Version 4.215 - 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 WITH MCC,S,"$4,280.30 ","$27,261.79 ","$7,880.09 ","$27,261.79 ",20210101
002,DRG,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,S,"$3,976.10 ","$32,227.85 ","$6,419.36 ","$32,227.85 ",20210101
003,DRG,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R.",S,"$4,581.84 ","$18,529.04 ","$7,945.63 ","$18,529.04 ",20210101
004,DRG,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R.",S,"$4,531.53 ","$11,720.82 ","$7,246.98 ","$11,720.82 ",20210101
005,DRG,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,S,"$3,528.61 ","$26,561.76 ","$7,776.41 ","$26,561.76 ",20210101
006,DRG,LIVER TRANSPLANT WITHOUT MCC,S,"$3,041.61 ","$35,213.07 ","$6,270.19 ","$35,213.07 ",20210101
007,DRG,LUNG TRANSPLANT,S,"$4,230.26 ","$30,761.41 ","$6,971.33 ","$30,761.41 ",20210101
008,DRG,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,S,"$3,914.60 ","$49,307.20 ","$8,166.31 ","$49,307.20 ",20210101
010,DRG,PANCREAS TRANSPLANT,S,"$4,270.65 ","$29,275.75 ","$8,104.57 ","$29,275.75 ",20210101
011,DRG,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",S,"$4,045.40 ","$12,950.09 ","$7,190.95 ","$12,950.09 ",20210101
012,DRG,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",S,"$4,087.76 ","$16,043.50 ","$7,331.77 ","$16,043.50 ",20210101
013,DRG,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",S,"$3,696.91 ","$14,697.30 ","$6,239.64 ","$14,697.30 ",20210101
014,DRG,ALLOGENEIC BONE MARROW TRANSPLANT,N,"$5,558.92 ","$14,224.78 ","$6,898.64 ","$14,224.78 ",20210101
016,DRG,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,N,"$5,341.12 ","$11,593.31 ","$6,576.34 ","$11,593.31 ",20210101
017,DRG,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,N,"$3,928.59 ","$11,013.03 ","$5,232.68 ","$11,013.03 ",20210101
018,DRG,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY,N,"$6,654.92 ","$61,493.35 ","$7,796.95 ","$61,493.35 ",20210101
019,DRG,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,S,"$4,712.77 ","$44,604.87 ","$9,596.64 ","$44,604.87 ",20210101
020,DRG,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,S,"$4,200.23 ","$21,201.07 ","$8,642.39 ","$21,201.07 ",20210101
021,DRG,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,S,"$4,848.14 ","$18,936.75 ","$8,754.83 ","$18,936.75 ",20210101
022,DRG,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,S,"$4,484.48 ","$25,671.51 ","$7,974.85 ","$25,671.51 ",20210101
023,DRG,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,S,"$3,673.52 ","$18,387.02 ","$7,702.61 ","$18,387.02 ",20210101
024,DRG,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,S,"$3,668.98 ","$25,795.94 ","$7,273.44 ","$25,795.94 ",20210101
025,DRG,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,S,"$3,900.81 ","$17,655.47 ","$7,967.35 ","$17,655.47 ",20210101
026,DRG,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,S,"$4,082.60 ","$21,699.93 ","$8,065.31 ","$21,699.93 ",20210101
027,DRG,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,S,"$3,808.36 ","$38,903.40 ","$7,370.12 ","$38,903.40 ",20210101
028,DRG,SPINAL PROCEDURES WITH MCC,S,"$3,343.81 ","$14,972.42 ","$6,936.61 ","$14,972.42 ",20210101
029,DRG,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,S,"$3,661.48 ","$20,754.36 ","$7,044.70 ","$20,754.36 ",20210101
030,DRG,SPINAL PROCEDURES WITHOUT CC/MCC,S,"$3,893.77 ","$31,632.45 ","$7,811.49 ","$31,632.45 ",20210101
031,DRG,VENTRICULAR SHUNT PROCEDURES WITH MCC,S,"$3,667.69 ","$11,693.58 ","$7,004.78 ","$11,693.58 ",20210101
032,DRG,VENTRICULAR SHUNT PROCEDURES WITH CC,S,"$3,725.39 ","$18,151.58 ","$6,859.30 ","$18,151.58 ",20210101
033,DRG,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,S,"$3,311.40 ","$29,252.69 ","$6,526.24 ","$29,252.69 ",20210101
034,DRG,CAROTID ARTERY STENT PROCEDURE WITH MCC,S,"$3,232.80 ","$17,912.84 ","$6,340.15 ","$17,912.84 ",20210101
035,DRG,CAROTID ARTERY STENT PROCEDURE WITH CC,S,"$3,311.65 ","$28,658.62 ","$6,487.21 ","$28,658.62 ",20210101
036,DRG,CAROTID ARTERY STENT PROCEDURE WITHOUT CC/MCC,S,"$3,227.75 ","$49,311.60 ","$6,166.06 ","$49,311.60 ",20210101
037,DRG,EXTRACRANIAL PROCEDURES WITH MCC,S,"$3,246.37 ","$15,692.47 ","$6,071.90 ","$15,692.47 ",20210101
038,DRG,EXTRACRANIAL PROCEDURES WITH CC,S,"$3,279.63 ","$22,514.41 ","$5,992.48 ","$22,514.41 ",20210101
039,DRG,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,S,"$3,002.81 ","$32,383.70 ","$5,517.62 ","$32,383.70 ",20210101
040,DRG,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",S,"$3,644.58 ","$11,160.73 ","$6,519.38 ","$11,160.73 ",20210101
041,DRG,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",S,"$3,796.20 ","$15,793.40 ","$6,619.09 ","$15,793.40 ",20210101
042,DRG,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",S,"$3,830.97 ","$24,467.85 ","$6,397.47 ","$24,467.85 ",20210101
052,DRG,SPINAL DISORDERS AND INJURIES WITH CC/MCC,N,"$2,388.89 ","$3,202.42 ","$6,129.93 ","$3,202.42 ",20210101
053,DRG,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,N,"$2,039.10 ","$3,176.04 ","$5,375.84 ","$3,176.04 ",20210101
054,DRG,NERVOUS SYSTEM NEOPLASMS WITH MCC,N,"$3,363.16 ","$6,960.82 ","$6,012.60 ","$6,960.82 ",20210101
055,DRG,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,N,"$2,796.42 ","$5,474.62 ","$5,218.09 ","$5,474.62 ",20210101
056,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,N,"$2,197.18 ","$3,099.07 ","$4,881.82 ","$3,099.07 ",20210101
057,DRG,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,N,"$2,389.89 ","$2,317.33 ","$5,172.45 ","$2,317.33 ",20210101
058,DRG,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,N,"$2,669.65 ","$5,036.18 ","$5,240.69 ","$5,036.18 ",20210101
059,DRG,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,N,"$2,733.36 ","$4,995.09 ","$5,135.12 ","$4,995.09 ",20210101
060,DRG,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,N,"$2,945.44 ","$5,841.83 ","$5,388.18 ","$5,841.83 ",20210101
061,DRG,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",N,"$4,047.67 ","$17,597.16 ","$7,629.56 ","$17,597.16 ",20210101
062,DRG,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",N,"$4,025.41 ","$22,677.39 ","$7,455.81 ","$22,677.39 ",20210101
063,DRG,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",N,"$4,763.76 ","$31,198.80 ","$8,232.64 ","$31,198.80 ",20210101
064,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,N,"$3,502.66 ","$8,890.99 ","$6,573.91 ","$8,890.99 ",20210101
065,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,N,"$3,162.48 ","$8,767.37 ","$5,652.49 ","$8,767.37 ",20210101
066,DRG,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,N,"$2,477.27 ","$8,928.10 ","$4,429.59 ","$8,928.10 ",20210101
067,DRG,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCT WITH MCC,N,"$4,001.40 ","$12,216.94 ","$6,905.89 ","$12,216.94 ",20210101
068,DRG,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCT WITHOUT MCC,N,"$3,407.25 ","$13,569.33 ","$5,872.21 ","$13,569.33 ",20210101
069,DRG,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,N,"$3,199.57 ","$12,228.08 ","$5,315.21 ","$12,228.08 ",20210101
070,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,N,"$2,583.91 ","$5,680.05 ","$5,150.55 ","$5,680.05 ",20210101
071,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,N,"$2,342.53 ","$4,481.35 ","$4,599.87 ","$4,481.35 ",20210101
072,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,N,"$2,339.78 ","$5,769.19 ","$4,754.14 ","$5,769.19 ",20210101
073,DRG,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,N,"$2,951.34 ","$6,523.72 ","$5,586.60 ","$6,523.72 ",20210101
074,DRG,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,N,"$2,941.24 ","$6,605.65 ","$5,559.15 ","$6,605.65 ",20210101
075,DRG,VIRAL MENINGITIS WITH CC/MCC,N,"$3,059.69 ","$7,572.94 ","$5,123.09 ","$7,572.94 ",20210101
076,DRG,VIRAL MENINGITIS WITHOUT CC/MCC,N,"$2,840.73 ","$6,997.32 ","$4,708.10 ","$6,997.32 ",20210101
077,DRG,HYPERTENSIVE ENCEPHALOPATHY WITH MCC,N,"$3,396.22 ","$9,084.71 ","$6,412.94 ","$9,084.71 ",20210101
078,DRG,HYPERTENSIVE ENCEPHALOPATHY WITH CC,N,"$3,141.88 ","$8,570.63 ","$5,662.11 ","$8,570.63 ",20210101
079,DRG,HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,N,"$2,922.81 ","$9,598.60 ","$5,299.08 ","$9,598.60 ",20210101
080,DRG,NONTRAUMATIC STUPOR AND COMA WITH MCC,N,"$3,399.60 ","$7,148.19 ","$6,369.30 ","$7,148.19 ",20210101
081,DRG,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,N,"$3,019.66 ","$6,067.35 ","$5,540.91 ","$6,067.35 ",20210101
082,DRG,"TRAUMATIC STUPOR AND COMA, COMA >1 HOUR WITH MCC",N,"$3,771.88 ","$10,020.89 ","$7,793.93 ","$10,020.89 ",20210101
083,DRG,"TRAUMATIC STUPOR AND COMA, COMA >1 HOUR WITH CC",N,"$3,534.21 ","$8,394.45 ","$7,188.48 ","$8,394.45 ",20210101
084,DRG,"TRAUMATIC STUPOR AND COMA, COMA >1 HOUR WITHOUT CC/MCC",N,"$3,420.46 ","$10,122.94 ","$7,297.85 ","$10,122.94 ",20210101
085,DRG,"TRAUMATIC STUPOR AND COMA, COMA <1 HOUR WITH MCC",N,"$3,453.25 ","$8,157.92 ","$6,893.02 ","$8,157.92 ",20210101
086,DRG,"TRAUMATIC STUPOR AND COMA, COMA <1 HOUR WITH CC",N,"$3,770.92 ","$8,818.19 ","$7,415.64 ","$8,818.19 ",20210101
087,DRG,"TRAUMATIC STUPOR AND COMA, COMA <1 HOUR WITHOUT CC/MCC",N,"$3,299.42 ","$9,447.12 ","$6,803.53 ","$9,447.12 ",20210101
088,DRG,CONCUSSION WITH MCC,N,"$3,282.77 ","$10,524.92 ","$6,932.00 ","$10,524.92 ",20210101
089,DRG,CONCUSSION WITH CC,N,"$3,541.47 ","$11,807.57 ","$7,361.26 ","$11,807.57 ",20210101
090,DRG,CONCUSSION WITHOUT CC/MCC,N,"$3,930.18 ","$15,214.63 ","$7,449.13 ","$15,214.63 ",20210101
091,DRG,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,N,"$2,215.06 ","$4,605.74 ","$5,465.37 ","$4,605.74 ",20210101
092,DRG,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,N,"$2,484.37 ","$4,550.33 ","$5,503.05 ","$4,550.33 ",20210101
093,DRG,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,N,"$2,368.61 ","$4,997.26 ","$5,322.50 ","$4,997.26 ",20210101
094,DRG,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,N,"$3,022.07 ","$7,326.90 ","$5,737.76 ","$7,326.90 ",20210101
095,DRG,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,N,"$2,789.91 ","$7,419.57 ","$5,252.60 ","$7,419.57 ",20210101
096,DRG,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,N,"$2,722.87 ","$10,097.03 ","$5,245.65 ","$10,097.03 ",20210101
097,DRG,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,N,"$3,306.38 ","$8,513.74 ","$5,919.85 ","$8,513.74 ",20210101
098,DRG,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,N,"$3,178.35 ","$7,515.85 ","$5,585.28 ","$7,515.85 ",20210101
099,DRG,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,N,"$2,510.54 ","$7,138.63 ","$4,406.93 ","$7,138.63 ",20210101
100,DRG,SEIZURES WITH MCC,N,"$3,426.20 ","$8,886.12 ","$6,431.85 ","$8,886.12 ",20210101
101,DRG,SEIZURES WITHOUT MCC,N,"$3,384.11 ","$7,771.40 ","$5,411.44 ","$7,771.40 ",20210101
102,DRG,HEADACHES WITH MCC,N,"$3,436.96 ","$9,188.95 ","$5,952.63 ","$9,188.95 ",20210101
103,DRG,HEADACHES WITHOUT MCC,N,"$2,753.03 ","$8,039.18 ","$4,712.16 ","$8,039.18 ",20210101
113,DRG,ORBITAL PROCEDURES WITH CC/MCC,S,"$3,648.66 ","$13,733.87 ","$7,477.01 ","$13,733.87 ",20210101
114,DRG,ORBITAL PROCEDURES WITHOUT CC/MCC,S,"$3,398.94 ","$18,409.80 ","$7,746.80 ","$18,409.80 ",20210101
115,DRG,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,S,"$3,850.80 ","$12,646.93 ","$6,561.08 ","$12,646.93 ",20210101
116,DRG,INTRAOCULAR PROCEDURES WITH CC/MCC,S,"$3,534.59 ","$9,725.08 ","$6,109.93 ","$9,725.08 ",20210101
117,DRG,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,S,"$4,017.55 ","$18,085.02 ","$8,235.66 ","$18,085.02 ",20210101
