California Code of Regulations
Title 8 - Industrial Relations
Division 1 - Department of Industrial Relations
Chapter 4.5 - Division of Workers' Compensation
Subchapter 1 - Administrative Director-Administrative Rules
Article 5.5 - Application of the Official Medical Fee Schedule (Treatment)
Appendix B - DRG Weights and Revised DRG Weights 2001 Rates
Universal Citation: 8 CA Code of Regs B
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(California revisions shown in italics incorporate the DWC Revised Ratios)
| DRG Number | Description | HCFA 2001 DRG Weights | DWC Revised Ratio | DWC Revised Weight | Geometric Mean LOS |
| 1 | CRANIOTOMY AGE >17 EXCEPT FOR TRAUMA | 3.097 | 1.000 | 3.097 | 6.3 |
| 2 | CRANIOTOMY FOR TRAUMA AGE >17 | 3.1142 | 1.000 | 3.1142 | 7.3 |
| 3 | CRANIOTOMY AGE 0-17 | 1.9629 | 1.000 | 1.9629 | 12.7 |
| 4 | SPINAL PROCEDURES | 2.2918 | 0.628 | 1.4399 | 4.8 |
| 5 | EXTRACRANIAL VASCULAR PROCEDURES | 1.4321 | 1.000 | 1.4321 | 2.3 |
| 6 | CARPAL TUNNEL RELEASE | 0.8246 | 1.000 | 0.8246 | 2.2 |
| 7 | PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC | 2.5919 | 1.000 | 2.5919 | 6.9 |
| 8 | PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC | 1.3948 | 0.808 | 1.1273 | 2.1 |
| 9 | SPINAL DISORDERS & INJURIES | 1.3134 | 1.000 | 1.3134 | 4.7 |
| 10 | NERVOUS SYSTEM NEOPLASMS W CC | 1.2273 | 1.000 | 1.2273 | 4.9 |
| 11 | NERVOUS SYSTEM NEOPLASMS W/O CC | 0.8345 | 1.000 | 0.8345 | 3.1 |
| 12 | DEGENERATIVE NERVOUS SYSTEM DISORDERS | 0.8925 | 1.000 | 0.8925 | 4.5 |
| 13 | MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA | 0.7644 | 1.000 | 0.7644 | 4.1 |
| 14 | SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TIA | 1.207 | 1.000 | 1.2070 | 4.7 |
| 15 | TRANSIENT ISCHEMIC ATTACK & PRECEREBRAL OCCLUSIONS | 0.748 | 1.000 | 0.7480 | 2.9 |
| 16 | NONSPECIFIC CEREBROVASCULAR DISORDERS W CC | 1.1652 | 1.000 | 1.1652 | 4.7 |
| 17 | NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC | 0.6539 | 1.000 | 0.6539 | 2.6 |
| 18 | CRANIAL & PERIPHERAL NERVE DISORDERS W CC | 0.96 | 1.000 | 0.9600 | 4.3 |
| 19 | CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC | 0.6963 | 1.000 | 0.6963 | 2.9 |
| 20 | NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS | 2.7744 | 1.000 | 2.7744 | 7.9 |
| 21 | VIRAL MENINGITIS | 1.4966 | 1.000 | 1.4966 | 5.2 |
| 22 | HYPERTENSIVE ENCEPHALOPATHY | 1.0082 | 1.000 | 1.0082 | 3.8 |
| 23 | NONTRAUMATIC STUPOR & COMA | 0.8027 | 1.000 | 0.8027 | 3.2 |
| 24 | SEIZURE & HEADACHE AGE >17 W CC | 0.9914 | 1.000 | 0.9914 | 3.7 |
| 25 | SEIZURE & HEADACHE AGE >17 W/O CC | 0.6043 | 0.749 | 0.4523 | 2.6 |
| 26 | SEIZURE & HEADACHE AGE 0-17 | 0.6441 | 1.000 | 0.6441 | 2.4 |
| 27 | TRAUMATIC STUPOR & COMA, COMA >1 HR | 1.2912 | 1.000 | 1.2912 | 3.2 |
| 28 | TRAUMATIC STUPOR & COMA, COMA < 1 HR AGE >17 W CC | 1.3102 | 1.000 | 1.3102 | 4.5 |
| 29 | TRAUMATIC STUPOR & COMA, COMA < 1 HR AGE >17 W/O CC | 0.7015 | 1.003 | 0.7033 | 2.8 |
| 30 | TRAUMATIC STUPOR & COMA, COMA < 1HR AGE 0-17 | 0.332 | 1.000 | 0.3320 | 2 |
| 31 | CONCUSSION AGE >17 W CC | 0.8715 | 1.000 | 0.8715 | 3.1 |
| 32 | CONCUSSION AGE >17 W/O CC | 0.5422 | 0.875 | 0.4744 | 2.1 |
| 33 | CONCUSSION AGE 0-17 | 0.2086 | 1.000 | 0.2086 | 1.6 |
| 34 | OTHER DISORDERS OF NERVOUS SYSTEM W CC | 1.0099 | 1.000 | 1.0099 | 3.8 |
| 35 | OTHER DISORDERS OF NERVOUS SYSTEM W/O CC | 0.6027 | 1.000 | 0.6027 | 2.7 |
| 36 | RETINAL PROCEDURES | 0.6639 | 1.000 | 0.6639 | 1.2 |
| 37 | ORBITAL PROCEDURES | 1.0016 | 1.000 | 1.0016 | 2.6 |
| 38 | PRIMARY IRIS PROCEDURES | 0.4833 | 1.000 | 0.4833 | 1.8 |
| 39 | LENS PROCEDURES WITH OR WITHOUT VITRECTOMY | 0.5778 | 1.000 | 0.5778 | 1.5 |
| 40 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17 | 0.8635 | 1.000 | 0.8635 | 2.3 |
| 41 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17 | 0.338 | 1.000 | 0.3380 | 1.6 |
| 42 | INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS | 0.6478 | 1.066 | 0.6906 | 1.6 |
| 43 | HYPHEMA | 0.4977 | 1.000 | 0.4977 | 2.6 |
| 44 | ACUTE MAJOR EYE INFECTIONS | 0.6337 | 1.000 | 0.6337 | 4.1 |
| 45 | NEUROLOGICAL EYE DISORDERS | 0.7022 | 1.000 | 0.7022 | 2.7 |
| 46 | OTHER DISORDERS OF THE EYE AGE >17 W CC | 0.7749 | 1.000 | 0.7749 | 3.5 |
| 47 | OTHER DISORDERS OF THE EYE AGE >17 W/O CC | 0.5085 | 1.000 | 0.5085 | 2.5 |
| 48 | OTHER DISORDERS OF THE EYE AGE 0-17 | 0.2977 | 1.000 | 0.2977 | 2.9 |
| 49 | MAJOR HEAD & NECK PROCEDURES | 1.8301 | 1.000 | 1.8301 | 3.5 |
| 50 | SIALOADENECTOMY | 0.8537 | 1.000 | 0.8537 | 1.6 |
| 51 | SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY | 0.7934 | 1.000 | 0.7934 | 1.8 |
| 52 | CLEFT LIP & PALATE REPAIR | 0.841 | 1.000 | 0.8410 | 1.6 |
| 53 | SINUS & MASTOID PROCEDURES AGE >17 | 1.2118 | 1.000 | 1.2118 | 2.3 |
| 54 | SINUS & MASTOID PROCEDURES AGE 0-17 | 0.4826 | 1.000 | 0.4826 | 3.2 |
| 55 | MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES | 0.9039 | 1.000 | 0.9039 | 1.9 |
| 56 | RHINOPLASTY | 0.9451 | 1.000 | 0.9451 | 2.1 |
| 57 | T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17 | 1.0704 | 1.000 | 1.0704 | 2.5 |
| 58 | T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17 | 0.274 | 1.000 | 0.2740 | 1.5 |
| 59 | TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17 | 0.6943 | 1.000 | 0.6943 | 1.8 |
| 60 | TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17 | 0.2087 | 1.000 | 0.2087 | 1.5 |
| 61 | MYRINGOTOMY W TUBE INSERTION AGE >17 | 1.266 | 1.000 | 1.2660 | 2.8 |
| 62 | MYRINGOTOMY W TUBE INSERTION AGE 0-17 | 0.2955 | 1.000 | 0.2955 | 1.3 |
