Final Cost Outlier Thresholds Effective December 1, 2009
Also available as an Excel Spreadsheet (XLS)
APR–DRG | APR–DRG Description | 2009 Cost Outlier Thresholds |
---|---|---|
001 | Liver Transplant | $ 632,417 |
002 | Heart &/or Lung Transplant | $ 1,328,568 |
003 | Bone Marrow Transplant | $ 531,628 |
004 | Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure | $ 965,288 |
005 | Tracheostomy W Long Term Mechanical Ventilation W/O Extensive Procedure | $ 649,358 |
006 | Pancreas Transplant | $ 325,730 |
020 | Craniotomy for Trauma | $ 164,112 |
021 | Craniotomy Except for Trauma | $ 181,388 |
022 | Ventricular Shunt Procedures | $ 95,683 |
023 | Spinal Procedures | $ 120,713 |
024 | Extracranial Vascular Procedures | $ 90,435 |
026 | Other Nervous System & Related Procedures | $ 102,040 |
040 | Spinal Disorders & Injuries | $ 72,211 |
041 | Nervous System Malignancy | $ 76,357 |
042 | Degenerative Nervous System Disorders Exc Mult Sclerosis | $ 67,799 |
043 | Multiple Sclerosis & Other Demyelinating Diseases | $ 42,221 |
044 | Intracranial Hemorrhage | $ 103,759 |
045 | CVA & Precerebral Occulusion w/ Infarct | $ 55,435 |
046 | Nonspecific CVA & Precerebral Occlusion w/o Infarct | $ 42,630 |
047 | Transient Ischemia | $ 23,797 |
048 | Peripheral, Cranial & Autonomic Nerve Disorders | $ 40,095 |
049 | Bacterial & Tuberculous Infections of Nervous System | $ 126,954 |
050 | Non-bacterial Infections of Nervous System Exc Viral Meningitis | $ 99,215 |
051 | Viral Meningitis | $ 31,949 |
052 | Nontraumatic Stupor & Coma | $ 48,171 |
053 | Seizure | $ 31,048 |
054 | Migraine & Other Headaches | $ 24,485 |
055 | Head Trauma w/ Coma > 1 Hr or Hemorrhage | $ 54,351 |
056 | Brain Contusion/Laceration & Compliated Skull FX, COMA < 1 HR OR No Coma | $ 46,345 |
057 | Concussion, Closed Skull FX Nos, Uncomplicated Intracranial Injury, Coma <1 Hr or No Coma | $ 20,296 |
058 | Other Disorders of Nervous System | $ 39,041 |
070 | Orbital Procedures | $ 46,429 |
073 | Eye Procedures Except Orbit | $ 36,133 |
080 | Acute Major Eye Infections | $ 28,610 |
082 | Eye Disorders Except Major Infections | $ 28,515 |
089 | Major Cranial/Facial Bone Procedures | $ 103,812 |
090 | Major Larynx & Trachea Procedures | $ 159,811 |
091 | Other Major Head & Neck Procedures | $ 184,507 |
092 | Facial Bone Procedures Except Major Cranial/Facial Bone Procedures | $ 51,207 |
093 | Sinus & Mastoid Procedures | $ 45,034 |
095 | Cleft Lip & Palate Repair | $ 34,657 |
097 | Tonsill & Adenoid Procedures | $ 28,234 |
098 | Other Ear, Nose, Mouth & Throat Procedures | $ 37,361 |
110 | Ear, Nose, Mouth Throat, Cranial/Facial Malignancies | $ 73,550 |
111 | Vertigo & Other Labyrinth Disorders | $ 21,525 |
113 | Infections Of The Upper Respiratory Tract | $ 19,824 |
114 | Dental & Oral Diseases & Injuries | $ 30,574 |
115 | Other Ear, Nose, Mouth,Throat & Cranial/Facial Diagnoses | $ 26,755 |
120 | Major Respiratory & Chest Procedures | $ 111,067 |
121 | Other Respiratory & Chest Procedures | $ 95,174 |
130 | Respiratory System Diagnosis w/ Ventilator Support 96+ Hours | $ 243,053 |