121,DRG,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,N,"$3,321.89 ","$4,266.67 ","$5,882.50 ","$4,266.67 ",20210101
122,DRG,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,N,"$3,039.69 ","$3,513.63 ","$6,440.62 ","$3,513.63 ",20210101
123,DRG,NEUROLOGICAL EYE DISORDERS,N,"$3,229.38 ","$11,349.28 ","$5,374.74 ","$11,349.28 ",20210101
124,DRG,OTHER DISORDERS OF THE EYE WITH MCC,N,"$4,103.59 ","$8,144.07 ","$6,981.48 ","$8,144.07 ",20210101
125,DRG,OTHER DISORDERS OF THE EYE WITHOUT MCC,N,"$3,414.05 ","$6,872.92 ","$5,445.96 ","$6,872.92 ",20210101
135,DRG,SINUS AND MASTOID PROCEDURES WITH CC/MCC,S,"$3,705.75 ","$14,650.27 ","$6,092.06 ","$14,650.27 ",20210101
136,DRG,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,S,"$4,020.14 ","$26,684.19 ","$6,516.64 ","$26,684.19 ",20210101
137,DRG,MOUTH PROCEDURES WITH CC/MCC,S,"$3,151.49 ","$8,868.68 ","$5,849.84 ","$8,868.68 ",20210101
138,DRG,MOUTH PROCEDURES WITHOUT CC/MCC,S,"$3,807.07 ","$14,158.49 ","$6,128.17 ","$14,158.49 ",20210101
139,DRG,SALIVARY GLAND PROCEDURES,S,"$3,803.03 ","$19,116.31 ","$6,941.74 ","$19,116.31 ",20210101
140,DRG,MAJOR HEAD AND NECK PROCEDURES WITH MCC,S,"$3,964.33 ","$16,503.28 ","$8,217.28 ","$16,503.28 ",20210101
141,DRG,MAJOR HEAD AND NECK PROCEDURES WITH CC,S,"$3,904.83 ","$21,579.17 ","$7,024.14 ","$21,579.17 ",20210101
142,DRG,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,S,"$4,493.33 ","$35,651.80 ","$8,527.50 ","$35,651.80 ",20210101
143,DRG,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",S,"$3,705.18 ","$13,010.13 ","$6,832.60 ","$13,010.13 ",20210101
144,DRG,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",S,"$3,644.38 ","$16,792.00 ","$6,824.04 ","$16,792.00 ",20210101
145,DRG,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",S,"$4,349.30 ","$24,988.59 ","$7,652.98 ","$24,988.59 ",20210101
146,DRG,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",N,"$3,906.45 ","$7,269.93 ","$6,901.98 ","$7,269.93 ",20210101
147,DRG,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",N,"$3,851.20 ","$7,203.80 ","$6,102.72 ","$7,203.80 ",20210101
148,DRG,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",N,"$3,325.19 ","$8,454.61 ","$6,192.62 ","$8,454.61 ",20210101
149,DRG,DYSEQUILIBRIUM,N,"$3,523.81 ","$9,878.42 ","$5,492.52 ","$9,878.42 ",20210101
150,DRG,EPISTAXIS WITH MCC,N,"$3,401.38 ","$7,231.59 ","$5,890.49 ","$7,231.59 ",20210101
151,DRG,EPISTAXIS WITHOUT MCC,N,"$3,470.91 ","$6,297.31 ","$5,765.46 ","$6,297.31 ",20210101
152,DRG,OTITIS MEDIA AND URI WITH MCC,N,"$3,474.10 ","$6,701.19 ","$5,555.05 ","$6,701.19 ",20210101
153,DRG,OTITIS MEDIA AND URI WITHOUT MCC,N,"$3,057.69 ","$6,107.52 ","$4,939.72 ","$6,107.52 ",20210101
154,DRG,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",N,"$3,293.47 ","$7,084.63 ","$5,725.13 ","$7,084.63 ",20210101
155,DRG,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",N,"$3,205.06 ","$6,737.27 ","$5,443.26 ","$6,737.27 ",20210101
156,DRG,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",N,"$3,034.86 ","$6,893.48 ","$5,519.25 ","$6,893.48 ",20210101
157,DRG,DENTAL AND ORAL DISEASES WITH MCC,N,"$3,433.30 ","$7,424.44 ","$5,933.05 ","$7,424.44 ",20210101
158,DRG,DENTAL AND ORAL DISEASES WITH CC,N,"$3,346.05 ","$7,053.46 ","$5,366.28 ","$7,053.46 ",20210101
159,DRG,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,N,"$3,569.61 ","$8,487.08 ","$5,859.84 ","$8,487.08 ",20210101
163,DRG,MAJOR CHEST PROCEDURES WITH MCC,S,"$3,424.11 ","$13,042.85 ","$6,132.19 ","$13,042.85 ",20210101
164,DRG,MAJOR CHEST PROCEDURES WITH CC,S,"$3,904.58 ","$17,087.75 ","$5,743.83 ","$17,087.75 ",20210101
165,DRG,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,S,"$3,394.40 ","$20,510.12 ","$4,869.58 ","$20,510.12 ",20210101
166,DRG,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,S,"$3,743.25 ","$9,484.96 ","$5,522.59 ","$9,484.96 ",20210101
167,DRG,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,S,"$3,821.37 ","$12,564.64 ","$5,645.05 ","$12,564.64 ",20210101
168,DRG,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,S,"$3,693.13 ","$18,557.24 ","$5,630.74 ","$18,557.24 ",20210101
175,DRG,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,N,"$3,286.72 ","$8,381.23 ","$5,450.55 ","$8,381.23 ",20210101
176,DRG,PULMONARY EMBOLISM WITHOUT MCC,N,"$3,061.84 ","$7,943.00 ","$5,006.69 ","$7,943.00 ",20210101
177,DRG,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,N,"$3,049.54 ","$6,549.72 ","$5,064.68 ","$6,549.72 ",20210101
178,DRG,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,N,"$3,188.35 ","$6,381.51 ","$5,190.81 ","$6,381.51 ",20210101
179,DRG,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,N,"$2,885.02 ","$5,934.93 ","$5,017.48 ","$5,934.93 ",20210101
180,DRG,RESPIRATORY NEOPLASMS WITH MCC,N,"$3,294.68 ","$7,809.68 ","$5,311.20 ","$7,809.68 ",20210101
181,DRG,RESPIRATORY NEOPLASMS WITH CC,N,"$3,420.10 ","$8,080.72 ","$5,292.56 ","$8,080.72 ",20210101
182,DRG,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,N,"$2,634.11 ","$8,477.33 ","$4,357.22 ","$8,477.33 ",20210101
183,DRG,MAJOR CHEST TRAUMA WITH MCC,N,"$3,372.99 ","$7,294.19 ","$6,801.74 ","$7,294.19 ",20210101
184,DRG,MAJOR CHEST TRAUMA WITH CC,N,"$3,498.40 ","$7,897.24 ","$7,186.56 ","$7,897.24 ",20210101
185,DRG,MAJOR CHEST TRAUMA WITHOUT CC/MCC,N,"$3,896.89 ","$9,023.88 ","$8,395.16 ","$9,023.88 ",20210101
186,DRG,PLEURAL EFFUSION WITH MCC,N,"$2,987.91 ","$6,830.87 ","$4,672.72 ","$6,830.87 ",20210101
187,DRG,PLEURAL EFFUSION WITH CC,N,"$3,047.41 ","$6,932.69 ","$4,772.65 ","$6,932.69 ",20210101
188,DRG,PLEURAL EFFUSION WITHOUT CC/MCC,N,"$2,715.98 ","$6,897.78 ","$4,254.89 ","$6,897.78 ",20210101
189,DRG,PULMONARY EDEMA AND RESPIRATORY FAILURE,N,"$2,970.44 ","$5,918.17 ","$4,643.16 ","$5,918.17 ",20210101
190,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,N,"$2,573.00 ","$6,127.20 ","$4,424.45 ","$6,127.20 ",20210101
191,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,N,"$2,708.24 ","$6,213.64 ","$4,526.01 ","$6,213.64 ",20210101
192,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,N,"$2,315.97 ","$5,593.51 ","$4,200.09 ","$5,593.51 ",20210101
193,DRG,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,N,"$2,863.38 ","$6,580.80 ","$4,774.22 ","$6,580.80 ",20210101
194,DRG,SIMPLE PNEUMONIA AND PLEURISY WITH CC,N,"$2,726.86 ","$5,865.45 ","$4,553.58 ","$5,865.45 ",20210101
195,DRG,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,N,"$2,297.32 ","$4,940.98 ","$4,090.96 ","$4,940.98 ",20210101
196,DRG,INTERSTITIAL LUNG DISEASE WITH MCC,N,"$3,570.13 ","$6,984.03 ","$5,909.90 ","$6,984.03 ",20210101
197,DRG,INTERSTITIAL LUNG DISEASE WITH CC,N,"$3,152.63 ","$6,555.67 ","$5,136.45 ","$6,555.67 ",20210101
198,DRG,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,N,"$3,430.79 ","$8,068.94 ","$5,949.95 ","$8,068.94 ",20210101
199,DRG,PNEUMOTHORAX WITH MCC,N,"$3,050.13 ","$6,478.35 ","$5,399.03 ","$6,478.35 ",20210101
200,DRG,PNEUMOTHORAX WITH CC,N,"$3,081.42 ","$6,749.60 ","$5,510.56 ","$6,749.60 ",20210101
201,DRG,PNEUMOTHORAX WITHOUT CC/MCC,N,"$2,489.40 ","$5,639.30 ","$3,919.64 ","$5,639.30 ",20210101
202,DRG,BRONCHITIS AND ASTHMA WITH CC/MCC,N,"$2,957.23 ","$6,462.72 ","$4,881.31 ","$6,462.72 ",20210101
203,DRG,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,N,"$2,571.95 ","$5,471.19 ","$4,582.03 ","$5,471.19 ",20210101
204,DRG,RESPIRATORY SIGNS AND SYMPTOMS,N,"$3,147.25 ","$8,475.04 ","$4,951.16 ","$8,475.04 ",20210101
205,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,N,"$3,499.46 ","$7,913.89 ","$5,783.31 ","$7,913.89 ",20210101
206,DRG,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,N,"$3,360.62 ","$8,671.30 ","$5,547.09 ","$8,671.30 ",20210101
207,DRG,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,N,"$3,556.43 ","$8,418.35 ","$5,692.70 ","$8,418.35 ",20210101
208,DRG,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,N,"$3,162.51 ","$10,050.49 ","$5,884.01 ","$10,050.49 ",20210101
215,DRG,OTHER HEART ASSIST SYSTEM IMPLANT,S,"$3,415.80 ","$43,400.01 ","$6,906.83 ","$43,400.01 ",20210101
216,DRG,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,S,"$3,844.62 ","$21,638.97 ","$6,607.30 ","$21,638.97 ",20210101
217,DRG,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,S,"$3,866.39 ","$25,308.21 ","$6,218.90 ","$25,308.21 ",20210101
218,DRG,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,S,"$3,577.16 ","$32,590.04 ","$6,197.86 ","$32,590.04 ",20210101
219,DRG,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,S,"$4,220.32 ","$26,236.38 ","$7,282.37 ","$26,236.38 ",20210101
220,DRG,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,S,"$4,197.55 ","$30,294.19 ","$6,615.56 ","$30,294.19 ",20210101
221,DRG,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,S,"$3,802.45 ","$36,781.31 ","$6,248.55 ","$36,781.31 ",20210101
222,DRG,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI/HF/SHOCK WITH MCC,S,"$3,531.88 ","$25,240.96 ","$6,081.04 ","$25,240.96 ",20210101
223,DRG,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI/HF/SHOCK WITHOUT MCC,S,"$3,855.23 ","$38,966.78 ","$5,716.98 ","$38,966.78 ",20210101
224,DRG,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI/HF/SHOCK WITH MCC,S,"$3,548.95 ","$29,666.95 ","$6,401.53 ","$29,666.95 ",20210101
225,DRG,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI/HF/SHOCK WITHOUT MCC,S,"$3,360.89 ","$42,809.85 ","$5,303.52 ","$42,809.85 ",20210101
226,DRG,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC,S,"$3,521.19 ","$29,910.85 ","$6,058.69 ","$29,910.85 ",20210101
227,DRG,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,S,"$3,372.57 ","$46,409.30 ","$5,069.49 ","$46,409.30 ",20210101
228,DRG,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,S,"$3,451.29 ","$21,813.54 ","$6,228.97 ","$21,813.54 ",20210101
229,DRG,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,S,"$3,065.54 ","$28,801.88 ","$5,318.02 ","$28,801.88 ",20210101
231,DRG,CORONARY BYPASS WITH PTCA WITH MCC,S,"$3,265.91 ","$26,442.76 ","$6,076.45 ","$26,442.76 ",20210101
232,DRG,CORONARY BYPASS WITH PTCA WITHOUT MCC,S,"$3,247.81 ","$28,371.53 ","$5,913.97 ","$28,371.53 ",20210101
233,DRG,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC,S,"$3,438.97 ","$21,135.52 ","$6,061.52 ","$21,135.52 ",20210101
234,DRG,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC,S,"$3,215.05 ","$22,438.46 ","$5,445.69 ","$22,438.46 ",20210101
235,DRG,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,S,"$3,818.04 ","$21,170.42 ","$6,464.93 ","$21,170.42 ",20210101
236,DRG,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,S,"$3,422.53 ","$23,133.57 ","$5,615.97 ","$23,133.57 ",20210101
239,DRG,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,S,"$2,992.01 ","$8,924.75 ","$4,949.53 ","$8,924.75 ",20210101
240,DRG,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,S,"$2,919.68 ","$8,533.67 ","$4,496.60 ","$8,533.67 ",20210101
241,DRG,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,S,"$2,609.29 ","$8,694.75 ","$4,477.83 ","$8,694.75 ",20210101
242,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,S,"$3,746.34 ","$19,196.67 ","$6,279.79 ","$19,196.67 ",20210101
243,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,S,"$3,603.61 ","$23,784.22 ","$5,631.48 ","$23,784.22 ",20210101
244,DRG,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,S,"$3,598.75 ","$31,210.83 ","$5,664.06 ","$31,210.83 ",20210101
245,DRG,AICD GENERATOR PROCEDURES,S,"$3,744.18 ","$30,423.12 ","$5,924.04 ","$30,423.12 ",20210101