| 63 | OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES | 1.3402 | 0.875 | 1.1731 | 3 |
| 64 | EAR, NOSE, MOUTH & THROAT MALIGNANCY | 1.2288 | 1.000 | 1.2288 | 4.3 |
| 65 | DYSEQUILIBRIUM | 0.5385 | 1.000 | 0.5385 | 2.3 |
| 66 | EPISTAXIS | 0.559 | 1.000 | 0.5590 | 2.5 |
| 67 | EPIGLOTTITIS | 0.8105 | 1.000 | 0.8105 | 2.8 |
| 68 | OTITIS MEDIA & URI AGE >17 W CC | 0.675 | 1.000 | 0.6750 | 3.4 |
| 69 | OTITIS MEDIA & URI AGE >17 W/O CC | 0.5152 | 1.000 | 0.5152 | 2.7 |
| 70 | OTITIS MEDIA & URI AGE 0-17 | 0.4628 | 1.000 | 0.4628 | 2.4 |
| 71 | LARYNGOTRACHEITIS | 0.7712 | 1.000 | 0.7712 | 3 |
| 72 | NASAL TRAUMA & DEFORMITY | 0.6428 | 1.000 | 0.6428 | 2.6 |
| 73 | OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 | 0.7777 | 1.000 | 0.7777 | 3.3 |
| 74 | OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17 | 0.3358 | 1.000 | 0.3358 | 2.1 |
| 75 | MAJOR CHEST PROCEDURES | 3.1331 | 1.000 | 3.1331 | 7.8 |
| 76 | OTHER RESP SYSTEM O.R. PROCEDURES W CC | 2.7908 | 1.000 | 2.7908 | 8.4 |
| 77 | OTHER RESP SYSTEM O.R. PROCEDURES W/O CC | 1.1887 | 1.000 | 1.1887 | 3.5 |
| 78 | PULMONARY EMBOLISM | 1.3698 | 1.000 | 1.3698 | 6 |
| 79 | RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC | 1.6501 | 1.000 | 1.6501 | 6.6 |
| 80 | RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC | 0.9373 | 1.000 | 0.9373 | 4.7 |
| 81 | RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17 | 1.5204 | 1.000 | 1.5204 | 6.1 |
| 82 | RESPIRATORY NEOPLASMS | 1.3799 | 1.000 | 1.3799 | 5.2 |
| 83 | MAJOR CHEST TRAUMA W CC | 0.9808 | 1.000 | 0.9808 | 4.4 |
| 84 | MAJOR CHEST TRAUMA W/O CC | 0.5539 | 1.000 | 0.5539 | 2.8 |
| 85 | PLEURAL EFFUSION W CC | 1.2198 | 1.000 | 1.2198 | 4.9 |
| 86 | PLEURAL EFFUSION W/O CC | 0.6984 | 1.000 | 0.6984 | 2.9 |
| 87 | PULMONARY EDEMA & RESPIRATORY FAILURE | 1.3781 | 1.000 | 1.3781 | 4.8 |
| 88 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE | 0.9317 | 1.000 | 0.9317 | 4.2 |
| 89 | SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC | 1.0647 | 1.000 | 1.0647 | 5 |
| 90 | SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC | 0.659 | 1.000 | 0.6590 | 3.6 |
| 91 | SIMPLE PNEUMONIA & PLEURISY AGE 0-17 | 0.689 | 1.000 | 0.6890 | 2.8 |
| 92 | INTERSTITIAL LUNG DISEASE W CC | 1.1863 | 1.000 | 1.1863 | 5 |
| 93 | INTERSTITIAL LUNG DISEASE W/O CC | 0.7309 | 1.000 | 0.7309 | 3.3 |
| 94 | PNEUMOTHORAX W CC | 1.1704 | 1.000 | 1.1704 | 4.8 |
| 95 | PNEUMOTHORAX W/O CC | 0.6098 | 1.000 | 0.6098 | 3 |
| 96 | BRONCHITIS & ASTHMA AGE >17 W CC | 0.7871 | 1.000 | 0.7871 | 3.9 |
| 97 | BRONCHITIS & ASTHMA AGE >17 W/O CC | 0.5873 | 1.000 | 0.5873 | 3.1 |
| 98 | BRONCHITIS & ASTHMA AGE 0-17 | 0.8768 | 1.000 | 0.8768 | 3.2 |
| 99 | RESPIRATORY SIGNS & SYMPTOMS W CC | 0.7117 | 1.000 | 0.7117 | 2.5 |
| 100 | RESPIRATORY SIGNS & SYMPTOMS W/O CC | 0.5437 | 1.000 | 0.5437 | 1.8 |
| 101 | OTHER RESPIRATORY SYSTEM DIAGNOSES W CC | 0.8563 | 1.000 | 0.8563 | 3.3 |
| 102 | OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC | 0.555 | 1.000 | 0.5550 | 2.1 |
| 103 | HEART TRANSPLANT | excluded | excluded | excluded | excluded |
| 104 | CARDIAC VALVE PROCEDURES W CARDIAC CATH | 7.1843 | 1.000 | 7.1843 | 8.9 |
| 105 | CARDIAC VALVE PROCEDURES W/O CARDIAC CATH | 5.6567 | 1.000 | 5.6567 | 7.4 |
| 106 | CORONARY BYPASS W CARDIAC CATH | 7.5203 | 1.000 | 7.5203 | 9.3 |
| 107 | CORONARY BYPASS W/O CARDIAC CATH | 5.3762 | 1.000 | 5.3762 | 9.2 |
| 108 | OTHER CARDIOTHORACIC PROCEDURES | 5.6525 | 1.000 | 5.6525 | 8 |
| 109 | CORONARY BYPASS W/O PTCA OR CARDIAC CATH | 4.0198 | 1.000 | 4.0198 | 6.8 |
| 110 | MAJOR CARDIOVASCULAR PROCEDURES W CC | 4.1358 | 1.000 | 4.1358 | 7.1 |
| 111 | MAJOR CARDIOVASCULAR PROCEDURES W/O CC | 2.241 | 1.000 | 2.2410 | 4.7 |
| 112 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES | 1.8677 | 0.841 | 1.5705 | 2.6 |
| 113 | AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE | 2.7806 | 1.000 | 2.7806 | 9.8 |
| 114 | UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS | 1.5656 | 1.000 | 1.5656 | 6 |
| 115 | PERM PACE IMPLNT W AMI,HRT FAIL OR SHOCK OR AICD LEAD OR GEN PROC | 3.4711 | 1.000 | 3.4711 | 6 |
| 116 | OTH PERM CARDIAC PACEMAKER IMPLANT OR PTCA W CORONARY ART STENT | 2.419 | 1.000 | 2.4190 | 2.6 |
| 117 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT | 1.2966 | 1.000 | 1.2966 | 2.6 |
| 118 | CARDIAC PACEMAKER DEVICE REPLACEMENT | 1.4939 | 1.000 | 1.4939 | 1.9 |
| 119 | VEIN LIGATION & STRIPPING | 1.26 | 1.000 | 1.2600 | 2.9 |
| 120 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | 2.0352 | 1.000 | 2.0352 | 4.9 |
| 121 | CIRCULATORY DISORDERS W AMI & MAJOR COMP DISCH ALIVE | 1.6194 | 1.000 | 1.6194 | 5.5 |
| 122 | CIRCULATORY DISORDERS W AMI W/O MAJOR COMP DISCH ALIVE | 1.0884 | 1.000 | 1.0884 | 3.3 |
| 123 | CIRCULATORY DISORDERS W AMI, EXPIRED | 1.5528 | 1.000 | 1.5528 | 2.8 |
| 124 | CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG | 1.4134 | 1.000 | 1.4134 | 3.3 |
| 125 | CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG | 1.0606 | 1.000 | 1.0606 | 2.2 |
| 126 | ACUTE & SUBACUTE ENDOCARDITIS | 2.5379 | 1.000 | 2.5379 | 9.3 |
| 127 | HEART FAILURE & SHOCK | 1.013 | 1.000 | 1.0130 | 4.2 |
| 128 | DEEP VEIN THROMBOPHLEBITIS | 0.7651 | 1.000 | 0.7651 | 5 |
| 129 | CARDIAC ARREST, UNEXPLAINED | 1.0968 | 1.000 | 1.0968 | 1.8 |
| 130 | PERIPHERAL VASCULAR DISORDERS W CC | 0.9471 | 1.000 | 0.9471 | 4.7 |
| 131 | PERIPHERAL VASCULAR DISORDERS W/O CC | 0.5898 | 1.000 | 0.5898 | 3.6 |
