Version 3.14 - 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,"$3,316.73 ","$24,369.04 ","$6,424.89 ","$24,369.04 ",20140101
002,DRG,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC,S,"$3,169.70 ","$27,901.18 ","$6,352.76 ","$27,901.18 ",20140101
003,DRG,"ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R.",S,"$3,543.26 ","$13,702.45 ","$6,075.39 ","$13,702.45 ",20140101
004,DRG,"TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.",S,"$3,246.34 ","$9,483.26 ","$5,485.38 ","$9,483.26 ",20140101
005,DRG,LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT,S,"$3,215.14 ","$24,642.20 ","$6,941.79 ","$24,642.20 ",20140101
006,DRG,LIVER TRANSPLANT W/O MCC,S,"$2,504.49 ","$28,388.26 ","$5,189.49 ","$28,388.26 ",20140101
007,DRG,LUNG TRANSPLANT,S,"$3,229.65 ","$26,470.67 ","$5,797.03 ","$26,470.67 ",20140101
008,DRG,SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT,S,"$2,989.85 ","$37,114.74 ","$6,209.10 ","$37,114.74 ",20140101
010,DRG,PANCREAS TRANSPLANT,S,"$2,679.80 ","$23,532.64 ","$5,339.78 ","$23,532.64 ",20140101
011,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC",S,"$2,963.27 ","$10,301.66 ","$5,807.57 ","$10,301.66 ",20140101
012,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC",S,"$3,109.82 ","$10,715.47 ","$5,686.92 ","$10,715.47 ",20140101
013,DRG,"TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC",S,"$2,798.90 ","$9,740.11 ","$4,945.38 ","$9,740.11 ",20140101
014,DRG,ALLOGENEIC BONE MARROW TRANSPLANT,S,"$4,691.92 ","$12,575.98 ","$5,598.21 ","$12,575.98 ",20140101
016,DRG,AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC,S,"$3,978.56 ","$8,346.47 ","$4,915.56 ","$8,346.47 ",20140101
017,DRG,AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC,S,"$3,636.14 ","$7,314.91 ","$5,056.29 ","$7,314.91 ",20140101
020,DRG,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC,S,"$3,491.17 ","$17,202.24 ","$7,169.04 ","$17,202.24 ",20140101
021,DRG,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC,S,"$3,418.17 ","$14,680.34 ","$7,121.57 ","$14,680.34 ",20140101
022,DRG,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC,S,"$3,421.29 ","$18,463.90 ","$6,702.45 ","$18,463.90 ",20140101
023,DRG,CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT,S,"$2,908.97 ","$14,123.99 ","$6,247.95 ","$14,123.99 ",20140101
024,DRG,CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC,S,"$3,402.74 ","$18,260.71 ","$6,543.59 ","$18,260.71 ",20140101
025,DRG,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,S,"$3,044.42 ","$13,691.14 ","$6,360.79 ","$13,691.14 ",20140101
026,DRG,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,S,"$3,319.30 ","$15,668.30 ","$6,679.58 ","$15,668.30 ",20140101
027,DRG,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,S,"$3,094.91 ","$24,003.80 ","$6,295.80 ","$24,003.80 ",20140101
028,DRG,SPINAL PROCEDURES W MCC,S,"$2,699.19 ","$12,616.56 ","$5,576.95 ","$12,616.56 ",20140101
029,DRG,SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS,S,"$2,719.08 ","$14,993.99 ","$5,537.26 ","$14,993.99 ",20140101
030,DRG,SPINAL PROCEDURES W/O CC/MCC,S,"$2,510.53 ","$17,233.69 ","$4,934.83 ","$17,233.69 ",20140101
031,DRG,VENTRICULAR SHUNT PROCEDURES W MCC,S,"$2,906.46 ","$10,002.84 ","$5,957.21 ","$10,002.84 ",20140101
032,DRG,VENTRICULAR SHUNT PROCEDURES W CC,S,"$2,882.08 ","$12,607.00 ","$5,743.49 ","$12,607.00 ",20140101
033,DRG,VENTRICULAR SHUNT PROCEDURES W/O CC/MCC,S,"$2,558.50 ","$19,327.38 ","$5,057.89 ","$19,327.38 ",20140101
034,DRG,CAROTID ARTERY STENT PROCEDURE W MCC,S,"$2,685.35 ","$17,441.97 ","$5,415.33 ","$17,441.97 ",20140101
035,DRG,CAROTID ARTERY STENT PROCEDURE W CC,S,"$2,751.24 ","$25,161.55 ","$5,047.53 ","$25,161.55 ",20140101
036,DRG,CAROTID ARTERY STENT PROCEDURE W/O CC/MCC,S,"$2,641.02 ","$40,254.98 ","$4,819.55 ","$40,254.98 ",20140101
037,DRG,EXTRACRANIAL PROCEDURES W MCC,S,"$2,465.51 ","$11,566.34 ","$4,472.06 ","$11,566.34 ",20140101
038,DRG,EXTRACRANIAL PROCEDURES W CC,S,"$2,564.11 ","$15,746.96 ","$4,608.34 ","$15,746.96 ",20140101
039,DRG,EXTRACRANIAL PROCEDURES W/O CC/MCC,S,"$2,369.11 ","$23,042.24 ","$4,447.77 ","$23,042.24 ",20140101
040,DRG,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC,S,"$2,627.64 ","$8,678.96 ","$5,148.09 ","$8,678.96 ",20140101
041,DRG,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM,S,"$2,429.45 ","$9,122.25 ","$4,529.85 ","$9,122.25 ",20140101
042,DRG,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC,S,"$3,010.25 ","$20,564.40 ","$5,446.31 ","$20,564.40 ",20140101
052,DRG,SPINAL DISORDERS & INJURIES W CC/MCC,N,"$1,680.32 ","$3,641.53 ","$4,389.34 ","$3,641.53 ",20140101
053,DRG,SPINAL DISORDERS & INJURIES W/O CC/MCC,N,"$1,255.86 ","$3,077.39 ","$3,050.28 ","$3,077.39 ",20140101
054,DRG,NERVOUS SYSTEM NEOPLASMS W MCC,N,"$2,662.69 ","$6,133.81 ","$4,956.45 ","$6,133.81 ",20140101
055,DRG,NERVOUS SYSTEM NEOPLASMS W/O MCC,N,"$2,355.29 ","$5,866.93 ","$4,219.38 ","$5,866.93 ",20140101
056,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC,N,"$2,309.35 ","$3,768.48 ","$4,572.69 ","$3,768.48 ",20140101
057,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC,N,"$2,582.29 ","$2,157.28 ","$4,799.54 ","$2,157.28 ",20140101
058,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC,N,"$2,683.49 ","$5,817.47 ","$4,825.98 ","$5,817.47 ",20140101
059,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC,N,"$2,517.55 ","$5,167.01 ","$3,777.97 ","$5,167.01 ",20140101
060,DRG,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC,N,"$2,521.22 ","$5,261.31 ","$4,106.87 ","$5,261.31 ",20140101
061,DRG,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC,N,"$3,017.62 ","$11,108.02 ","$5,941.81 ","$11,108.02 ",20140101
062,DRG,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC,N,"$3,113.83 ","$12,524.40 ","$6,073.59 ","$12,524.40 ",20140101
063,DRG,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC,N,"$3,144.73 ","$15,261.09 ","$5,944.17 ","$15,261.09 ",20140101
064,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC,N,"$2,635.52 ","$7,234.33 ","$5,278.61 ","$7,234.33 ",20140101
065,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC,N,"$2,444.67 ","$6,521.59 ","$4,608.21 ","$6,521.59 ",20140101
066,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC,N,"$2,289.49 ","$7,418.21 ","$4,310.58 ","$7,418.21 ",20140101
067,DRG,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC,N,"$2,209.91 ","$6,937.04 ","$4,005.76 ","$6,937.04 ",20140101
068,DRG,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC,N,"$1,727.87 ","$6,304.98 ","$3,155.34 ","$6,304.98 ",20140101
069,DRG,TRANSIENT ISCHEMIA,N,"$2,662.25 ","$9,366.23 ","$4,645.70 ","$9,366.23 ",20140101
070,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC,N,"$2,345.99 ","$6,291.62 ","$4,389.96 ","$6,291.62 ",20140101
071,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,N,"$2,508.49 ","$5,340.08 ","$4,376.89 ","$5,340.08 ",20140101
072,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC,N,"$2,236.79 ","$6,268.31 ","$3,921.85 ","$6,268.31 ",20140101
073,DRG,CRANIAL & PERIPHERAL NERVE DISORDERS W MCC,N,"$2,301.71 ","$5,670.22 ","$3,912.50 ","$5,670.22 ",20140101
074,DRG,CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC,N,"$2,356.44 ","$5,673.75 ","$4,099.09 ","$5,673.75 ",20140101
075,DRG,VIRAL MENINGITIS W CC/MCC,N,"$2,361.83 ","$6,709.91 ","$4,243.29 ","$6,709.91 ",20140101
076,DRG,VIRAL MENINGITIS W/O CC/MCC,N,"$2,084.37 ","$5,797.70 ","$3,763.52 ","$5,797.70 ",20140101
077,DRG,HYPERTENSIVE ENCEPHALOPATHY W MCC,N,"$2,287.70 ","$6,783.29 ","$4,592.27 ","$6,783.29 ",20140101
078,DRG,HYPERTENSIVE ENCEPHALOPATHY W CC,N,"$2,371.26 ","$6,391.82 ","$4,519.88 ","$6,391.82 ",20140101
079,DRG,HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC,N,"$2,324.44 ","$6,943.19 ","$4,371.42 ","$6,943.19 ",20140101
080,DRG,NONTRAUMATIC STUPOR & COMA W MCC,N,"$2,809.02 ","$6,358.28 ","$5,271.73 ","$6,358.28 ",20140101
081,DRG,NONTRAUMATIC STUPOR & COMA W/O MCC,N,"$2,261.74 ","$4,732.84 ","$4,395.41 ","$4,732.84 ",20140101
082,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC",N,"$2,525.91 ","$8,028.24 ","$5,851.16 ","$8,028.24 ",20140101
083,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR W CC",N,"$2,711.04 ","$6,677.79 ","$5,862.63 ","$6,677.79 ",20140101
084,DRG,"TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC",N,"$2,532.40 ","$8,033.65 ","$5,816.68 ","$8,033.65 ",20140101
085,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC",N,"$2,388.90 ","$5,973.31 ","$5,027.95 ","$5,973.31 ",20140101
086,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR W CC",N,"$2,330.55 ","$5,189.47 ","$4,780.26 ","$5,189.47 ",20140101
087,DRG,"TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC",N,"$2,138.04 ","$5,463.77 ","$4,565.43 ","$5,463.77 ",20140101
088,DRG,CONCUSSION W MCC,N,"$2,958.05 ","$8,912.39 ","$6,345.06 ","$8,912.39 ",20140101
089,DRG,CONCUSSION W CC,N,"$3,217.37 ","$9,505.79 ","$6,863.51 ","$9,505.79 ",20140101
090,DRG,CONCUSSION W/O CC/MCC,N,"$3,189.97 ","$11,311.28 ","$6,496.85 ","$11,311.28 ",20140101
091,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W MCC,N,"$2,396.44 ","$6,026.43 ","$4,733.94 ","$6,026.43 ",20140101
092,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W CC,N,"$2,465.95 ","$5,263.12 ","$4,287.54 ","$5,263.12 ",20140101
093,DRG,OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,N,"$2,241.70 ","$5,884.11 ","$3,867.01 ","$5,884.11 ",20140101
094,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC,N,"$2,349.70 ","$7,349.14 ","$4,798.06 ","$7,349.14 ",20140101
095,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,N,"$2,472.09 ","$8,018.21 ","$4,589.07 ","$8,018.21 ",20140101
096,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC,N,"$2,513.81 ","$10,863.56 ","$4,482.61 ","$10,863.56 ",20140101
097,DRG,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC,N,"$2,715.26 ","$7,628.87 ","$4,756.61 ","$7,628.87 ",20140101
098,DRG,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC,N,"$2,556.14 ","$6,455.22 ","$4,331.40 ","$6,455.22 ",20140101
099,DRG,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC,N,"$2,092.89 ","$5,876.80 ","$3,402.87 ","$5,876.80 ",20140101
100,DRG,SEIZURES W MCC,N,"$2,612.84 ","$6,835.63 ","$4,861.55 ","$6,835.63 ",20140101
101,DRG,SEIZURES W/O MCC,N,"$2,732.16 ","$6,329.99 ","$4,462.69 ","$6,329.99 ",20140101
102,DRG,HEADACHES W MCC,N,"$2,576.70 ","$7,362.63 ","$4,687.97 ","$7,362.63 ",20140101
103,DRG,HEADACHES W/O MCC,N,"$2,119.97 ","$6,258.26 ","$3,720.72 ","$6,258.26 ",20140101
113,DRG,ORBITAL PROCEDURES W CC/MCC,S,"$3,169.79 ","$11,624.06 ","$6,524.35 ","$11,624.06 ",20140101
114,DRG,ORBITAL PROCEDURES W/O CC/MCC,S,"$2,893.67 ","$14,204.46 ","$6,339.05 ","$14,204.46 ",20140101
115,DRG,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,S,"$2,810.28 ","$9,585.41 ","$4,994.49 ","$9,585.41 ",20140101
