$9,151.37 ",20130101
413,DRG,CHOLECYSTECTOMY W C.D.E. W/O CC/MCC,S,"$2,055.16 ","$10,374.65 ","$4,004.52 ","$10,374.65 ",20130101
414,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC,S,"$2,163.51 ","$8,849.40 ","$4,357.55 ","$8,849.40 ",20130101
415,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC,S,"$2,230.60 ","$8,517.66 ","$4,104.03 ","$8,517.66 ",20130101
416,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC,S,"$2,120.45 ","$9,318.92 ","$3,912.83 ","$9,318.92 ",20130101
417,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC,S,"$2,161.43 ","$9,825.41 ","$4,064.70 ","$9,825.41 ",20130101
418,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC,S,"$2,312.15 ","$10,992.21 ","$4,004.98 ","$10,992.21 ",20130101
419,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC,S,"$2,281.76 ","$13,426.93 ","$3,715.89 ","$13,426.93 ",20130101
420,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC,S,"$2,426.65 ","$8,704.31 ","$4,858.21 ","$8,704.31 ",20130101
421,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC,S,"$2,658.43 ","$9,341.49 ","$4,581.98 ","$9,341.49 ",20130101
422,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC,S,"$2,623.87 ","$11,288.03 ","$4,693.01 ","$11,288.03 ",20130101
423,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC,S,"$2,592.11 ","$8,535.88 ","$4,821.25 ","$8,535.88 ",20130101
424,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC,S,"$2,399.81 ","$7,533.88 ","$4,166.17 ","$7,533.88 ",20130101
425,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC,S,"$2,638.20 ","$10,099.08 ","$5,528.65 ","$10,099.08 ",20130101
432,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC,N,"$2,379.94 ","$6,617.06 ","$4,596.44 ","$6,617.06 ",20130101
433,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS W CC,N,"$2,241.42 ","$5,407.15 ","$3,776.87 ","$5,407.15 ",20130101
434,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC,N,"$1,909.62 ","$4,628.49 ","$3,669.99 ","$4,628.49 ",20130101
435,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC,N,"$2,604.79 ","$6,637.23 ","$4,489.55 ","$6,637.23 ",20130101
436,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC,N,"$2,494.37 ","$5,874.47 ","$3,941.12 ","$5,874.47 ",20130101
437,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC,N,"$1,897.04 ","$5,790.78 ","$3,038.25 ","$5,790.78 ",20130101
438,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC,N,"$2,172.23 ","$6,404.63 ","$4,136.91 ","$6,404.63 ",20130101
439,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC,N,"$2,031.30 ","$5,067.50 ","$3,531.68 ","$5,067.50 ",20130101
440,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC,N,"$1,951.70 ","$4,973.85 ","$3,281.50 ","$4,973.85 ",20130101
441,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC",N,"$2,484.48 ","$6,575.47 ","$4,764.26 ","$6,575.47 ",20130101
442,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC",N,"$2,378.46 ","$5,234.97 ","$4,128.97 ","$5,234.97 ",20130101
443,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC",N,"$2,370.14 ","$5,397.45 ","$4,102.38 ","$5,397.45 ",20130101
444,DRG,DISORDERS OF THE BILIARY TRACT W MCC,N,"$2,475.27 ","$6,761.35 ","$4,329.01 ","$6,761.35 ",20130101
445,DRG,DISORDERS OF THE BILIARY TRACT W CC,N,"$2,493.67 ","$6,812.20 ","$4,083.06 ","$6,812.20 ",20130101
446,DRG,DISORDERS OF THE BILIARY TRACT W/O CC/MCC,N,"$2,439.80 ","$7,203.20 ","$3,899.37 ","$7,203.20 ",20130101
453,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC,S,"$2,863.60 ","$28,039.08 ","$5,940.63 ","$28,039.08 ",20130101
454,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC,S,"$2,899.23 ","$41,377.93 ","$5,775.79 ","$41,377.93 ",20130101
455,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC,S,"$2,709.78 ","$53,817.70 ","$4,932.49 ","$53,817.70 ",20130101
456,DRG,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC,S,"$2,908.91 ","$25,853.94 ","$6,073.93 ","$25,853.94 ",20130101
457,DRG,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC,S,"$2,723.11 ","$34,353.72 ","$5,680.78 ","$34,353.72 ",20130101
458,DRG,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC,S,"$2,316.69 ","$42,302.38 ","$4,482.14 ","$42,302.38 ",20130101
459,DRG,SPINAL FUSION EXCEPT CERVICAL W MCC,S,"$2,396.69 ","$22,097.08 ","$5,012.37 ","$22,097.08 ",20130101
460,DRG,SPINAL FUSION EXCEPT CERVICAL W/O MCC,S,"$2,265.08 ","$35,080.04 ","$4,414.50 ","$35,080.04 ",20130101
461,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC,S,"$2,621.58 ","$19,274.49 ","$5,037.41 ","$19,274.49 ",20130101
462,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC,S,"$2,435.38 ","$26,498.11 ","$3,777.03 ","$26,498.11 ",20130101
463,DRG,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC",S,"$2,566.08 ","$7,492.91 ","$5,252.61 ","$7,492.91 ",20130101
464,DRG,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC",S,"$2,622.14 ","$9,272.19 ","$4,925.52 ","$9,272.19 ",20130101
465,DRG,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC",S,"$2,731.38 ","$11,587.31 ","$4,997.36 ","$11,587.31 ",20130101
466,DRG,REVISION OF HIP OR KNEE REPLACEMENT W MCC,S,"$2,302.73 ","$15,697.76 ","$4,598.53 ","$15,697.76 ",20130101
467,DRG,REVISION OF HIP OR KNEE REPLACEMENT W CC,S,"$2,360.09 ","$22,414.86 ","$4,408.07 ","$22,414.86 ",20130101
468,DRG,REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC,S,"$2,393.05 ","$24,477.03 ","$3,967.43 ","$24,477.03 ",20130101
469,DRG,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC,S,"$2,537.11 ","$13,881.88 ","$4,953.12 ","$13,881.88 ",20130101
470,DRG,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,S,"$2,297.05 ","$19,270.73 ","$4,017.14 ","$19,270.73 ",20130101
471,DRG,CERVICAL SPINAL FUSION W MCC,S,"$2,656.77 ","$17,523.73 ","$5,629.54 ","$17,523.73 ",20130101
472,DRG,CERVICAL SPINAL FUSION W CC,S,"$2,896.41 ","$29,776.99 ","$5,677.33 ","$29,776.99 ",20130101
473,DRG,CERVICAL SPINAL FUSION W/O CC/MCC,S,"$2,256.56 ","$41,909.95 ","$4,530.89 ","$41,909.95 ",20130101
474,DRG,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC,S,"$2,240.83 ","$6,949.89 ","$4,149.93 ","$6,949.89 ",20130101
475,DRG,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC,S,"$2,232.31 ","$6,513.72 ","$3,755.25 ","$6,513.72 ",20130101