131 | Cystic Fibrosis - Pulmonary Disease | $ 92,839 |
132 | BPD & Oth Chronic Respiratory Dis Arising In Perinatal Period | $ 89,709 |
133 | Pulmonary Edema & Respiratory Failure | $ 78,887 |
134 | Pulmonary Embolism | $ 51,842 |
135 | Major Chest & Respiratory Trauma | $ 37,685 |
136 | Respiratory Malignancy | $ 84,922 |
137 | Major Respiratory Infections & Inflammations | $ 79,872 |
138 | Bronchiolitis & RSV Pneumonia | $ 25,704 |
139 | Other Pneumonia | $ 32,873 |
140 | Chronic Obstructive Pulmonary Disease | $ 34,154 |
141 | Asthma | $ 23,474 |
142 | Interstitial Lung Disease | $ 56,614 |
143 | Other Respiratory Diagnosis Except Signs, Symptoms & Minor Diagnoses | $ 45,725 |
144 | Respiratory System Signs, Symptoms & Other Diagnoses | $ 25,740 |
160 | Major Cardiothoracic Repair of Heart Anomaly | $ 270,150 |
161 | Cardiac Defibrillator & Heart Assist Anomaly | $ 238,407 |
162 | Cardiac Valve Procedures w/ Cardiac Catheterization | $ 266,063 |
163 | Cardiac Valve Procedures w/o Cardiac Catheterization | $ 176,411 |
165 | Coronary Bypass w/ Cardiac Cath Or Percutaneous Cardiac Procedure | $ 180,517 |
166 | Coronary Bypass w/o Cardiac Cath Or Percutaneous Cardiac Procedure | $ 133,055 |
167 | Other Cardiothoracic Procedures | $ 163,863 |
169 | Major Thoracic & Abdominal Vascular Procedures | $ 180,372 |
170 | Permanent Cardiac Pacemaker Implant w/ AMI, Heart Failure or Shock | $ 174,349 |
171 | Perm Cardiac Pacemaker Implant w/o AMI, Heart Failure or Shock | $ 91,012 |
173 | Other Vascular Procedures | $ 117,406 |
174 | Percutaneous Cardiovascular Procedures w/ AMI | $ 85,886 |
175 | Percutaneous Cardiovascular Procedures w/o AMI | $ 62,795 |
176 | Cardiac Pacemaker & Defibrillator Device Replacement | $ 145,243 |
177 | Cardiac Pacemaker & Defibrillator Revision Except Device Replacement | $ 109,839 |
180 | Other Circulatory System Procedures | $ 143,747 |
190 | Acute Myocardial Infarction | $ 62,189 |
191 | Cardiac Catheterization w/ Circ Disord Exc Ischemic Heart Disease | $ 63,184 |
192 | Cardiac Catheterization for Ischemic Heart Disease | $ 33,064 |
193 | Acute & Subacute Endocarditis | $ 131,145 |
194 | Heart Failure | $ 45,833 |
196 | Cardiac Arrest | $ 69,077 |
197 | Peripheral & Other Vascular Disorders | $ 45,486 |
198 | Angina Pectoris & Coronary Atherosclerosis | $ 20,584 |
199 | Hypertension | $ 23,750 |
200 | Cardiac Congenital & Valvular Disorders | $ 43,152 |
201 | Cardiac Arrhythmia & Conduction Disorders | $ 26,444 |
203 | Chest Pain | $ 16,243 |
204 | Syncope & Collapse | $ 23,198 |
205 | Cardiomyopathy | $ 33,763 |
206 | Malfunction, Reaction & Comp of Cardiac or Vasc Device or Proc | $ 83,814 |
207 | Other Circulatory System Diagnoses | $ 36,459 |
220 | Major Stomach, Esophageal & Duodenal Procedures | $ 139,311 |
221 | Major Small & Large Bowel Procedures | $ 87,113 |
222 | Minor Stomach, Esophageal & Duodenal Procedures | $ 37,985 |
223 | Minor Small & Large Bowel Procedures | $ 61,759 |
224 | Peritoneal Adhesiolysis | $ 67,875 |
225 | Appendectomy | $ 28,500 |
226 | Anal Procedures | $ 28,415 |
227 | Hernia Procedures Except Inguinal, Femoral & Umbilical | $ 44,118 |