116,DRG,INTRAOCULAR PROCEDURES W CC/MCC,S,"$2,800.74 ","$9,326.98 ","$5,424.52 ","$9,326.98 ",20140101
117,DRG,INTRAOCULAR PROCEDURES W/O CC/MCC,S,"$2,328.11 ","$10,499.35 ","$5,030.38 ","$10,499.35 ",20140101
121,DRG,ACUTE MAJOR EYE INFECTIONS W CC/MCC,N,"$2,507.62 ","$4,211.89 ","$4,253.96 ","$4,211.89 ",20140101
122,DRG,ACUTE MAJOR EYE INFECTIONS W/O CC/MCC,N,"$2,129.09 ","$3,171.75 ","$4,332.36 ","$3,171.75 ",20140101
123,DRG,NEUROLOGICAL EYE DISORDERS,N,"$2,624.37 ","$8,517.90 ","$4,249.56 ","$8,517.90 ",20140101
124,DRG,OTHER DISORDERS OF THE EYE W MCC,N,"$2,844.39 ","$5,959.87 ","$4,587.07 ","$5,959.87 ",20140101
125,DRG,OTHER DISORDERS OF THE EYE W/O MCC,N,"$2,622.11 ","$5,239.95 ","$4,342.40 ","$5,239.95 ",20140101
129,DRG,MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE,S,"$3,039.21 ","$16,163.14 ","$5,718.80 ","$16,163.14 ",20140101
130,DRG,MAJOR HEAD & NECK PROCEDURES W/O CC/MCC,S,"$2,908.79 ","$19,404.06 ","$5,481.08 ","$19,404.06 ",20140101
131,DRG,CRANIAL/FACIAL PROCEDURES W CC/MCC,S,"$3,125.97 ","$16,063.76 ","$6,517.91 ","$16,063.76 ",20140101
132,DRG,CRANIAL/FACIAL PROCEDURES W/O CC/MCC,S,"$3,967.31 ","$24,750.11 ","$7,229.79 ","$24,750.11 ",20140101
133,DRG,"OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W CC/MCC",S,"$2,699.10 ","$10,571.69 ","$5,246.19 ","$10,571.69 ",20140101
134,DRG,"OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC",S,"$2,695.91 ","$14,663.35 ","$4,945.32 ","$14,663.35 ",20140101
135,DRG,SINUS & MASTOID PROCEDURES W CC/MCC,S,"$2,696.04 ","$11,875.33 ","$5,556.00 ","$11,875.33 ",20140101
136,DRG,SINUS & MASTOID PROCEDURES W/O CC/MCC,S,"$2,683.79 ","$16,411.61 ","$4,497.68 ","$16,411.61 ",20140101
137,DRG,MOUTH PROCEDURES W CC/MCC,S,"$2,378.23 ","$7,424.96 ","$4,864.16 ","$7,424.96 ",20140101
138,DRG,MOUTH PROCEDURES W/O CC/MCC,S,"$2,938.14 ","$12,231.33 ","$5,314.68 ","$12,231.33 ",20140101
139,DRG,SALIVARY GLAND PROCEDURES,S,"$2,989.13 ","$20,825.62 ","$5,171.64 ","$20,825.62 ",20140101
146,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC",N,"$2,678.88 ","$5,990.94 ","$5,154.68 ","$5,990.94 ",20140101
147,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC",N,"$2,717.20 ","$5,779.49 ","$4,702.25 ","$5,779.49 ",20140101
148,DRG,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC",N,"$2,580.75 ","$5,796.52 ","$4,626.40 ","$5,796.52 ",20140101
149,DRG,DYSEQUILIBRIUM,N,"$2,671.98 ","$7,323.73 ","$4,350.21 ","$7,323.73 ",20140101
150,DRG,EPISTAXIS W MCC,N,"$2,677.57 ","$6,277.54 ","$4,910.26 ","$6,277.54 ",20140101
151,DRG,EPISTAXIS W/O MCC,N,"$2,669.37 ","$4,978.79 ","$4,783.86 ","$4,978.79 ",20140101
152,DRG,OTITIS MEDIA & URI W MCC,N,"$2,543.38 ","$5,873.65 ","$4,446.10 ","$5,873.65 ",20140101
153,DRG,OTITIS MEDIA & URI W/O MCC,N,"$2,144.28 ","$4,761.26 ","$3,808.21 ","$4,761.26 ",20140101
154,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC",N,"$2,460.17 ","$5,959.13 ","$4,688.07 ","$5,959.13 ",20140101
155,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC",N,"$2,340.48 ","$5,208.71 ","$4,150.61 ","$5,208.71 ",20140101
156,DRG,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC",N,"$2,422.16 ","$5,375.33 ","$4,453.40 ","$5,375.33 ",20140101
157,DRG,DENTAL & ORAL DISEASES W MCC,N,"$2,809.09 ","$6,904.94 ","$5,324.86 ","$6,904.94 ",20140101
158,DRG,DENTAL & ORAL DISEASES W CC,N,"$2,395.77 ","$5,124.41 ","$4,226.24 ","$5,124.41 ",20140101
159,DRG,DENTAL & ORAL DISEASES W/O CC/MCC,N,"$2,571.44 ","$5,787.16 ","$4,617.92 ","$5,787.16 ",20140101
163,DRG,MAJOR CHEST PROCEDURES W MCC,S,"$2,576.32 ","$9,873.28 ","$4,624.21 ","$9,873.28 ",20140101
164,DRG,MAJOR CHEST PROCEDURES W CC,S,"$2,907.62 ","$11,251.29 ","$4,571.80 ","$11,251.29 ",20140101
165,DRG,MAJOR CHEST PROCEDURES W/O CC/MCC,S,"$2,564.41 ","$12,420.56 ","$3,936.46 ","$12,420.56 ",20140101
166,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W MCC,S,"$2,428.93 ","$8,147.02 ","$4,415.50 ","$8,147.02 ",20140101
167,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W CC,S,"$2,508.13 ","$8,284.74 ","$4,325.93 ","$8,284.74 ",20140101
168,DRG,OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC,S,"$2,372.15 ","$9,660.86 ","$4,045.46 ","$9,660.86 ",20140101
175,DRG,PULMONARY EMBOLISM W MCC,N,"$2,172.74 ","$5,702.21 ","$3,709.68 ","$5,702.21 ",20140101
176,DRG,PULMONARY EMBOLISM W/O MCC,N,"$2,156.37 ","$5,160.47 ","$3,638.41 ","$5,160.47 ",20140101
177,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,N,"$2,334.81 ","$5,733.89 ","$4,142.03 ","$5,733.89 ",20140101
178,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,N,"$2,361.57 ","$5,262.11 ","$4,185.10 ","$5,262.11 ",20140101
179,DRG,RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC,N,"$2,170.83 ","$4,718.89 ","$3,944.28 ","$4,718.89 ",20140101
180,DRG,RESPIRATORY NEOPLASMS W MCC,N,"$2,395.68 ","$6,321.45 ","$4,165.93 ","$6,321.45 ",20140101
181,DRG,RESPIRATORY NEOPLASMS W CC,N,"$2,462.17 ","$6,061.37 ","$4,076.17 ","$6,061.37 ",20140101
182,DRG,RESPIRATORY NEOPLASMS W/O CC/MCC,N,"$1,368.89 ","$3,863.63 ","$2,406.22 ","$3,863.63 ",20140101
183,DRG,MAJOR CHEST TRAUMA W MCC,N,"$2,448.67 ","$5,737.84 ","$4,928.37 ","$5,737.84 ",20140101
184,DRG,MAJOR CHEST TRAUMA W CC,N,"$2,668.70 ","$6,389.60 ","$5,371.69 ","$6,389.60 ",20140101
185,DRG,MAJOR CHEST TRAUMA W/O CC/MCC,N,"$2,956.48 ","$6,755.96 ","$5,909.18 ","$6,755.96 ",20140101
186,DRG,PLEURAL EFFUSION W MCC,N,"$2,300.92 ","$6,056.28 ","$3,952.51 ","$6,056.28 ",20140101
187,DRG,PLEURAL EFFUSION W CC,N,"$2,451.84 ","$5,852.30 ","$4,061.78 ","$5,852.30 ",20140101
188,DRG,PLEURAL EFFUSION W/O CC/MCC,N,"$2,151.74 ","$5,524.19 ","$3,699.22 ","$5,524.19 ",20140101
189,DRG,PULMONARY EDEMA & RESPIRATORY FAILURE,N,"$2,045.84 ","$5,153.69 ","$3,729.49 ","$5,153.69 ",20140101
190,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,N,"$2,028.02 ","$4,979.70 ","$3,632.86 ","$4,979.70 ",20140101
191,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC,N,"$1,980.84 ","$4,716.43 ","$3,504.13 ","$4,716.43 ",20140101
192,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,N,"$1,737.03 ","$4,221.15 ","$3,212.14 ","$4,221.15 ",20140101
193,DRG,SIMPLE PNEUMONIA & PLEURISY W MCC,N,"$2,174.50 ","$5,599.99 ","$3,878.65 ","$5,599.99 ",20140101
194,DRG,SIMPLE PNEUMONIA & PLEURISY W CC,N,"$2,092.31 ","$4,795.57 ","$3,713.08 ","$4,795.57 ",20140101
195,DRG,SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,N,"$1,811.14 ","$4,122.15 ","$3,327.65 ","$4,122.15 ",20140101
196,DRG,INTERSTITIAL LUNG DISEASE W MCC,N,"$2,479.83 ","$5,686.89 ","$4,395.51 ","$5,686.89 ",20140101
197,DRG,INTERSTITIAL LUNG DISEASE W CC,N,"$2,377.65 ","$5,338.71 ","$4,012.30 ","$5,338.71 ",20140101
198,DRG,INTERSTITIAL LUNG DISEASE W/O CC/MCC,N,"$2,457.50 ","$5,797.91 ","$4,292.62 ","$5,797.91 ",20140101
199,DRG,PNEUMOTHORAX W MCC,N,"$2,245.06 ","$5,321.32 ","$4,034.71 ","$5,321.32 ",20140101
200,DRG,PNEUMOTHORAX W CC,N,"$2,246.31 ","$5,251.80 ","$3,997.63 ","$5,251.80 ",20140101
201,DRG,PNEUMOTHORAX W/O CC/MCC,N,"$1,880.10 ","$4,185.71 ","$3,217.72 ","$4,185.71 ",20140101
202,DRG,BRONCHITIS & ASTHMA W CC/MCC,N,"$2,167.18 ","$4,873.70 ","$3,890.90 ","$4,873.70 ",20140101
203,DRG,BRONCHITIS & ASTHMA W/O CC/MCC,N,"$1,945.45 ","$4,192.49 ","$3,551.44 ","$4,192.49 ",20140101
204,DRG,RESPIRATORY SIGNS & SYMPTOMS,N,"$2,304.87 ","$6,586.19 ","$3,845.06 ","$6,586.19 ",20140101
205,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC,N,"$2,572.96 ","$6,614.23 ","$4,642.11 ","$6,614.23 ",20140101
206,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC,N,"$2,562.25 ","$6,565.78 ","$4,391.49 ","$6,565.78 ",20140101
207,DRG,RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS,N,"$2,410.30 ","$7,667.78 ","$4,720.02 ","$7,667.78 ",20140101
208,DRG,RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <96 HOURS,N,"$2,341.50 ","$8,191.04 ","$4,594.64 ","$8,191.04 ",20140101
215,DRG,OTHER HEART ASSIST SYSTEM IMPLANT,S,"$3,078.96 ","$31,374.17 ","$6,305.39 ","$31,374.17 ",20140101
216,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,S,"$3,454.44 ","$18,964.50 ","$5,756.14 ","$18,964.50 ",20140101
217,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC,S,"$3,553.71 ","$21,554.64 ","$5,632.92 ","$21,554.64 ",20140101
218,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC,S,"$3,131.33 ","$23,459.00 ","$5,016.61 ","$23,459.00 ",20140101
219,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC,S,"$3,361.04 ","$21,122.30 ","$5,929.73 ","$21,122.30 ",20140101
220,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC,S,"$3,256.49 ","$23,883.96 ","$5,633.11 ","$23,883.96 ",20140101
221,DRG,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC,S,"$3,089.47 ","$27,644.80 ","$5,237.67 ","$27,644.80 ",20140101
222,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC,S,"$3,004.62 ","$22,841.25 ","$5,062.23 ","$22,841.25 ",20140101
223,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC,S,"$2,906.64 ","$33,310.98 ","$4,272.30 ","$33,310.98 ",20140101
224,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC,S,"$2,890.18 ","$24,870.42 ","$4,899.46 ","$24,870.42 ",20140101
225,DRG,CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC,S,"$2,880.51 ","$39,344.87 ","$4,350.79 ","$39,344.87 ",20140101
226,DRG,CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC,S,"$2,827.61 ","$25,163.34 ","$4,755.95 ","$25,163.34 ",20140101
227,DRG,CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC,S,"$2,879.38 ","$56,582.64 ","$4,301.93 ","$56,582.64 ",20140101
228,DRG,OTHER CARDIOTHORACIC PROCEDURES W MCC,S,"$2,532.29 ","$17,569.42 ","$4,913.70 ","$17,569.42 ",20140101
229,DRG,OTHER CARDIOTHORACIC PROCEDURES W CC,S,"$2,646.10 ","$20,374.29 ","$4,751.91 ","$20,374.29 ",20140101
230,DRG,OTHER CARDIOTHORACIC PROCEDURES W/O CC/MCC,S,"$2,621.61 ","$28,071.49 ","$4,863.61 ","$28,071.49 ",20140101
231,DRG,CORONARY BYPASS W PTCA W MCC,S,"$2,463.94 ","$21,744.36 ","$4,810.13 ","$21,744.36 ",20140101
232,DRG,CORONARY BYPASS W PTCA W/O MCC,S,"$2,350.01 ","$22,613.60 ","$4,532.22 ","$22,613.60 ",20140101
233,DRG,CORONARY BYPASS W CARDIAC CATH W MCC,S,"$2,590.62 ","$16,818.03 ","$4,801.52 ","$16,818.03 ",20140101
234,DRG,CORONARY BYPASS W CARDIAC CATH W/O MCC,S,"$2,532.36 ","$18,301.12 ","$4,421.69 ","$18,301.12 ",20140101
235,DRG,CORONARY BYPASS W/O CARDIAC CATH W MCC,S,"$2,595.95 ","$16,443.19 ","$4,929.22 ","$16,443.19 ",20140101
236,DRG,CORONARY BYPASS W/O CARDIAC CATH W/O MCC,S,"$2,428.27 ","$18,225.54 ","$4,435.32 ","$18,225.54 ",20140101
237,DRG,MAJOR CARDIOVASC PROCEDURES W MCC,S,"$2,688.68 ","$15,631.70 ","$5,067.10 ","$15,631.70 ",20140101
238,DRG,MAJOR CARDIOVASC PROCEDURES W/O MCC,S,"$2,321.10 ","$24,463.14 ","$4,109.14 ","$24,463.14 ",20140101
239,DRG,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC,S,"$2,495.21 ","$7,982.05 ","$4,378.87 ","$7,982.05 ",20140101