476,DRG,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC,S,"$2,090.13 ","$7,693.29 ","$3,288.96 ","$7,693.29 ",20130101
477,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC,S,"$2,367.77 ","$7,616.14 ","$3,903.75 ","$7,616.14 ",20130101
478,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC,S,"$2,317.79 ","$9,649.76 ","$3,701.39 ","$9,649.76 ",20130101
479,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC,S,"$2,122.52 ","$13,137.01 ","$3,379.10 ","$13,137.01 ",20130101
480,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC,S,"$2,413.24 ","$9,979.76 ","$4,621.72 ","$9,979.76 ",20130101
481,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC,S,"$2,382.00 ","$10,772.99 ","$4,256.49 ","$10,772.99 ",20130101
482,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,S,"$2,496.21 ","$11,452.12 ","$4,379.96 ","$11,452.12 ",20130101
483,DRG,MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC,S,"$2,364.93 ","$24,622.22 ","$4,456.71 ","$24,622.22 ",20130101
484,DRG,MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC,S,"$2,224.92 ","$33,048.72 ","$3,842.09 ","$33,048.72 ",20130101
485,DRG,KNEE PROCEDURES W PDX OF INFECTION W MCC,S,"$1,997.85 ","$7,604.75 ","$3,890.73 ","$7,604.75 ",20130101
486,DRG,KNEE PROCEDURES W PDX OF INFECTION W CC,S,"$2,240.96 ","$8,128.01 ","$3,590.20 ","$8,128.01 ",20130101
487,DRG,KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC,S,"$2,099.21 ","$8,166.94 ","$3,456.70 ","$8,166.94 ",20130101
488,DRG,KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC,S,"$2,347.74 ","$12,231.43 ","$4,608.02 ","$12,231.43 ",20130101
489,DRG,KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC,S,"$2,499.64 ","$16,164.95 ","$4,094.71 ","$16,164.95 ",20130101
490,DRG,BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM,S,"$2,517.72 ","$13,958.92 ","$4,865.50 ","$13,958.92 ",20130101
491,DRG,BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC,S,"$2,423.17 ","$18,182.36 ","$4,158.57 ","$18,182.36 ",20130101
492,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC",S,"$2,381.72 ","$11,241.87 ","$4,645.71 ","$11,241.87 ",20130101
493,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC",S,"$2,464.17 ","$13,265.84 ","$4,390.46 ","$13,265.84 ",20130101
494,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC",S,"$2,410.77 ","$15,083.00 ","$4,077.53 ","$15,083.00 ",20130101
495,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC,S,"$2,423.65 ","$7,724.17 ","$4,735.27 ","$7,724.17 ",20130101
496,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC,S,"$2,498.57 ","$10,052.23 ","$4,629.69 ","$10,052.23 ",20130101
497,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC,S,"$2,554.03 ","$16,112.39 ","$4,546.00 ","$16,112.39 ",20130101
498,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC,S,"$2,252.15 ","$8,334.16 ","$4,521.04 ","$8,334.16 ",20130101
499,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC,S,"$2,649.62 ","$12,754.45 ","$3,981.83 ","$12,754.45 ",20130101
500,DRG,SOFT TISSUE PROCEDURES W MCC,S,"$2,286.58 ","$7,163.11 ","$4,702.76 ","$7,163.11 ",20130101
501,DRG,SOFT TISSUE PROCEDURES W CC,S,"$2,382.89 ","$7,765.18 ","$4,120.06 ","$7,765.18 ",20130101
502,DRG,SOFT TISSUE PROCEDURES W/O CC/MCC,S,"$2,634.98 ","$12,628.43 ","$4,383.82 ","$12,628.43 ",20130101
503,DRG,FOOT PROCEDURES W MCC,S,"$2,377.44 ","$6,783.76 ","$4,087.27 ","$6,783.76 ",20130101
504,DRG,FOOT PROCEDURES W CC,S,"$2,628.19 ","$7,914.23 ","$4,331.04 ","$7,914.23 ",20130101
505,DRG,FOOT PROCEDURES W/O CC/MCC,S,"$2,756.81 ","$12,740.95 ","$4,534.44 ","$12,740.95 ",20130101
506,DRG,MAJOR THUMB OR JOINT PROCEDURES,S,"$2,613.24 ","$9,749.02 ","$4,182.46 ","$9,749.02 ",20130101
507,DRG,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC,S,"$2,277.22 ","$10,502.94 ","$3,982.59 ","$10,502.94 ",20130101
508,DRG,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC,S,"$2,241.02 ","$20,596.50 ","$4,300.07 ","$20,596.50 ",20130101
509,DRG,ARTHROSCOPY,S,"$2,426.62 ","$10,904.14 ","$3,849.49 ","$10,904.14 ",20130101
510,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC",S,"$2,270.11 ","$11,466.87 ","$4,756.46 ","$11,466.87 ",20130101
511,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC",S,"$2,543.28 ","$13,874.20 ","$4,592.38 ","$13,874.20 ",20130101
512,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC",S,"$2,354.13 ","$17,260.87 ","$4,239.81 ","$17,260.87 ",20130101
513,DRG,"HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC",S,"$2,485.41 ","$8,801.58 ","$4,295.04 ","$8,801.58 ",20130101
514,DRG,"HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC",S,"$2,540.37 ","$10,687.17 ","$4,579.94 ","$10,687.17 ",20130101
515,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC,S,"$2,643.74 ","$10,380.60 ","$5,341.27 ","$10,380.60 ",20130101
516,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC,S,"$2,497.21 ","$11,302.26 ","$4,609.16 ","$11,302.26 ",20130101
517,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,S,"$2,527.31 ","$16,470.44 ","$4,634.83 ","$16,470.44 ",20130101
533,DRG,FRACTURES OF FEMUR W MCC,N,"$2,239.62 ","$5,179.19 ","$4,359.55 ","$5,179.19 ",20130101
534,DRG,FRACTURES OF FEMUR W/O MCC,N,"$2,189.23 ","$3,690.08 ","$3,794.85 ","$3,690.08 ",20130101
535,DRG,FRACTURES OF HIP & PELVIS W MCC,N,"$2,200.10 ","$4,949.96 ","$4,337.55 ","$4,949.96 ",20130101
536,DRG,FRACTURES OF HIP & PELVIS W/O MCC,N,"$2,086.05 ","$3,378.50 ","$3,970.49 ","$3,378.50 ",20130101
537,DRG,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC",N,"$2,714.43 ","$5,561.47 ","$4,848.06 ","$5,561.47 ",20130101
538,DRG,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC",N,"$2,539.01 ","$4,760.72 ","$4,149.19 ","$4,760.72 ",20130101
539,DRG,OSTEOMYELITIS W MCC,N,"$2,122.09 ","$3,630.48 ","$3,638.52 ","$3,630.48 ",20130101
540,DRG,OSTEOMYELITIS W CC,N,"$2,240.47 ","$3,621.25 ","$3,700.51 ","$3,621.25 ",20130101
541,DRG,OSTEOMYELITIS W/O CC/MCC,N,"$2,281.32 ","$3,369.37 ","$3,485.08 ","$3,369.37 ",20130101
542,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC,N,"$2,756.32 ","$6,105.20 ","$4,666.44 ","$6,105.20 ",20130101
543,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC,N,"$2,702.45 ","$5,244.85 ","$4,409.84 ","$5,244.85 ",20130101