246,DRG,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS,S,"$3,628.83 ","$26,937.25 ","$6,087.32 ","$26,937.25 ",20210101
247,DRG,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC,S,"$3,457.25 ","$39,451.62 ","$5,356.78 ","$39,451.62 ",20210101
248,DRG,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS,S,"$3,133.34 ","$22,198.90 ","$5,606.28 ","$22,198.90 ",20210101
249,DRG,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC,S,"$2,994.12 ","$33,108.35 ","$5,065.99 ","$33,108.35 ",20210101
250,DRG,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC,S,"$3,281.14 ","$20,026.00 ","$5,729.47 ","$20,026.00 ",20210101
251,DRG,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC,S,"$3,539.10 ","$30,972.42 ","$5,531.84 ","$30,972.42 ",20210101
252,DRG,OTHER VASCULAR PROCEDURES WITH MCC,S,"$3,526.38 ","$14,924.37 ","$5,984.75 ","$14,924.37 ",20210101
253,DRG,OTHER VASCULAR PROCEDURES WITH CC,S,"$3,677.59 ","$19,302.57 ","$5,782.23 ","$19,302.57 ",20210101
254,DRG,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,S,"$3,251.39 ","$27,708.43 ","$5,397.27 ","$27,708.43 ",20210101
255,DRG,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,S,"$3,347.85 ","$9,149.40 ","$5,318.86 ","$9,149.40 ",20210101
256,DRG,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,S,"$3,238.32 ","$8,643.56 ","$5,000.12 ","$8,643.56 ",20210101
257,DRG,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,S,"$2,850.62 ","$7,887.05 ","$4,045.39 ","$7,887.05 ",20210101
258,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,S,"$4,473.45 ","$18,462.07 ","$7,041.82 ","$18,462.07 ",20210101
259,DRG,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,S,"$4,588.85 ","$26,898.67 ","$6,405.39 ","$26,898.67 ",20210101
260,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,S,"$3,628.65 ","$12,850.63 ","$6,046.65 ","$12,850.63 ",20210101
261,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,S,"$4,014.20 ","$18,606.34 ","$5,793.80 ","$18,606.34 ",20210101
262,DRG,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,S,"$4,097.90 ","$25,302.43 ","$5,807.65 ","$25,302.43 ",20210101
263,DRG,VEIN LIGATION AND STRIPPING,S,"$3,470.96 ","$13,494.40 ","$5,709.39 ","$13,494.40 ",20210101
264,DRG,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,S,"$3,762.70 ","$9,750.56 ","$5,807.10 ","$9,750.56 ",20210101
265,DRG,AICD LEAD PROCEDURES,S,"$3,654.89 ","$26,438.04 ","$6,381.39 ","$26,438.04 ",20210101
266,DRG,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,S,"$4,010.44 ","$44,457.80 ","$7,099.18 ","$44,457.80 ",20210101
267,DRG,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,S,"$5,513.95 ","$90,450.40 ","$9,527.17 ","$90,450.40 ",20210101
268,DRG,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,S,"$2,935.66 ","$22,468.01 ","$5,305.39 ","$22,468.01 ",20210101
269,DRG,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,S,"$2,761.95 ","$58,052.45 ","$4,793.04 ","$58,052.45 ",20210101
270,DRG,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,S,"$3,308.23 ","$18,832.78 ","$6,088.02 ","$18,832.78 ",20210101
271,DRG,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,S,"$3,258.16 ","$23,012.81 ","$5,405.36 ","$23,012.81 ",20210101
272,DRG,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,S,"$3,219.49 ","$40,529.27 ","$5,500.72 ","$40,529.27 ",20210101
273,DRG,PERCUTANEOUS INTRACARDIAC PROCEDURES WITH MCC,S,"$3,886.34 ","$26,555.17 ","$6,582.89 ","$26,555.17 ",20210101
274,DRG,PERCUTANEOUS INTRACARDIAC PROCEDURES WITHOUT MCC,S,"$3,519.75 ","$58,657.96 ","$5,479.38 ","$58,657.96 ",20210101
280,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",N,"$3,655.96 ","$9,047.01 ","$5,963.09 ","$9,047.01 ",20210101
281,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",N,"$3,641.64 ","$10,883.63 ","$5,694.81 ","$10,883.63 ",20210101
282,DRG,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",N,"$3,596.29 ","$14,199.75 ","$5,535.36 ","$14,199.75 ",20210101
283,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",N,"$3,943.03 ","$13,397.56 ","$7,230.70 ","$13,397.56 ",20210101
284,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",N,"$3,453.00 ","$11,017.98 ","$5,855.58 ","$11,017.98 ",20210101
285,DRG,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",N,"$2,560.38 ","$10,698.61 ","$5,310.35 ","$10,698.61 ",20210101
286,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",N,"$3,553.76 ","$10,102.53 ","$5,774.02 ","$10,102.53 ",20210101
287,DRG,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",N,"$3,329.24 ","$15,491.27 ","$4,981.81 ","$15,491.27 ",20210101
288,DRG,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,N,"$3,234.20 ","$5,235.72 ","$4,477.39 ","$5,235.72 ",20210101
289,DRG,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,N,"$2,928.97 ","$4,368.73 ","$4,114.65 ","$4,368.73 ",20210101
290,DRG,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,N,"$3,457.23 ","$5,493.01 ","$4,534.68 ","$5,493.01 ",20210101
291,DRG,HEART FAILURE AND SHOCK WITH MCC,N,"$3,085.44 ","$5,989.29 ","$4,959.81 ","$5,989.29 ",20210101
292,DRG,HEART FAILURE AND SHOCK WITH CC,N,"$2,933.46 ","$5,016.49 ","$4,677.67 ","$5,016.49 ",20210101
293,DRG,HEART FAILURE AND SHOCK WITHOUT CC/MCC,N,"$2,804.54 ","$5,393.15 ","$4,727.34 ","$5,393.15 ",20210101
294,DRG,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,N,"$3,323.56 ","$7,498.69 ","$5,974.78 ","$7,498.69 ",20210101
295,DRG,DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,N,"$3,014.09 ","$5,784.53 ","$6,023.47 ","$5,784.53 ",20210101
296,DRG,"CARDIAC ARREST, UNEXPLAINED WITH MCC",N,"$3,916.78 ","$17,671.83 ","$7,297.34 ","$17,671.83 ",20210101
297,DRG,"CARDIAC ARREST, UNEXPLAINED WITH CC",N,"$2,903.17 ","$11,507.97 ","$6,381.70 ","$11,507.97 ",20210101
298,DRG,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",N,"$2,990.81 ","$10,463.68 ","$7,245.21 ","$10,463.68 ",20210101
299,DRG,PERIPHERAL VASCULAR DISORDERS WITH MCC,N,"$3,606.71 ","$7,762.34 ","$6,106.14 ","$7,762.34 ",20210101
300,DRG,PERIPHERAL VASCULAR DISORDERS WITH CC,N,"$3,455.43 ","$6,720.34 ","$5,810.13 ","$6,720.34 ",20210101
301,DRG,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,N,"$3,167.22 ","$7,145.82 ","$5,791.62 ","$7,145.82 ",20210101
302,DRG,ATHEROSCLEROSIS WITH MCC,N,"$4,113.19 ","$9,074.06 ","$6,848.98 ","$9,074.06 ",20210101
303,DRG,ATHEROSCLEROSIS WITHOUT MCC,N,"$3,799.07 ","$9,406.43 ","$6,250.76 ","$9,406.43 ",20210101
304,DRG,HYPERTENSION WITH MCC,N,"$3,243.01 ","$7,451.14 ","$5,392.41 ","$7,451.14 ",20210101
305,DRG,HYPERTENSION WITHOUT MCC,N,"$2,940.99 ","$7,324.10 ","$4,679.08 ","$7,324.10 ",20210101
306,DRG,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,N,"$4,856.91 ","$8,124.59 ","$7,590.70 ","$8,124.59 ",20210101
307,DRG,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,N,"$4,565.38 ","$9,299.10 ","$7,206.78 ","$9,299.10 ",20210101
308,DRG,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,N,"$3,255.47 ","$6,860.56 ","$5,178.20 ","$6,860.56 ",20210101
309,DRG,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,N,"$3,114.59 ","$6,427.46 ","$4,793.36 ","$6,427.46 ",20210101
310,DRG,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,N,"$2,959.37 ","$6,706.00 ","$4,575.85 ","$6,706.00 ",20210101
311,DRG,ANGINA PECTORIS,N,"$3,544.13 ","$8,281.87 ","$4,912.31 ","$8,281.87 ",20210101
312,DRG,SYNCOPE AND COLLAPSE,N,"$3,392.86 ","$8,405.45 ","$5,248.74 ","$8,405.45 ",20210101
313,DRG,CHEST PAIN,N,"$3,573.14 ","$11,439.02 ","$5,195.67 ","$11,439.02 ",20210101
314,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,N,"$3,340.77 ","$7,971.87 ","$5,714.32 ","$7,971.87 ",20210101
315,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,N,"$3,459.93 ","$7,917.35 ","$5,676.12 ","$7,917.35 ",20210101
316,DRG,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,N,"$2,945.06 ","$9,019.17 ","$4,877.03 ","$9,019.17 ",20210101
319,DRG,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,S,"$1,711.12 ","$17,589.11 ","$2,796.09 ","$17,589.11 ",20210101
320,DRG,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,S,"$1,739.89 ","$27,669.57 ","$2,428.03 ","$27,669.57 ",20210101
326,DRG,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",S,"$3,245.70 ","$12,246.16 ","$6,089.12 ","$12,246.16 ",20210101
327,DRG,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",S,"$3,702.81 ","$15,476.40 ","$6,464.49 ","$15,476.40 ",20210101
328,DRG,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",S,"$3,437.06 ","$23,952.60 ","$5,942.60 ","$23,952.60 ",20210101
329,DRG,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,S,"$3,066.16 ","$11,019.08 ","$5,691.27 ","$11,019.08 ",20210101
330,DRG,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,S,"$3,239.94 ","$12,567.55 ","$5,444.56 ","$12,567.55 ",20210101
331,DRG,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,S,"$3,046.16 ","$17,148.70 ","$4,925.84 ","$17,148.70 ",20210101
332,DRG,RECTAL RESECTION WITH MCC,S,"$3,585.91 ","$13,421.26 ","$6,914.31 ","$13,421.26 ",20210101
333,DRG,RECTAL RESECTION WITH CC,S,"$3,584.55 ","$16,052.63 ","$5,832.75 ","$16,052.63 ",20210101
334,DRG,RECTAL RESECTION WITHOUT CC/MCC,S,"$3,417.60 ","$20,629.84 ","$5,822.61 ","$20,629.84 ",20210101
335,DRG,PERITONEAL ADHESIOLYSIS WITH MCC,S,"$3,227.00 ","$10,576.17 ","$6,011.76 ","$10,576.17 ",20210101
336,DRG,PERITONEAL ADHESIOLYSIS WITH CC,S,"$3,097.15 ","$10,156.79 ","$5,256.51 ","$10,156.79 ",20210101
337,DRG,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,S,"$2,937.27 ","$12,291.78 ","$4,838.50 ","$12,291.78 ",20210101
338,DRG,APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC,S,"$2,602.73 ","$10,380.68 ","$5,149.63 ","$10,380.68 ",20210101
339,DRG,APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC,S,"$2,755.58 ","$10,635.08 ","$4,769.56 ","$10,635.08 ",20210101
340,DRG,APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,S,"$2,759.14 ","$14,633.10 ","$4,456.74 ","$14,633.10 ",20210101
341,DRG,APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC,S,"$2,858.65 ","$12,279.16 ","$5,112.59 ","$12,279.16 ",20210101
342,DRG,APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC,S,"$3,027.94 ","$15,134.37 ","$4,986.20 ","$15,134.37 ",20210101
343,DRG,APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,S,"$3,033.67 ","$21,610.79 ","$4,845.13 ","$21,610.79 ",20210101
344,DRG,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,S,"$2,936.70 ","$8,576.33 ","$5,149.33 ","$8,576.33 ",20210101
345,DRG,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,S,"$3,164.37 ","$9,837.44 ","$5,348.70 ","$9,837.44 ",20210101
346,DRG,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,S,"$2,949.85 ","$12,225.45 ","$4,661.05 ","$12,225.45 ",20210101
347,DRG,ANAL AND STOMAL PROCEDURES WITH MCC,S,"$3,263.66 ","$9,839.54 ","$5,765.17 ","$9,839.54 ",20210101
348,DRG,ANAL AND STOMAL PROCEDURES WITH CC,S,"$3,462.72 ","$11,419.47 ","$5,646.74 ","$11,419.47 ",20210101
349,DRG,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,S,"$3,342.44 ","$15,301.43 ","$5,405.19 ","$15,301.43 ",20210101
350,DRG,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,S,"$3,163.14 ","$11,929.65 ","$5,744.86 ","$11,929.65 ",20210101
351,DRG,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,S,"$3,601.86 ","$14,952.22 ","$5,815.20 ","$14,952.22 ",20210101
352,DRG,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,S,"$3,688.85 ","$21,139.42 ","$6,129.63 ","$21,139.42 ",20210101
353,DRG,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,S,"$3,057.99 ","$12,909.18 ","$6,008.33 ","$12,909.18 ",20210101