240,DRG,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC,S,"$2,387.01 ","$7,182.74 ","$3,930.17 ","$7,182.74 ",20140101
241,DRG,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC,S,"$1,960.72 ","$6,842.73 ","$3,298.05 ","$6,842.73 ",20140101
242,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT W MCC,S,"$2,923.11 ","$14,642.39 ","$5,037.75 ","$14,642.39 ",20140101
243,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT W CC,S,"$2,815.69 ","$18,213.58 ","$4,565.25 ","$18,213.58 ",20140101
244,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC,S,"$2,688.86 ","$24,016.49 ","$4,268.33 ","$24,016.49 ",20140101
245,DRG,AICD GENERATOR PROCEDURES,S,"$2,880.74 ","$33,236.96 ","$4,340.68 ","$33,236.96 ",20140101
246,DRG,PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS,S,"$2,849.15 ","$23,949.57 ","$4,960.43 ","$23,949.57 ",20140101
247,DRG,PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC,S,"$2,651.62 ","$33,426.45 ","$4,235.24 ","$33,426.45 ",20140101
248,DRG,PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W MCC OR 4+ VES/STENTS,S,"$2,844.40 ","$17,938.82 ","$5,006.98 ","$17,938.82 ",20140101
249,DRG,PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC,S,"$2,728.57 ","$26,798.10 ","$4,500.66 ","$26,798.10 ",20140101
250,DRG,PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC,S,"$3,248.65 ","$16,013.47 ","$5,459.13 ","$16,013.47 ",20140101
251,DRG,PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC,S,"$3,469.60 ","$31,425.52 ","$5,298.57 ","$31,425.52 ",20140101
252,DRG,OTHER VASCULAR PROCEDURES W MCC,S,"$2,574.49 ","$11,618.26 ","$4,493.59 ","$11,618.26 ",20140101
253,DRG,OTHER VASCULAR PROCEDURES W CC,S,"$2,775.65 ","$14,316.32 ","$4,510.79 ","$14,316.32 ",20140101
254,DRG,OTHER VASCULAR PROCEDURES W/O CC/MCC,S,"$2,360.51 ","$20,645.05 ","$3,859.08 ","$20,645.05 ",20140101
255,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC,S,"$2,487.39 ","$6,674.73 ","$4,117.77 ","$6,674.73 ",20140101
256,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC,S,"$2,304.84 ","$5,675.65 ","$3,713.33 ","$5,675.65 ",20140101
257,DRG,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC,S,"$2,099.96 ","$6,007.40 ","$3,142.59 ","$6,007.40 ",20140101
258,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC,S,"$2,679.45 ","$11,597.74 ","$4,395.27 ","$11,597.74 ",20140101
259,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC,S,"$2,800.17 ","$17,451.85 ","$4,186.49 ","$17,451.85 ",20140101
260,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC,S,"$2,786.16 ","$9,606.34 ","$4,913.57 ","$9,606.34 ",20140101
261,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC,S,"$2,561.06 ","$11,972.60 ","$4,272.20 ","$11,972.60 ",20140101
262,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC,S,"$2,604.61 ","$15,480.32 ","$4,198.63 ","$15,480.32 ",20140101
263,DRG,VEIN LIGATION & STRIPPING,S,"$2,532.78 ","$8,982.99 ","$4,301.37 ","$8,982.99 ",20140101
264,DRG,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,S,"$2,524.59 ","$8,099.88 ","$4,481.31 ","$8,099.88 ",20140101
265,DRG,AICD LEAD PROCEDURES,S,"$2,630.61 ","$21,930.40 ","$4,332.28 ","$21,930.40 ",20140101
280,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC",N,"$2,827.20 ","$7,564.47 ","$5,040.74 ","$7,564.47 ",20140101
281,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC",N,"$3,059.69 ","$8,914.53 ","$5,229.15 ","$8,914.53 ",20140101
282,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC",N,"$3,071.34 ","$11,385.82 ","$5,326.58 ","$11,385.82 ",20140101
283,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC",N,"$3,219.28 ","$11,350.69 ","$6,341.02 ","$11,350.69 ",20140101
284,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC",N,"$2,504.37 ","$9,030.36 ","$5,113.62 ","$9,030.36 ",20140101
285,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W/O CC/MCC",N,"$2,255.95 ","$9,001.52 ","$4,866.52 ","$9,001.52 ",20140101
286,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC",N,"$2,681.90 ","$9,196.21 ","$4,639.38 ","$9,196.21 ",20140101
287,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC",N,"$2,598.35 ","$12,686.19 ","$4,177.36 ","$12,686.19 ",20140101
288,DRG,ACUTE & SUBACUTE ENDOCARDITIS W MCC,N,"$2,401.51 ","$5,275.68 ","$4,341.31 ","$5,275.68 ",20140101
289,DRG,ACUTE & SUBACUTE ENDOCARDITIS W CC,N,"$2,414.27 ","$4,440.76 ","$4,208.93 ","$4,440.76 ",20140101
290,DRG,ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC,N,"$2,442.62 ","$4,770.53 ","$4,186.07 ","$4,770.53 ",20140101
291,DRG,HEART FAILURE & SHOCK W MCC,N,"$2,305.54 ","$5,417.65 ","$4,076.97 ","$5,417.65 ",20140101
292,DRG,HEART FAILURE & SHOCK W CC,N,"$2,273.39 ","$4,395.57 ","$3,872.65 ","$4,395.57 ",20140101
293,DRG,HEART FAILURE & SHOCK W/O CC/MCC,N,"$2,086.18 ","$4,287.82 ","$3,705.41 ","$4,287.82 ",20140101
294,DRG,DEEP VEIN THROMBOPHLEBITIS W CC/MCC,N,"$2,208.16 ","$4,318.16 ","$4,162.86 ","$4,318.16 ",20140101
295,DRG,DEEP VEIN THROMBOPHLEBITIS W/O CC/MCC,N,"$1,658.69 ","$2,560.02 ","$3,336.84 ","$2,560.02 ",20140101
296,DRG,"CARDIAC ARREST, UNEXPLAINED W MCC",N,"$2,785.10 ","$13,076.06 ","$5,391.29 ","$13,076.06 ",20140101
297,DRG,"CARDIAC ARREST, UNEXPLAINED W CC",N,"$2,336.37 ","$11,184.51 ","$5,082.10 ","$11,184.51 ",20140101
298,DRG,"CARDIAC ARREST, UNEXPLAINED W/O CC/MCC",N,"$2,097.22 ","$7,904.31 ","$4,320.10 ","$7,904.31 ",20140101
299,DRG,PERIPHERAL VASCULAR DISORDERS W MCC,N,"$2,327.58 ","$5,218.65 ","$4,150.74 ","$5,218.65 ",20140101
300,DRG,PERIPHERAL VASCULAR DISORDERS W CC,N,"$2,349.04 ","$4,388.95 ","$4,063.47 ","$4,388.95 ",20140101
301,DRG,PERIPHERAL VASCULAR DISORDERS W/O CC/MCC,N,"$2,080.72 ","$4,009.61 ","$3,807.26 ","$4,009.61 ",20140101
302,DRG,ATHEROSCLEROSIS W MCC,N,"$2,603.53 ","$6,346.98 ","$4,712.28 ","$6,346.98 ",20140101
303,DRG,ATHEROSCLEROSIS W/O MCC,N,"$2,796.86 ","$7,353.16 ","$4,907.78 ","$7,353.16 ",20140101
304,DRG,HYPERTENSION W MCC,N,"$2,499.55 ","$5,935.73 ","$4,377.69 ","$5,935.73 ",20140101
305,DRG,HYPERTENSION W/O MCC,N,"$2,439.85 ","$6,002.02 ","$4,003.86 ","$6,002.02 ",20140101
306,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC,N,"$2,711.37 ","$5,290.54 ","$4,606.79 ","$5,290.54 ",20140101
307,DRG,CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,N,"$2,673.85 ","$5,171.29 ","$4,543.96 ","$5,171.29 ",20140101
308,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,N,"$2,476.50 ","$5,555.22 ","$4,163.42 ","$5,555.22 ",20140101
309,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,N,"$2,490.24 ","$5,388.85 ","$4,055.24 ","$5,388.85 ",20140101
310,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,N,"$2,382.92 ","$5,541.42 ","$3,849.59 ","$5,541.42 ",20140101
311,DRG,ANGINA PECTORIS,N,"$2,260.53 ","$6,520.85 ","$4,116.97 ","$6,520.85 ",20140101
312,DRG,SYNCOPE & COLLAPSE,N,"$2,674.51 ","$6,759.97 ","$4,416.57 ","$6,759.97 ",20140101
313,DRG,CHEST PAIN,N,"$2,654.96 ","$8,354.66 ","$4,206.78 ","$8,354.66 ",20140101
314,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC,N,"$2,432.54 ","$6,670.20 ","$4,437.21 ","$6,670.20 ",20140101
315,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,N,"$2,458.50 ","$5,899.78 ","$4,303.82 ","$5,899.78 ",20140101
316,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC,N,"$2,384.05 ","$6,344.98 ","$4,108.09 ","$6,344.98 ",20140101
326,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC",S,"$2,489.19 ","$10,019.54 ","$4,825.90 ","$10,019.54 ",20140101
327,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC W CC",S,"$2,665.85 ","$10,184.31 ","$5,050.97 ","$10,184.31 ",20140101
328,DRG,"STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC",S,"$2,451.33 ","$14,623.29 ","$4,828.29 ","$14,623.29 ",20140101
329,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,S,"$2,272.96 ","$8,950.33 ","$4,442.00 ","$8,950.33 ",20140101
330,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,S,"$2,373.13 ","$8,366.42 ","$4,276.72 ","$8,366.42 ",20140101
331,DRG,MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,S,"$2,307.40 ","$9,937.84 ","$4,057.86 ","$9,937.84 ",20140101
332,DRG,RECTAL RESECTION W MCC,S,"$2,454.08 ","$9,600.54 ","$4,704.12 ","$9,600.54 ",20140101
333,DRG,RECTAL RESECTION W CC,S,"$2,505.94 ","$9,407.04 ","$4,408.00 ","$9,407.04 ",20140101
334,DRG,RECTAL RESECTION W/O CC/MCC,S,"$2,426.61 ","$10,937.98 ","$4,202.87 ","$10,937.98 ",20140101
335,DRG,PERITONEAL ADHESIOLYSIS W MCC,S,"$2,289.20 ","$8,493.33 ","$4,461.50 ","$8,493.33 ",20140101
336,DRG,PERITONEAL ADHESIOLYSIS W CC,S,"$2,371.05 ","$7,906.91 ","$4,302.56 ","$7,906.91 ",20140101
337,DRG,PERITONEAL ADHESIOLYSIS W/O CC/MCC,S,"$2,347.00 ","$9,397.26 ","$4,186.65 ","$9,397.26 ",20140101
338,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC,S,"$2,112.83 ","$8,573.84 ","$4,224.51 ","$8,573.84 ",20140101
339,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC,S,"$2,175.07 ","$8,175.19 ","$3,911.35 ","$8,175.19 ",20140101
340,DRG,APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC,S,"$2,229.86 ","$9,986.99 ","$3,705.20 ","$9,986.99 ",20140101
341,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC,S,"$2,278.15 ","$10,713.95 ","$4,227.94 ","$10,713.95 ",20140101
342,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC,S,"$2,413.85 ","$12,550.54 ","$4,301.20 ","$12,550.54 ",20140101
343,DRG,APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC,S,"$2,492.24 ","$18,270.07 ","$4,309.59 ","$18,270.07 ",20140101
344,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W MCC,S,"$2,517.07 ","$8,397.94 ","$4,816.86 ","$8,397.94 ",20140101
345,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W CC,S,"$2,355.50 ","$7,017.35 ","$4,087.94 ","$7,017.35 ",20140101
346,DRG,MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,S,"$2,163.86 ","$7,558.72 ","$3,569.52 ","$7,558.72 ",20140101
347,DRG,ANAL & STOMAL PROCEDURES W MCC,S,"$2,245.33 ","$7,541.26 ","$4,197.46 ","$7,541.26 ",20140101
348,DRG,ANAL & STOMAL PROCEDURES W CC,S,"$2,331.22 ","$7,577.78 ","$4,238.19 ","$7,577.78 ",20140101
349,DRG,ANAL & STOMAL PROCEDURES W/O CC/MCC,S,"$2,171.42 ","$8,947.03 ","$3,665.48 ","$8,947.03 ",20140101
350,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES W MCC,S,"$2,621.86 ","$9,381.11 ","$4,781.58 ","$9,381.11 ",20140101
351,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES W CC,S,"$2,676.56 ","$9,846.65 ","$4,462.44 ","$9,846.65 ",20140101
352,DRG,INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC,S,"$2,813.66 ","$13,636.20 ","$4,576.04 ","$13,636.20 ",20140101
353,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC,S,"$2,342.09 ","$10,308.75 ","$4,643.93 ","$10,308.75 ",20140101
354,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC,S,"$2,361.84 ","$10,250.36 ","$4,297.62 ","$10,250.36 ",20140101
355,DRG,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC,S,"$2,376.12 ","$13,042.51 ","$4,090.78 ","$13,042.51 ",20140101