| 132 | ATHEROSCLEROSIS W CC | 0.6707 | 1.000 | 0.6707 | 2.4 |
| 133 | ATHEROSCLEROSIS W/O CC | 0.5663 | 1.000 | 0.5663 | 1.9 |
| 134 | HYPERTENSION | 0.5917 | 1.000 | 0.5917 | 2.6 |
| 135 | CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC | 0.9083 | 1.000 | 0.9083 | 3.3 |
| 136 | CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O CC | 0.6065 | 1.000 | 0.6065 | 2.2 |
| 137 | CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17 | 0.8192 | 1.000 | 0.8192 | 3.3 |
| 138 | CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC | 0.8291 | 1.000 | 0.8291 | 3.1 |
| 139 | CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC | 0.5141 | 1.000 | 0.5141 | 2 |
| 140 | ANGINA PECTORIS | 0.574 | 0.783 | 0.4497 | 2.2 |
| 141 | SYNCOPE & COLLAPSE W CC | 0.7219 | 1.000 | 0.7219 | 2.9 |
| 142 | SYNCOPE & COLLAPSE W/O CC | 0.5552 | 1.000 | 0.5552 | 2.2 |
| 143 | CHEST PAIN | 0.5402 | 0.842 | 0.4547 | 1.8 |
| 144 | OTHER CIRCULATORY SYSTEM DIAGNOSES W CC | 1.1668 | 1.000 | 1.1668 | 3.8 |
| 145 | OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC | 0.6322 | 1.000 | 0.6322 | 2.2 |
| 146 | RECTAL RESECTION W CC | 2.743 | 1.000 | 2.7430 | 8.9 |
| 147 | RECTAL RESECTION W/O CC | 1.6221 | 1.000 | 1.6221 | 6 |
| 148 | MAJOR SMALL & LARGE BOWEL PROCEDURES W CC | 3.4347 | 1.000 | 3.4347 | 10.1 |
| 149 | MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC | 1.5667 | 1.000 | 1.5667 | 6.1 |
| 150 | PERITONEAL ADHESIOLYSIS W CC | 2.8523 | 1.000 | 2.8523 | 9.1 |
| 151 | PERITONEAL ADHESIOLYSIS W/O CC | 1.3427 | 1.000 | 1.3427 | 4.8 |
| 152 | MINOR SMALL & LARGE BOWEL PROCEDURES W CC | 1.9462 | 1.000 | 1.9462 | 6.8 |
| 153 | MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC | 1.208 | 1.000 | 1.2080 | 4.9 |
| 154 | STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W CC | 4.1475 | 1.000 | 4.1475 | 10.1 |
| 155 | STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC | 1.3751 | 1.000 | 1.3751 | 3.3 |
| 156 | STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17 | 0.8436 | 1.000 | 0.8436 | 6 |
| 157 | ANAL & STOMAL PROCEDURES W CC | 1.2388 | 1.000 | 1.2388 | 3.9 |
| 158 | ANAL & STOMAL PROCEDURES W/O CC | 0.6638 | 1.000 | 0.6638 | 2.1 |
| 159 | HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC | 1.3347 | 1.000 | 1.3347 | 3.8 |
| 160 | HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC | 0.7837 | 0.902 | 0.7066 | 2.2 |
| 161 | INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC | 1.1017 | 1.000 | 1.1017 | 2.9 |
| 162 | INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O CC | 0.6229 | 0.867 | 0.5402 | 1.6 |
| 163 | HERNIA PROCEDURES AGE 0-17 | 0.6921 | 1.000 | 0.6921 | 2.4 |
| 164 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC | 2.376 | 1.000 | 2.3760 | 7.1 |
| 165 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC | 1.2838 | 1.000 | 1.2838 | 4.3 |
| 166 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC | 1.4802 | 1.000 | 1.4802 | 4 |
| 167 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC | 0.8937 | 1.000 | 0.8937 | 2.3 |
| 168 | MOUTH PROCEDURES W CC | 1.2141 | 1.000 | 1.2141 | 3.2 |
| 169 | MOUTH PROCEDURES W/O CC | 0.7455 | 1.000 | 0.7455 | 1.9 |
| 170 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC | 2.8686 | 1.000 | 2.8686 | 7.7 |
| 171 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC | 1.1975 | 1.000 | 1.1975 | 3.6 |
| 172 | DIGESTIVE MALIGNANCY W CC | 1.3485 | 1.000 | 1.3485 | 5.1 |
| 173 | DIGESTIVE MALIGNANCY W/O CC | 0.77 | 1.000 | 0.7700 | 2.8 |
| 174 | G.I. HEMORRHAGE W CC | 0.9985 | 1.000 | 0.9985 | 3.9 |
| 175 | G.I. HEMORRHAGE W/O CC | 0.5501 | 1.000 | 0.5501 | 2.5 |
| 176 | COMPLICATED PEPTIC ULCER | 1.1052 | 1.000 | 1.1052 | 4.1 |
| 177 | UNCOMPLICATED PEPTIC ULCER W CC | 0.8998 | 1.000 | 0.8998 | 3.7 |
| 178 | UNCOMPLICATED PEPTIC ULCER W/O CC | 0.6604 | 1.000 | 0.6604 | 2.6 |
| 179 | INFLAMMATORY BOWEL DISEASE | 1.0576 | 1.000 | 1.0576 | 4.7 |
| 180 | G.I. OBSTRUCTION W CC | 0.9423 | 1.000 | 0.9423 | 4.2 |
| 181 | G.I. OBSTRUCTION W/O CC | 0.5304 | 1.000 | 0.5304 | 2.8 |
| 182 | ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC | 0.7922 | 1.000 | 0.7922 | 3.4 |
| 183 | ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC | 0.5717 | 1.000 | 0.5717 | 2.4 |
| 184 | ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17 | 0.5119 | 1.000 | 0.5119 | 2.5 |
| 185 | DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17 | 0.8621 | 1.000 | 0.8621 | 3.3 |
| 186 | DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17 | 0.3216 | 1.000 | 0.3216 | 2.9 |
| 187 | DENTAL EXTRACTIONS & RESTORATIONS | 0.7649 | 1.000 | 0.7649 | 2.9 |
| 188 | OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC | 1.1005 | 1.000 | 1.1005 | 4.1 |
| 189 | OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC | 0.5796 | 1.000 | 0.5796 | 2.4 |
| 190 | OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 | 0.9884 | 1.000 | 0.9884 | 4.1 |
| 191 | PANCREAS, LIVER & SHUNT PROCEDURES W CC | 4.3914 | 1.000 | 4.3914 | 10.5 |
| 192 | PANCREAS, LIVER & SHUNT PROCEDURES W/O CC | 1.7916 | 1.000 | 1.7916 | 5.3 |
| 193 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC | 3.3861 | 1.000 | 3.3861 | 10.3 |
| 194 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC | 1.6191 | 1.000 | 1.6191 | 5.6 |
| 195 | CHOLECYSTECTOMY W C.D.E. W CC | 2.9062 | 1.000 | 2.9062 | 8.3 |
| 196 | CHOLECYSTECTOMY W C.D.E. W/O CC | 1.6593 | 1.000 | 1.6593 | 4.9 |
| 197 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC | 2.4544 | 1.000 | 2.4544 | 7.2 |