354,DRG,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,S,"$3,255.68 ","$14,936.38 ","$5,604.10 ","$14,936.38 ",20210101
355,DRG,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,S,"$3,160.12 ","$19,430.44 ","$5,307.88 ","$19,430.44 ",20210101
356,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,S,"$3,343.87 ","$11,915.50 ","$6,007.18 ","$11,915.50 ",20210101
357,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,S,"$3,422.14 ","$13,157.55 ","$5,902.62 ","$13,157.55 ",20210101
358,DRG,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,S,"$2,841.74 ","$14,259.57 ","$5,032.52 ","$14,259.57 ",20210101
368,DRG,MAJOR ESOPHAGEAL DISORDERS WITH MCC,N,"$3,382.84 ","$9,192.04 ","$5,923.33 ","$9,192.04 ",20210101
369,DRG,MAJOR ESOPHAGEAL DISORDERS WITH CC,N,"$3,149.64 ","$8,433.06 ","$5,291.85 ","$8,433.06 ",20210101
370,DRG,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,N,"$2,858.80 ","$8,316.64 ","$4,896.58 ","$8,316.64 ",20210101
371,DRG,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,N,"$3,108.53 ","$5,653.79 ","$4,937.42 ","$5,653.79 ",20210101
372,DRG,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,N,"$2,939.39 ","$5,102.84 ","$4,658.85 ","$5,102.84 ",20210101
373,DRG,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,N,"$2,807.39 ","$5,189.17 ","$4,495.31 ","$5,189.17 ",20210101
374,DRG,DIGESTIVE MALIGNANCY WITH MCC,N,"$3,567.25 ","$6,891.72 ","$5,541.46 ","$6,891.72 ",20210101
375,DRG,DIGESTIVE MALIGNANCY WITH CC,N,"$3,450.92 ","$7,272.64 ","$5,294.88 ","$7,272.64 ",20210101
376,DRG,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,N,"$3,015.54 ","$8,835.18 ","$4,733.64 ","$8,835.18 ",20210101
377,DRG,GASTROINTESTINAL HEMORRHAGE WITH MCC,N,"$3,229.82 ","$8,429.05 ","$5,590.58 ","$8,429.05 ",20210101
378,DRG,GASTROINTESTINAL HEMORRHAGE WITH CC,N,"$3,107.74 ","$8,040.06 ","$5,187.40 ","$8,040.06 ",20210101
379,DRG,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,N,"$2,994.46 ","$7,724.18 ","$4,933.82 ","$7,724.18 ",20210101
380,DRG,COMPLICATED PEPTIC ULCER WITH MCC,N,"$3,160.82 ","$7,787.45 ","$5,495.44 ","$7,787.45 ",20210101
381,DRG,COMPLICATED PEPTIC ULCER WITH CC,N,"$3,143.05 ","$8,113.84 ","$5,193.96 ","$8,113.84 ",20210101
382,DRG,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,N,"$2,787.96 ","$7,959.18 ","$4,695.47 ","$7,959.18 ",20210101
383,DRG,UNCOMPLICATED PEPTIC ULCER WITH MCC,N,"$3,037.74 ","$7,888.49 ","$4,782.32 ","$7,888.49 ",20210101
384,DRG,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,N,"$3,112.77 ","$9,851.50 ","$4,881.43 ","$9,851.50 ",20210101
385,DRG,INFLAMMATORY BOWEL DISEASE WITH MCC,N,"$3,215.48 ","$6,285.20 ","$5,167.58 ","$6,285.20 ",20210101
386,DRG,INFLAMMATORY BOWEL DISEASE WITH CC,N,"$3,053.07 ","$6,250.80 ","$4,971.46 ","$6,250.80 ",20210101
387,DRG,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,N,"$2,867.00 ","$6,182.07 ","$4,619.50 ","$6,182.07 ",20210101
388,DRG,GASTROINTESTINAL OBSTRUCTION WITH MCC,N,"$2,991.17 ","$5,974.41 ","$5,040.16 ","$5,974.41 ",20210101
389,DRG,GASTROINTESTINAL OBSTRUCTION WITH CC,N,"$2,894.52 ","$5,434.05 ","$4,673.23 ","$5,434.05 ",20210101
390,DRG,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,N,"$2,771.42 ","$5,341.67 ","$4,486.39 ","$5,341.67 ",20210101
391,DRG,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",N,"$3,036.46 ","$6,772.78 ","$4,862.41 ","$6,772.78 ",20210101
392,DRG,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",N,"$2,770.54 ","$6,692.96 ","$4,521.01 ","$6,692.96 ",20210101
393,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,N,"$3,219.42 ","$6,965.26 ","$5,340.67 ","$6,965.26 ",20210101
394,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,N,"$3,141.67 ","$6,732.00 ","$5,051.57 ","$6,732.00 ",20210101
395,DRG,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,N,"$3,115.47 ","$7,589.02 ","$5,030.39 ","$7,589.02 ",20210101
405,DRG,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",S,"$3,706.52 ","$14,553.81 ","$7,075.67 ","$14,553.81 ",20210101
406,DRG,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",S,"$4,014.44 ","$17,017.56 ","$6,850.53 ","$17,017.56 ",20210101
407,DRG,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",S,"$3,868.96 ","$19,472.53 ","$6,422.17 ","$19,472.53 ",20210101
408,DRG,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,S,"$3,619.01 ","$12,262.70 ","$6,716.89 ","$12,262.70 ",20210101
409,DRG,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,S,"$3,377.99 ","$12,732.67 ","$5,549.87 ","$12,732.67 ",20210101
410,DRG,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,S,"$3,350.58 ","$14,732.38 ","$5,454.59 ","$14,732.38 ",20210101
411,DRG,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,S,"$3,147.21 ","$13,843.87 ","$6,171.14 ","$13,843.87 ",20210101
412,DRG,CHOLECYSTECTOMY WITH C.D.E. WITH CC,S,"$3,175.98 ","$15,021.91 ","$5,544.75 ","$15,021.91 ",20210101
413,DRG,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,S,"$3,049.76 ","$16,690.27 ","$5,040.79 ","$16,690.27 ",20210101
414,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,S,"$3,228.97 ","$12,632.06 ","$5,965.22 ","$12,632.06 ",20210101
415,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,S,"$2,947.13 ","$12,508.99 ","$5,134.08 ","$12,508.99 ",20210101
416,DRG,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,S,"$2,635.45 ","$13,890.46 ","$4,651.70 ","$13,890.46 ",20210101
417,DRG,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,S,"$3,139.00 ","$14,134.09 ","$5,524.85 ","$14,134.09 ",20210101
418,DRG,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,S,"$3,091.28 ","$15,848.24 ","$5,060.64 ","$15,848.24 ",20210101
419,DRG,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,S,"$3,174.43 ","$20,188.49 ","$5,012.65 ","$20,188.49 ",20210101
420,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,S,"$3,519.75 ","$11,660.37 ","$6,439.25 ","$11,660.37 ",20210101
421,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,S,"$3,431.04 ","$13,239.63 ","$6,242.96 ","$13,239.63 ",20210101
422,DRG,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,S,"$3,671.91 ","$18,375.30 ","$6,182.79 ","$18,375.30 ",20210101
423,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,S,"$3,578.95 ","$11,038.49 ","$6,254.73 ","$11,038.49 ",20210101
424,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,S,"$3,994.96 ","$12,623.76 ","$6,249.79 ","$12,623.76 ",20210101
425,DRG,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,S,"$4,432.93 ","$20,439.44 ","$6,908.64 ","$20,439.44 ",20210101
432,DRG,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,N,"$3,171.83 ","$7,884.37 ","$5,634.14 ","$7,884.37 ",20210101
433,DRG,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,N,"$2,918.28 ","$6,621.46 ","$4,729.14 ","$6,621.46 ",20210101
434,DRG,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,N,"$2,697.98 ","$6,366.45 ","$4,599.05 ","$6,366.45 ",20210101
435,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,N,"$3,419.09 ","$8,321.59 ","$5,420.36 ","$8,321.59 ",20210101
436,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,N,"$3,461.38 ","$7,989.02 ","$5,263.27 ","$7,989.02 ",20210101
437,DRG,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,N,"$2,760.48 ","$8,906.96 ","$4,545.57 ","$8,906.96 ",20210101
438,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,N,"$2,937.01 ","$7,316.38 ","$5,161.76 ","$7,316.38 ",20210101
439,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,N,"$2,664.93 ","$6,128.52 ","$4,376.59 ","$6,128.52 ",20210101
440,DRG,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,N,"$2,529.37 ","$6,411.16 ","$4,153.99 ","$6,411.16 ",20210101
441,DRG,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS, ALCOHOLIC HEPATITIS WITH MCC",N,"$3,217.91 ","$7,646.36 ","$5,714.14 ","$7,646.36 ",20210101
442,DRG,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS, ALCOHOLIC HEPATITIS WITH CC",N,"$2,887.71 ","$6,111.69 ","$4,729.99 ","$6,111.69 ",20210101
443,DRG,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS, ALCOHOLIC HEPATITIS WITHOUT CC/MCC",N,"$2,706.07 ","$6,195.58 ","$4,423.74 ","$6,195.58 ",20210101
444,DRG,DISORDERS OF THE BILIARY TRACT WITH MCC,N,"$3,384.96 ","$8,824.36 ","$5,574.37 ","$8,824.36 ",20210101
445,DRG,DISORDERS OF THE BILIARY TRACT WITH CC,N,"$3,316.81 ","$9,489.18 ","$5,171.49 ","$9,489.18 ",20210101
446,DRG,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,N,"$3,186.59 ","$10,820.24 ","$4,996.18 ","$10,820.24 ",20210101
453,DRG,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC,S,"$3,436.98 ","$36,030.51 ","$7,213.19 ","$36,030.51 ",20210101
454,DRG,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC,S,"$3,136.85 ","$48,965.18 ","$6,459.37 ","$48,965.18 ",20210101
455,DRG,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC,S,"$2,752.56 ","$61,391.10 ","$5,521.43 ","$61,391.10 ",20210101
456,DRG,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSION WITH MCC,S,"$3,704.32 ","$27,362.01 ","$7,426.65 ","$27,362.01 ",20210101
457,DRG,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSION WITH CC,S,"$3,733.56 ","$40,525.26 ","$7,221.98 ","$40,525.26 ",20210101
458,DRG,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSION WITHOUT CC/MCC,S,"$3,138.53 ","$53,066.50 ","$6,026.44 ","$53,066.50 ",20210101
459,DRG,SPINAL FUSION EXCEPT CERVICAL WITH MCC,S,"$3,214.01 ","$26,079.87 ","$6,538.62 ","$26,079.87 ",20210101
460,DRG,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,S,"$3,040.03 ","$42,982.85 ","$5,950.24 ","$42,982.85 ",20210101
461,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,S,"$3,655.58 ","$25,173.80 ","$6,695.73 ","$25,173.80 ",20210101
462,DRG,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,S,"$3,225.48 ","$35,367.69 ","$4,461.96 ","$35,367.69 ",20210101
463,DRG,"WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC",S,"$3,457.48 ","$9,529.99 ","$5,977.96 ","$9,529.99 ",20210101
464,DRG,"WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC",S,"$3,322.35 ","$12,709.68 ","$5,957.43 ","$12,709.68 ",20210101
465,DRG,"WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC",S,"$3,529.77 ","$21,964.49 ","$6,725.80 ","$21,964.49 ",20210101
466,DRG,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,S,"$3,182.86 ","$19,359.51 ","$6,111.93 ","$19,359.51 ",20210101
467,DRG,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,S,"$3,267.34 ","$31,672.65 ","$5,516.73 ","$31,672.65 ",20210101
468,DRG,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,S,"$3,096.00 ","$45,922.93 ","$4,951.00 ","$45,922.93 ",20210101
469,DRG,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,S,"$3,953.15 ","$24,560.40 ","$7,468.81 ","$24,560.40 ",20210101
470,DRG,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,S,"$3,414.79 ","$35,853.07 ","$5,538.17 ","$35,853.07 ",20210101
471,DRG,CERVICAL SPINAL FUSION WITH MCC,S,"$3,433.05 ","$20,820.87 ","$7,124.38 ","$20,820.87 ",20210101
472,DRG,CERVICAL SPINAL FUSION WITH CC,S,"$3,554.10 ","$36,858.84 ","$6,851.30 ","$36,858.84 ",20210101
473,DRG,CERVICAL SPINAL FUSION WITHOUT CC/MCC,S,"$3,026.14 ","$52,665.61 ","$6,327.21 ","$52,665.61 ",20210101
474,DRG,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,S,"$3,089.43 ","$9,350.88 ","$5,574.56 ","$9,350.88 ",20210101
475,DRG,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,S,"$2,881.80 ","$8,573.33 ","$4,503.16 ","$8,573.33 ",20210101
476,DRG,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,S,"$3,247.38 ","$12,877.10 ","$5,601.64 ","$12,877.10 ",20210101