356,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC,S,"$2,509.08 ","$8,307.78 ","$4,598.11 ","$8,307.78 ",20140101
357,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC,S,"$2,494.71 ","$8,713.42 ","$4,411.79 ","$8,713.42 ",20140101
358,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC,S,"$2,330.75 ","$10,909.96 ","$4,368.42 ","$10,909.96 ",20140101
368,DRG,MAJOR ESOPHAGEAL DISORDERS W MCC,N,"$2,427.44 ","$7,189.60 ","$4,694.38 ","$7,189.60 ",20140101
369,DRG,MAJOR ESOPHAGEAL DISORDERS W CC,N,"$2,405.32 ","$6,549.21 ","$4,320.36 ","$6,549.21 ",20140101
370,DRG,MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC,N,"$2,200.60 ","$6,436.78 ","$4,005.24 ","$6,436.78 ",20140101
371,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC,N,"$2,502.40 ","$5,173.84 ","$4,277.31 ","$5,173.84 ",20140101
372,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,N,"$2,453.23 ","$4,221.20 ","$3,970.05 ","$4,221.20 ",20140101
373,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC,N,"$2,280.13 ","$3,897.58 ","$3,693.31 ","$3,897.58 ",20140101
374,DRG,DIGESTIVE MALIGNANCY W MCC,N,"$2,642.10 ","$6,003.19 ","$4,700.98 ","$6,003.19 ",20140101
375,DRG,DIGESTIVE MALIGNANCY W CC,N,"$2,536.48 ","$5,460.02 ","$4,213.36 ","$5,460.02 ",20140101
376,DRG,DIGESTIVE MALIGNANCY W/O CC/MCC,N,"$1,680.60 ","$4,462.67 ","$2,864.96 ","$4,462.67 ",20140101
377,DRG,G.I. HEMORRHAGE W MCC,N,"$2,526.68 ","$7,032.28 ","$4,713.08 ","$7,032.28 ",20140101
378,DRG,G.I. HEMORRHAGE W CC,N,"$2,361.08 ","$6,143.50 ","$4,297.18 ","$6,143.50 ",20140101
379,DRG,G.I. HEMORRHAGE W/O CC/MCC,N,"$2,340.04 ","$5,899.16 ","$4,232.53 ","$5,899.16 ",20140101
380,DRG,COMPLICATED PEPTIC ULCER W MCC,N,"$2,255.66 ","$6,335.95 ","$4,282.40 ","$6,335.95 ",20140101
381,DRG,COMPLICATED PEPTIC ULCER W CC,N,"$2,252.48 ","$5,962.08 ","$4,088.68 ","$5,962.08 ",20140101
382,DRG,COMPLICATED PEPTIC ULCER W/O CC/MCC,N,"$2,252.12 ","$6,410.30 ","$3,916.08 ","$6,410.30 ",20140101
383,DRG,UNCOMPLICATED PEPTIC ULCER W MCC,N,"$2,330.09 ","$7,006.02 ","$4,146.11 ","$7,006.02 ",20140101
384,DRG,UNCOMPLICATED PEPTIC ULCER W/O MCC,N,"$2,205.33 ","$6,862.08 ","$3,708.57 ","$6,862.08 ",20140101
385,DRG,INFLAMMATORY BOWEL DISEASE W MCC,N,"$2,342.02 ","$5,526.26 ","$4,339.99 ","$5,526.26 ",20140101
386,DRG,INFLAMMATORY BOWEL DISEASE W CC,N,"$2,261.92 ","$4,976.81 ","$3,963.90 ","$4,976.81 ",20140101
387,DRG,INFLAMMATORY BOWEL DISEASE W/O CC/MCC,N,"$2,236.74 ","$4,951.49 ","$3,790.50 ","$4,951.49 ",20140101
388,DRG,G.I. OBSTRUCTION W MCC,N,"$2,251.21 ","$5,396.18 ","$4,087.42 ","$5,396.18 ",20140101
389,DRG,G.I. OBSTRUCTION W CC,N,"$2,217.31 ","$4,578.17 ","$3,788.56 ","$4,578.17 ",20140101
390,DRG,G.I. OBSTRUCTION W/O CC/MCC,N,"$2,134.88 ","$4,375.49 ","$3,639.19 ","$4,375.49 ",20140101
391,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC",N,"$2,238.42 ","$5,619.33 ","$3,964.37 ","$5,619.33 ",20140101
392,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",N,"$2,186.37 ","$5,340.75 ","$3,693.01 ","$5,340.75 ",20140101
393,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC,N,"$2,452.34 ","$5,944.19 ","$4,427.68 ","$5,944.19 ",20140101
394,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,N,"$2,405.05 ","$5,333.96 ","$4,144.03 ","$5,333.96 ",20140101
395,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC,N,"$2,572.11 ","$6,044.29 ","$4,278.23 ","$6,044.29 ",20140101
405,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W MCC",S,"$2,779.37 ","$11,175.67 ","$5,618.82 ","$11,175.67 ",20140101
406,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W CC",S,"$3,079.79 ","$11,721.24 ","$5,678.87 ","$11,721.24 ",20140101
407,DRG,"PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC",S,"$2,934.01 ","$12,508.26 ","$5,479.70 ","$12,508.26 ",20140101
408,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC,S,"$2,654.19 ","$9,250.52 ","$4,921.72 ","$9,250.52 ",20140101
409,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC,S,"$2,562.13 ","$8,741.48 ","$4,696.55 ","$8,741.48 ",20140101
410,DRG,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC,S,"$2,468.04 ","$9,324.51 ","$4,325.15 ","$9,324.51 ",20140101
411,DRG,CHOLECYSTECTOMY W C.D.E. W MCC,S,"$2,254.41 ","$9,720.74 ","$4,332.76 ","$9,720.74 ",20140101
412,DRG,CHOLECYSTECTOMY W C.D.E. W CC,S,"$2,140.50 ","$9,056.15 ","$3,978.68 ","$9,056.15 ",20140101
413,DRG,CHOLECYSTECTOMY W C.D.E. W/O CC/MCC,S,"$2,137.80 ","$11,191.92 ","$3,994.76 ","$11,191.92 ",20140101
414,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC,S,"$2,282.79 ","$9,232.67 ","$4,480.04 ","$9,232.67 ",20140101
415,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC,S,"$2,284.90 ","$8,872.67 ","$4,154.29 ","$8,872.67 ",20140101
416,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC,S,"$2,206.86 ","$10,041.88 ","$4,023.47 ","$10,041.88 ",20140101
417,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC,S,"$2,233.49 ","$10,146.79 ","$4,203.18 ","$10,146.79 ",20140101
418,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC,S,"$2,439.01 ","$11,547.27 ","$4,109.78 ","$11,547.27 ",20140101
419,DRG,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC,S,"$2,365.87 ","$13,803.83 ","$3,830.64 ","$13,803.83 ",20140101
420,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC,S,"$2,583.45 ","$8,962.02 ","$4,959.75 ","$8,962.02 ",20140101
421,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC,S,"$2,658.88 ","$9,287.40 ","$4,415.79 ","$9,287.40 ",20140101
422,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC,S,"$2,636.82 ","$10,650.81 ","$4,245.69 ","$10,650.81 ",20140101
423,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC,S,"$2,792.27 ","$9,243.52 ","$5,171.46 ","$9,243.52 ",20140101
424,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC,S,"$2,412.16 ","$7,685.34 ","$4,035.10 ","$7,685.34 ",20140101
425,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC,S,"$2,670.45 ","$10,673.86 ","$5,163.41 ","$10,673.86 ",20140101
432,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC,N,"$2,538.17 ","$6,959.90 ","$4,839.41 ","$6,959.90 ",20140101
433,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS W CC,N,"$2,275.12 ","$5,513.57 ","$3,816.26 ","$5,513.57 ",20140101
434,DRG,CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC,N,"$2,157.53 ","$5,237.21 ","$3,814.41 ","$5,237.21 ",20140101
435,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC,N,"$2,657.52 ","$6,843.16 ","$4,603.72 ","$6,843.16 ",20140101
436,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC,N,"$2,558.12 ","$6,094.55 ","$4,120.67 ","$6,094.55 ",20140101
437,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC,N,"$1,890.02 ","$5,722.89 ","$2,895.03 ","$5,722.89 ",20140101
438,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC,N,"$2,254.50 ","$6,487.95 ","$4,193.75 ","$6,487.95 ",20140101
439,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC,N,"$2,084.04 ","$5,110.43 ","$3,607.98 ","$5,110.43 ",20140101
440,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC,N,"$1,959.50 ","$5,006.11 ","$3,374.92 ","$5,006.11 ",20140101
441,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC",N,"$2,597.29 ","$6,824.38 ","$4,953.68 ","$6,824.38 ",20140101
442,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC",N,"$2,471.94 ","$5,420.56 ","$4,237.41 ","$5,420.56 ",20140101
443,DRG,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC",N,"$2,338.73 ","$5,279.50 ","$3,985.91 ","$5,279.50 ",20140101
444,DRG,DISORDERS OF THE BILIARY TRACT W MCC,N,"$2,556.38 ","$6,951.57 ","$4,498.34 ","$6,951.57 ",20140101
445,DRG,DISORDERS OF THE BILIARY TRACT W CC,N,"$2,594.56 ","$7,096.57 ","$4,212.50 ","$7,096.57 ",20140101
446,DRG,DISORDERS OF THE BILIARY TRACT W/O CC/MCC,N,"$2,497.15 ","$7,434.82 ","$3,926.78 ","$7,434.82 ",20140101
453,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC,S,"$3,134.28 ","$30,479.59 ","$6,449.19 ","$30,479.59 ",20140101
454,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC,S,"$3,042.20 ","$44,443.65 ","$6,013.44 ","$44,443.65 ",20140101
455,DRG,COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC,S,"$2,838.15 ","$56,710.14 ","$4,886.21 ","$56,710.14 ",20140101
456,DRG,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC,S,"$2,923.81 ","$25,535.87 ","$6,061.21 ","$25,535.87 ",20140101
457,DRG,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC,S,"$2,857.45 ","$35,374.90 ","$5,823.00 ","$35,374.90 ",20140101
458,DRG,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC,S,"$2,407.66 ","$42,723.14 ","$4,650.34 ","$42,723.14 ",20140101
459,DRG,SPINAL FUSION EXCEPT CERVICAL W MCC,S,"$2,410.06 ","$22,584.64 ","$5,117.96 ","$22,584.64 ",20140101
460,DRG,SPINAL FUSION EXCEPT CERVICAL W/O MCC,S,"$2,349.04 ","$35,980.54 ","$4,525.38 ","$35,980.54 ",20140101
461,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC,S,"$2,610.71 ","$19,986.63 ","$5,140.58 ","$19,986.63 ",20140101
462,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC,S,"$2,499.44 ","$27,433.11 ","$3,757.64 ","$27,433.11 ",20140101
463,DRG,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC",S,"$2,742.65 ","$8,012.48 ","$5,447.61 ","$8,012.48 ",20140101
464,DRG,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC",S,"$2,723.30 ","$10,028.06 ","$5,172.45 ","$10,028.06 ",20140101
465,DRG,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC",S,"$3,008.99 ","$13,152.62 ","$5,567.89 ","$13,152.62 ",20140101
466,DRG,REVISION OF HIP OR KNEE REPLACEMENT W MCC,S,"$2,547.02 ","$17,169.85 ","$5,073.86 ","$17,169.85 ",20140101
467,DRG,REVISION OF HIP OR KNEE REPLACEMENT W CC,S,"$2,407.65 ","$23,338.75 ","$4,457.32 ","$23,338.75 ",20140101
468,DRG,REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC,S,"$2,499.18 ","$26,406.90 ","$4,175.02 ","$26,406.90 ",20140101
469,DRG,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC,S,"$2,549.51 ","$14,004.05 ","$4,981.45 ","$14,004.05 ",20140101
470,DRG,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,S,"$2,365.44 ","$19,983.51 ","$4,092.35 ","$19,983.51 ",20140101
471,DRG,CERVICAL SPINAL FUSION W MCC,S,"$2,816.28 ","$18,553.66 ","$5,809.52 ","$18,553.66 ",20140101
472,DRG,CERVICAL SPINAL FUSION W CC,S,"$3,055.38 ","$31,907.95 ","$5,996.96 ","$31,907.95 ",20140101
473,DRG,CERVICAL SPINAL FUSION W/O CC/MCC,S,"$2,354.37 ","$43,523.52 ","$4,689.42 ","$43,523.52 ",20140101
474,DRG,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC,S,"$2,414.14 ","$7,492.71 ","$4,540.19 ","$7,492.71 ",20140101
475,DRG,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC,S,"$2,417.70 ","$7,162.51 ","$4,020.15 ","$7,162.51 ",20140101
476,DRG,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC,S,"$2,479.71 ","$8,982.48 ","$4,101.37 ","$8,982.48 ",20140101
477,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC,S,"$2,527.39 ","$8,195.97 ","$4,261.61 ","$8,195.97 ",20140101
478,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC,S,"$2,348.09 ","$9,562.52 ","$3,670.45 ","$9,562.52 ",20140101