544,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC,N,"$2,630.32 ","$4,480.71 ","$4,399.60 ","$4,480.71 ",20130101
545,DRG,CONNECTIVE TISSUE DISORDERS W MCC,N,"$2,589.42 ","$7,397.14 ","$4,879.50 ","$7,397.14 ",20130101
546,DRG,CONNECTIVE TISSUE DISORDERS W CC,N,"$2,516.12 ","$5,685.24 ","$4,447.33 ","$5,685.24 ",20130101
547,DRG,CONNECTIVE TISSUE DISORDERS W/O CC/MCC,N,"$2,649.23 ","$5,782.10 ","$4,629.79 ","$5,782.10 ",20130101
548,DRG,SEPTIC ARTHRITIS W MCC,N,"$2,259.68 ","$4,370.10 ","$4,110.43 ","$4,370.10 ",20130101
549,DRG,SEPTIC ARTHRITIS W CC,N,"$2,242.32 ","$3,927.29 ","$3,917.75 ","$3,927.29 ",20130101
550,DRG,SEPTIC ARTHRITIS W/O CC/MCC,N,"$2,022.21 ","$3,560.75 ","$3,772.19 ","$3,560.75 ",20130101
551,DRG,MEDICAL BACK PROBLEMS W MCC,N,"$2,316.03 ","$5,569.99 ","$4,516.58 ","$5,569.99 ",20130101
552,DRG,MEDICAL BACK PROBLEMS W/O MCC,N,"$2,544.44 ","$5,279.08 ","$4,676.71 ","$5,279.08 ",20130101
553,DRG,BONE DISEASES & ARTHROPATHIES W MCC,N,"$2,734.00 ","$5,718.97 ","$4,936.14 ","$5,718.97 ",20130101
554,DRG,BONE DISEASES & ARTHROPATHIES W/O MCC,N,"$2,263.46 ","$3,233.07 ","$4,253.76 ","$3,233.07 ",20130101
555,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,N,"$2,357.78 ","$5,774.51 ","$4,203.45 ","$5,774.51 ",20130101
556,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC,N,"$2,201.95 ","$4,788.55 ","$3,814.01 ","$4,788.55 ",20130101
557,DRG,"TENDONITIS, MYOSITIS & BURSITIS W MCC",N,"$2,138.07 ","$4,643.67 ","$3,862.65 ","$4,643.67 ",20130101
558,DRG,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",N,"$2,146.49 ","$4,089.45 ","$3,584.31 ","$4,089.45 ",20130101
559,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC",N,"$2,016.90 ","$3,730.17 ","$3,803.06 ","$3,730.17 ",20130101
560,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",N,"$2,028.26 ","$3,289.46 ","$3,587.72 ","$3,289.46 ",20130101
561,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",N,"$1,994.65 ","$4,012.26 ","$3,583.81 ","$4,012.26 ",20130101
562,DRG,"FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC",N,"$2,359.67 ","$5,377.84 ","$4,402.63 ","$5,377.84 ",20130101
563,DRG,"FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC",N,"$2,648.58 ","$4,823.25 ","$4,764.39 ","$4,823.25 ",20130101
564,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC,N,"$2,319.35 ","$4,879.10 ","$4,154.57 ","$4,879.10 ",20130101
565,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,N,"$2,337.86 ","$4,333.91 ","$4,257.92 ","$4,333.91 ",20130101
566,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC,N,"$2,032.22 ","$3,565.13 ","$3,527.18 ","$3,565.13 ",20130101
570,DRG,SKIN DEBRIDEMENT W MCC,S,"$2,212.86 ","$4,447.57 ","$3,972.92 ","$4,447.57 ",20130101
571,DRG,SKIN DEBRIDEMENT W CC,S,"$2,470.52 ","$5,172.10 ","$4,310.47 ","$5,172.10 ",20130101
572,DRG,SKIN DEBRIDEMENT W/O CC/MCC,S,"$2,568.66 ","$6,196.24 ","$4,147.49 ","$6,196.24 ",20130101
573,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC,S,"$2,352.67 ","$5,286.00 ","$4,449.25 ","$5,286.00 ",20130101
574,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC,S,"$2,533.45 ","$5,194.50 ","$4,319.37 ","$5,194.50 ",20130101
575,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC,S,"$2,489.21 ","$5,787.91 ","$4,585.90 ","$5,787.91 ",20130101
576,DRG,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC,S,"$2,715.89 ","$10,000.59 ","$6,177.02 ","$10,000.59 ",20130101
577,DRG,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC,S,"$4,433.83 ","$15,934.59 ","$8,301.58 ","$15,934.59 ",20130101
578,DRG,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC,S,"$4,766.62 ","$21,051.18 ","$8,419.61 ","$21,051.18 ",20130101
579,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC",S,"$2,381.96 ","$6,384.01 ","$4,559.13 ","$6,384.01 ",20130101
580,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W CC",S,"$2,753.86 ","$9,525.46 ","$4,909.36 ","$9,525.46 ",20130101
581,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC",S,"$2,832.05 ","$16,803.81 ","$5,003.35 ","$16,803.81 ",20130101
582,DRG,MASTECTOMY FOR MALIGNANCY W CC/MCC,S,"$2,845.88 ","$17,218.13 ","$5,232.26 ","$17,218.13 ",20130101
583,DRG,MASTECTOMY FOR MALIGNANCY W/O CC/MCC,S,"$2,604.98 ","$20,866.66 ","$4,821.55 ","$20,866.66 ",20130101
584,DRG,"BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC",S,"$2,987.51 ","$11,297.83 ","$5,391.95 ","$11,297.83 ",20130101
585,DRG,"BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC",S,"$2,782.70 ","$20,351.48 ","$5,884.10 ","$20,351.48 ",20130101
592,DRG,SKIN ULCERS W MCC,N,"$1,927.39 ","$3,116.68 ","$3,385.91 ","$3,116.68 ",20130101
593,DRG,SKIN ULCERS W CC,N,"$2,129.91 ","$3,113.38 ","$3,476.84 ","$3,113.38 ",20130101
594,DRG,SKIN ULCERS W/O CC/MCC,N,"$1,843.50 ","$2,532.25 ","$3,243.89 ","$2,532.25 ",20130101
595,DRG,MAJOR SKIN DISORDERS W MCC,N,"$2,491.75 ","$5,638.88 ","$5,667.37 ","$5,638.88 ",20130101
596,DRG,MAJOR SKIN DISORDERS W/O MCC,N,"$2,353.42 ","$3,782.39 ","$4,318.60 ","$3,782.39 ",20130101
597,DRG,MALIGNANT BREAST DISORDERS W MCC,N,"$2,160.40 ","$4,659.49 ","$4,293.63 ","$4,659.49 ",20130101
598,DRG,MALIGNANT BREAST DISORDERS W CC,N,"$2,728.09 ","$4,685.23 ","$4,438.35 ","$4,685.23 ",20130101
599,DRG,MALIGNANT BREAST DISORDERS W/O CC/MCC,N,"$2,496.20 ","$4,321.24 ","$3,485.98 ","$4,321.24 ",20130101
600,DRG,NON-MALIGNANT BREAST DISORDERS W CC/MCC,N,"$2,208.35 ","$4,323.20 ","$3,666.08 ","$4,323.20 ",20130101
601,DRG,NON-MALIGNANT BREAST DISORDERS W/O CC/MCC,N,"$2,324.35 ","$4,050.18 ","$3,740.63 ","$4,050.18 ",20130101
602,DRG,CELLULITIS W MCC,N,"$2,381.96 ","$4,861.06 ","$4,147.54 ","$4,861.06 ",20130101
603,DRG,CELLULITIS W/O MCC,N,"$2,144.31 ","$3,549.95 ","$3,531.60 ","$3,549.95 ",20130101
604,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC",N,"$2,710.73 ","$6,577.28 ","$5,097.24 ","$6,577.28 ",20130101
605,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",N,"$2,881.07 ","$6,337.48 ","$5,238.52 ","$6,337.48 ",20130101
606,DRG,MINOR SKIN DISORDERS W MCC,N,"$2,365.39 ","$4,559.98 ","$4,196.42 ","$4,559.98 ",20130101
607,DRG,MINOR SKIN DISORDERS W/O MCC,N,"$2,258.62 ","$3,685.66 ","$3,917.33 ","$3,685.66 ",20130101
614,DRG,ADRENAL & PITUITARY PROCEDURES W CC/MCC,S,"$2,721.65 ","$13,475.04 ","$5,641.92 ","$13,475.04 ",20130101