477,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,S,"$3,348.60 ","$9,926.89 ","$5,554.67 ","$9,926.89 ",20210101
478,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,S,"$3,334.26 ","$12,486.73 ","$5,242.29 ","$12,486.73 ",20210101
479,DRG,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,S,"$3,191.22 ","$16,627.51 ","$5,125.18 ","$16,627.51 ",20210101
480,DRG,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,S,"$2,936.79 ","$12,408.68 ","$5,423.18 ","$12,408.68 ",20210101
481,DRG,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,S,"$3,226.59 ","$15,205.94 ","$5,373.37 ","$15,205.94 ",20210101
482,DRG,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,S,"$3,402.81 ","$17,661.42 ","$5,559.50 ","$17,661.42 ",20210101
483,DRG,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,S,"$2,948.78 ","$52,718.35 ","$5,479.45 ","$52,718.35 ",20210101
485,DRG,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,S,"$3,245.87 ","$11,787.99 ","$5,767.93 ","$11,787.99 ",20210101
486,DRG,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,S,"$2,970.92 ","$11,971.37 ","$4,861.29 ","$11,971.37 ",20210101
487,DRG,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,S,"$2,626.77 ","$13,056.78 ","$4,007.87 ","$13,056.78 ",20210101
488,DRG,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,S,"$3,332.78 ","$16,804.38 ","$5,825.14 ","$16,804.38 ",20210101
489,DRG,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,S,"$3,264.71 ","$25,331.70 ","$5,091.00 ","$25,331.70 ",20210101
492,DRG,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT, FEMUR WITH MCC",S,"$3,248.48 ","$15,759.55 ","$6,330.40 ","$15,759.55 ",20210101
493,DRG,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT, FEMUR WITH CC",S,"$3,136.55 ","$17,511.64 ","$5,307.66 ","$17,511.64 ",20210101
494,DRG,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT, FEMUR WITHOUT CC/MCC",S,"$3,354.59 ","$23,013.44 ","$5,286.07 ","$23,013.44 ",20210101
495,DRG,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,S,"$3,668.69 ","$13,514.69 ","$6,707.75 ","$13,514.69 ",20210101
496,DRG,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,S,"$3,346.95 ","$16,345.89 ","$5,697.06 ","$16,345.89 ",20210101
497,DRG,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,S,"$3,433.33 ","$27,228.92 ","$6,119.78 ","$27,228.92 ",20210101
498,DRG,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,S,"$3,867.71 ","$13,216.82 ","$6,672.95 ","$13,216.82 ",20210101
499,DRG,LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,S,"$3,953.82 ","$24,477.48 ","$6,909.28 ","$24,477.48 ",20210101
500,DRG,SOFT TISSUE PROCEDURES WITH MCC,S,"$3,691.25 ","$9,195.35 ","$6,279.02 ","$9,195.35 ",20210101
501,DRG,SOFT TISSUE PROCEDURES WITH CC,S,"$3,240.75 ","$10,768.39 ","$5,685.99 ","$10,768.39 ",20210101
502,DRG,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,S,"$3,559.76 ","$18,215.31 ","$6,133.11 ","$18,215.31 ",20210101
503,DRG,FOOT PROCEDURES WITH MCC,S,"$3,664.25 ","$10,859.08 ","$6,327.55 ","$10,859.08 ",20210101
504,DRG,FOOT PROCEDURES WITH CC,S,"$3,442.52 ","$11,532.17 ","$5,511.86 ","$11,532.17 ",20210101
505,DRG,FOOT PROCEDURES WITHOUT CC/MCC,S,"$4,163.64 ","$23,039.38 ","$6,464.10 ","$23,039.38 ",20210101
506,DRG,MAJOR THUMB OR JOINT PROCEDURES,S,"$3,350.77 ","$11,142.56 ","$5,226.71 ","$11,142.56 ",20210101
507,DRG,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,S,"$3,402.47 ","$12,552.72 ","$5,441.10 ","$12,552.72 ",20210101
508,DRG,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,S,"$2,752.19 ","$19,568.76 ","$4,622.32 ","$19,568.76 ",20210101
509,DRG,ARTHROSCOPY,S,"$3,594.13 ","$12,083.57 ","$5,539.91 ","$12,083.57 ",20210101
510,DRG,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",S,"$3,491.41 ","$16,494.93 ","$6,796.20 ","$16,494.93 ",20210101
511,DRG,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",S,"$3,342.67 ","$18,986.58 ","$5,913.89 ","$18,986.58 ",20210101
512,DRG,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",S,"$3,441.51 ","$25,854.60 ","$5,540.71 ","$25,854.60 ",20210101
513,DRG,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",S,"$3,300.64 ","$10,514.19 ","$5,904.38 ","$10,514.19 ",20210101
514,DRG,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",S,"$3,473.75 ","$14,371.08 ","$5,426.32 ","$14,371.08 ",20210101
515,DRG,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,S,"$3,319.91 ","$12,575.44 ","$6,082.23 ","$12,575.44 ",20210101
516,DRG,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,S,"$3,523.49 ","$16,706.81 ","$5,974.41 ","$16,706.81 ",20210101
517,DRG,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,S,"$3,638.63 ","$24,552.75 ","$6,334.45 ","$24,552.75 ",20210101
518,DRG,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,S,"$3,816.83 ","$22,594.58 ","$7,577.07 ","$22,594.58 ",20210101
519,DRG,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,S,"$3,509.58 ","$18,299.23 ","$6,275.51 ","$18,299.23 ",20210101
520,DRG,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,S,"$3,755.74 ","$27,266.48 ","$6,423.76 ","$27,266.48 ",20210101
521,DRG,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,S,"$3,406.81 ","$15,507.31 ","$6,222.34 ","$15,507.31 ",20210101
522,DRG,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,S,"$3,120.40 ","$17,509.08 ","$5,072.89 ","$17,509.08 ",20210101
533,DRG,FRACTURES OF FEMUR WITH MCC,N,"$3,102.52 ","$6,324.07 ","$5,715.27 ","$6,324.07 ",20210101
534,DRG,FRACTURES OF FEMUR WITHOUT MCC,N,"$3,627.35 ","$5,799.58 ","$5,781.10 ","$5,799.58 ",20210101
535,DRG,FRACTURES OF HIP AND PELVIS WITH MCC,N,"$3,109.47 ","$6,283.14 ","$5,738.19 ","$6,283.14 ",20210101
536,DRG,FRACTURES OF HIP AND PELVIS WITHOUT MCC,N,"$3,096.73 ","$5,246.69 ","$5,499.92 ","$5,246.69 ",20210101
537,DRG,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",N,"$3,474.02 ","$6,650.24 ","$5,338.48 ","$6,650.24 ",20210101
538,DRG,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",N,"$3,379.38 ","$6,473.05 ","$5,117.23 ","$6,473.05 ",20210101
539,DRG,OSTEOMYELITIS WITH MCC,N,"$3,340.25 ","$4,237.22 ","$4,880.32 ","$4,237.22 ",20210101
540,DRG,OSTEOMYELITIS WITH CC,N,"$3,097.65 ","$4,392.11 ","$4,747.84 ","$4,392.11 ",20210101
541,DRG,OSTEOMYELITIS WITHOUT CC/MCC,N,"$2,594.57 ","$3,547.31 ","$4,766.40 ","$3,547.31 ",20210101
542,DRG,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,N,"$3,789.00 ","$7,367.45 ","$6,140.29 ","$7,367.45 ",20210101
543,DRG,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,N,"$3,837.12 ","$7,220.27 ","$5,913.28 ","$7,220.27 ",20210101
544,DRG,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,N,"$3,706.71 ","$6,966.89 ","$5,832.87 ","$6,966.89 ",20210101
545,DRG,CONNECTIVE TISSUE DISORDERS WITH MCC,N,"$3,371.28 ","$7,881.48 ","$6,214.92 ","$7,881.48 ",20210101
546,DRG,CONNECTIVE TISSUE DISORDERS WITH CC,N,"$3,259.72 ","$6,799.60 ","$5,402.38 ","$6,799.60 ",20210101
547,DRG,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,N,"$3,224.48 ","$7,062.96 ","$6,237.17 ","$7,062.96 ",20210101
548,DRG,SEPTIC ARTHRITIS WITH MCC,N,"$2,987.27 ","$5,161.88 ","$4,569.98 ","$5,161.88 ",20210101
549,DRG,SEPTIC ARTHRITIS WITH CC,N,"$3,013.79 ","$5,255.05 ","$4,785.30 ","$5,255.05 ",20210101
550,DRG,SEPTIC ARTHRITIS WITHOUT CC/MCC,N,"$2,719.46 ","$5,407.62 ","$4,484.49 ","$5,407.62 ",20210101
551,DRG,MEDICAL BACK PROBLEMS WITH MCC,N,"$3,417.10 ","$7,563.40 ","$6,875.99 ","$7,563.40 ",20210101
552,DRG,MEDICAL BACK PROBLEMS WITHOUT MCC,N,"$3,914.57 ","$8,002.39 ","$7,499.99 ","$8,002.39 ",20210101
553,DRG,BONE DISEASES AND ARTHROPATHIES WITH MCC,N,"$4,139.85 ","$7,870.74 ","$6,835.30 ","$7,870.74 ",20210101
554,DRG,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,N,"$4,826.72 ","$6,973.32 ","$8,473.00 ","$6,973.32 ",20210101
555,DRG,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,N,"$2,371.66 ","$4,799.58 ","$4,883.79 ","$4,799.58 ",20210101
556,DRG,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,N,"$2,390.36 ","$4,353.40 ","$4,589.62 ","$4,353.40 ",20210101
557,DRG,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",N,"$2,923.41 ","$5,362.04 ","$4,905.23 ","$5,362.04 ",20210101
558,DRG,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",N,"$2,739.21 ","$4,742.15 ","$4,494.00 ","$4,742.15 ",20210101
559,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",N,"$2,052.14 ","$3,105.39 ","$4,535.63 ","$3,105.39 ",20210101
560,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",N,"$2,122.59 ","$2,704.28 ","$4,468.80 ","$2,704.28 ",20210101
561,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",N,"$1,861.74 ","$2,321.38 ","$4,619.18 ","$2,321.38 ",20210101
562,DRG,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",N,"$3,480.76 ","$7,798.74 ","$6,186.28 ","$7,798.74 ",20210101
563,DRG,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",N,"$3,835.67 ","$7,330.71 ","$6,323.80 ","$7,330.71 ",20210101
564,DRG,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,N,"$3,564.38 ","$7,081.49 ","$6,176.35 ","$7,081.49 ",20210101
565,DRG,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,N,"$3,007.79 ","$5,688.18 ","$5,219.40 ","$5,688.18 ",20210101
566,DRG,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,N,"$2,999.32 ","$6,052.76 ","$5,893.84 ","$6,052.76 ",20210101
570,DRG,SKIN DEBRIDEMENT WITH MCC,S,"$3,550.45 ","$6,282.50 ","$5,387.93 ","$6,282.50 ",20210101
571,DRG,SKIN DEBRIDEMENT WITH CC,S,"$3,449.44 ","$7,477.52 ","$5,916.80 ","$7,477.52 ",20210101
572,DRG,SKIN DEBRIDEMENT WITHOUT CC/MCC,S,"$3,761.83 ","$11,559.52 ","$6,757.98 ","$11,559.52 ",20210101
573,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,S,"$3,436.87 ","$7,622.47 ","$5,981.52 ","$7,622.47 ",20210101
574,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,S,"$3,523.41 ","$8,179.10 ","$6,165.90 ","$8,179.10 ",20210101
575,DRG,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,S,"$3,068.79 ","$8,636.75 ","$5,127.44 ","$8,636.75 ",20210101
576,DRG,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,S,"$3,797.04 ","$13,341.36 ","$7,823.52 ","$13,341.36 ",20210101
577,DRG,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,S,"$3,780.44 ","$15,003.17 ","$7,277.54 ","$15,003.17 ",20210101
578,DRG,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,S,"$4,491.53 ","$23,515.43 ","$8,848.60 ","$23,515.43 ",20210101
579,DRG,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",S,"$3,618.93 ","$8,106.90 ","$5,950.00 ","$8,106.90 ",20210101
580,DRG,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",S,"$3,739.12 ","$11,515.42 ","$6,293.10 ","$11,515.42 ",20210101
581,DRG,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",S,"$4,295.09 ","$24,478.57 ","$7,927.90 ","$24,478.57 ",20210101
582,DRG,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,S,"$4,203.60 ","$25,156.63 ","$7,707.84 ","$25,156.63 ",20210101
583,DRG,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,S,"$4,098.70 ","$38,563.05 ","$8,115.67 ","$38,563.05 ",20210101
584,DRG,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",S,"$4,017.23 ","$18,799.80 ","$7,203.14 ","$18,799.80 ",20210101
585,DRG,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",S,"$3,830.93 ","$31,995.55 ","$7,896.47 ","$31,995.55 ",20210101
592,DRG,SKIN ULCERS WITH MCC,N,"$3,057.21 ","$3,692.97 ","$4,640.77 ","$3,692.97 ",20210101
593,DRG,SKIN ULCERS WITH CC,N,"$2,699.73 ","$3,187.11 ","$4,383.91 ","$3,187.11 ",20210101
594,DRG,SKIN ULCERS WITHOUT CC/MCC,N,"$2,396.23 ","$3,095.06 ","$4,550.24 ","$3,095.06 ",20210101
595,DRG,MAJOR SKIN DISORDERS WITH MCC,N,"$3,988.95 ","$7,032.59 ","$7,647.28 ","$7,032.59 ",20210101