479,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC,S,"$2,382.70 ","$13,952.20 ","$3,663.81 ","$13,952.20 ",20140101
480,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC,S,"$2,525.19 ","$10,629.89 ","$4,863.02 ","$10,629.89 ",20140101
481,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC,S,"$2,471.19 ","$11,361.20 ","$4,385.78 ","$11,361.20 ",20140101
482,DRG,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,S,"$2,667.31 ","$12,479.77 ","$4,657.00 ","$12,479.77 ",20140101
483,DRG,MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC,S,"$2,384.68 ","$26,051.62 ","$4,605.66 ","$26,051.62 ",20140101
484,DRG,MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC,S,"$2,278.06 ","$35,173.00 ","$3,924.26 ","$35,173.00 ",20140101
485,DRG,KNEE PROCEDURES W PDX OF INFECTION W MCC,S,"$2,183.87 ","$8,196.14 ","$4,429.54 ","$8,196.14 ",20140101
486,DRG,KNEE PROCEDURES W PDX OF INFECTION W CC,S,"$2,203.11 ","$8,302.63 ","$3,576.50 ","$8,302.63 ",20140101
487,DRG,KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC,S,"$2,214.99 ","$8,825.83 ","$3,793.45 ","$8,825.83 ",20140101
488,DRG,KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC,S,"$2,345.29 ","$12,414.42 ","$4,507.20 ","$12,414.42 ",20140101
489,DRG,KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC,S,"$2,668.37 ","$17,261.06 ","$4,349.16 ","$17,261.06 ",20140101
490,DRG,BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM,S,"$2,682.87 ","$14,539.53 ","$5,194.52 ","$14,539.53 ",20140101
491,DRG,BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC,S,"$2,599.18 ","$19,022.79 ","$4,460.79 ","$19,022.79 ",20140101
492,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC",S,"$2,466.67 ","$11,952.05 ","$4,945.29 ","$11,952.05 ",20140101
493,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC",S,"$2,517.20 ","$13,744.47 ","$4,456.50 ","$13,744.47 ",20140101
494,DRG,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC",S,"$2,523.69 ","$16,127.81 ","$4,205.44 ","$16,127.81 ",20140101
495,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC,S,"$2,567.86 ","$8,124.01 ","$4,907.39 ","$8,124.01 ",20140101
496,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC,S,"$2,638.49 ","$10,660.82 ","$4,739.01 ","$10,660.82 ",20140101
497,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC,S,"$2,708.47 ","$16,716.43 ","$4,907.12 ","$16,716.43 ",20140101
498,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC,S,"$2,550.46 ","$9,158.34 ","$5,047.14 ","$9,158.34 ",20140101
499,DRG,LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC,S,"$2,890.50 ","$14,594.16 ","$5,119.45 ","$14,594.16 ",20140101
500,DRG,SOFT TISSUE PROCEDURES W MCC,S,"$2,458.50 ","$7,416.84 ","$4,766.40 ","$7,416.84 ",20140101
501,DRG,SOFT TISSUE PROCEDURES W CC,S,"$2,428.32 ","$7,984.07 ","$4,235.35 ","$7,984.07 ",20140101
502,DRG,SOFT TISSUE PROCEDURES W/O CC/MCC,S,"$2,758.22 ","$13,266.76 ","$4,496.82 ","$13,266.76 ",20140101
503,DRG,FOOT PROCEDURES W MCC,S,"$2,548.63 ","$7,159.12 ","$4,328.86 ","$7,159.12 ",20140101
504,DRG,FOOT PROCEDURES W CC,S,"$2,603.45 ","$7,996.56 ","$4,273.17 ","$7,996.56 ",20140101
505,DRG,FOOT PROCEDURES W/O CC/MCC,S,"$2,888.24 ","$13,478.65 ","$4,807.67 ","$13,478.65 ",20140101
506,DRG,MAJOR THUMB OR JOINT PROCEDURES,S,"$2,806.45 ","$10,588.09 ","$4,372.50 ","$10,588.09 ",20140101
507,DRG,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC,S,"$2,557.88 ","$11,214.19 ","$4,844.30 ","$11,214.19 ",20140101
508,DRG,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC,S,"$2,441.22 ","$20,934.22 ","$4,444.93 ","$20,934.22 ",20140101
509,DRG,ARTHROSCOPY,S,"$2,642.16 ","$11,963.87 ","$3,785.89 ","$11,963.87 ",20140101
510,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC",S,"$2,590.87 ","$12,741.66 ","$5,330.24 ","$12,741.66 ",20140101
511,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC",S,"$2,737.75 ","$15,112.27 ","$4,886.89 ","$15,112.27 ",20140101
512,DRG,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC",S,"$2,484.42 ","$18,347.34 ","$4,382.96 ","$18,347.34 ",20140101
513,DRG,"HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC",S,"$2,700.89 ","$9,301.48 ","$4,623.70 ","$9,301.48 ",20140101
514,DRG,"HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC",S,"$2,431.22 ","$10,513.09 ","$4,486.20 ","$10,513.09 ",20140101
515,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC,S,"$2,699.85 ","$10,478.71 ","$5,329.23 ","$10,478.71 ",20140101
516,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC,S,"$2,714.35 ","$12,730.94 ","$4,948.88 ","$12,730.94 ",20140101
517,DRG,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,S,"$2,707.75 ","$18,076.58 ","$4,872.19 ","$18,076.58 ",20140101
533,DRG,FRACTURES OF FEMUR W MCC,N,"$2,127.11 ","$5,026.39 ","$4,135.27 ","$5,026.39 ",20140101
534,DRG,FRACTURES OF FEMUR W/O MCC,N,"$2,502.77 ","$4,237.92 ","$4,472.60 ","$4,237.92 ",20140101
535,DRG,FRACTURES OF HIP & PELVIS W MCC,N,"$2,101.61 ","$4,725.76 ","$4,095.36 ","$4,725.76 ",20140101
536,DRG,FRACTURES OF HIP & PELVIS W/O MCC,N,"$2,190.88 ","$3,610.82 ","$4,133.98 ","$3,610.82 ",20140101
537,DRG,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC",N,"$2,963.23 ","$6,165.84 ","$5,448.89 ","$6,165.84 ",20140101
538,DRG,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC",N,"$2,356.47 ","$4,518.01 ","$4,214.75 ","$4,518.01 ",20140101
539,DRG,OSTEOMYELITIS W MCC,N,"$2,213.89 ","$3,650.41 ","$3,673.13 ","$3,650.41 ",20140101
540,DRG,OSTEOMYELITIS W CC,N,"$2,285.78 ","$3,670.70 ","$3,667.85 ","$3,670.70 ",20140101
541,DRG,OSTEOMYELITIS W/O CC/MCC,N,"$2,271.26 ","$3,467.54 ","$3,718.94 ","$3,467.54 ",20140101
542,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC,N,"$2,653.56 ","$5,864.91 ","$4,528.65 ","$5,864.91 ",20140101
543,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC,N,"$2,745.57 ","$5,373.08 ","$4,430.15 ","$5,373.08 ",20140101
544,DRG,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC,N,"$2,392.80 ","$4,168.67 ","$4,027.35 ","$4,168.67 ",20140101
545,DRG,CONNECTIVE TISSUE DISORDERS W MCC,N,"$2,696.86 ","$7,506.37 ","$5,170.91 ","$7,506.37 ",20140101
546,DRG,CONNECTIVE TISSUE DISORDERS W CC,N,"$2,724.87 ","$6,201.53 ","$4,702.95 ","$6,201.53 ",20140101
547,DRG,CONNECTIVE TISSUE DISORDERS W/O CC/MCC,N,"$2,667.20 ","$5,974.15 ","$4,741.10 ","$5,974.15 ",20140101
548,DRG,SEPTIC ARTHRITIS W MCC,N,"$2,237.91 ","$4,176.07 ","$3,966.39 ","$4,176.07 ",20140101
549,DRG,SEPTIC ARTHRITIS W CC,N,"$2,309.71 ","$3,973.01 ","$3,800.74 ","$3,973.01 ",20140101
550,DRG,SEPTIC ARTHRITIS W/O CC/MCC,N,"$2,174.35 ","$3,666.80 ","$3,869.33 ","$3,666.80 ",20140101
551,DRG,MEDICAL BACK PROBLEMS W MCC,N,"$2,487.97 ","$5,980.70 ","$4,893.13 ","$5,980.70 ",20140101
552,DRG,MEDICAL BACK PROBLEMS W/O MCC,N,"$2,549.77 ","$5,375.26 ","$4,741.86 ","$5,375.26 ",20140101
553,DRG,BONE DISEASES & ARTHROPATHIES W MCC,N,"$2,583.22 ","$5,719.01 ","$4,589.41 ","$5,719.01 ",20140101
554,DRG,BONE DISEASES & ARTHROPATHIES W/O MCC,N,"$2,042.10 ","$2,971.57 ","$3,858.74 ","$2,971.57 ",20140101
555,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,N,"$2,172.95 ","$5,569.68 ","$3,880.66 ","$5,569.68 ",20140101
556,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC,N,"$2,250.18 ","$4,948.74 ","$3,853.14 ","$4,948.74 ",20140101
557,DRG,"TENDONITIS, MYOSITIS & BURSITIS W MCC",N,"$2,161.75 ","$4,700.17 ","$3,839.09 ","$4,700.17 ",20140101
558,DRG,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",N,"$2,201.61 ","$4,225.45 ","$3,637.49 ","$4,225.45 ",20140101
559,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC",N,"$2,038.60 ","$3,600.15 ","$3,765.10 ","$3,600.15 ",20140101
560,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",N,"$1,998.31 ","$3,229.10 ","$3,548.83 ","$3,229.10 ",20140101
561,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",N,"$2,055.65 ","$4,226.30 ","$3,699.61 ","$4,226.30 ",20140101
562,DRG,"FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC",N,"$2,250.48 ","$5,100.18 ","$4,141.96 ","$5,100.18 ",20140101
563,DRG,"FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC",N,"$2,624.41 ","$4,873.15 ","$4,698.41 ","$4,873.15 ",20140101
564,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC,N,"$2,234.73 ","$4,608.06 ","$3,935.00 ","$4,608.06 ",20140101
565,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,N,"$2,462.81 ","$4,459.69 ","$4,370.60 ","$4,459.69 ",20140101
566,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC,N,"$1,871.00 ","$3,405.53 ","$3,378.22 ","$3,405.53 ",20140101
570,DRG,SKIN DEBRIDEMENT W MCC,S,"$2,317.18 ","$4,474.65 ","$4,059.98 ","$4,474.65 ",20140101
571,DRG,SKIN DEBRIDEMENT W CC,S,"$2,307.62 ","$4,935.26 ","$3,966.76 ","$4,935.26 ",20140101
572,DRG,SKIN DEBRIDEMENT W/O CC/MCC,S,"$2,165.36 ","$5,347.41 ","$3,615.31 ","$5,347.41 ",20140101
573,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC,S,"$2,268.98 ","$5,030.07 ","$4,239.74 ","$5,030.07 ",20140101
574,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC,S,"$2,539.27 ","$5,587.07 ","$4,580.47 ","$5,587.07 ",20140101
575,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC,S,"$2,469.58 ","$6,132.66 ","$4,074.73 ","$6,132.66 ",20140101
576,DRG,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC,S,"$2,804.77 ","$10,450.30 ","$6,374.93 ","$10,450.30 ",20140101
577,DRG,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC,S,"$4,472.84 ","$16,604.20 ","$9,202.31 ","$16,604.20 ",20140101
578,DRG,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC,S,"$4,937.44 ","$22,486.58 ","$9,122.18 ","$22,486.58 ",20140101
579,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC",S,"$2,452.29 ","$6,328.87 ","$4,695.20 ","$6,328.87 ",20140101
580,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W CC",S,"$2,832.92 ","$9,919.32 ","$5,011.47 ","$9,919.32 ",20140101
581,DRG,"OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC",S,"$2,917.32 ","$17,312.02 ","$5,237.46 ","$17,312.02 ",20140101
582,DRG,MASTECTOMY FOR MALIGNANCY W CC/MCC,S,"$2,989.00 ","$18,514.62 ","$5,502.84 ","$18,514.62 ",20140101
583,DRG,MASTECTOMY FOR MALIGNANCY W/O CC/MCC,S,"$2,766.10 ","$22,801.77 ","$5,105.34 ","$22,801.77 ",20140101
584,DRG,"BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC",S,"$3,077.84 ","$12,601.32 ","$6,005.25 ","$12,601.32 ",20140101
585,DRG,"BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC",S,"$2,889.37 ","$21,076.98 ","$6,486.31 ","$21,076.98 ",20140101
592,DRG,SKIN ULCERS W MCC,N,"$2,224.30 ","$3,400.71 ","$3,774.81 ","$3,400.71 ",20140101
593,DRG,SKIN ULCERS W CC,N,"$2,249.35 ","$3,307.76 ","$3,630.42 ","$3,307.76 ",20140101
594,DRG,SKIN ULCERS W/O CC/MCC,N,"$1,752.36 ","$2,437.37 ","$3,134.90 ","$2,437.37 ",20140101
595,DRG,MAJOR SKIN DISORDERS W MCC,N,"$2,876.44 ","$6,494.61 ","$6,348.83 ","$6,494.61 ",20140101