615,DRG,ADRENAL & PITUITARY PROCEDURES W/O CC/MCC,S,"$2,675.89 ","$18,471.50 ","$5,181.81 ","$18,471.50 ",20130101
616,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC",S,"$2,420.60 ","$6,962.31 ","$4,493.71 ","$6,962.31 ",20130101
617,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC",S,"$2,220.38 ","$6,243.86 ","$3,719.82 ","$6,243.86 ",20130101
618,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W/O CC/MCC",S,"$1,865.54 ","$5,207.83 ","$3,000.71 ","$5,207.83 ",20130101
619,DRG,O.R. PROCEDURES FOR OBESITY W MCC,S,"$2,488.64 ","$15,555.81 ","$4,842.29 ","$15,555.81 ",20130101
620,DRG,O.R. PROCEDURES FOR OBESITY W CC,S,"$2,516.95 ","$21,649.01 ","$4,567.16 ","$21,649.01 ",20130101
621,DRG,O.R. PROCEDURES FOR OBESITY W/O CC/MCC,S,"$2,295.26 ","$28,519.42 ","$3,846.16 ","$28,519.42 ",20130101
622,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC",S,"$2,688.38 ","$5,986.85 ","$4,906.81 ","$5,986.85 ",20130101
623,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC",S,"$2,722.67 ","$5,923.97 ","$4,610.76 ","$5,923.97 ",20130101
624,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W/O CC/MCC",S,"$3,712.30 ","$9,120.70 ","$7,925.32 ","$9,120.70 ",20130101
625,DRG,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W MCC",S,"$2,554.87 ","$11,272.21 ","$4,967.36 ","$11,272.21 ",20130101
626,DRG,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W CC",S,"$2,883.97 ","$16,649.57 ","$5,227.07 ","$16,649.57 ",20130101
627,DRG,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC",S,"$2,574.68 ","$22,338.41 ","$4,484.86 ","$22,338.41 ",20130101
628,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC",S,"$2,397.45 ","$8,007.44 ","$4,188.04 ","$8,007.44 ",20130101
629,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC",S,"$2,585.44 ","$7,270.22 ","$4,188.44 ","$7,270.22 ",20130101
630,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC/MCC",S,"$2,868.33 ","$12,061.09 ","$5,172.35 ","$12,061.09 ",20130101
637,DRG,DIABETES W MCC,N,"$2,278.64 ","$5,258.40 ","$4,276.43 ","$5,258.40 ",20130101
638,DRG,DIABETES W CC,N,"$2,278.75 ","$4,274.03 ","$3,979.85 ","$4,274.03 ",20130101
639,DRG,DIABETES W/O CC/MCC,N,"$2,193.32 ","$3,997.46 ","$3,807.06 ","$3,997.46 ",20130101
640,DRG,"MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC",N,"$2,284.62 ","$5,146.73 ","$4,116.46 ","$5,146.73 ",20130101
641,DRG,"MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC",N,"$2,154.61 ","$4,166.28 ","$3,776.05 ","$4,166.28 ",20130101
642,DRG,INBORN AND OTHER DISORDERS OF METABOLISM,N,"$2,175.41 ","$5,968.40 ","$4,102.65 ","$5,968.40 ",20130101
643,DRG,ENDOCRINE DISORDERS W MCC,N,"$2,335.01 ","$5,233.77 ","$4,222.44 ","$5,233.77 ",20130101
644,DRG,ENDOCRINE DISORDERS W CC,N,"$2,802.82 ","$5,272.13 ","$4,637.20 ","$5,272.13 ",20130101
645,DRG,ENDOCRINE DISORDERS W/O CC/MCC,N,"$2,696.54 ","$5,405.05 ","$4,613.68 ","$5,405.05 ",20130101
652,DRG,KIDNEY TRANSPLANT,S,"$3,006.02 ","$31,837.51 ","$6,120.71 ","$31,837.51 ",20130101
653,DRG,MAJOR BLADDER PROCEDURES W MCC,S,"$2,479.80 ","$9,664.76 ","$4,713.48 ","$9,664.76 ",20130101
654,DRG,MAJOR BLADDER PROCEDURES W CC,S,"$2,569.08 ","$10,008.12 ","$4,654.36 ","$10,008.12 ",20130101
655,DRG,MAJOR BLADDER PROCEDURES W/O CC/MCC,S,"$2,695.22 ","$12,168.61 ","$4,790.41 ","$12,168.61 ",20130101
656,DRG,KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC,S,"$2,429.60 ","$10,873.19 ","$4,787.75 ","$10,873.19 ",20130101
657,DRG,KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC,S,"$2,478.09 ","$11,602.81 ","$4,539.02 ","$11,602.81 ",20130101
658,DRG,KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC,S,"$2,422.72 ","$15,219.57 ","$4,393.14 ","$15,219.57 ",20130101
659,DRG,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC,S,"$2,671.91 ","$8,637.30 ","$4,892.93 ","$8,637.30 ",20130101
660,DRG,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC,S,"$2,895.67 ","$10,794.10 ","$4,971.52 ","$10,794.10 ",20130101
661,DRG,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC,S,"$2,486.00 ","$16,577.48 ","$4,461.06 ","$16,577.48 ",20130101
662,DRG,MINOR BLADDER PROCEDURES W MCC,S,"$2,526.31 ","$7,354.30 ","$4,697.29 ","$7,354.30 ",20130101
663,DRG,MINOR BLADDER PROCEDURES W CC,S,"$2,297.29 ","$8,004.56 ","$3,982.49 ","$8,004.56 ",20130101
664,DRG,MINOR BLADDER PROCEDURES W/O CC/MCC,S,"$2,043.50 ","$16,642.82 ","$3,443.41 ","$16,642.82 ",20130101
665,DRG,PROSTATECTOMY W MCC,S,"$2,346.81 ","$6,650.13 ","$4,166.14 ","$6,650.13 ",20130101
666,DRG,PROSTATECTOMY W CC,S,"$2,568.20 ","$7,521.60 ","$4,319.29 ","$7,521.60 ",20130101
667,DRG,PROSTATECTOMY W/O CC/MCC,S,"$2,277.15 ","$10,419.01 ","$3,751.95 ","$10,419.01 ",20130101
668,DRG,TRANSURETHRAL PROCEDURES W MCC,S,"$2,723.46 ","$8,367.19 ","$4,834.59 ","$8,367.19 ",20130101
669,DRG,TRANSURETHRAL PROCEDURES W CC,S,"$2,799.54 ","$10,201.59 ","$4,656.25 ","$10,201.59 ",20130101
670,DRG,TRANSURETHRAL PROCEDURES W/O CC/MCC,S,"$2,717.18 ","$11,646.74 ","$4,271.55 ","$11,646.74 ",20130101
671,DRG,URETHRAL PROCEDURES W CC/MCC,S,"$2,559.87 ","$8,306.30 ","$4,626.59 ","$8,306.30 ",20130101
672,DRG,URETHRAL PROCEDURES W/O CC/MCC,S,"$3,375.09 ","$15,817.91 ","$4,520.06 ","$15,817.91 ",20130101
673,DRG,OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC,S,"$2,618.22 ","$8,703.06 ","$4,521.29 ","$8,703.06 ",20130101
674,DRG,OTHER KIDNEY & URINARY TRACT PROCEDURES W CC,S,"$2,370.65 ","$8,450.21 ","$3,958.87 ","$8,450.21 ",20130101
675,DRG,OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC,S,"$1,939.34 ","$15,888.85 ","$2,844.24 ","$15,888.85 ",20130101
682,DRG,RENAL FAILURE W MCC,N,"$2,218.56 ","$5,456.66 ","$3,965.65 ","$5,456.66 ",20130101
683,DRG,RENAL FAILURE W CC,N,"$2,243.84 ","$4,623.88 ","$3,799.13 ","$4,623.88 ",20130101
684,DRG,RENAL FAILURE W/O CC/MCC,N,"$2,012.21 ","$4,069.71 ","$3,410.41 ","$4,069.71 ",20130101
685,DRG,ADMIT FOR RENAL DIALYSIS,N,"$2,012.99 ","$6,175.83 ","$3,461.96 ","$6,175.83 ",20130101
686,DRG,KIDNEY & URINARY TRACT NEOPLASMS W MCC,N,"$2,720.03 ","$6,286.38 ","$5,085.64 ","$6,286.38 ",20130101
687,DRG,KIDNEY & URINARY TRACT NEOPLASMS W CC,N,"$2,594.86 ","$5,462.70 ","$4,491.07 ","$5,462.70 ",20130101