596,DRG,MAJOR SKIN DISORDERS WITHOUT MCC,N,"$3,216.09 ","$4,645.85 ","$5,634.82 ","$4,645.85 ",20210101
597,DRG,MALIGNANT BREAST DISORDERS WITH MCC,N,"$3,518.49 ","$6,791.15 ","$5,292.04 ","$6,791.15 ",20210101
598,DRG,MALIGNANT BREAST DISORDERS WITH CC,N,"$3,312.23 ","$6,263.26 ","$5,390.55 ","$6,263.26 ",20210101
599,DRG,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,N,"$4,452.15 ","$8,078.71 ","$7,720.92 ","$8,078.71 ",20210101
600,DRG,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,N,"$2,836.91 ","$4,887.97 ","$4,401.79 ","$4,887.97 ",20210101
601,DRG,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,N,"$2,931.90 ","$4,820.01 ","$4,974.52 ","$4,820.01 ",20210101
602,DRG,CELLULITIS WITH MCC,N,"$2,858.68 ","$5,193.08 ","$4,644.87 ","$5,193.08 ",20210101
603,DRG,CELLULITIS WITHOUT MCC,N,"$2,803.81 ","$4,497.16 ","$4,468.52 ","$4,497.16 ",20210101
604,DRG,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",N,"$3,844.20 ","$9,504.93 ","$6,683.86 ","$9,504.93 ",20210101
605,DRG,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",N,"$3,618.09 ","$8,345.57 ","$6,118.81 ","$8,345.57 ",20210101
606,DRG,MINOR SKIN DISORDERS WITH MCC,N,"$3,462.99 ","$5,539.97 ","$5,474.18 ","$5,539.97 ",20210101
607,DRG,MINOR SKIN DISORDERS WITHOUT MCC,N,"$3,297.14 ","$5,122.49 ","$5,328.30 ","$5,122.49 ",20210101
614,DRG,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,S,"$4,083.41 ","$21,329.98 ","$7,787.71 ","$21,329.98 ",20210101
615,DRG,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,S,"$3,761.12 ","$31,526.19 ","$7,290.27 ","$31,526.19 ",20210101
616,DRG,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL, AND METABOLIC DISORDERS WITH MCC",S,"$3,011.85 ","$8,805.16 ","$5,102.55 ","$8,805.16 ",20210101
617,DRG,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL, AND METABOLIC DISORDERS WITH CC",S,"$2,920.04 ","$8,530.94 ","$4,569.37 ","$8,530.94 ",20210101
618,DRG,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL, AND METABOLIC DISORDERS WITHOUT CC/MCC",S,"$2,925.53 ","$8,492.20 ","$4,170.60 ","$8,492.20 ",20210101
619,DRG,O.R. PROCEDURES FOR OBESITY WITH MCC,S,"$3,276.09 ","$23,204.56 ","$6,609.91 ","$23,204.56 ",20210101
620,DRG,O.R. PROCEDURES FOR OBESITY WITH CC,S,"$3,198.85 ","$33,097.74 ","$5,517.18 ","$33,097.74 ",20210101
621,DRG,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,S,"$2,884.59 ","$38,968.70 ","$4,784.96 ","$38,968.70 ",20210101
622,DRG,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL, AND METABOLIC DISORDERS WITH MCC",S,"$3,362.27 ","$6,964.08 ","$5,444.49 ","$6,964.08 ",20210101
623,DRG,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL, AND METABOLIC DISORDERS WITH CC",S,"$3,290.48 ","$7,565.95 ","$5,527.17 ","$7,565.95 ",20210101
624,DRG,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL, AND METABOLIC DISORDERS WITHOUT CC/MCC",S,"$3,467.12 ","$9,683.72 ","$6,252.03 ","$9,683.72 ",20210101
625,DRG,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",S,"$3,878.81 ","$16,434.03 ","$7,491.35 ","$16,434.03 ",20210101
626,DRG,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",S,"$3,837.58 ","$22,428.22 ","$6,514.88 ","$22,428.22 ",20210101
627,DRG,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",S,"$3,461.68 ","$32,089.34 ","$5,677.19 ","$32,089.34 ",20210101
628,DRG,"OTHER ENDOCRINE, NUTRITIONAL, AND METABOLIC O.R. PROCEDURES WITH MCC",S,"$3,318.49 ","$10,402.15 ","$5,706.26 ","$10,402.15 ",20210101
629,DRG,"OTHER ENDOCRINE, NUTRITIONAL, AND METABOLIC O.R. PROCEDURES WITH CC",S,"$3,070.02 ","$9,488.03 ","$4,960.45 ","$9,488.03 ",20210101
630,DRG,"OTHER ENDOCRINE, NUTRITIONAL, AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",S,"$3,550.71 ","$19,030.21 ","$6,030.47 ","$19,030.21 ",20210101
637,DRG,DIABETES WITH MCC,N,"$3,292.03 ","$6,761.57 ","$5,625.66 ","$6,761.57 ",20210101
638,DRG,DIABETES WITH CC,N,"$3,102.62 ","$5,636.44 ","$5,158.59 ","$5,636.44 ",20210101
639,DRG,DIABETES WITHOUT CC/MCC,N,"$2,946.86 ","$5,730.54 ","$5,056.93 ","$5,730.54 ",20210101
640,DRG,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",N,"$3,104.14 ","$6,259.41 ","$5,115.32 ","$6,259.41 ",20210101
641,DRG,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",N,"$2,894.15 ","$5,567.58 ","$4,891.55 ","$5,567.58 ",20210101
642,DRG,INBORN AND OTHER DISORDERS OF METABOLISM,N,"$3,491.17 ","$9,728.71 ","$6,613.15 ","$9,728.71 ",20210101
643,DRG,ENDOCRINE DISORDERS WITH MCC,N,"$3,609.46 ","$6,606.67 ","$6,096.87 ","$6,606.67 ",20210101
644,DRG,ENDOCRINE DISORDERS WITH CC,N,"$3,386.24 ","$5,786.41 ","$5,525.21 ","$5,786.41 ",20210101
645,DRG,ENDOCRINE DISORDERS WITHOUT CC/MCC,N,"$3,369.56 ","$6,037.85 ","$5,660.31 ","$6,037.85 ",20210101
650,DRG,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,S,"$3,654.99 ","$36,632.91 ","$7,990.66 ","$36,632.91 ",20210101
651,DRG,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,S,"$3,824.66 ","$40,407.91 ","$8,160.91 ","$40,407.91 ",20210101
652,DRG,KIDNEY TRANSPLANT,S,"$3,856.93 ","$47,519.82 ","$7,606.67 ","$47,519.82 ",20210101
653,DRG,MAJOR BLADDER PROCEDURES WITH MCC,S,"$3,228.01 ","$12,411.76 ","$5,989.16 ","$12,411.76 ",20210101
654,DRG,MAJOR BLADDER PROCEDURES WITH CC,S,"$3,642.29 ","$16,930.89 ","$6,135.09 ","$16,930.89 ",20210101
655,DRG,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,S,"$3,554.39 ","$21,557.45 ","$5,862.22 ","$21,557.45 ",20210101
656,DRG,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,S,"$3,499.89 ","$16,244.86 ","$6,537.19 ","$16,244.86 ",20210101
657,DRG,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,S,"$3,413.17 ","$20,211.28 ","$5,859.73 ","$20,211.28 ",20210101
658,DRG,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,S,"$3,216.00 ","$28,479.86 ","$5,417.72 ","$28,479.86 ",20210101
659,DRG,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,S,"$3,336.82 ","$10,617.64 ","$5,998.67 ","$10,617.64 ",20210101
660,DRG,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,S,"$3,489.19 ","$14,294.47 ","$5,716.64 ","$14,294.47 ",20210101
661,DRG,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,S,"$3,141.35 ","$21,603.13 ","$4,946.93 ","$21,603.13 ",20210101
662,DRG,MINOR BLADDER PROCEDURES WITH MCC,S,"$3,293.87 ","$8,587.37 ","$5,577.03 ","$8,587.37 ",20210101
663,DRG,MINOR BLADDER PROCEDURES WITH CC,S,"$3,140.03 ","$10,936.35 ","$5,299.52 ","$10,936.35 ",20210101
664,DRG,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,S,"$3,659.39 ","$21,043.33 ","$5,398.08 ","$21,043.33 ",20210101
665,DRG,PROSTATECTOMY WITH MCC,S,"$3,459.89 ","$9,185.06 ","$5,408.31 ","$9,185.06 ",20210101
666,DRG,PROSTATECTOMY WITH CC,S,"$3,461.69 ","$10,547.44 ","$5,272.44 ","$10,547.44 ",20210101
667,DRG,PROSTATECTOMY WITHOUT CC/MCC,S,"$3,161.49 ","$13,611.12 ","$4,842.31 ","$13,611.12 ",20210101
668,DRG,TRANSURETHRAL PROCEDURES WITH MCC,S,"$3,290.47 ","$9,070.04 ","$5,565.94 ","$9,070.04 ",20210101
669,DRG,TRANSURETHRAL PROCEDURES WITH CC,S,"$3,711.80 ","$12,304.19 ","$6,093.74 ","$12,304.19 ",20210101
670,DRG,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,S,"$3,637.50 ","$16,503.91 ","$5,982.57 ","$16,503.91 ",20210101
671,DRG,URETHRAL PROCEDURES WITH CC/MCC,S,"$3,605.05 ","$12,406.48 ","$5,922.49 ","$12,406.48 ",20210101
672,DRG,URETHRAL PROCEDURES WITHOUT CC/MCC,S,"$3,885.36 ","$25,941.19 ","$5,522.68 ","$25,941.19 ",20210101
673,DRG,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,S,"$3,298.70 ","$9,097.37 ","$5,443.19 ","$9,097.37 ",20210101
674,DRG,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,S,"$3,060.15 ","$9,286.56 ","$4,957.62 ","$9,286.56 ",20210101
675,DRG,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,S,"$3,264.40 ","$17,113.26 ","$5,275.37 ","$17,113.26 ",20210101
682,DRG,RENAL FAILURE WITH MCC,N,"$3,037.55 ","$6,256.79 ","$5,022.07 ","$6,256.79 ",20210101
683,DRG,RENAL FAILURE WITH CC,N,"$2,845.77 ","$5,541.09 ","$4,583.35 ","$5,541.09 ",20210101
684,DRG,RENAL FAILURE WITHOUT CC/MCC,N,"$2,567.57 ","$5,618.55 ","$4,250.48 ","$5,618.55 ",20210101
686,DRG,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,N,"$4,280.21 ","$8,271.93 ","$6,967.34 ","$8,271.93 ",20210101
687,DRG,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,N,"$3,308.00 ","$6,682.15 ","$5,052.51 ","$6,682.15 ",20210101
688,DRG,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,N,"$3,480.75 ","$12,949.58 ","$6,164.80 ","$12,949.58 ",20210101
689,DRG,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,N,"$3,048.97 ","$5,589.41 ","$5,002.75 ","$5,589.41 ",20210101
690,DRG,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,N,"$2,904.44 ","$5,516.17 ","$4,721.57 ","$5,516.17 ",20210101
693,DRG,URINARY STONES WITH MCC,N,"$3,253.09 ","$7,831.37 ","$5,662.02 ","$7,831.37 ",20210101
694,DRG,URINARY STONES WITHOUT MCC,N,"$3,058.31 ","$9,018.20 ","$4,954.02 ","$9,018.20 ",20210101
695,DRG,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,N,"$3,560.47 ","$6,473.12 ","$5,695.84 ","$6,473.12 ",20210101
696,DRG,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,N,"$3,276.36 ","$5,916.45 ","$5,180.38 ","$5,916.45 ",20210101
697,DRG,URETHRAL STRICTURE,N,"$3,208.33 ","$8,780.85 ","$5,278.94 ","$8,780.85 ",20210101
698,DRG,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,N,"$3,336.30 ","$6,486.11 ","$5,666.13 ","$6,486.11 ",20210101
699,DRG,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,N,"$3,340.62 ","$6,696.93 ","$5,280.09 ","$6,696.93 ",20210101
700,DRG,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,N,"$3,280.22 ","$7,115.15 ","$5,324.13 ","$7,115.15 ",20210101
707,DRG,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,S,"$3,650.50 ","$27,230.08 ","$6,856.46 ","$27,230.08 ",20210101
708,DRG,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,S,"$3,234.66 ","$47,288.84 ","$5,149.13 ","$47,288.84 ",20210101
709,DRG,PENIS PROCEDURES WITH CC/MCC,S,"$3,970.42 ","$14,966.98 ","$7,315.49 ","$14,966.98 ",20210101
710,DRG,PENIS PROCEDURES WITHOUT CC/MCC,S,"$3,548.15 ","$30,470.10 ","$6,114.15 ","$30,470.10 ",20210101
711,DRG,TESTES PROCEDURES WITH CC/MCC,S,"$3,884.02 ","$11,789.24 ","$6,665.28 ","$11,789.24 ",20210101
712,DRG,TESTES PROCEDURES WITHOUT CC/MCC,S,"$3,817.37 ","$15,721.38 ","$5,201.61 ","$15,721.38 ",20210101
713,DRG,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,S,"$3,476.45 ","$13,443.81 ","$5,844.00 ","$13,443.81 ",20210101
714,DRG,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,S,"$3,848.79 ","$19,652.44 ","$5,457.15 ","$19,652.44 ",20210101
715,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,S,"$4,212.92 ","$12,103.90 ","$6,345.10 ","$12,103.90 ",20210101
716,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,S,"$4,138.59 ","$45,196.14 ","$6,911.71 ","$45,196.14 ",20210101
717,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,S,"$3,115.06 ","$10,392.84 ","$5,208.50 ","$10,392.84 ",20210101
718,DRG,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,S,"$3,299.32 ","$17,018.17 ","$5,271.09 ","$17,018.17 ",20210101
722,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",N,"$3,887.95 ","$6,932.04 ","$6,142.58 ","$6,932.04 ",20210101
723,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",N,"$4,084.69 ","$7,352.83 ","$6,281.66 ","$7,352.83 ",20210101
724,DRG,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",N,"$5,460.16 ","$14,322.69 ","$9,005.15 ","$14,322.69 ",20210101
725,DRG,BENIGN PROSTATIC HYPERTROPHY WITH MCC,N,"$3,614.73 ","$5,963.49 ","$5,086.47 ","$5,963.49 ",20210101
726,DRG,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,N,"$3,300.04 ","$5,825.92 ","$5,021.54 ","$5,825.92 ",20210101