596,DRG,MAJOR SKIN DISORDERS W/O MCC,N,"$2,581.77 ","$4,075.67 ","$4,697.50 ","$4,075.67 ",20140101
597,DRG,MALIGNANT BREAST DISORDERS W MCC,N,"$2,263.47 ","$4,717.45 ","$4,276.60 ","$4,717.45 ",20140101
598,DRG,MALIGNANT BREAST DISORDERS W CC,N,"$2,465.17 ","$4,374.02 ","$4,290.92 ","$4,374.02 ",20140101
599,DRG,MALIGNANT BREAST DISORDERS W/O CC/MCC,N,"$2,273.11 ","$4,159.05 ","$3,223.36 ","$4,159.05 ",20140101
600,DRG,NON-MALIGNANT BREAST DISORDERS W CC/MCC,N,"$2,275.02 ","$4,496.49 ","$3,914.60 ","$4,496.49 ",20140101
601,DRG,NON-MALIGNANT BREAST DISORDERS W/O CC/MCC,N,"$2,407.87 ","$4,162.84 ","$3,803.57 ","$4,162.84 ",20140101
602,DRG,CELLULITIS W MCC,N,"$2,280.59 ","$4,623.41 ","$3,971.79 ","$4,623.41 ",20140101
603,DRG,CELLULITIS W/O MCC,N,"$2,184.21 ","$3,649.96 ","$3,611.37 ","$3,649.96 ",20140101
604,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC",N,"$2,778.74 ","$6,772.40 ","$5,147.12 ","$6,772.40 ",20140101
605,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",N,"$3,011.50 ","$6,771.69 ","$5,413.31 ","$6,771.69 ",20140101
606,DRG,MINOR SKIN DISORDERS W MCC,N,"$2,413.36 ","$4,688.59 ","$4,598.61 ","$4,688.59 ",20140101
607,DRG,MINOR SKIN DISORDERS W/O MCC,N,"$2,403.34 ","$3,930.39 ","$4,163.01 ","$3,930.39 ",20140101
614,DRG,ADRENAL & PITUITARY PROCEDURES W CC/MCC,S,"$2,973.77 ","$14,919.76 ","$6,112.15 ","$14,919.76 ",20140101
615,DRG,ADRENAL & PITUITARY PROCEDURES W/O CC/MCC,S,"$2,855.04 ","$20,433.83 ","$5,549.57 ","$20,433.83 ",20140101
616,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC",S,"$2,354.92 ","$6,837.55 ","$4,438.65 ","$6,837.55 ",20140101
617,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC",S,"$2,306.39 ","$6,507.76 ","$3,761.99 ","$6,507.76 ",20140101
618,DRG,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W/O CC/MCC",S,"$2,129.31 ","$5,690.03 ","$3,708.53 ","$5,690.03 ",20140101
619,DRG,O.R. PROCEDURES FOR OBESITY W MCC,S,"$2,717.31 ","$16,344.83 ","$5,343.24 ","$16,344.83 ",20140101
620,DRG,O.R. PROCEDURES FOR OBESITY W CC,S,"$2,588.82 ","$22,465.57 ","$4,767.80 ","$22,465.57 ",20140101
621,DRG,O.R. PROCEDURES FOR OBESITY W/O CC/MCC,S,"$2,399.44 ","$28,940.89 ","$3,997.63 ","$28,940.89 ",20140101
622,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC",S,"$2,505.85 ","$5,424.48 ","$4,357.72 ","$5,424.48 ",20140101
623,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC",S,"$2,784.60 ","$5,999.37 ","$4,722.33 ","$5,999.37 ",20140101
624,DRG,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W/O CC/MCC",S,"$3,884.71 ","$9,703.86 ","$7,673.81 ","$9,703.86 ",20140101
625,DRG,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W MCC",S,"$2,680.13 ","$12,137.71 ","$5,329.73 ","$12,137.71 ",20140101
626,DRG,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W CC",S,"$3,070.65 ","$18,102.01 ","$5,451.30 ","$18,102.01 ",20140101
627,DRG,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC",S,"$2,702.13 ","$23,727.09 ","$4,696.64 ","$23,727.09 ",20140101
628,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC",S,"$2,587.97 ","$8,706.02 ","$4,588.16 ","$8,706.02 ",20140101
629,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC",S,"$2,610.10 ","$7,436.37 ","$4,145.80 ","$7,436.37 ",20140101
630,DRG,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC/MCC",S,"$2,975.46 ","$13,181.76 ","$5,131.30 ","$13,181.76 ",20140101
637,DRG,DIABETES W MCC,N,"$2,419.88 ","$5,496.44 ","$4,453.08 ","$5,496.44 ",20140101
638,DRG,DIABETES W CC,N,"$2,363.33 ","$4,449.31 ","$4,139.56 ","$4,449.31 ",20140101
639,DRG,DIABETES W/O CC/MCC,N,"$2,299.59 ","$4,332.20 ","$3,988.57 ","$4,332.20 ",20140101
640,DRG,"MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC",N,"$2,422.17 ","$5,431.02 ","$4,330.00 ","$5,431.02 ",20140101
641,DRG,"MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC",N,"$2,195.30 ","$4,260.70 ","$3,832.81 ","$4,260.70 ",20140101
642,DRG,INBORN AND OTHER DISORDERS OF METABOLISM,N,"$2,688.24 ","$7,574.29 ","$5,127.13 ","$7,574.29 ",20140101
643,DRG,ENDOCRINE DISORDERS W MCC,N,"$2,470.13 ","$5,399.61 ","$4,469.65 ","$5,399.61 ",20140101
644,DRG,ENDOCRINE DISORDERS W CC,N,"$2,603.16 ","$4,931.72 ","$4,370.66 ","$4,931.72 ",20140101
645,DRG,ENDOCRINE DISORDERS W/O CC/MCC,N,"$2,726.71 ","$5,504.27 ","$4,680.72 ","$5,504.27 ",20140101
652,DRG,KIDNEY TRANSPLANT,S,"$3,158.53 ","$34,039.12 ","$6,580.14 ","$34,039.12 ",20140101
653,DRG,MAJOR BLADDER PROCEDURES W MCC,S,"$2,751.54 ","$10,680.23 ","$5,228.48 ","$10,680.23 ",20140101
654,DRG,MAJOR BLADDER PROCEDURES W CC,S,"$2,694.81 ","$10,759.65 ","$4,945.57 ","$10,759.65 ",20140101
655,DRG,MAJOR BLADDER PROCEDURES W/O CC/MCC,S,"$2,724.90 ","$12,560.09 ","$4,940.66 ","$12,560.09 ",20140101
656,DRG,KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC,S,"$2,673.68 ","$12,024.41 ","$5,175.03 ","$12,024.41 ",20140101
657,DRG,KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC,S,"$2,655.81 ","$12,682.58 ","$4,846.80 ","$12,682.58 ",20140101
658,DRG,KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC,S,"$2,563.55 ","$16,696.28 ","$4,568.72 ","$16,696.28 ",20140101
659,DRG,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC,S,"$2,809.83 ","$9,179.96 ","$5,194.66 ","$9,179.96 ",20140101
660,DRG,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC,S,"$3,015.21 ","$11,412.95 ","$5,162.40 ","$11,412.95 ",20140101
661,DRG,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC,S,"$2,597.95 ","$17,888.35 ","$4,790.02 ","$17,888.35 ",20140101
662,DRG,MINOR BLADDER PROCEDURES W MCC,S,"$2,578.98 ","$7,961.06 ","$4,786.50 ","$7,961.06 ",20140101
663,DRG,MINOR BLADDER PROCEDURES W CC,S,"$2,502.40 ","$8,546.81 ","$4,188.60 ","$8,546.81 ",20140101
664,DRG,MINOR BLADDER PROCEDURES W/O CC/MCC,S,"$2,197.44 ","$17,442.94 ","$3,626.84 ","$17,442.94 ",20140101
665,DRG,PROSTATECTOMY W MCC,S,"$2,469.91 ","$6,749.68 ","$4,115.96 ","$6,749.68 ",20140101
666,DRG,PROSTATECTOMY W CC,S,"$2,419.85 ","$7,289.96 ","$4,036.35 ","$7,289.96 ",20140101
667,DRG,PROSTATECTOMY W/O CC/MCC,S,"$2,556.27 ","$11,663.75 ","$3,947.10 ","$11,663.75 ",20140101
668,DRG,TRANSURETHRAL PROCEDURES W MCC,S,"$2,607.44 ","$8,064.12 ","$4,612.09 ","$8,064.12 ",20140101
669,DRG,TRANSURETHRAL PROCEDURES W CC,S,"$2,778.83 ","$10,314.96 ","$4,685.19 ","$10,314.96 ",20140101
670,DRG,TRANSURETHRAL PROCEDURES W/O CC/MCC,S,"$2,756.49 ","$12,044.88 ","$4,360.99 ","$12,044.88 ",20140101
671,DRG,URETHRAL PROCEDURES W CC/MCC,S,"$2,577.26 ","$8,565.06 ","$4,444.18 ","$8,565.06 ",20140101
672,DRG,URETHRAL PROCEDURES W/O CC/MCC,S,"$3,362.18 ","$16,211.40 ","$4,656.87 ","$16,211.40 ",20140101
673,DRG,OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC,S,"$2,583.01 ","$8,565.21 ","$4,484.39 ","$8,565.21 ",20140101
674,DRG,OTHER KIDNEY & URINARY TRACT PROCEDURES W CC,S,"$2,389.39 ","$8,589.58 ","$4,024.91 ","$8,589.58 ",20140101
675,DRG,OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC,S,"$2,044.44 ","$15,912.53 ","$3,071.09 ","$15,912.53 ",20140101
682,DRG,RENAL FAILURE W MCC,N,"$2,327.54 ","$5,648.97 ","$4,131.23 ","$5,648.97 ",20140101
683,DRG,RENAL FAILURE W CC,N,"$2,256.40 ","$4,663.31 ","$3,800.37 ","$4,663.31 ",20140101
684,DRG,RENAL FAILURE W/O CC/MCC,N,"$2,074.65 ","$4,282.69 ","$3,519.14 ","$4,282.69 ",20140101
685,DRG,ADMIT FOR RENAL DIALYSIS,N,"$2,132.21 ","$6,589.35 ","$3,528.52 ","$6,589.35 ",20140101
686,DRG,KIDNEY & URINARY TRACT NEOPLASMS W MCC,N,"$2,683.46 ","$6,232.00 ","$5,016.06 ","$6,232.00 ",20140101
687,DRG,KIDNEY & URINARY TRACT NEOPLASMS W CC,N,"$2,551.16 ","$5,497.08 ","$4,250.63 ","$5,497.08 ",20140101
688,DRG,KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC,N,"$2,078.33 ","$5,399.22 ","$3,326.57 ","$5,399.22 ",20140101
689,DRG,KIDNEY & URINARY TRACT INFECTIONS W MCC,N,"$2,283.82 ","$4,615.25 ","$3,955.79 ","$4,615.25 ",20140101
690,DRG,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,N,"$2,200.28 ","$4,257.48 ","$3,756.14 ","$4,257.48 ",20140101
691,DRG,URINARY STONES W ESW LITHOTRIPSY W CC/MCC,N,"$2,156.71 ","$12,244.04 ","$3,811.43 ","$12,244.04 ",20140101
692,DRG,URINARY STONES W ESW LITHOTRIPSY W/O CC/MCC,N,"$1,813.58 ","$15,498.16 ","$3,734.74 ","$15,498.16 ",20140101
693,DRG,URINARY STONES W/O ESW LITHOTRIPSY W MCC,N,"$2,460.62 ","$7,307.52 ","$4,440.24 ","$7,307.52 ",20140101
694,DRG,URINARY STONES W/O ESW LITHOTRIPSY W/O MCC,N,"$2,269.19 ","$8,409.34 ","$3,731.38 ","$8,409.34 ",20140101
695,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC,N,"$2,685.41 ","$5,605.76 ","$4,805.22 ","$5,605.76 ",20140101
696,DRG,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC,N,"$2,636.92 ","$4,779.33 ","$4,292.32 ","$4,779.33 ",20140101
697,DRG,URETHRAL STRICTURE,N,"$2,580.24 ","$7,418.47 ","$4,319.92 ","$7,418.47 ",20140101
698,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,N,"$2,573.17 ","$5,727.68 ","$4,580.23 ","$5,727.68 ",20140101
699,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC,N,"$2,561.79 ","$5,528.15 ","$4,206.09 ","$5,528.15 ",20140101
700,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC,N,"$2,409.92 ","$5,298.76 ","$3,877.62 ","$5,298.76 ",20140101
707,DRG,MAJOR MALE PELVIC PROCEDURES W CC/MCC,S,"$2,687.68 ","$17,066.44 ","$5,073.06 ","$17,066.44 ",20140101
708,DRG,MAJOR MALE PELVIC PROCEDURES W/O CC/MCC,S,"$2,550.00 ","$31,342.51 ","$4,256.24 ","$31,342.51 ",20140101
709,DRG,PENIS PROCEDURES W CC/MCC,S,"$2,385.59 ","$9,742.56 ","$4,465.09 ","$9,742.56 ",20140101
710,DRG,PENIS PROCEDURES W/O CC/MCC,S,"$2,843.21 ","$25,776.03 ","$4,181.01 ","$25,776.03 ",20140101
711,DRG,TESTES PROCEDURES W CC/MCC,S,"$2,443.04 ","$7,691.72 ","$4,427.05 ","$7,691.72 ",20140101
712,DRG,TESTES PROCEDURES W/O CC/MCC,S,"$2,596.48 ","$11,596.02 ","$4,937.92 ","$11,596.02 ",20140101
713,DRG,TRANSURETHRAL PROSTATECTOMY W CC/MCC,S,"$2,504.20 ","$9,115.72 ","$4,301.48 ","$9,115.72 ",20140101
714,DRG,TRANSURETHRAL PROSTATECTOMY W/O CC/MCC,S,"$2,571.78 ","$13,361.75 ","$4,276.33 ","$13,361.75 ",20140101
715,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC,S,"$3,419.86 ","$11,367.33 ","$6,080.59 ","$11,367.33 ",20140101
716,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W/O CC/MCC,S,"$2,789.75 ","$28,358.50 ","$4,091.09 ","$28,358.50 ",20140101
717,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC,S,"$2,347.54 ","$6,270.32 ","$4,071.47 ","$6,270.32 ",20140101
718,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC,S,"$2,150.68 ","$8,175.74 ","$3,521.47 ","$8,175.74 ",20140101
722,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC",N,"$2,498.35 ","$4,985.35 ","$4,177.74 ","$4,985.35 ",20140101
723,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC",N,"$2,371.43 ","$4,384.45 ","$3,982.50 ","$4,384.45 ",20140101
724,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W/O CC/MCC",N,"$2,770.85 ","$6,506.18 ","$4,248.48 ","$6,506.18 ",20140101
725,DRG,BENIGN PROSTATIC HYPERTROPHY W MCC,N,"$2,520.43 ","$4,916.06 ","$4,004.90 ","$4,916.06 ",20140101