688,DRG,KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC,N,"$1,747.64 ","$4,533.33 ","$2,905.28 ","$4,533.33 ",20130101
689,DRG,KIDNEY & URINARY TRACT INFECTIONS W MCC,N,"$2,243.98 ","$4,508.05 ","$3,913.69 ","$4,508.05 ",20130101
690,DRG,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,N,"$2,179.12 ","$4,170.93 ","$3,725.33 ","$4,170.93 ",20130101
691,DRG,URINARY STONES W ESW LITHOTRIPSY W CC/MCC,N,"$2,226.46 ","$12,133.95 ","$3,890.16 ","$12,133.95 ",20130101
692,DRG,URINARY STONES W ESW LITHOTRIPSY W/O CC/MCC,N,"$1,636.25 ","$14,568.56 ","$3,504.62 ","$14,568.56 ",20130101
693,DRG,URINARY STONES W/O ESW LITHOTRIPSY W MCC,N,"$2,375.05 ","$7,161.89 ","$4,286.04 ","$7,161.89 ",20130101
694,DRG,URINARY STONES W/O ESW LITHOTRIPSY W/O MCC,N,"$2,234.12 ","$8,120.98 ","$3,606.80 ","$8,120.98 ",20130101
695,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC,N,"$2,528.31 ","$5,299.02 ","$4,358.86 ","$5,299.02 ",20130101
696,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC,N,"$2,546.76 ","$4,605.62 ","$4,206.97 ","$4,605.62 ",20130101
697,DRG,URETHRAL STRICTURE,N,"$2,296.29 ","$6,658.55 ","$4,130.54 ","$6,658.55 ",20130101
698,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,N,"$2,533.36 ","$5,812.68 ","$4,537.12 ","$5,812.68 ",20130101
699,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC,N,"$2,562.16 ","$5,544.62 ","$4,211.37 ","$5,544.62 ",20130101
700,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC,N,"$2,380.65 ","$5,226.02 ","$3,925.88 ","$5,226.02 ",20130101
707,DRG,MAJOR MALE PELVIC PROCEDURES W CC/MCC,S,"$2,600.07 ","$16,333.73 ","$4,837.42 ","$16,333.73 ",20130101
708,DRG,MAJOR MALE PELVIC PROCEDURES W/O CC/MCC,S,"$2,352.83 ","$27,390.17 ","$3,948.01 ","$27,390.17 ",20130101
709,DRG,PENIS PROCEDURES W CC/MCC,S,"$2,483.89 ","$10,004.37 ","$4,893.85 ","$10,004.37 ",20130101
710,DRG,PENIS PROCEDURES W/O CC/MCC,S,"$2,459.74 ","$24,304.51 ","$3,738.09 ","$24,304.51 ",20130101
711,DRG,TESTES PROCEDURES W CC/MCC,S,"$2,106.12 ","$6,974.37 ","$3,935.33 ","$6,974.37 ",20130101
712,DRG,TESTES PROCEDURES W/O CC/MCC,S,"$2,274.42 ","$10,298.22 ","$4,834.78 ","$10,298.22 ",20130101
713,DRG,TRANSURETHRAL PROSTATECTOMY W CC/MCC,S,"$2,498.45 ","$9,156.59 ","$4,334.12 ","$9,156.59 ",20130101
714,DRG,TRANSURETHRAL PROSTATECTOMY W/O CC/MCC,S,"$2,387.70 ","$12,523.79 ","$3,947.03 ","$12,523.79 ",20130101
715,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC,S,"$2,495.63 ","$8,994.32 ","$4,760.23 ","$8,994.32 ",20130101
716,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W/O CC/MCC,S,"$2,287.25 ","$26,597.91 ","$3,717.41 ","$26,597.91 ",20130101
717,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC,S,"$2,314.42 ","$6,425.87 ","$3,997.48 ","$6,425.87 ",20130101
718,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC,S,"$2,098.94 ","$7,900.95 ","$3,468.50 ","$7,900.95 ",20130101
722,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC",N,"$2,341.53 ","$4,803.17 ","$4,585.24 ","$4,803.17 ",20130101
723,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC",N,"$2,722.81 ","$5,025.47 ","$4,465.13 ","$5,025.47 ",20130101
724,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W/O CC/MCC",N,"$3,100.84 ","$7,146.93 ","$4,874.87 ","$7,146.93 ",20130101
725,DRG,BENIGN PROSTATIC HYPERTROPHY W MCC,N,"$2,421.41 ","$4,661.32 ","$4,002.22 ","$4,661.32 ",20130101
726,DRG,BENIGN PROSTATIC HYPERTROPHY W/O MCC,N,"$2,816.81 ","$4,997.27 ","$4,455.69 ","$4,997.27 ",20130101
727,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC,N,"$2,155.95 ","$4,730.68 ","$3,866.54 ","$4,730.68 ",20130101
728,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC,N,"$2,080.77 ","$4,097.93 ","$3,588.75 ","$4,097.93 ",20130101
729,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC,N,"$2,021.94 ","$4,201.98 ","$3,534.85 ","$4,201.98 ",20130101
730,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC,N,"$1,945.39 ","$4,738.60 ","$3,119.21 ","$4,738.60 ",20130101
734,DRG,"PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W CC/MCC",S,"$3,034.90 ","$12,142.43 ","$6,273.35 ","$12,142.43 ",20130101
735,DRG,"PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W/O CC/MCC",S,"$2,882.95 ","$19,541.31 ","$4,519.50 ","$19,541.31 ",20130101
736,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC,S,"$2,508.31 ","$9,406.36 ","$4,999.88 ","$9,406.36 ",20130101
737,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC,S,"$2,686.50 ","$10,081.11 ","$5,259.33 ","$10,081.11 ",20130101
738,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC,S,"$2,701.73 ","$13,074.77 ","$4,658.53 ","$13,074.77 ",20130101
739,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC",S,"$2,773.53 ","$10,726.96 ","$5,603.17 ","$10,726.96 ",20130101
740,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC",S,"$2,964.60 ","$12,881.20 ","$5,475.74 ","$12,881.20 ",20130101
741,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC",S,"$2,843.20 ","$18,967.51 ","$4,799.75 ","$18,967.51 ",20130101
742,DRG,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC,S,"$2,338.42 ","$12,353.91 ","$4,601.61 ","$12,353.91 ",20130101
743,DRG,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,S,"$2,188.97 ","$16,838.32 ","$3,930.35 ","$16,838.32 ",20130101
744,DRG,"D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC",S,"$2,908.71 ","$8,333.64 ","$4,876.58 ","$8,333.64 ",20130101
745,DRG,"D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC",S,"$2,623.62 ","$13,188.72 ","$3,874.06 ","$13,188.72 ",20130101
746,DRG,"VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC",S,"$2,260.12 ","$9,995.60 ","$3,996.78 ","$9,995.60 ",20130101
747,DRG,"VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC",S,"$2,336.17 ","$19,192.31 ","$3,705.98 ","$19,192.31 ",20130101
748,DRG,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,S,"$2,137.23 ","$19,608.86 ","$3,896.51 ","$19,608.86 ",20130101
749,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC,S,"$2,529.73 ","$8,561.32 ","$5,192.25 ","$8,561.32 ",20130101
750,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC,S,"$2,203.20 ","$12,431.68 ","$4,143.53 ","$12,431.68 ",20130101
754,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC",N,"$2,664.67 ","$5,528.21 ","$4,852.26 ","$5,528.21 ",20130101