| 198 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC | 1.2339 | 1.000 | 1.2339 | 3.9 |
| 199 | HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY | 2.3584 | 1.000 | 2.3584 | 7.2 |
| 200 | HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY | 3.2262 | 1.000 | 3.2262 | 7 |
| 201 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES | 3.4035 | 1.000 | 3.4035 | 10.2 |
| 202 | CIRRHOSIS & ALCOHOLIC HEPATITIS | 1.3001 | 1.000 | 1.3001 | 4.9 |
| 203 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS | 1.325 | 1.000 | 1.3250 | 5 |
| 204 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY | 1.2018 | 1.000 | 1.2018 | 4.5 |
| 205 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC | 1.2048 | 1.000 | 1.2048 | 4.7 |
| 206 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC | 0.6751 | 1.000 | 0.6751 | 3 |
| 207 | DISORDERS OF THE BILIARY TRACT W CC | 1.1032 | 1.000 | 1.1032 | 4 |
| 208 | DISORDERS OF THE BILIARY TRACT W/O CC | 0.6538 | 1.000 | 0.6538 | 2.3 |
| 209 | MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF LOWER EXTREMITY | 2.0912 | 0.950 | 1.9866 | 4.6 |
| 210 | HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC | 1.8152 | 1.180 | 2.1419 | 6 |
| 211 | HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC | 1.2647 | 0.973 | 1.2300 | 4.5 |
| 212 | HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17 | 0.8472 | 1.000 | 0.8472 | 11.1 |
| 213 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS | 1.7726 | 1.000 | 1.7726 | 6.4 |
| 214 | NO LONGER VALID | 0 | 0.967 | 0.0000 | 0 |
| 215 | NO LONGER VALID | 0 | 0.956 | 0.0000 | 0 |
| 216 | BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE | 2.2042 | 1.000 | 2.2042 | 7.1 |
| 217 | WND DEBRID & SKN GRFT EXCEPT HAND, FOR MUSCSKELET & CONN TISS DIS | 2.923 | 0.572 | 1.6711 | 8.9 |
| 218 | LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT,FEMUR AGE >17 W CC | 1.5337 | 1.030 | 1.5794 | 4.2 |
| 219 | LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT,FEMUR AGE >17 W/O CC | 1.0255 | 0.968 | 0.9928 | 2.7 |
| 220 | LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT,FEMUR AGE 0-17 | 0.5844 | 1.000 | 0.5844 | 5.3 |
| 221 | NO LONGER VALID | 0 | 0.818 | 0.0000 | 0 |
| 222 | NO LONGER VALID | 0 | 1.038 | 0.0000 | 0 |
| 223 | MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC | 0.9585 | 0.885 | 0.8483 | 2 |
| 224 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC | 0.7997 | 1.012 | 0.8095 | 1.7 |
| 225 | FOOT PROCEDURES | 1.0851 | 1.001 | 1.0860 | 3.3 |
| 226 | SOFT TISSUE PROCEDURES W CC | 1.477 | 1.000 | 1.4770 | 4.3 |
| 227 | SOFT TISSUE PROCEDURES W/O CC | 0.8036 | 0.944 | 0.7588 | 2.1 |
| 228 | MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC | 1.0664 | 0.906 | 0.9665 | 2.4 |
| 229 | HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC | 0.7169 | 1.037 | 0.7432 | 1.8 |
| 230 | LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR | 1.249 | 1.000 | 1.2490 | 3.4 |
| 231 | LOCAL EXCISION & REMOVAL OF INT FIX DEVICES EXCEPT HIP & FEMUR | 1.3825 | 0.734 | 1.0149 | 3.2 |
| 232 | ARTHROSCOPY | 1.0828 | 0.817 | 0.8842 | 2.3 |
| 233 | OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC | 2.089 | 1.000 | 2.0890 | 5.3 |
| 234 | OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC | 1.2661 | 0.813 | 1.0297 | 2.7 |
| 235 | FRACTURES OF FEMUR | 0.7582 | 1.000 | 0.7582 | 3.8 |
| 236 | FRACTURES OF HIP & PELVIS | 0.7218 | 0.979 | 0.7066 | 4 |
| 237 | SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH | 0.5681 | 1.000 | 0.5681 | 3 |
| 238 | OSTEOMYELITIS | 1.3496 | 1.000 | 1.3496 | 6.4 |
| 239 | PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY | 0.9745 | 1.000 | 0.9745 | 4.9 |
| 240 | CONNECTIVE TISSUE DISORDERS W CC | 1.2712 | 1.000 | 1.2712 | 4.9 |
| 241 | CONNECTIVE TISSUE DISORDERS W/O CC | 0.6177 | 1.000 | 0.6177 | 3.1 |
| 242 | SEPTIC ARTHRITIS | 1.0724 | 1.000 | 1.0724 | 5.1 |
| 243 | MEDICAL BACK PROBLEMS | 0.7262 | 0.761 | 0.5526 | 3.7 |
| 244 | BONE DISEASES & SPECIFIC ARTHROPATHIES W CC | 0.7155 | 1.000 | 0.7155 | 3.7 |
| 245 | BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC | 0.4832 | 1.000 | 0.4832 | 2.8 |
| 246 | NON-SPECIFIC ARTHROPATHIES | 0.557 | 1.000 | 0.5570 | 2.9 |
| 247 | SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE | 0.5696 | 1.000 | 0.5696 | 2.6 |
| 248 | TENDONITIS, MYOSITIS & BURSITIS | 0.7864 | 1.000 | 0.7864 | 3.7 |
| 249 | AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE | 0.6913 | 1.000 | 0.6913 | 2.6 |
| 250 | FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W CC | 0.6929 | 1.000 | 0.6929 | 3.3 |
| 251 | FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC | 0.4995 | 0.901 | 0.4501 | 2.4 |
| 252 | FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE 0-17 | 0.2538 | 1.000 | 0.2538 | 1.8 |
| 253 | FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC | 0.7253 | 1.000 | 0.7253 | 3.7 |
| 254 | FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC | 0.4413 | 1.003 | 0.4427 | 2.6 |
| 255 | FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17 | 0.2956 | 1.000 | 0.2956 | 2.9 |
| 256 | OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES | 0.7959 | 1.000 | 0.7959 | 3.8 |
| 257 | TOTAL MASTECTOMY FOR MALIGNANCY W CC | 0.9107 | 1.000 | 0.9107 | 2.3 |
| 258 | TOTAL MASTECTOMY FOR MALIGNANCY W/O CC | 0.7232 | 1.000 | 0.7232 | 1.8 |
| 259 | SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC | 0.9068 | 1.000 | 0.9068 | 1.8 |