727,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,N,"$3,047.13 ","$5,694.61 ","$4,779.17 ","$5,694.61 ",20210101
728,DRG,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,N,"$2,996.13 ","$5,420.22 ","$4,754.99 ","$5,420.22 ",20210101
729,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,N,"$3,137.01 ","$6,048.04 ","$4,856.20 ","$6,048.04 ",20210101
730,DRG,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,N,"$3,346.45 ","$7,346.08 ","$4,861.53 ","$7,346.08 ",20210101
734,DRG,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",S,"$4,211.37 ","$19,675.75 ","$7,977.73 ","$19,675.75 ",20210101
735,DRG,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",S,"$3,562.86 ","$31,619.78 ","$5,589.06 ","$31,619.78 ",20210101
736,DRG,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,S,"$3,764.71 ","$14,252.25 ","$6,983.75 ","$14,252.25 ",20210101
737,DRG,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,S,"$3,970.87 ","$16,833.19 ","$6,984.21 ","$16,833.19 ",20210101
738,DRG,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,S,"$3,332.17 ","$20,180.30 ","$5,049.47 ","$20,180.30 ",20210101
739,DRG,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND ADNEXAL MALIGNANCY WITH MCC,S,"$3,712.58 ","$14,632.18 ","$7,105.63 ","$14,632.18 ",20210101
740,DRG,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND ADNEXAL MALIGNANCY WITH CC,S,"$3,761.82 ","$20,580.84 ","$6,687.59 ","$20,580.84 ",20210101
741,DRG,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND ADNEXAL MALIGNANCY WITHOUT CC/MCC,S,"$3,756.63 ","$32,303.96 ","$6,432.58 ","$32,303.96 ",20210101
742,DRG,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,S,"$3,250.64 ","$18,317.51 ","$5,953.01 ","$18,317.51 ",20210101
743,DRG,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,S,"$2,876.39 ","$24,711.22 ","$4,732.85 ","$24,711.22 ",20210101
744,DRG,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",S,"$3,819.93 ","$10,922.00 ","$5,984.09 ","$10,922.00 ",20210101
745,DRG,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",S,"$3,699.33 ","$18,894.23 ","$5,746.45 ","$18,894.23 ",20210101
746,DRG,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",S,"$2,939.62 ","$10,556.60 ","$5,183.56 ","$10,556.60 ",20210101
747,DRG,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",S,"$2,941.69 ","$20,280.43 ","$4,863.95 ","$20,280.43 ",20210101
748,DRG,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,S,"$3,283.44 ","$31,013.56 ","$6,123.96 ","$31,013.56 ",20210101
749,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,S,"$3,488.82 ","$12,268.09 ","$6,645.09 ","$12,268.09 ",20210101
750,DRG,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,S,"$3,806.38 ","$23,416.75 ","$6,645.62 ","$23,416.75 ",20210101
754,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",N,"$3,269.89 ","$6,356.18 ","$5,324.18 ","$6,356.18 ",20210101
755,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",N,"$3,493.75 ","$6,998.92 ","$5,361.72 ","$6,998.92 ",20210101
756,DRG,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",N,"$3,596.42 ","$10,119.89 ","$6,572.97 ","$10,119.89 ",20210101
757,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",N,"$2,807.60 ","$5,494.62 ","$4,664.72 ","$5,494.62 ",20210101
758,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",N,"$2,961.21 ","$5,576.40 ","$4,718.28 ","$5,576.40 ",20210101
759,DRG,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",N,"$2,940.33 ","$5,641.99 ","$4,943.11 ","$5,641.99 ",20210101
760,DRG,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,N,"$3,759.32 ","$8,344.94 ","$6,023.17 ","$8,344.94 ",20210101
761,DRG,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,N,"$3,535.19 ","$9,226.32 ","$6,077.75 ","$9,226.32 ",20210101
768,DRG,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,S,"$2,811.38 ","$6,882.45 ","$4,866.05 ","$6,882.45 ",20210101
769,DRG,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURE,S,"$2,980.78 ","$12,752.21 ","$5,432.77 ","$12,752.21 ",20210101
770,DRG,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",S,"$3,340.97 ","$12,741.52 ","$6,921.02 ","$12,741.52 ",20210101
776,DRG,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURE,N,"$3,167.78 ","$4,897.07 ","$5,976.04 ","$4,897.07 ",20210101
779,DRG,ABORTION WITHOUT D&C,N,"$3,387.39 ","$9,944.88 ","$5,431.64 ","$9,944.88 ",20210101
783,DRG,CESAREAN SECTION WITH STERILIZATION WITH MCC,S,"$3,109.09 ","$6,946.34 ","$5,709.89 ","$6,946.34 ",20210101
784,DRG,CESAREAN SECTION WITH STERILIZATION WITH CC,S,"$2,684.37 ","$7,139.15 ","$4,418.90 ","$7,139.15 ",20210101
785,DRG,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,S,"$2,434.77 ","$8,229.24 ","$4,443.85 ","$8,229.24 ",20210101
786,DRG,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,S,"$3,240.13 ","$7,399.39 ","$5,982.69 ","$7,399.39 ",20210101
787,DRG,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,S,"$3,003.80 ","$6,881.42 ","$5,673.88 ","$6,881.42 ",20210101
788,DRG,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,S,"$2,698.43 ","$7,630.11 ","$4,505.45 ","$7,630.11 ",20210101
789,DRG,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",N,"$4,329.99 ","$10,167.21 ","$6,138.30 ","$10,167.21 ",20210101
790,DRG,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",N,"$1,916.81 ","$6,705.30 ","$3,488.36 ","$6,705.30 ",20210101
791,DRG,PREMATURITY WITH MAJOR PROBLEMS,N,"$1,624.10 ","$5,681.38 ","$2,955.67 ","$5,681.38 ",20210101
792,DRG,PREMATURITY WITHOUT MAJOR PROBLEMS,N,"$2,259.99 ","$2,778.76 ","$3,203.81 ","$2,778.76 ",20210101
793,DRG,FULL TERM NEONATE WITH MAJOR PROBLEMS,N,"$2,063.39 ","$4,781.37 ","$4,358.82 ","$4,781.37 ",20210101
794,DRG,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,N,"$1,329.22 ","$2,343.60 ","$1,884.32 ","$2,343.60 ",20210101
795,DRG,NORMAL NEWBORN,N,$600.15 ,"$2,099.41 ","$1,092.20 ","$2,099.41 ",20210101
796,DRG,VAGINAL DELIVERY WITH STERILIZATION/D&C WITH MCC,S,"$3,541.90 ","$7,514.28 ","$5,001.73 ","$7,514.28 ",20210101
797,DRG,VAGINAL DELIVERY WITH STERILIZATION/D&C WITH CC,S,"$2,923.10 ","$9,919.19 ","$6,086.07 ","$9,919.19 ",20210101
798,DRG,VAGINAL DELIVERY WITH STERILIZATION/D&C WITHOUT CC/MCC,S,"$1,005.65 ","$11,665.49 ","$1,460.72 ","$11,665.49 ",20210101
799,DRG,SPLENECTOMY WITH MCC,S,"$3,294.08 ","$16,721.89 ","$6,884.08 ","$16,721.89 ",20210101
800,DRG,SPLENECTOMY WITH CC,S,"$3,148.56 ","$17,289.08 ","$5,814.82 ","$17,289.08 ",20210101
801,DRG,SPLENECTOMY WITHOUT CC/MCC,S,"$2,897.02 ","$22,000.05 ","$4,717.65 ","$22,000.05 ",20210101
802,DRG,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,S,"$3,913.69 ","$11,167.94 ","$6,282.98 ","$11,167.94 ",20210101
803,DRG,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,S,"$3,410.11 ","$13,075.89 ","$5,546.68 ","$13,075.89 ",20210101
804,DRG,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,S,"$3,301.94 ","$20,630.96 ","$5,349.09 ","$20,630.96 ",20210101
805,DRG,VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH MCC,N,"$3,093.82 ","$5,706.59 ","$5,156.14 ","$5,706.59 ",20210101
806,DRG,VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC,N,"$3,173.16 ","$5,881.77 ","$5,281.81 ","$5,881.77 ",20210101
807,DRG,VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC,N,"$2,739.94 ","$6,049.16 ","$4,995.59 ","$6,049.16 ",20210101
808,DRG,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,N,"$3,818.14 ","$9,668.84 ","$5,970.51 ","$9,668.84 ",20210101
809,DRG,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,N,"$3,270.30 ","$7,938.79 ","$4,939.26 ","$7,938.79 ",20210101
810,DRG,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,N,"$3,261.75 ","$9,917.10 ","$5,145.32 ","$9,917.10 ",20210101
811,DRG,RED BLOOD CELL DISORDERS WITH MCC,N,"$3,178.10 ","$7,850.71 ","$5,081.59 ","$7,850.71 ",20210101
812,DRG,RED BLOOD CELL DISORDERS WITHOUT MCC,N,"$2,811.72 ","$6,436.61 ","$4,424.96 ","$6,436.61 ",20210101
813,DRG,COAGULATION DISORDERS,N,"$3,449.62 ","$12,684.04 ","$5,879.72 ","$12,684.04 ",20210101
814,DRG,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,N,"$3,970.16 ","$9,493.56 ","$6,641.38 ","$9,493.56 ",20210101
815,DRG,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,N,"$3,486.70 ","$8,024.28 ","$5,827.60 ","$8,024.28 ",20210101
816,DRG,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,N,"$2,748.67 ","$8,047.88 ","$5,314.41 ","$8,047.88 ",20210101
817,DRG,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH MCC,S,"$3,577.12 ","$12,205.58 ","$7,483.68 ","$12,205.58 ",20210101
818,DRG,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH CC,S,"$3,351.02 ","$9,745.69 ","$5,731.80 ","$9,745.69 ",20210101
819,DRG,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITHOUT CC/MCC,S,"$3,391.54 ","$16,615.52 ","$9,724.13 ","$16,615.52 ",20210101
820,DRG,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITH MCC,S,"$3,950.92 ","$12,968.53 ","$6,922.11 ","$12,968.53 ",20210101
821,DRG,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITH CC,S,"$3,777.42 ","$16,663.05 ","$6,364.32 ","$16,663.05 ",20210101
822,DRG,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC,S,"$3,536.41 ","$24,145.36 ","$5,861.90 ","$24,145.36 ",20210101
823,DRG,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITH MCC,S,"$3,853.15 ","$11,439.92 ","$5,965.47 ","$11,439.92 ",20210101
824,DRG,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITH CC,S,"$4,080.66 ","$13,500.85 ","$6,017.10 ","$13,500.85 ",20210101
825,DRG,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITHOUT CC/MCC,S,"$3,523.56 ","$17,240.66 ","$5,053.37 ","$17,240.66 ",20210101
826,DRG,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH MCC,S,"$3,653.09 ","$12,861.24 ","$6,774.47 ","$12,861.24 ",20210101
827,DRG,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH CC,S,"$3,832.89 ","$14,764.03 ","$6,168.03 ","$14,764.03 ",20210101
828,DRG,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC,S,"$3,420.60 ","$18,820.24 ","$5,344.60 ","$18,820.24 ",20210101
829,DRG,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURE WITH CC/MCC,S,"$4,132.60 ","$13,203.94 ","$6,732.28 ","$13,203.94 ",20210101
830,DRG,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURE WITHOUT CC/MCC,S,"$3,941.75 ","$21,911.02 ","$6,621.71 ","$21,911.02 ",20210101
831,DRG,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITH MCC,N,"$3,276.72 ","$5,327.79 ","$6,651.81 ","$5,327.79 ",20210101
832,DRG,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITH CC,N,"$3,039.29 ","$2,980.86 ","$4,747.77 ","$2,980.86 ",20210101
833,DRG,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITHOUT CC/MCC,N,"$2,933.41 ","$3,692.65 ","$4,868.35 ","$3,692.65 ",20210101
834,DRG,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH MCC,N,"$4,477.62 ","$11,513.43 ","$5,976.45 ","$11,513.43 ",20210101
835,DRG,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH CC,N,"$4,200.79 ","$10,536.24 ","$5,413.34 ","$10,536.24 ",20210101
836,DRG,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITHOUT CC/MCC,N,"$3,659.00 ","$9,665.49 ","$5,279.29 ","$9,665.49 ",20210101
837,DRG,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,N,"$4,253.84 ","$10,072.12 ","$5,707.89 ","$10,072.12 ",20210101
838,DRG,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,N,"$4,116.48 ","$10,667.69 ","$5,249.39 ","$10,667.69 ",20210101
839,DRG,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,N,"$3,756.61 ","$8,012.71 ","$4,623.83 ","$8,012.71 ",20210101
840,DRG,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,N,"$4,120.57 ","$9,914.01 ","$6,021.15 ","$9,914.01 ",20210101