755,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC",N,"$2,393.49 ","$4,715.38 ","$4,003.31 ","$4,715.38 ",20130101
756,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC",N,"$2,431.58 ","$4,912.34 ","$3,078.85 ","$4,912.34 ",20130101
757,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC",N,"$2,140.16 ","$4,821.70 ","$3,850.28 ","$4,821.70 ",20130101
758,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC",N,"$2,182.11 ","$4,569.21 ","$3,684.44 ","$4,569.21 ",20130101
759,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC",N,"$2,186.77 ","$4,384.95 ","$3,896.44 ","$4,384.95 ",20130101
760,DRG,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC,N,"$2,802.76 ","$6,189.00 ","$4,480.73 ","$6,189.00 ",20130101
761,DRG,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC,N,"$3,376.54 ","$7,432.10 ","$5,573.15 ","$7,432.10 ",20130101
765,DRG,CESAREAN SECTION W CC/MCC,S,"$2,269.16 ","$5,164.93 ","$4,189.21 ","$5,164.93 ",20130101
766,DRG,CESAREAN SECTION W/O CC/MCC,S,"$2,055.20 ","$5,566.14 ","$4,147.13 ","$5,566.14 ",20130101
767,DRG,VAGINAL DELIVERY W STERILIZATION &/OR D&C,S,"$1,756.52 ","$6,855.84 ","$3,696.62 ","$6,855.84 ",20130101
768,DRG,VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C,S,"$3,251.93 ","$6,678.01 ","$6,241.65 ","$6,678.01 ",20130101
769,DRG,POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE,S,"$2,158.69 ","$9,490.09 ","$4,556.89 ","$9,490.09 ",20130101
770,DRG,"ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",S,"$2,619.31 ","$10,052.03 ","$4,486.95 ","$10,052.03 ",20130101
774,DRG,VAGINAL DELIVERY W COMPLICATING DIAGNOSES,N,"$2,181.47 ","$4,528.46 ","$4,318.11 ","$4,528.46 ",20130101
775,DRG,VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES,N,"$2,139.19 ","$4,596.05 ","$4,360.64 ","$4,596.05 ",20130101
776,DRG,POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE,N,"$2,404.94 ","$4,024.11 ","$4,679.69 ","$4,024.11 ",20130101
777,DRG,ECTOPIC PREGNANCY,N,"$2,529.71 ","$12,970.67 ","$4,175.45 ","$12,970.67 ",20130101
778,DRG,THREATENED ABORTION,N,"$2,066.65 ","$2,601.11 ","$3,856.37 ","$2,601.11 ",20130101
779,DRG,ABORTION W/O D&C,N,"$2,716.22 ","$6,829.05 ","$5,645.74 ","$6,829.05 ",20130101
780,DRG,FALSE LABOR,N,"$1,889.75 ","$3,477.96 ","$3,203.25 ","$3,477.96 ",20130101
781,DRG,OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS,N,"$2,373.22 ","$2,991.51 ","$4,216.70 ","$2,991.51 ",20130101
782,DRG,OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS,N,"$2,163.05 ","$3,577.59 ","$4,023.76 ","$3,577.59 ",20130101
789,DRG,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",N,"$3,569.12 ","$7,751.94 ","$6,695.09 ","$7,751.94 ",20130101
790,DRG,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",N,"$2,694.74 ","$5,852.82 ","$5,054.89 ","$5,852.82 ",20130101
791,DRG,PREMATURITY W MAJOR PROBLEMS,N,"$2,065.25 ","$4,485.62 ","$3,874.08 ","$4,485.62 ",20130101
792,DRG,PREMATURITY W/O MAJOR PROBLEMS,N,"$1,523.71 ","$3,309.40 ","$2,858.23 ","$3,309.40 ",20130101
793,DRG,FULL TERM NEONATE W MAJOR PROBLEMS,N,"$1,611.73 ","$3,500.58 ","$3,023.34 ","$3,500.58 ",20130101
794,DRG,NEONATE W OTHER SIGNIFICANT PROBLEMS,N,$921.91 ,"$2,002.34 ","$1,729.36 ","$2,002.34 ",20130101
795,DRG,NORMAL NEWBORN,N,$609.53 ,"$1,323.85 ","$1,143.36 ","$1,323.85 ",20130101
799,DRG,SPLENECTOMY W MCC,S,"$2,417.58 ","$12,334.30 ","$4,832.13 ","$12,334.30 ",20130101
800,DRG,SPLENECTOMY W CC,S,"$2,311.41 ","$11,928.15 ","$4,626.87 ","$11,928.15 ",20130101
801,DRG,SPLENECTOMY W/O CC/MCC,S,"$2,215.96 ","$13,660.46 ","$3,675.27 ","$13,660.46 ",20130101
802,DRG,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W MCC,S,"$2,888.61 ","$8,897.12 ","$4,736.07 ","$8,897.12 ",20130101
803,DRG,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC,S,"$2,520.48 ","$8,902.49 ","$4,418.30 ","$8,902.49 ",20130101
804,DRG,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W/O CC/MCC,S,"$2,367.14 ","$11,782.08 ","$3,968.73 ","$11,782.08 ",20130101
808,DRG,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC,N,"$2,517.12 ","$7,329.61 ","$4,396.87 ","$7,329.61 ",20130101
809,DRG,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,N,"$2,400.96 ","$6,325.18 ","$4,002.92 ","$6,325.18 ",20130101
810,DRG,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC,N,"$2,283.54 ","$6,750.22 ","$3,909.87 ","$6,750.22 ",20130101
811,DRG,RED BLOOD CELL DISORDERS W MCC,N,"$2,313.49 ","$5,993.92 ","$4,002.47 ","$5,993.92 ",20130101
812,DRG,RED BLOOD CELL DISORDERS W/O MCC,N,"$2,141.12 ","$5,129.04 ","$3,572.40 ","$5,129.04 ",20130101
813,DRG,COAGULATION DISORDERS,N,"$2,567.63 ","$12,196.23 ","$4,571.96 ","$12,196.23 ",20130101
814,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC,N,"$2,584.11 ","$6,785.28 ","$4,728.36 ","$6,785.28 ",20130101
815,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC,N,"$2,357.59 ","$5,836.12 ","$4,011.63 ","$5,836.12 ",20130101
816,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,N,"$2,048.38 ","$5,216.49 ","$3,520.01 ","$5,216.49 ",20130101
820,DRG,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC,S,"$2,863.23 ","$10,950.13 ","$5,412.80 ","$10,950.13 ",20130101
821,DRG,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC,S,"$2,827.15 ","$11,060.99 ","$4,694.11 ","$11,060.99 ",20130101
822,DRG,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC,S,"$2,830.28 ","$15,583.79 ","$4,790.65 ","$15,583.79 ",20130101
823,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W MCC,S,"$2,874.84 ","$9,324.31 ","$5,103.11 ","$9,324.31 ",20130101
824,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC,S,"$2,729.05 ","$9,243.33 ","$4,340.45 ","$9,243.33 ",20130101
825,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC/MCC,S,"$2,852.71 ","$12,461.18 ","$4,458.21 ","$12,461.18 ",20130101
826,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC,S,"$2,601.30 ","$10,410.09 ","$5,341.95 ","$10,410.09 ",20130101
827,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC,S,"$2,732.76 ","$10,103.18 ","$5,221.95 ","$10,103.18 ",20130101
828,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC,S,"$2,683.15 ","$13,041.74 ","$4,728.92 ","$13,041.74 ",20130101