| 260 | SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC | 0.6532 | 1.000 | 0.6532 | 1.3 |
| 261 | BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION | 0.9362 | 1.000 | 0.9362 | 1.7 |
| 262 | BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY | 0.8754 | 1.000 | 0.8754 | 2.7 |
| 263 | SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC | 2.1219 | 1.000 | 2.1219 | 8.9 |
| 264 | SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC | 1.1479 | 1.000 | 1.1479 | 5.4 |
| 265 | SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC | 1.5309 | 1.000 | 1.5309 | 4.3 |
| 266 | SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC | 0.8707 | 1.131 | 0.9844 | 2.4 |
| 267 | PERIANAL & PILONIDAL PROCEDURES | 1.0792 | 1.000 | 1.0792 | 3.1 |
| 268 | SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES | 1.1405 | 1.000 | 1.1405 | 2.4 |
| 269 | OTHER SKIN, SUBCUT TISS & BREAST PROC W CC | 1.7004 | 1.000 | 1.7004 | 5.8 |
| 270 | OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC | 0.767 | 1.000 | 0.7670 | 2.3 |
| 271 | SKIN ULCERS | 1.0104 | 1.000 | 1.0104 | 5.5 |
| 272 | MAJOR SKIN DISORDERS W CC | 0.9994 | 1.000 | 0.9994 | 4.8 |
| 273 | MAJOR SKIN DISORDERS W/O CC | 0.6179 | 1.000 | 0.6179 | 3.2 |
| 274 | MALIGNANT BREAST DISORDERS W CC | 1.2061 | 1.000 | 1.2061 | 4.9 |
| 275 | MALIGNANT BREAST DISORDERS W/O CC | 0.5301 | 1.000 | 0.5301 | 2.4 |
| 276 | NON-MALIGANT BREAST DISORDERS | 0.6899 | 1.000 | 0.6899 | 3.6 |
| 277 | CELLULITIS AGE >17 W CC | 0.8396 | 0.791 | 0.6641 | 4.7 |
| 278 | CELLULITIS AGE >17 W/O CC | 0.5522 | 0.865 | 0.4779 | 3.6 |
| 279 | CELLULITIS AGE 0-17 | 0.6644 | 1.000 | 0.6644 | 4.2 |
| 280 | TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC | 0.6788 | 1.000 | 0.6788 | 3.2 |
| 281 | TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC | 0.4729 | 0.971 | 0.4591 | 2.4 |
| 282 | TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17 | 0.257 | 1.000 | 0.2570 | 2.2 |
| 283 | MINOR SKIN DISORDERS W CC | 0.6917 | 1.000 | 0.6917 | 3.5 |
| 284 | MINOR SKIN DISORDERS W/O CC | 0.4336 | 1.000 | 0.4336 | 2.5 |
| 285 | AMPUTAT OF LOWER LIMB FOR ENDOCRINE, NUTRIT,& METABOL DISORDERS | 1.9961 | 1.000 | 1.9961 | 7.7 |
| 286 | ADRENAL & PITUITARY PROCEDURES | 2.1299 | 1.000 | 2.1299 | 4.9 |
| 287 | SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS | 1.8283 | 1.000 | 1.8283 | 7.8 |
| 288 | O.R. PROCEDURES FOR OBESITY | 2.1607 | 1.000 | 2.1607 | 4.5 |
| 289 | PARATHYROID PROCEDURES | 0.9914 | 1.000 | 0.9914 | 2 |
| 290 | THYROID PROCEDURES | 0.9193 | 1.000 | 0.9193 | 1.8 |
| 291 | THYROGLOSSAL PROCEDURES | 0.5487 | 1.000 | 0.5487 | 1.4 |
| 292 | OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC | 2.4538 | 1.000 | 2.4538 | 6.9 |
| 293 | OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC | 1.2289 | 1.000 | 1.2289 | 3.6 |
| 294 | DIABETES AGE >35 | 0.7589 | 1.000 | 0.7589 | 3.6 |
| 295 | DIABETES AGE 0-35 | 0.7587 | 1.000 | 0.7587 | 2.9 |
| 296 | NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC | 0.8594 | 1.000 | 0.8594 | 4 |
| 297 | NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC | 0.5179 | 1.000 | 0.5179 | 2.8 |
| 298 | NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17 | 0.5269 | 1.000 | 0.5269 | 2.5 |
| 299 | INBORN ERRORS OF METABOLISM | 0.9632 | 1.000 | 0.9632 | 4 |
| 300 | ENDOCRINE DISORDERS W CC | 1.0829 | 1.000 | 1.0829 | 4.7 |
| 301 | ENDOCRINE DISORDERS W/O CC | 0.6133 | 1.000 | 0.6133 | 2.9 |
| 302 | KIDNEY TRANSPLANT | excluded | excluded | excluded | excluded |
| 303 | KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM | 2.4602 | 1.000 | 2.4602 | 7 |
| 304 | KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC | 2.3407 | 1.000 | 2.3407 | 6.4 |
| 305 | KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC | 1.1825 | 1.000 | 1.1825 | 3.1 |
| 306 | PROSTATECTOMY W CC | 1.2489 | 1.000 | 1.2489 | 3.7 |
| 307 | PROSTATECTOMY W/O CC | 0.646 | 1.000 | 0.6460 | 1.9 |
| 308 | MINOR BLADDER PROCEDURES W CC | 1.6449 | 1.000 | 1.6449 | 4.2 |
| 309 | MINOR BLADDER PROCEDURES W/O CC | 0.9339 | 1.000 | 0.9339 | 2 |
| 310 | TRANSURETHRAL PROCEDURES W CC | 1.1172 | 1.000 | 1.1172 | 3 |
| 311 | TRANSURETHRAL PROCEDURES W/O CC | 0.6174 | 1.000 | 0.6174 | 1.6 |
| 312 | URETHRAL PROCEDURES, AGE >17 W CC | 1.0173 | 1.000 | 1.0173 | 3 |
| 313 | URETHRAL PROCEDURES, AGE >17 W/O CC | 0.6444 | 1.000 | 0.6444 | 1.7 |
| 314 | URETHRAL PROCEDURES, AGE 0-17 | 0.4953 | 1.000 | 0.4953 | 2.3 |
| 315 | OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES | 2.0474 | 1.000 | 2.0474 | 4.2 |
| 316 | RENAL FAILURE | 1.3424 | 1.000 | 1.3424 | 4.9 |
| 317 | ADMIT FOR RENAL DIALYSIS | 0.7395 | 1.000 | 0.7395 | 2.1 |
| 318 | KIDNEY & URINARY TRACT NEOPLASMS W CC | 1.1313 | 1.000 | 1.1313 | 4.3 |
| 319 | KIDNEY & URINARY TRACT NEOPLASMS W/O CC | 0.604 | 1.000 | 0.6040 | 2.2 |
| 320 | KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC | 0.8621 | 1.000 | 0.8621 | 4.3 |
| 321 | KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC | 0.5686 | 1.000 | 0.5686 | 3.2 |
| 322 | KIDNEY & URINARY TRACT INFECTIONS AGE 0-17 | 0.4939 | 1.000 | 0.4939 | 3.3 |
| 323 | URINARY STONES W CC, &/OR ESW LITHOTRIPSY | 0.7996 | 1.000 | 0.7996 | 2.4 |
| 324 | URINARY STONES W/O CC | 0.4509 | 1.000 | 0.4509 | 1.6 |
| 325 | KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC | 0.646 | 1.000 | 0.6460 | 3 |
| 326 | KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC | 0.4297 | 1.000 | 0.4297 | 2.1 |