841,DRG,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,N,"$3,695.71 ","$9,251.30 ","$5,218.32 ","$9,251.30 ",20210101
842,DRG,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,N,"$2,625.64 ","$7,778.65 ","$3,822.78 ","$7,778.65 ",20210101
843,DRG,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS DIAGNOSES WITH MCC,N,"$3,837.51 ","$7,807.96 ","$6,157.63 ","$7,807.96 ",20210101
844,DRG,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS DIAGNOSES WITH CC,N,"$3,538.07 ","$7,010.88 ","$5,357.36 ","$7,010.88 ",20210101
845,DRG,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS DIAGNOSES WITHOUT CC/MCC,N,"$3,100.92 ","$7,699.24 ","$4,605.71 ","$7,699.24 ",20210101
846,DRG,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,N,"$4,386.46 ","$10,229.52 ","$5,815.70 ","$10,229.52 ",20210101
847,DRG,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,N,"$4,045.02 ","$10,911.26 ","$4,701.07 ","$10,911.26 ",20210101
848,DRG,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,N,"$3,529.33 ","$10,172.45 ","$4,692.46 ","$10,172.45 ",20210101
849,DRG,RADIOTHERAPY,N,"$4,281.51 ","$7,761.98 ","$5,827.88 ","$7,761.98 ",20210101
853,DRG,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MCC,S,"$3,422.73 ","$11,491.54 ","$6,033.61 ","$11,491.54 ",20210101
854,DRG,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH CC,S,"$3,131.23 ","$9,734.68 ","$4,910.67 ","$9,734.68 ",20210101
855,DRG,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITHOUT CC/MCC,S,"$2,836.43 ","$10,970.85 ","$4,866.97 ","$10,970.85 ",20210101
856,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURE WITH MCC,S,"$3,297.94 ","$10,288.74 ","$6,057.58 ","$10,288.74 ",20210101
857,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURE WITH CC,S,"$3,073.29 ","$9,128.05 ","$5,051.92 ","$9,128.05 ",20210101
858,DRG,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURE WITHOUT CC/MCC,S,"$2,559.09 ","$8,857.91 ","$4,607.65 ","$8,857.91 ",20210101
862,DRG,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,N,"$3,287.71 ","$6,668.18 ","$5,580.20 ","$6,668.18 ",20210101
863,DRG,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,N,"$3,068.53 ","$5,397.74 ","$4,795.86 ","$5,397.74 ",20210101
864,DRG,FEVER AND INFLAMMATORY CONDITIONS,N,"$3,106.78 ","$7,037.54 ","$4,727.34 ","$7,037.54 ",20210101
865,DRG,VIRAL ILLNESS WITH MCC,N,"$3,709.99 ","$6,988.23 ","$5,881.70 ","$6,988.23 ",20210101
866,DRG,VIRAL ILLNESS WITHOUT MCC,N,"$3,074.19 ","$5,902.73 ","$4,644.97 ","$5,902.73 ",20210101
867,DRG,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,N,"$3,332.48 ","$7,327.27 ","$5,497.30 ","$7,327.27 ",20210101
868,DRG,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,N,"$3,186.49 ","$5,835.11 ","$5,301.09 ","$5,835.11 ",20210101
869,DRG,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,N,"$2,827.83 ","$5,306.57 ","$4,808.37 ","$5,306.57 ",20210101
870,DRG,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,N,"$4,161.66 ","$11,638.18 ","$6,801.59 ","$11,638.18 ",20210101
871,DRG,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,N,"$3,440.90 ","$7,712.84 ","$5,623.64 ","$7,712.84 ",20210101
872,DRG,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,N,"$3,253.16 ","$6,091.75 ","$4,855.73 ","$6,091.75 ",20210101
876,DRG,O.R. PROCEDURE WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,S,"$2,893.69 ","$4,232.78 ","$4,560.00 ","$4,232.78 ",20210101
880,DRG,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,N,"$2,255.32 ","$3,239.44 ","$4,119.69 ","$3,239.44 ",20210101
881,DRG,DEPRESSIVE NEUROSES,N,"$2,530.48 ",$895.93 ,"$4,015.58 ",$895.93 ,20210101
882,DRG,NEUROSES EXCEPT DEPRESSIVE,N,"$2,056.60 ",$875.05 ,"$3,868.53 ",$875.05 ,20210101
883,DRG,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,N,"$2,128.52 ",$683.77 ,"$3,620.85 ",$683.77 ,20210101
884,DRG,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,N,"$2,487.05 ","$1,475.41 ","$4,740.92 ","$1,475.41 ",20210101
885,DRG,PSYCHOSES,N,"$2,388.95 ",$633.90 ,"$3,773.03 ",$633.90 ,20210101
886,DRG,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,N,"$1,736.42 ",$710.05 ,"$3,669.07 ",$710.05 ,20210101
887,DRG,OTHER MENTAL DISORDERS DIAGNOSES,N,"$1,901.07 ","$1,471.72 ","$3,015.17 ","$1,471.72 ",20210101
894,DRG,"ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA",N,"$2,137.98 ","$2,058.18 ","$4,661.13 ","$2,058.18 ",20210101
895,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY,N,"$2,219.30 ",$281.85 ,"$4,556.44 ",$281.85 ,20210101
896,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC,N,"$2,719.55 ","$4,719.94 ","$4,945.23 ","$4,719.94 ",20210101
897,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC,N,"$1,924.91 ","$1,460.40 ","$3,784.91 ","$1,460.40 ",20210101
901,DRG,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,S,"$3,847.49 ","$9,198.98 ","$6,269.63 ","$9,198.98 ",20210101
902,DRG,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,S,"$3,437.73 ","$9,404.83 ","$5,987.35 ","$9,404.83 ",20210101
903,DRG,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,S,"$2,929.45 ","$10,858.90 ","$5,560.89 ","$10,858.90 ",20210101
904,DRG,SKIN GRAFTS FOR INJURIES WITH CC/MCC,S,"$3,298.21 ","$10,523.71 ","$6,381.78 ","$10,523.71 ",20210101
905,DRG,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,S,"$3,370.90 ","$12,314.18 ","$6,778.00 ","$12,314.18 ",20210101
906,DRG,HAND PROCEDURES FOR INJURIES,S,"$3,538.75 ","$16,195.46 ","$7,190.64 ","$16,195.46 ",20210101
907,DRG,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,S,"$3,283.77 ","$12,677.47 ","$6,307.25 ","$12,677.47 ",20210101
908,DRG,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,S,"$3,238.50 ","$13,297.71 ","$5,616.74 ","$13,297.71 ",20210101
909,DRG,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,S,"$3,121.12 ","$17,550.32 ","$5,447.58 ","$17,550.32 ",20210101
913,DRG,TRAUMATIC INJURY WITH MCC,N,"$4,200.63 ","$10,490.83 ","$7,876.57 ","$10,490.83 ",20210101
914,DRG,TRAUMATIC INJURY WITHOUT MCC,N,"$2,849.18 ","$6,825.33 ","$5,213.92 ","$6,825.33 ",20210101
915,DRG,ALLERGIC REACTIONS WITH MCC,N,"$3,024.43 ","$9,098.72 ","$6,153.60 ","$9,098.72 ",20210101
916,DRG,ALLERGIC REACTIONS WITHOUT MCC,N,"$2,937.92 ","$6,250.22 ","$5,522.98 ","$6,250.22 ",20210101
917,DRG,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,N,"$3,304.44 ","$8,405.74 ","$6,118.36 ","$8,405.74 ",20210101
918,DRG,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,N,"$3,220.68 ","$6,342.58 ","$5,379.66 ","$6,342.58 ",20210101
919,DRG,COMPLICATIONS OF TREATMENT WITH MCC,N,"$3,491.79 ","$7,677.53 ","$5,807.89 ","$7,677.53 ",20210101
920,DRG,COMPLICATIONS OF TREATMENT WITH CC,N,"$3,449.13 ","$7,021.10 ","$5,516.47 ","$7,021.10 ",20210101
921,DRG,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,N,"$2,943.31 ","$6,890.73 ","$4,785.73 ","$6,890.73 ",20210101
922,DRG,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",N,"$4,413.81 ","$9,040.61 ","$8,392.72 ","$9,040.61 ",20210101
923,DRG,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",N,"$3,690.50 ","$5,215.58 ","$5,983.29 ","$5,215.58 ",20210101
927,DRG,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,S,"$3,775.78 ","$18,068.48 ","$10,384.89 ","$18,068.48 ",20210101
928,DRG,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,S,"$4,170.64 ","$10,166.27 ","$9,791.98 ","$10,166.27 ",20210101
929,DRG,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,S,"$4,290.22 ","$9,973.53 ","$10,826.53 ","$9,973.53 ",20210101
933,DRG,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HRS WITHOUT SKIN GRAFT,N,"$2,902.84 ","$12,952.54 ","$8,334.61 ","$12,952.54 ",20210101
934,DRG,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,N,"$3,634.28 ","$5,601.01 ","$8,676.34 ","$5,601.01 ",20210101
935,DRG,NON-EXTENSIVE BURNS,N,"$4,115.07 ","$9,254.85 ","$11,090.93 ","$9,254.85 ",20210101
939,DRG,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,S,"$3,327.77 ","$8,109.91 ","$5,761.06 ","$8,109.91 ",20210101
940,DRG,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,S,"$3,005.97 ","$10,511.27 ","$5,453.80 ","$10,511.27 ",20210101
941,DRG,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,S,"$2,769.78 ","$18,927.15 ","$5,331.15 ","$18,927.15 ",20210101
945,DRG,REHABILITATION WITH CC/MCC,N,"$2,597.12 ","$3,701.09 ","$4,451.83 ","$3,701.09 ",20210101
946,DRG,REHABILITATION WITHOUT CC/MCC,N,"$2,508.94 ","$2,965.61 ","$3,887.24 ","$2,965.61 ",20210101
947,DRG,SIGNS AND SYMPTOMS WITH MCC,N,"$2,533.44 ","$4,362.39 ","$5,113.89 ","$4,362.39 ",20210101
948,DRG,SIGNS AND SYMPTOMS WITHOUT MCC,N,"$1,967.04 ","$3,527.97 ","$3,817.24 ","$3,527.97 ",20210101
949,DRG,AFTERCARE WITH CC/MCC,N,"$2,240.55 ","$2,551.54 ","$4,531.19 ","$2,551.54 ",20210101
950,DRG,AFTERCARE WITHOUT CC/MCC,N,"$1,864.18 ","$1,824.13 ","$4,037.36 ","$1,824.13 ",20210101
951,DRG,OTHER FACTORS INFLUENCING HEALTH STATUS,N,"$2,750.45 ","$3,321.80 ","$8,400.37 ","$3,321.80 ",20210101
955,DRG,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,S,"$4,601.01 ","$23,400.93 ","$10,471.62 ","$23,400.93 ",20210101
956,DRG,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",S,"$3,518.87 ","$18,266.47 ","$7,875.30 ","$18,266.47 ",20210101
957,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,S,"$3,362.46 ","$18,836.86 ","$7,966.26 ","$18,836.86 ",20210101
958,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,S,"$3,324.37 ","$17,269.71 ","$7,472.69 ","$17,269.71 ",20210101
959,DRG,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,S,"$3,406.33 ","$19,171.16 ","$7,459.98 ","$19,171.16 ",20210101
963,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,N,"$3,564.93 ","$10,233.65 ","$7,676.11 ","$10,233.65 ",20210101
964,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,N,"$3,475.15 ","$8,608.35 ","$7,620.76 ","$8,608.35 ",20210101
965,DRG,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,N,"$3,742.77 ","$9,555.83 ","$8,260.93 ","$9,555.83 ",20210101
969,DRG,HIV WITH EXTENSIVE O.R. PROCEDURE WITH MCC,S,"$3,945.52 ","$11,199.75 ","$6,623.87 ","$11,199.75 ",20210101
970,DRG,HIV WITH EXTENSIVE O.R. PROCEDURE WITHOUT MCC,S,"$3,555.10 ","$11,609.53 ","$6,003.97 ","$11,609.53 ",20210101
974,DRG,HIV WITH MAJOR RELATED CONDITION WITH MCC,N,"$3,895.12 ","$8,884.69 ","$6,321.45 ","$8,884.69 ",20210101
975,DRG,HIV WITH MAJOR RELATED CONDITION WITH CC,N,"$3,646.61 ","$6,486.75 ","$4,932.82 ","$6,486.75 ",20210101
976,DRG,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,N,"$3,218.98 ","$6,552.91 ","$4,909.04 ","$6,552.91 ",20210101
977,DRG,HIV WITH OR WITHOUT OTHER RELATED CONDITION,N,"$3,453.38 ","$6,461.84 ","$4,608.43 ","$6,461.84 ",20210101
981,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,S,"$3,354.13 ","$11,076.94 ","$5,755.48 ","$11,076.94 ",20210101
982,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,S,"$3,229.05 ","$12,665.93 ","$5,429.88 ","$12,665.93 ",20210101
983,DRG,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,S,"$2,992.48 ","$19,285.38 ","$5,450.82 ","$19,285.38 ",20210101
987,DRG,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,S,"$3,244.87 ","$8,787.96 ","$5,546.29 ","$8,787.96 ",20210101
988,DRG,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,S,"$3,123.40 ","$9,092.59 ","$5,138.24 ","$9,092.59 ",20210101
989,DRG,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,S,"$2,999.62 ","$13,489.79 ","$5,169.96 ","$13,489.79 ",20210101
000,SNF,SKILLED NURSING FACILITY PER DIEM,,"$1,097.30 ",,,,20210101
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