829,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC W CC/MCC,S,"$2,769.09 ","$9,195.32 ","$4,841.02 ","$9,195.32 ",20130101
830,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC W/O CC/MCC,S,"$2,703.54 ","$13,139.09 ","$4,751.74 ","$13,139.09 ",20130101
834,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC,N,"$3,060.23 ","$9,813.86 ","$5,272.53 ","$9,813.86 ",20130101
835,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC,N,"$2,927.56 ","$8,091.34 ","$4,546.82 ","$8,091.34 ",20130101
836,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC,N,"$2,640.77 ","$7,391.01 ","$4,205.10 ","$7,391.01 ",20130101
837,DRG,CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC,N,"$2,758.04 ","$8,601.81 ","$4,370.86 ","$8,601.81 ",20130101
838,DRG,CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,N,"$2,873.39 ","$8,780.82 ","$4,388.28 ","$8,780.82 ",20130101
839,DRG,CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,N,"$2,509.85 ","$6,331.02 ","$3,074.89 ","$6,331.02 ",20130101
840,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W MCC,N,"$2,793.92 ","$7,976.76 ","$4,865.05 ","$7,976.76 ",20130101
841,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W CC,N,"$2,619.91 ","$6,970.11 ","$4,299.49 ","$6,970.11 ",20130101
842,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC,N,"$2,079.64 ","$6,293.62 ","$3,379.77 ","$6,293.62 ",20130101
843,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC,N,"$2,678.91 ","$6,337.65 ","$4,822.93 ","$6,337.65 ",20130101
844,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC,N,"$2,470.17 ","$5,593.90 ","$4,316.68 ","$5,593.90 ",20130101
845,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC/MCC,N,"$1,825.85 ","$4,520.42 ","$3,008.59 ","$4,520.42 ",20130101
846,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,N,"$2,932.98 ","$8,575.16 ","$4,909.28 ","$8,575.16 ",20130101
847,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,N,"$2,605.40 ","$9,584.64 ","$3,500.00 ","$9,584.64 ",20130101
848,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W/O CC/MCC,N,"$2,658.30 ","$8,165.20 ","$3,759.74 ","$8,165.20 ",20130101
849,DRG,RADIOTHERAPY,N,"$3,182.03 ","$6,781.45 ","$5,330.04 ","$6,781.45 ",20130101
853,DRG,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC,S,"$2,642.70 ","$9,382.76 ","$4,915.40 ","$9,382.76 ",20130101
854,DRG,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC,S,"$2,350.29 ","$7,037.52 ","$4,055.18 ","$7,037.52 ",20130101
855,DRG,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC,S,"$2,548.23 ","$8,681.43 ","$4,117.81 ","$8,681.43 ",20130101
856,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC,S,"$2,346.83 ","$7,673.97 ","$4,572.05 ","$7,673.97 ",20130101
857,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC,S,"$2,391.32 ","$6,701.65 ","$4,280.60 ","$6,701.65 ",20130101
858,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC,S,"$2,204.10 ","$6,857.74 ","$3,845.48 ","$6,857.74 ",20130101
862,DRG,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC,N,"$2,286.10 ","$5,238.09 ","$4,254.01 ","$5,238.09 ",20130101
863,DRG,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC,N,"$2,213.02 ","$4,146.71 ","$3,673.99 ","$4,146.71 ",20130101
864,DRG,FEVER,N,"$2,309.62 ","$5,352.29 ","$3,886.77 ","$5,352.29 ",20130101
865,DRG,VIRAL ILLNESS W MCC,N,"$2,341.93 ","$6,101.55 ","$4,474.17 ","$6,101.55 ",20130101
866,DRG,VIRAL ILLNESS W/O MCC,N,"$2,257.86 ","$4,822.14 ","$3,844.38 ","$4,822.14 ",20130101
867,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC,N,"$2,402.96 ","$6,929.72 ","$4,528.50 ","$6,929.72 ",20130101
868,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC,N,"$2,433.52 ","$4,822.59 ","$4,336.79 ","$4,822.59 ",20130101
869,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC,N,"$2,198.16 ","$4,129.67 ","$3,797.25 ","$4,129.67 ",20130101
870,DRG,SEPTICEMIA OR SEVERE SEPSIS W MV 96+ HOURS,N,"$3,220.81 ","$9,957.44 ","$5,516.98 ","$9,957.44 ",20130101
871,DRG,SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC,N,"$2,495.57 ","$6,362.74 ","$4,540.98 ","$6,362.74 ",20130101
872,DRG,SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC,N,"$2,313.09 ","$4,697.60 ","$3,921.71 ","$4,697.60 ",20130101
876,DRG,O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS,S,"$2,141.39 ","$3,250.03 ","$3,362.54 ","$3,250.03 ",20130101
880,DRG,ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION,N,"$1,845.98 ","$2,672.90 ","$3,208.93 ","$2,672.90 ",20130101
881,DRG,DEPRESSIVE NEUROSES,N,"$2,014.40 ",$857.18 ,"$2,906.37 ",$857.18 ,20130101
882,DRG,NEUROSES EXCEPT DEPRESSIVE,N,"$1,919.82 ",$771.84 ,"$2,835.92 ",$771.84 ,20130101
883,DRG,DISORDERS OF PERSONALITY & IMPULSE CONTROL,N,"$1,981.53 ",$732.13 ,"$2,770.40 ",$732.13 ,20130101
884,DRG,ORGANIC DISTURBANCES & MENTAL RETARDATION,N,"$2,045.29 ","$1,298.69 ","$3,535.88 ","$1,298.69 ",20130101
885,DRG,PSYCHOSES,N,"$2,228.40 ",$721.76 ,"$2,931.64 ",$721.76 ,20130101
886,DRG,BEHAVIORAL & DEVELOPMENTAL DISORDERS,N,"$2,070.18 ",$841.39 ,"$3,475.02 ",$841.39 ,20130101
887,DRG,OTHER MENTAL DISORDER DIAGNOSES,N,"$1,358.20 ",$937.43 ,"$2,136.73 ",$937.43 ,20130101
894,DRG,"ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA",N,"$1,702.86 ","$1,348.33 ","$3,493.10 ","$1,348.33 ",20130101
895,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY,N,"$1,331.56 ",$396.03 ,"$3,185.60 ",$396.03 ,20130101
896,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC,N,"$2,228.27 ","$4,080.99 ","$4,255.20 ","$4,080.99 ",20130101
897,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,N,"$1,441.45 ","$1,090.49 ","$2,666.02 ","$1,090.49 ",20130101
901,DRG,WOUND DEBRIDEMENTS FOR INJURIES W MCC,S,"$2,427.14 ","$6,167.44 ","$4,883.56 ","$6,167.44 ",20130101
902,DRG,WOUND DEBRIDEMENTS FOR INJURIES W CC,S,"$2,385.10 ","$5,521.18 ","$4,287.80 ","$5,521.18 ",20130101
903,DRG,WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC,S,"$2,432.68 ","$6,769.79 ","$4,221.42 ","$6,769.79 ",20130101
904,DRG,SKIN GRAFTS FOR INJURIES W CC/MCC,S,"$2,667.91 ","$7,861.49 ","$5,272.01 ","$7,861.49 ",20130101
905,DRG,SKIN GRAFTS FOR INJURIES W/O CC/MCC,S,"$2,740.98 ","$8,901.01 ","$5,267.84 ","$8,901.01 ",20130101
906,DRG,HAND PROCEDURES FOR INJURIES,S,"$2,348.71 ","$10,440.83 ","$4,714.62 ","$10,440.83 ",20130101