| 327 | KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17 | 0.3543 | 1.000 | 0.3543 | 3.1 |
| 328 | URETHRAL STRICTURE AGE >17 W CC | 0.7455 | 1.000 | 0.7455 | 2.8 |
| 329 | URETHRAL STRICTURE AGE >17 W/O CC | 0.5253 | 1.000 | 0.5253 | 1.7 |
| 330 | URETHRAL STRICTURE AGE 0-17 | 0.3191 | 1.000 | 0.3191 | 1.6 |
| 331 | OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC | 1.0221 | 1.000 | 1.0221 | 4.1 |
| 332 | OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC | 0.5997 | 1.000 | 0.5997 | 2.5 |
| 333 | OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17 | 0.8247 | 1.000 | 0.8247 | 3.5 |
| 334 | MAJOR MALE PELVIC PROCEDURES W CC | 1.5591 | 1.000 | 1.5591 | 4.2 |
| 335 | MAJOR MALE PELVIC PROCEDURES W/O CC | 1.1697 | 1.000 | 1.1697 | 3.2 |
| 336 | TRANSURETHRAL PROSTATECTOMY W CC | 0.888 | 1.000 | 0.8880 | 2.7 |
| 337 | TRANSURETHRAL PROSTATECTOMY W/O CC | 0.6152 | 1.000 | 0.6152 | 1.9 |
| 338 | TESTES PROCEDURES, FOR MALIGNANCY | 1.19 | 1.000 | 1.1900 | 3.5 |
| 339 | TESTES PROCEDURES, NON-MALIGNANCY AGE >17 | 1.0769 | 1.000 | 1.0769 | 3 |
| 340 | TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17 | 0.2835 | 1.000 | 0.2835 | 2.4 |
| 341 | PENIS PROCEDURES | 1.1709 | 1.000 | 1.1709 | 2.1 |
| 342 | CIRCUMCISION AGE >17 | 0.824 | 1.000 | 0.8240 | 2.5 |
| 343 | CIRCUMCISION AGE 0-17 | 0.1541 | 1.000 | 0.1541 | 1.7 |
| 344 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY | 1.1519 | 1.000 | 1.1519 | 1.6 |
| 345 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXCEPT FOR MALIGNANCY | 0.88 | 1.000 | 0.8800 | 2.6 |
| 346 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC | 0.9756 | 1.000 | 0.9756 | 4.3 |
| 347 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W/O CC | 0.5922 | 1.000 | 0.5922 | 2.4 |
| 348 | BENIGN PROSTATIC HYPERTROPHY W CC | 0.7142 | 1.000 | 0.7142 | 3.2 |
| 349 | BENIGN PROSTATIC HYPERTROPHY W/O CC | 0.438 | 1.000 | 0.4380 | 2 |
| 350 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM | 0.6992 | 1.000 | 0.6992 | 3.6 |
| 351 | STERILIZATION, MALE | 0.2364 | 1.000 | 0.2364 | 1.3 |
| 352 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES | 0.6858 | 1.000 | 0.6858 | 2.8 |
| 353 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY | 1.9292 | 1.000 | 1.9292 | 5.3 |
| 354 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC | 1.5284 | 1.000 | 1.5284 | 4.9 |
| 355 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC | 0.9278 | 1.000 | 0.9278 | 3.1 |
| 356 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | 0.7846 | 1.000 | 0.7846 | 2.1 |
| 357 | UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY | 2.3628 | 1.000 | 2.3628 | 6.9 |
| 358 | UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC | 1.2263 | 1.000 | 1.2263 | 3.7 |
| 359 | UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC | 0.8593 | 1.000 | 0.8593 | 2.6 |
| 360 | VAGINA, CERVIX & VULVA PROCEDURES | 0.886 | 1.000 | 0.8860 | 2.4 |
| 361 | LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION | 1.2318 | 1.000 | 1.2318 | 2.2 |
| 362 | ENDOSCOPIC TUBAL INTERRUPTION | 0.3022 | 1.000 | 0.3022 | 1.4 |
| 363 | D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY | 0.8136 | 1.000 | 0.8136 | 2.5 |
| 364 | D&C, CONIZATION EXCEPT FOR MALIGNANCY | 0.753 | 1.000 | 0.7530 | 2.6 |
| 365 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES | 1.8425 | 1.000 | 1.8425 | 4.9 |
| 366 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC | 1.2467 | 1.000 | 1.2467 | 4.8 |
| 367 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC | 0.5676 | 1.000 | 0.5676 | 2.4 |
| 368 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM | 1.1205 | 1.000 | 1.1205 | 5 |
| 369 | MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS | 0.5704 | 1.000 | 0.5704 | 2.4 |
| 370 | CESAREAN SECTION W CC | 1.0631 | 1.000 | 1.0631 | 4.4 |
| 371 | CESAREAN SECTION W/O CC | 0.7157 | 1.000 | 0.7157 | 3.3 |
| 372 | VAGINAL DELIVERY W COMPLICATING DIAGNOSES | 0.6077 | 1.000 | 0.6077 | 2.7 |
| 373 | VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES | 0.4169 | 1.000 | 0.4169 | 2 |
| 374 | VAGINAL DELIVERY W STERILIZATION &/OR D&C | 0.7565 | 1.000 | 0.7565 | 2.6 |
| 375 | VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C | 0.686 | 1.000 | 0.6860 | 4.4 |
| 376 | POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE | 0.5224 | 1.000 | 0.5224 | 2.6 |
| 377 | POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE | 0.8899 | 1.000 | 0.8899 | 2.6 |
| 378 | ECTOPIC PREGNANCY | 0.7664 | 1.000 | 0.7664 | 2 |
| 379 | THREATENED ABORTION | 0.3959 | 1.000 | 0.3959 | 2 |
| 380 | ABORTION W/O D&C | 0.4843 | 1.000 | 0.4843 | 1.8 |
| 381 | ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | 0.5331 | 1.000 | 0.5331 | 1.5 |
| 382 | FALSE LABOR | 0.2127 | 1.000 | 0.2127 | 1.3 |
| 383 | OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS | 0.5137 | 1.000 | 0.5137 | 2.7 |
| 384 | OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS | 0.3161 | 1.000 | 0.3161 | 1.6 |
| 385 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | 1.3767 | 1.000 | 1.3767 | 1.8 |
| 386 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | 4.54 | 1.000 | 4.5400 | 17.9 |
| 387 | PREMATURITY W MAJOR PROBLEMS | 3.1007 | 1.000 | 3.1007 | 13.3 |
| 388 | PREMATURITY W/O MAJOR PROBLEMS | 1.8709 | 1.000 | 1.8709 | 8.6 |
| 389 | FULL TERM NEONATE W MAJOR PROBLEMS | 1.8408 | 1.000 | 1.8408 | 4.7 |
| 390 | NEONATE W OTHER SIGNIFICANT PROBLEMS | 0.9471 | 1.000 | 0.9471 | 3 |
| 391 | NORMAL NEWBORN | 0.1527 | 1.000 | 0.1527 | 3.1 |