726,DRG,BENIGN PROSTATIC HYPERTROPHY W/O MCC,N,"$2,834.03 ","$5,107.19 ","$4,483.63 ","$5,107.19 ",20140101
727,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC,N,"$2,246.83 ","$4,955.42 ","$3,948.51 ","$4,955.42 ",20140101
728,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC,N,"$2,213.29 ","$4,335.37 ","$3,749.34 ","$4,335.37 ",20140101
729,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC,N,"$2,354.91 ","$4,778.42 ","$4,131.11 ","$4,778.42 ",20140101
730,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC,N,"$1,949.04 ","$4,691.18 ","$3,122.60 ","$4,691.18 ",20140101
734,DRG,"PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W CC/MCC",S,"$3,297.02 ","$13,402.64 ","$6,428.24 ","$13,402.64 ",20140101
735,DRG,"PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W/O CC/MCC",S,"$3,008.09 ","$20,736.48 ","$4,970.63 ","$20,736.48 ",20140101
736,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC,S,"$2,607.90 ","$10,104.75 ","$5,375.66 ","$10,104.75 ",20140101
737,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC,S,"$2,835.00 ","$10,769.65 ","$5,413.51 ","$10,769.65 ",20140101
738,DRG,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC,S,"$2,683.92 ","$13,518.15 ","$4,196.29 ","$13,518.15 ",20140101
739,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC",S,"$2,938.02 ","$11,317.08 ","$5,742.74 ","$11,317.08 ",20140101
740,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC",S,"$3,185.25 ","$14,854.71 ","$5,968.53 ","$14,854.71 ",20140101
741,DRG,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC",S,"$2,948.64 ","$20,911.15 ","$4,990.74 ","$20,911.15 ",20140101
742,DRG,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC,S,"$2,523.60 ","$13,355.07 ","$4,955.87 ","$13,355.07 ",20140101
743,DRG,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,S,"$2,318.16 ","$18,439.11 ","$4,180.41 ","$18,439.11 ",20140101
744,DRG,"D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC",S,"$3,023.98 ","$9,074.25 ","$5,292.31 ","$9,074.25 ",20140101
745,DRG,"D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC",S,"$2,593.21 ","$13,505.80 ","$4,184.21 ","$13,505.80 ",20140101
746,DRG,"VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC",S,"$2,391.43 ","$10,191.88 ","$4,290.76 ","$10,191.88 ",20140101
747,DRG,"VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC",S,"$2,452.44 ","$19,133.43 ","$3,811.58 ","$19,133.43 ",20140101
748,DRG,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,S,"$2,235.32 ","$20,225.67 ","$4,126.96 ","$20,225.67 ",20140101
749,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC,S,"$2,748.53 ","$9,228.62 ","$5,485.22 ","$9,228.62 ",20140101
750,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC,S,"$2,435.93 ","$13,486.41 ","$4,338.81 ","$13,486.41 ",20140101
754,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC",N,"$2,404.12 ","$5,275.14 ","$4,584.31 ","$5,275.14 ",20140101
755,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC",N,"$2,460.77 ","$4,978.52 ","$4,343.64 ","$4,978.52 ",20140101
756,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC",N,"$2,089.61 ","$4,387.08 ","$3,248.67 ","$4,387.08 ",20140101
757,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC",N,"$2,230.36 ","$4,929.60 ","$4,028.30 ","$4,929.60 ",20140101
758,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC",N,"$2,237.88 ","$4,617.84 ","$3,687.21 ","$4,617.84 ",20140101
759,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC",N,"$2,139.25 ","$4,322.79 ","$3,510.31 ","$4,322.79 ",20140101
760,DRG,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC,N,"$2,845.61 ","$6,228.21 ","$4,689.50 ","$6,228.21 ",20140101
761,DRG,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC,N,"$3,227.31 ","$7,134.92 ","$5,595.72 ","$7,134.92 ",20140101
765,DRG,CESAREAN SECTION W CC/MCC,S,"$2,350.43 ","$5,389.17 ","$4,391.60 ","$5,389.17 ",20140101
766,DRG,CESAREAN SECTION W/O CC/MCC,S,"$2,155.93 ","$5,820.99 ","$3,998.47 ","$5,820.99 ",20140101
767,DRG,VAGINAL DELIVERY W STERILIZATION &/OR D&C,S,"$1,766.29 ","$6,467.71 ","$4,212.39 ","$6,467.71 ",20140101
768,DRG,VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C,S,"$3,353.08 ","$6,844.57 ","$6,180.93 ","$6,844.57 ",20140101
769,DRG,POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE,S,"$2,162.37 ","$9,998.62 ","$4,509.99 ","$9,998.62 ",20140101
770,DRG,"ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",S,"$2,678.53 ","$10,217.59 ","$4,929.68 ","$10,217.59 ",20140101
774,DRG,VAGINAL DELIVERY W COMPLICATING DIAGNOSES,N,"$2,286.54 ","$4,721.92 ","$4,020.73 ","$4,721.92 ",20140101
775,DRG,VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES,N,"$2,193.09 ","$4,760.91 ","$4,764.63 ","$4,760.91 ",20140101
776,DRG,POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE,N,"$2,487.49 ","$3,952.81 ","$4,576.68 ","$3,952.81 ",20140101
777,DRG,ECTOPIC PREGNANCY,N,"$2,891.82 ","$14,857.08 ","$4,756.24 ","$14,857.08 ",20140101
778,DRG,THREATENED ABORTION,N,"$2,194.38 ","$2,809.32 ","$3,704.95 ","$2,809.32 ",20140101
779,DRG,ABORTION W/O D&C,N,"$2,666.98 ","$6,409.54 ","$5,514.10 ","$6,409.54 ",20140101
780,DRG,FALSE LABOR,N,"$1,767.12 ","$3,413.84 ","$3,059.74 ","$3,413.84 ",20140101
781,DRG,OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS,N,"$2,529.44 ","$3,089.16 ","$4,158.03 ","$3,089.16 ",20140101
782,DRG,OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS,N,"$2,390.91 ","$3,834.14 ","$4,223.76 ","$3,834.14 ",20140101
789,DRG,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",N,"$3,746.51 ","$8,123.75 ","$7,025.20 ","$8,123.75 ",20140101
790,DRG,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",N,"$2,709.55 ","$5,875.26 ","$5,080.76 ","$5,875.26 ",20140101
791,DRG,PREMATURITY W MAJOR PROBLEMS,N,"$2,090.57 ","$4,533.08 ","$3,920.09 ","$4,533.08 ",20140101
792,DRG,PREMATURITY W/O MAJOR PROBLEMS,N,"$1,534.79 ","$3,327.96 ","$2,877.94 ","$3,327.96 ",20140101
793,DRG,FULL TERM NEONATE W MAJOR PROBLEMS,N,"$1,687.98 ","$3,660.13 ","$3,165.18 ","$3,660.13 ",20140101
794,DRG,NEONATE W OTHER SIGNIFICANT PROBLEMS,N,$979.00 ,"$2,122.83 ","$1,835.77 ","$2,122.83 ",20140101
795,DRG,NORMAL NEWBORN,N,$637.12 ,"$1,381.52 ","$1,194.69 ","$1,381.52 ",20140101
799,DRG,SPLENECTOMY W MCC,S,"$2,570.08 ","$12,338.44 ","$4,984.58 ","$12,338.44 ",20140101
800,DRG,SPLENECTOMY W CC,S,"$2,594.01 ","$13,463.81 ","$5,090.70 ","$13,463.81 ",20140101
801,DRG,SPLENECTOMY W/O CC/MCC,S,"$2,319.62 ","$14,633.73 ","$3,920.77 ","$14,633.73 ",20140101
802,DRG,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W MCC,S,"$3,094.02 ","$9,919.31 ","$5,235.43 ","$9,919.31 ",20140101
803,DRG,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC,S,"$2,715.67 ","$9,465.77 ","$4,584.74 ","$9,465.77 ",20140101
804,DRG,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W/O CC/MCC,S,"$2,637.90 ","$14,441.59 ","$4,798.54 ","$14,441.59 ",20140101
808,DRG,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC,N,"$2,711.55 ","$7,919.40 ","$4,725.59 ","$7,919.40 ",20140101
809,DRG,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,N,"$2,532.11 ","$6,591.34 ","$4,120.26 ","$6,591.34 ",20140101
810,DRG,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC,N,"$2,378.83 ","$6,816.57 ","$3,874.17 ","$6,816.57 ",20140101
811,DRG,RED BLOOD CELL DISORDERS W MCC,N,"$2,442.09 ","$6,290.21 ","$4,214.27 ","$6,290.21 ",20140101
812,DRG,RED BLOOD CELL DISORDERS W/O MCC,N,"$2,248.05 ","$5,415.24 ","$3,750.30 ","$5,415.24 ",20140101
813,DRG,COAGULATION DISORDERS,N,"$2,706.64 ","$13,280.37 ","$4,887.47 ","$13,280.37 ",20140101
814,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC,N,"$2,718.13 ","$7,049.59 ","$4,879.47 ","$7,049.59 ",20140101
815,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC,N,"$2,424.68 ","$6,125.88 ","$4,272.05 ","$6,125.88 ",20140101
816,DRG,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,N,"$2,107.85 ","$5,457.22 ","$3,686.30 ","$5,457.22 ",20140101
820,DRG,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC,S,"$2,959.34 ","$11,531.46 ","$5,696.18 ","$11,531.46 ",20140101
821,DRG,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC,S,"$3,042.72 ","$12,259.96 ","$5,311.29 ","$12,259.96 ",20140101
822,DRG,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC,S,"$2,969.77 ","$16,594.94 ","$5,116.55 ","$16,594.94 ",20140101
823,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W MCC,S,"$2,851.69 ","$9,236.00 ","$5,090.52 ","$9,236.00 ",20140101
824,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC,S,"$2,895.30 ","$9,797.36 ","$4,560.20 ","$9,797.36 ",20140101
825,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC/MCC,S,"$3,113.00 ","$13,911.93 ","$5,104.64 ","$13,911.93 ",20140101
826,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC,S,"$2,727.98 ","$10,604.28 ","$5,431.69 ","$10,604.28 ",20140101
827,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC,S,"$2,908.80 ","$10,557.07 ","$5,306.13 ","$10,557.07 ",20140101
828,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC,S,"$2,971.45 ","$14,525.43 ","$5,198.83 ","$14,525.43 ",20140101
829,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC W CC/MCC,S,"$2,931.23 ","$9,963.47 ","$5,079.91 ","$9,963.47 ",20140101
830,DRG,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC W/O CC/MCC,S,"$2,990.43 ","$15,251.42 ","$5,820.35 ","$15,251.42 ",20140101
834,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC,N,"$3,216.79 ","$9,805.49 ","$5,357.83 ","$9,805.49 ",20140101
835,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC,N,"$3,016.83 ","$8,192.13 ","$4,537.51 ","$8,192.13 ",20140101
836,DRG,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC,N,"$2,929.24 ","$7,723.91 ","$4,157.63 ","$7,723.91 ",20140101
837,DRG,CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC,N,"$2,840.84 ","$8,331.55 ","$4,436.37 ","$8,331.55 ",20140101
838,DRG,CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,N,"$3,218.02 ","$9,479.25 ","$4,481.62 ","$9,479.25 ",20140101
839,DRG,CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,N,"$2,849.20 ","$6,434.87 ","$3,238.24 ","$6,434.87 ",20140101
840,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W MCC,N,"$2,921.13 ","$8,320.96 ","$5,074.88 ","$8,320.96 ",20140101
841,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W CC,N,"$2,766.15 ","$7,259.55 ","$4,413.89 ","$7,259.55 ",20140101
842,DRG,LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC,N,"$2,133.82 ","$6,460.20 ","$3,537.40 ","$6,460.20 ",20140101
843,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC,N,"$2,715.71 ","$6,486.14 ","$4,822.55 ","$6,486.14 ",20140101
844,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC,N,"$2,421.64 ","$5,503.98 ","$4,126.14 ","$5,503.98 ",20140101
845,DRG,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC/MCC,N,"$1,779.67 ","$4,259.18 ","$2,957.57 ","$4,259.18 ",20140101