907,DRG,OTHER O.R. PROCEDURES FOR INJURIES W MCC,S,"$2,362.39 ","$9,509.50 ","$4,736.18 ","$9,509.50 ",20130101
908,DRG,OTHER O.R. PROCEDURES FOR INJURIES W CC,S,"$2,375.88 ","$9,061.39 ","$4,527.57 ","$9,061.39 ",20130101
909,DRG,OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC,S,"$2,299.78 ","$11,435.89 ","$4,329.43 ","$11,435.89 ",20130101
913,DRG,TRAUMATIC INJURY W MCC,N,"$2,206.04 ","$5,042.43 ","$4,112.57 ","$5,042.43 ",20130101
914,DRG,TRAUMATIC INJURY W/O MCC,N,"$2,210.82 ","$4,728.64 ","$4,160.63 ","$4,728.64 ",20130101
915,DRG,ALLERGIC REACTIONS W MCC,N,"$2,350.75 ","$7,058.25 ","$4,827.94 ","$7,058.25 ",20130101
916,DRG,ALLERGIC REACTIONS W/O MCC,N,"$2,241.51 ","$4,257.33 ","$4,253.11 ","$4,257.33 ",20130101
917,DRG,POISONING & TOXIC EFFECTS OF DRUGS W MCC,N,"$2,389.00 ","$7,291.90 ","$4,591.04 ","$7,291.90 ",20130101
918,DRG,POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,N,"$2,409.45 ","$5,117.50 ","$4,175.84 ","$5,117.50 ",20130101
919,DRG,COMPLICATIONS OF TREATMENT W MCC,N,"$2,300.17 ","$5,798.60 ","$4,329.24 ","$5,798.60 ",20130101
920,DRG,COMPLICATIONS OF TREATMENT W CC,N,"$2,350.79 ","$5,150.95 ","$4,179.18 ","$5,150.95 ",20130101
921,DRG,COMPLICATIONS OF TREATMENT W/O CC/MCC,N,"$2,255.70 ","$5,166.98 ","$3,898.45 ","$5,166.98 ",20130101
922,DRG,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC",N,"$3,011.03 ","$7,447.36 ","$5,674.93 ","$7,447.36 ",20130101
923,DRG,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC",N,"$2,590.75 ","$5,179.62 ","$4,445.90 ","$5,179.62 ",20130101
927,DRG,EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV 96+ HRS W SKIN GRAFT,S,"$2,635.95 ","$13,304.22 ","$7,345.66 ","$13,304.22 ",20130101
928,DRG,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC,S,"$2,399.20 ","$6,978.74 ","$6,743.65 ","$6,978.74 ",20130101
929,DRG,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W/O CC/MCC,S,"$2,417.58 ","$6,228.34 ","$6,779.87 ","$6,228.34 ",20130101
933,DRG,EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV 96+ HRS W/O SKIN GRAFT,N,"$2,013.93 ","$9,732.60 ","$6,593.03 ","$9,732.60 ",20130101
934,DRG,FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ,N,"$2,464.97 ","$4,669.49 ","$7,625.56 ","$4,669.49 ",20130101
935,DRG,NON-EXTENSIVE BURNS,N,"$2,289.13 ","$4,828.50 ","$6,874.06 ","$4,828.50 ",20130101
939,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC,S,"$2,204.59 ","$5,424.52 ","$4,284.05 ","$5,424.52 ",20130101
940,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC,S,"$2,378.76 ","$6,062.48 ","$4,516.51 ","$6,062.48 ",20130101
941,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC,S,"$2,328.77 ","$11,301.47 ","$5,172.41 ","$11,301.47 ",20130101
945,DRG,REHABILITATION W CC/MCC,N,"$1,630.82 ","$2,160.77 ","$2,587.02 ","$2,160.77 ",20130101
946,DRG,REHABILITATION W/O CC/MCC,N,"$1,519.47 ","$1,637.47 ","$2,300.22 ","$1,637.47 ",20130101
947,DRG,SIGNS & SYMPTOMS W MCC,N,"$2,249.72 ","$5,265.06 ","$4,016.31 ","$5,265.06 ",20130101
948,DRG,SIGNS & SYMPTOMS W/O MCC,N,"$2,161.43 ","$4,532.01 ","$3,657.46 ","$4,532.01 ",20130101
949,DRG,AFTERCARE W CC/MCC,N,"$1,939.29 ","$2,708.42 ","$3,068.53 ","$2,708.42 ",20130101
950,DRG,AFTERCARE W/O CC/MCC,N,"$1,454.43 ","$1,705.29 ","$2,660.73 ","$1,705.29 ",20130101
951,DRG,OTHER FACTORS INFLUENCING HEALTH STATUS,N,"$1,338.96 ","$1,960.75 ","$3,982.03 ","$1,960.75 ",20130101
955,DRG,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,S,"$2,724.87 ","$14,612.86 ","$6,465.95 ","$14,612.86 ",20130101
956,DRG,"LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA",S,"$2,717.53 ","$13,520.34 ","$6,030.24 ","$13,520.34 ",20130101
957,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC,S,"$2,369.07 ","$13,741.57 ","$5,635.56 ","$13,741.57 ",20130101
958,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC,S,"$2,556.83 ","$13,394.41 ","$5,940.67 ","$13,394.41 ",20130101
959,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC,S,"$2,240.16 ","$13,408.37 ","$5,589.79 ","$13,408.37 ",20130101
963,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC,N,"$2,225.24 ","$7,740.55 ","$5,164.07 ","$7,740.55 ",20130101
964,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA W CC,N,"$2,420.97 ","$6,334.18 ","$5,445.88 ","$6,334.18 ",20130101
965,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC,N,"$2,334.89 ","$6,129.76 ","$5,633.30 ","$6,129.76 ",20130101
969,DRG,HIV W EXTENSIVE O.R. PROCEDURE W MCC,S,"$2,823.47 ","$9,327.16 ","$5,562.34 ","$9,327.16 ",20130101
970,DRG,HIV W EXTENSIVE O.R. PROCEDURE W/O MCC,S,"$2,986.07 ","$9,076.11 ","$4,859.02 ","$9,076.11 ",20130101
974,DRG,HIV W MAJOR RELATED CONDITION W MCC,N,"$2,640.82 ","$6,909.70 ","$4,770.63 ","$6,909.70 ",20130101
975,DRG,HIV W MAJOR RELATED CONDITION W CC,N,"$2,662.05 ","$5,117.32 ","$3,984.99 ","$5,117.32 ",20130101
976,DRG,HIV W MAJOR RELATED CONDITION W/O CC/MCC,N,"$2,350.23 ","$4,231.82 ","$3,493.09 ","$4,231.82 ",20130101
977,DRG,HIV W OR W/O OTHER RELATED CONDITION,N,"$2,493.36 ","$5,539.15 ","$4,019.44 ","$5,539.15 ",20130101
981,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC,S,"$2,357.93 ","$9,189.73 ","$4,491.42 ","$9,189.73 ",20130101
982,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC,S,"$2,444.38 ","$9,848.23 ","$4,286.88 ","$9,848.23 ",20130101
983,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC,S,"$2,079.14 ","$11,942.78 ","$3,585.61 ","$11,942.78 ",20130101
984,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC,S,"$2,239.90 ","$5,739.76 ","$3,715.83 ","$5,739.76 ",20130101
985,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC,S,"$2,300.62 ","$6,096.47 ","$3,915.51 ","$6,096.47 ",20130101
986,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC,S,"$2,279.35 ","$8,491.50 ","$4,266.17 ","$8,491.50 ",20130101
987,DRG,NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC,S,"$2,433.84 ","$7,084.40 ","$4,440.73 ","$7,084.40 ",20130101
988,DRG,NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC,S,"$2,338.38 ","$6,828.13 ","$4,025.86 ","$6,828.13 ",20130101
989,DRG,NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC,S,"$1,922.20 ","$8,139.16 ","$3,382.14 ","$8,139.16 ",20130101
000,SNF,SKILLED NURSING FACILITY PER DIEM,,$769.10 ,,,,20130101