| 392 | SPLENECTOMY AGE >17 | 3.1739 | 1.000 | 3.1739 | 7.1 |
| 393 | SPLENECTOMY AGE 0-17 | 1.3486 | 1.000 | 1.3486 | 9.1 |
| 394 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS | 1.5969 | 1.000 | 1.5969 | 4.1 |
| 395 | RED BLOOD CELL DISORDERS AGE >17 | 0.8257 | 1.000 | 0.8257 | 3.3 |
| 396 | RED BLOOD CELL DISORDERS AGE 0-17 | 1.1573 | 1.000 | 1.1573 | 2.5 |
| 397 | COAGULATION DISORDERS | 1.2278 | 1.000 | 1.2278 | 3.8 |
| 398 | RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC | 1.275 | 1.000 | 1.2750 | 4.7 |
| 399 | RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC | 0.6881 | 1.000 | 0.6881 | 2.8 |
| 400 | LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE | 2.6309 | 1.000 | 2.6309 | 5.8 |
| 401 | LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC | 2.7198 | 1.000 | 2.7198 | 7.8 |
| 402 | LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC | 1.0985 | 1.000 | 1.0985 | 2.8 |
| 403 | LYMPHOMA & NON-ACUTE LEUKEMIA W CC | 1.7594 | 1.000 | 1.7594 | 5.7 |
| 404 | LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC | 0.848 | 1.000 | 0.8480 | 3.1 |
| 405 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17 | 1.912 | 1.000 | 1.9120 | 4.9 |
| 406 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC | 2.8275 | 1.000 | 2.8275 | 7.6 |
| 407 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC | 1.3179 | 1.000 | 1.3179 | 3.6 |
| 408 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC | 2.0008 | 1.000 | 2.0008 | 4.8 |
| 409 | RADIOTHERAPY | 1.1215 | 1.000 | 1.1215 | 4.4 |
| 410 | CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS | 0.9468 | 1.000 | 0.9468 | 2.9 |
| 411 | HISTORY OF MALIGNANCY W/O ENDOSCOPY | 0.3305 | 1.000 | 0.3305 | 2 |
| 412 | HISTORY OF MALIGNANCY W ENDOSCOPY | 0.4841 | 1.000 | 0.4841 | 2 |
| 413 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC | 1.3645 | 1.000 | 1.3645 | 5.3 |
| 414 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC | 0.7548 | 1.000 | 0.7548 | 3 |
| 415 | O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES | 3.5925 | 0.491 | 1.7628 | 10.4 |
| 416 | SEPTICEMIA AGE >17 | 1.5278 | 1.000 | 1.5278 | 5.5 |
| 417 | SEPTICEMIA AGE 0-17 | 1.1717 | 1.000 | 1.1717 | 3.7 |
| 418 | POSTOPERATIVE & POST-TRAUMATIC INFECTIONS | 1.0074 | 0.680 | 0.6851 | 4.8 |
| 419 | FEVER OF UNKNOWN ORIGIN AGE >17 W CC | 0.8709 | 1.000 | 0.8709 | 3.7 |
| 420 | FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC | 0.6057 | 1.000 | 0.6057 | 3 |
| 421 | VIRAL ILLNESS AGE >17 | 0.6796 | 1.000 | 0.6796 | 3.1 |
| 422 | VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17 | 0.7854 | 1.000 | 0.7854 | 2.8 |
| 423 | OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES | 1.725 | 1.000 | 1.7250 | 5.9 |
| 424 | O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS | excluded | excluded | excluded | excluded |
| 425 | ACUTE ADJUST REACT & DISTURBANCES OF PSYCHOSOCIAL DYSFUNCTION | excluded | excluded | excluded | excluded |
| 426 | DEPRESSIVE NEUROSES | excluded | excluded | excluded | excluded |
| 427 | NEUROSES EXCEPT DEPRESSIVE | excluded | excluded | excluded | excluded |
| 428 | DISORDERS OF PERSONALITY & IMPULSE CONTROL | excluded | excluded | excluded | excluded |
| 429 | ORGANIC DISTURBANCES & MENTAL RETARDATION | excluded | excluded | excluded | excluded |
| 430 | PSYCHOSES | excluded | excluded | excluded | excluded |
| 431 | CHILDHOOD MENTAL DISORDERS | excluded | excluded | excluded | excluded |
| 432 | OTHER MENTAL DISORDER DIAGNOSES | excluded | excluded | excluded | excluded |
| 433 | ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA | excluded | excluded | excluded | excluded |
| 434 | ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W CC | excluded | excluded | excluded | excluded |
| 435 | ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W/O CC | excluded | excluded | excluded | excluded |
| 436 | ALC/DRUG DEPENDENCE W REHABILITATION THERAPY | excluded | excluded | excluded | excluded |
| 437 | ALC/DRUG DEPENDENCE, COMBINED REHAB & DETOX THERAPY | excluded | excluded | excluded | excluded |
| 438 | NO LONGER VALID | 0 | 1.000 | 0.0000 | 0 |
| 439 | SKIN GRAFTS FOR INJURIES | 1.7092 | 1.000 | 1.7092 | 5.3 |
| 440 | WOUND DEBRIDEMENTS FOR INJURIES | 1.9096 | 0.774 | 1.4776 | 5.8 |
| 441 | HAND PROCEDURES FOR INJURIES | 0.9463 | 0.991 | 0.9382 | 2.2 |
| 442 | OTHER O.R. PROCEDURES FOR INJURIES W CC | 2.3403 | 1.000 | 2.3403 | 5.4 |
| 443 | OTHER O.R. PROCEDURES FOR INJURIES W/O CC | 0.9978 | 1.002 | 1.0002 | 2.5 |
| 444 | TRAUMATIC INJURY AGE >17 W CC | 0.7243 | 1.000 | 0.7243 | 3.2 |
| 445 | TRAUMATIC INJURY AGE >17 W/O CC | 0.5076 | 0.811 | 0.4118 | 2.4 |
| 446 | TRAUMATIC INJURY AGE 0-17 | 0.2964 | 1.000 | 0.2964 | 2.4 |
| 447 | ALLERGIC REACTIONS AGE >17 | 0.5166 | 1.000 | 0.5166 | 1.9 |
| 448 | ALLERGIC REACTIONS AGE 0-17 | 0.0975 | 1.000 | 0.0975 | 2.9 |
| 449 | POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC | 0.8076 | 1.000 | 0.8076 | 2.6 |
| 450 | POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC | 0.4406 | 0.666 | 0.2933 | 1.6 |
| 451 | POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17 | 0.2632 | 1.000 | 0.2632 | 2.1 |
| 452 | COMPLICATIONS OF TREATMENT W CC | 1.0152 | 1.000 | 1.0152 | 3.5 |
| 453 | COMPLICATIONS OF TREATMENT W/O CC | 0.4987 | 1.000 | 0.4987 | 2.2 |
| 454 | OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC | 0.8593 | 1.000 | 0.8593 | 3.2 |
| 455 | OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC | 0.4672 | 0.748 | 0.3496 | 2 |