846,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,N,"$3,113.65 ","$8,995.60 ","$4,896.52 ","$8,995.60 ",20140101
847,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,N,"$2,732.88 ","$9,784.75 ","$3,607.28 ","$9,784.75 ",20140101
848,DRG,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W/O CC/MCC,N,"$2,542.73 ","$8,312.42 ","$4,038.82 ","$8,312.42 ",20140101
849,DRG,RADIOTHERAPY,N,"$3,283.13 ","$7,757.12 ","$5,257.40 ","$7,757.12 ",20140101
853,DRG,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC,S,"$2,750.80 ","$9,663.21 ","$5,102.38 ","$9,663.21 ",20140101
854,DRG,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC,S,"$2,449.38 ","$7,318.07 ","$4,238.94 ","$7,318.07 ",20140101
855,DRG,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC,S,"$2,332.37 ","$8,324.14 ","$3,776.53 ","$8,324.14 ",20140101
856,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC,S,"$2,477.52 ","$8,025.64 ","$4,863.80 ","$8,025.64 ",20140101
857,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC,S,"$2,440.50 ","$7,080.83 ","$4,327.81 ","$7,080.83 ",20140101
858,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC,S,"$2,279.98 ","$7,245.39 ","$4,119.92 ","$7,245.39 ",20140101
862,DRG,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC,N,"$2,367.72 ","$5,328.80 ","$4,292.62 ","$5,328.80 ",20140101
863,DRG,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC,N,"$2,301.17 ","$4,327.11 ","$3,784.71 ","$4,327.11 ",20140101
864,DRG,FEVER,N,"$2,389.47 ","$5,598.60 ","$3,998.75 ","$5,598.60 ",20140101
865,DRG,VIRAL ILLNESS W MCC,N,"$2,490.41 ","$6,608.71 ","$4,609.14 ","$6,608.71 ",20140101
866,DRG,VIRAL ILLNESS W/O MCC,N,"$2,379.35 ","$5,052.89 ","$3,974.78 ","$5,052.89 ",20140101
867,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC,N,"$2,637.62 ","$7,452.34 ","$4,938.91 ","$7,452.34 ",20140101
868,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC,N,"$2,335.13 ","$4,628.38 ","$4,028.36 ","$4,628.38 ",20140101
869,DRG,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC,N,"$1,974.84 ","$3,982.57 ","$3,800.10 ","$3,982.57 ",20140101
870,DRG,SEPTICEMIA OR SEVERE SEPSIS W MV 96+ HOURS,N,"$3,324.42 ","$10,208.32 ","$5,757.48 ","$10,208.32 ",20140101
871,DRG,SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC,N,"$2,604.97 ","$6,452.88 ","$4,663.88 ","$6,452.88 ",20140101
872,DRG,SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W/O MCC,N,"$2,401.71 ","$4,751.95 ","$3,979.31 ","$4,751.95 ",20140101
876,DRG,O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS,S,"$2,319.55 ","$3,313.83 ","$3,600.48 ","$3,313.83 ",20140101
880,DRG,ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION,N,"$1,933.37 ","$2,785.25 ","$3,402.42 ","$2,785.25 ",20140101
881,DRG,DEPRESSIVE NEUROSES,N,"$2,010.90 ",$838.13 ,"$2,910.84 ",$838.13 ,20140101
882,DRG,NEUROSES EXCEPT DEPRESSIVE,N,"$1,897.95 ",$715.95 ,"$2,900.00 ",$715.95 ,20140101
883,DRG,DISORDERS OF PERSONALITY & IMPULSE CONTROL,N,"$2,010.04 ",$738.20 ,"$3,087.32 ",$738.20 ,20140101
884,DRG,ORGANIC DISTURBANCES & MENTAL RETARDATION,N,"$2,136.26 ","$1,327.45 ","$3,666.07 ","$1,327.45 ",20140101
885,DRG,PSYCHOSES,N,"$2,156.46 ",$688.55 ,"$2,947.51 ",$688.55 ,20140101
886,DRG,BEHAVIORAL & DEVELOPMENTAL DISORDERS,N,"$1,778.55 ",$737.09 ,"$2,945.50 ",$737.09 ,20140101
887,DRG,OTHER MENTAL DISORDER DIAGNOSES,N,"$1,335.48 ",$897.92 ,"$2,098.20 ",$897.92 ,20140101
894,DRG,"ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA",N,"$1,728.66 ","$1,381.43 ","$3,480.59 ","$1,381.43 ",20140101
895,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY,N,"$1,452.99 ",$459.25 ,"$3,587.96 ",$459.25 ,20140101
896,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC,N,"$2,236.16 ","$4,082.15 ","$4,258.77 ","$4,082.15 ",20140101
897,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,N,"$1,468.11 ","$1,094.90 ","$2,738.13 ","$1,094.90 ",20140101
901,DRG,WOUND DEBRIDEMENTS FOR INJURIES W MCC,S,"$2,651.79 ","$6,204.76 ","$4,738.14 ","$6,204.76 ",20140101
902,DRG,WOUND DEBRIDEMENTS FOR INJURIES W CC,S,"$2,684.29 ","$6,320.04 ","$5,058.29 ","$6,320.04 ",20140101
903,DRG,WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC,S,"$2,616.95 ","$7,494.96 ","$4,914.42 ","$7,494.96 ",20140101
904,DRG,SKIN GRAFTS FOR INJURIES W CC/MCC,S,"$2,860.45 ","$8,368.79 ","$5,529.45 ","$8,368.79 ",20140101
905,DRG,SKIN GRAFTS FOR INJURIES W/O CC/MCC,S,"$2,737.18 ","$8,795.06 ","$5,575.56 ","$8,795.06 ",20140101
906,DRG,HAND PROCEDURES FOR INJURIES,S,"$2,550.69 ","$11,507.07 ","$5,255.09 ","$11,507.07 ",20140101
907,DRG,OTHER O.R. PROCEDURES FOR INJURIES W MCC,S,"$2,456.44 ","$9,753.33 ","$4,913.92 ","$9,753.33 ",20140101
908,DRG,OTHER O.R. PROCEDURES FOR INJURIES W CC,S,"$2,540.11 ","$9,780.69 ","$4,676.17 ","$9,780.69 ",20140101
909,DRG,OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC,S,"$2,403.44 ","$12,180.19 ","$4,394.78 ","$12,180.19 ",20140101
913,DRG,TRAUMATIC INJURY W MCC,N,"$2,437.39 ","$5,680.65 ","$4,570.81 ","$5,680.65 ",20140101
914,DRG,TRAUMATIC INJURY W/O MCC,N,"$2,375.11 ","$5,156.09 ","$4,515.12 ","$5,156.09 ",20140101
915,DRG,ALLERGIC REACTIONS W MCC,N,"$2,401.38 ","$7,153.20 ","$4,891.71 ","$7,153.20 ",20140101
916,DRG,ALLERGIC REACTIONS W/O MCC,N,"$2,255.93 ","$4,374.20 ","$4,312.30 ","$4,374.20 ",20140101
917,DRG,POISONING & TOXIC EFFECTS OF DRUGS W MCC,N,"$2,495.02 ","$7,554.22 ","$4,795.76 ","$7,554.22 ",20140101
918,DRG,POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,N,"$2,521.62 ","$5,325.95 ","$4,338.18 ","$5,325.95 ",20140101
919,DRG,COMPLICATIONS OF TREATMENT W MCC,N,"$2,367.38 ","$5,864.70 ","$4,407.02 ","$5,864.70 ",20140101
920,DRG,COMPLICATIONS OF TREATMENT W CC,N,"$2,416.46 ","$5,252.56 ","$4,245.38 ","$5,252.56 ",20140101
921,DRG,COMPLICATIONS OF TREATMENT W/O CC/MCC,N,"$2,274.78 ","$5,313.34 ","$3,818.98 ","$5,313.34 ",20140101
922,DRG,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC",N,"$2,940.96 ","$7,573.01 ","$5,551.33 ","$7,573.01 ",20140101
923,DRG,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC",N,"$2,759.76 ","$5,409.28 ","$4,829.25 ","$5,409.28 ",20140101
927,DRG,EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV 96+ HRS W SKIN GRAFT,S,"$2,836.98 ","$13,619.23 ","$8,033.30 ","$13,619.23 ",20140101
928,DRG,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC,S,"$2,553.03 ","$7,319.35 ","$7,206.77 ","$7,319.35 ",20140101
929,DRG,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W/O CC/MCC,S,"$2,603.23 ","$6,440.74 ","$6,896.05 ","$6,440.74 ",20140101
933,DRG,EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV 96+ HRS W/O SKIN GRAFT,N,"$1,797.85 ","$9,002.26 ","$6,674.83 ","$9,002.26 ",20140101
934,DRG,FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ,N,"$2,267.01 ","$4,369.38 ","$6,994.67 ","$4,369.38 ",20140101
935,DRG,NON-EXTENSIVE BURNS,N,"$2,458.43 ","$5,344.86 ","$7,431.78 ","$5,344.86 ",20140101
939,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC,S,"$2,327.16 ","$5,591.12 ","$4,546.07 ","$5,591.12 ",20140101
940,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC,S,"$2,353.00 ","$5,974.20 ","$4,748.71 ","$5,974.20 ",20140101
941,DRG,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC,S,"$2,407.15 ","$11,809.82 ","$4,605.51 ","$11,809.82 ",20140101
945,DRG,REHABILITATION W CC/MCC,N,"$1,676.32 ","$2,193.68 ","$2,915.82 ","$2,193.68 ",20140101
946,DRG,REHABILITATION W/O CC/MCC,N,"$1,564.32 ","$1,655.65 ","$2,631.53 ","$1,655.65 ",20140101
947,DRG,SIGNS & SYMPTOMS W MCC,N,"$2,316.59 ","$5,385.09 ","$4,123.73 ","$5,385.09 ",20140101
948,DRG,SIGNS & SYMPTOMS W/O MCC,N,"$2,208.07 ","$4,706.40 ","$3,734.01 ","$4,706.40 ",20140101
949,DRG,AFTERCARE W CC/MCC,N,"$1,896.38 ","$2,547.47 ","$3,065.29 ","$2,547.47 ",20140101
950,DRG,AFTERCARE W/O CC/MCC,N,"$1,493.51 ","$1,751.43 ","$2,879.89 ","$1,751.43 ",20140101
951,DRG,OTHER FACTORS INFLUENCING HEALTH STATUS,N,"$1,404.57 ","$2,056.83 ","$4,177.15 ","$2,056.83 ",20140101
955,DRG,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,S,"$3,027.88 ","$16,391.93 ","$7,191.26 ","$16,391.93 ",20140101
956,DRG,"LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA",S,"$2,859.69 ","$14,421.34 ","$6,345.49 ","$14,421.34 ",20140101
957,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC,S,"$2,499.21 ","$14,300.69 ","$5,889.10 ","$14,300.69 ",20140101
958,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC,S,"$2,546.57 ","$13,573.02 ","$5,966.39 ","$13,573.02 ",20140101
959,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC,S,"$2,546.19 ","$13,781.43 ","$5,508.76 ","$13,781.43 ",20140101
963,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC,N,"$2,268.49 ","$7,793.04 ","$5,242.80 ","$7,793.04 ",20140101
964,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA W CC,N,"$2,405.14 ","$6,437.01 ","$5,591.48 ","$6,437.01 ",20140101
965,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC,N,"$2,472.23 ","$6,588.72 ","$5,900.28 ","$6,588.72 ",20140101
969,DRG,HIV W EXTENSIVE O.R. PROCEDURE W MCC,S,"$2,832.79 ","$9,506.21 ","$5,609.47 ","$9,506.21 ",20140101
970,DRG,HIV W EXTENSIVE O.R. PROCEDURE W/O MCC,S,"$2,552.80 ","$8,584.31 ","$4,128.95 ","$8,584.31 ",20140101
974,DRG,HIV W MAJOR RELATED CONDITION W MCC,N,"$2,732.72 ","$6,988.13 ","$4,923.78 ","$6,988.13 ",20140101
975,DRG,HIV W MAJOR RELATED CONDITION W CC,N,"$2,684.67 ","$5,129.02 ","$3,973.59 ","$5,129.02 ",20140101
976,DRG,HIV W MAJOR RELATED CONDITION W/O CC/MCC,N,"$2,407.23 ","$4,450.64 ","$3,740.40 ","$4,450.64 ",20140101
977,DRG,HIV W OR W/O OTHER RELATED CONDITION,N,"$2,434.85 ","$5,475.10 ","$3,908.20 ","$5,475.10 ",20140101
981,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC,S,"$2,471.28 ","$9,464.62 ","$4,676.11 ","$9,464.62 ",20140101
982,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC,S,"$2,434.51 ","$9,932.43 ","$4,253.90 ","$9,932.43 ",20140101
983,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC,S,"$2,182.90 ","$12,783.56 ","$3,803.31 ","$12,783.56 ",20140101
984,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC,S,"$2,253.74 ","$5,898.85 ","$3,595.08 ","$5,898.85 ",20140101
985,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC,S,"$2,192.98 ","$6,009.85 ","$3,603.61 ","$6,009.85 ",20140101
986,DRG,PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC,S,"$2,519.00 ","$9,897.65 ","$4,434.78 ","$9,897.65 ",20140101
987,DRG,NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC,S,"$2,540.47 ","$7,306.05 ","$4,675.79 ","$7,306.05 ",20140101
988,DRG,NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC,S,"$2,482.73 ","$7,312.76 ","$4,212.01 ","$7,312.76 ",20140101
989,DRG,NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC,S,"$2,203.25 ","$9,640.95 ","$3,893.25 ","$9,640.95 ",20140101
000,SNF,SKILLED NURSING FACILITY PER DIEM,,$786.19 ,,,,20140101
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