| 456 | NO LONGER VALID | 0 | 0 | 0 | 0 |
| 457 | NO LONGER VALID | 0 | 0 | 0 | 0 |
| 458 | NO LONGER VALID | 0 | 0 | 0 | 0 |
| 459 | NO LONGER VALID | 0 | 0 | 0 | 0 |
| 460 | NO LONGER VALID | 0 | 0 | 0 | 0 |
| 461 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES | 1.2101 | 0.921 | 1.1141 | 2.4 |
| 462 | REHABILITATION | excluded | excluded | excluded | excluded |
| 463 | SIGNS & SYMPTOMS W CC | 0.6936 | 1.000 | 0.6936 | 3.3 |
| 464 | SIGNS & SYMPTOMS W/O CC | 0.4775 | 1.000 | 0.4775 | 2.4 |
| 465 | AFTERCARE W HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS | 0.5756 | 1.000 | 0.5756 | 2.1 |
| 466 | AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS | 0.684 | 1.000 | 0.6840 | 2.3 |
| 467 | OTHER FACTORS INFLUENCING HEALTH STATUS | 0.5112 | 1.000 | 0.5112 | 2.3 |
| 468 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS | 3.6399 | 1.000 | 3.6399 | 9.2 |
| 469 | PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS | 0 | 1.000 | 0.0000 | 0 |
| 470 | UNGROUPABLE | 0 | 1.000 | 0.0000 | 0 |
| 471 | BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY | 3.1957 | 1.000 | 3.1957 | 5 |
| 472 | NO LONGER VALID | 0 | 0 | 0 | 0 |
| 473 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17 | 3.5822 | 1.000 | 3.5822 | 7.6 |
| 474 | NO LONGER VALID | 0 | 1.000 | 0.0000 | 0 |
| 475 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT | excluded | excluded | excluded | excluded |
| 476 | PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS | 2.2547 | 1.000 | 2.2547 | 8.4 |
| 477 | NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS | 1.8204 | 1.000 | 1.8204 | 5.4 |
| 478 | OTHER VASCULAR PROCEDURES W CC | 2.3333 | 1.000 | 2.3333 | 4.9 |
| 479 | OTHER VASCULAR PROCEDURES W/O CC | 1.4326 | 1.000 | 1.4326 | 2.8 |
| 480 | LIVER TRANSPLANT | excluded | excluded | excluded | excluded |
| 481 | BONE MARROW TRANSPLANT | excluded | excluded | excluded | excluded |
| 482 | TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES | excluded | excluded | excluded | excluded |
| 483 | TRACHEOSTOMY EXCEPT FOR FACE, MOUTH & NECK DIAGNOSES | excluded | excluded | excluded | excluded |
| 484 | CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA | 5.5606 | 1.000 | 5.5606 | 8.8 |
| 485 | LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TR | 3.0998 | 1.000 | 3.0998 | 7.7 |
| 486 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA | 4.9048 | 1.000 | 4.9048 | 8.1 |
| 487 | OTHER MULTIPLE SIGNIFICANT TRAUMA | 2.0604 | 1.000 | 2.0604 | 5.6 |
| 488 | HIV W EXTENSIVE O.R. PROCEDURE | 4.5574 | 1.000 | 4.5574 | 11.5 |
| 489 | HIV W MAJOR RELATED CONDITION | 1.7414 | 1.000 | 1.7414 | 6 |
| 490 | HIV W OR W/O OTHER RELATED CONDITION | 0.968 | 1.000 | 0.9680 | 3.7 |
| 491 | MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY | 1.6685 | 1.000 | 1.6685 | 2.9 |
| 492 | CHEMOTHERAPY W ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS | 4.2467 | 1.000 | 4.2467 | 10.9 |
| 493 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC | 1.818 | 1.000 | 1.8180 | 4.3 |
| 494 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC | 1.0388 | 1.000 | 1.0388 | 2 |
| 495 | LUNG TRANSPLANT | excluded | excluded | excluded | excluded |
| 496 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION Note -- For admissions on or after June 27, 2001, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). | 5.5532 | 1.000 | 5.5532 | .8 |
| 497 | SPINAL FUSION W CC Note -- For admissions on or after June 29, 2001, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). | 2.9441 | 1.000 | 2.9441 | 4.9 |
| 498 | SPINAL FUSION W/O CC Note -- For admissions on or after June 29, 2001, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). | 1.9057 | 1.000 | 1.9057 | 2.8 |
| 499 | BACK & NECK PROCS EXCEPT SPINAL FUSION W CC Note -- For admissions on or after June 29, 2001, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). | 1.4572 | 1.000 | 1.4572 | 3.6 |
| 500 | BACK & NECK PROCS EXCEPT SPINAL FUSION W/O CC Note -- For admissions on or after June 29, 2001, the cost of implantable hardware and instrumentation for this DRG is excluded from the DRG computed fee and reimbursed separately pursuant to § 9792.1(c)(9). | 0.9805 | 1.000 | 0.9805 | 2.2 |
| 501 | KNEE PROC W PDX OF INFECTION W CC | 2.6283 | 1.000 | 2.6283 | 8.4 |
| 502 | KNEE PROC W PDX OF INFECTION W/O CC | 1.4434 | 1.000 | 1.4434 | 4.9 |
| 503 | KNEE PROCEDURES W/O PDX OF INFECTION | 1.2156 | 1.000 | 1.2156 | 3.1 |
| 504 | EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT | excluded | excluded | excluded | excluded |
| 505 | EXTENSIVE 3RD DEGREE BURNS W/O SKIN GRAFT. | excluded | excluded | excluded | excluded |
| 506 | FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA. | excluded | excluded | excluded | excluded |
| 507 | FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W/O CC OR SIG TRAUMA. | excluded | excluded | excluded | excluded |
| 508 | FULL THICKNESS BURN W/O SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA. | excluded | excluded | excluded | excluded |
| 509 | FULL THICKNESS BURN W/O SKIN GRAFT OR INHAL INJ W/O CC OR SIG TRAUMA. | excluded | excluded | excluded | excluded |
| 510 | NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA | excluded | excluded | excluded | excluded |
| 511 | NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA. | excluded | excluded | excluded | excluded |
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