228 | Inguinal, Femoral & Umbilical Hernia Procedures | $ 29,930 |
229 | Other Digestive System & Abdominal Procedures | $ 93,949 |
240 | Digestive Malignancy | $ 78,562 |
241 | Peptic Ulcer & Gastritis | $ 32,054 |
242 | Major Esophageal Disorders | $ 47,974 |
243 | Other Esophageal Disorders | $ 25,735 |
244 | Diverticulitis & Diverticulosis | $ 24,716 |
245 | Inflammatory Bowel Disease | $ 41,673 |
246 | Gastrointestinal Vascular Insufficiency | $ 35,537 |
247 | Intestinal Obstruction | $ 27,451 |
248 | Major Gastrointestinal & Peritoneal Infections | $ 47,875 |
249 | Non-Bacterial Gastroenteritis, Nausea & Vomiting | $ 19,937 |
251 | Abdominal Pain | $ 20,970 |
252 | Malfunction, Reaction & Complication Of G.I. Device Or Procedure | $ 46,786 |
253 | Other & Unspecified Gastrointestinal Hemorrhage | $ 43,178 |
254 | Other Digestive System Diagnoses | $ 30,427 |
260 | Major Pancreas, Liver & Shunt Procedures | $ 155,997 |
261 | Major Biliary Tract Procedures | $ 123,946 |
262 | Cholecystectomy Except Laparoscopic | $ 67,556 |
263 | Laparoscopic Cholecystectomy | $ 40,184 |
264 | Other Hepatobiliary, Pancreas & Abdominal Procedures | $ 138,160 |
279 | Hepatic Coma & Other Major Acute Liver Disorders | $ 72,230 |
280 | Alcoholic Liver Disease | $ 68,779 |
281 | Malignancy of Hepatobiliary System & Pancreas | $ 71,024 |
282 | Disorders of Pancreas Except Malignancy | $ 35,933 |
283 | Other Disorders Of The Liver | $ 51,508 |
284 | Disorders of the Gallbladder & Biliary Tract | $ 39,286 |
301 | Hip Joint Replacement | $ 65,799 |
302 | Knee Joint Replacement | $ 61,532 |
303 | Dorsal & Lumbar Fusion Proc for Curvature of Back | $ 210,600 |
304 | Dorsal & Lumbar Fusion Proc Except for Curvature of Back | $ 148,526 |
305 | Amputation of Lower Limb Except Toes | $ 159,903 |
308 | Hip & Femur Procedures for Trauma Except Joint Replacement | $ 72,819 |
309 | Hip & Femur Procedures for Non-Trauma Except Joint Replacement | $ 77,944 |
310 | Intervertebral Disc Excision & Decompression | $ 35,260 |
312 | Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses | $ 190,600 |
313 | Knee & Lower Leg Procedures Except Foot | $ 54,541 |
314 | Foot & Toe Procedures | $ 68,279 |
315 | Shoulder, Upper Arm & Forearm Procedures | $ 47,153 |
316 | Hand & Wrist Procedures | $ 31,669 |
317 | Tendon, Muscle & Other Soft Tissue Procedures | $ 47,614 |
320 | Other Musculoskeletel System & Connective Tissue Procedures | $ 76,348 |
321 | Cervical Spinal Fusion & Other Back/Neck Proc Exc Disc Excis/Decomp | $ 66,129 |
340 | Fractures of Femur | $ 44,693 |
341 | Fracture of Pelvis or Dislocation of Hip | $ 36,852 |
342 | Fracture or Dislocation Except Femur, Pelvis & Back | $ 24,417 |
343 | Musculoskeletal Malignancy & Pathol Fractures D/T Muscskel Malig | $ 104,066 |
344 | Osteomyelitis, Septic Arthritis & Other Musculoskeletal Infections | $ 79,002 |
346 | Connective Tissue Disorders | $ 57,593 |
347 | Other Back & Neck Disorders, Fractures & Injuries | $ 30,329 |
349 | Malfunction, Reaction & Comp of Orthopedic Device or Procedure | $ 53,457 |
351 | Other Musculoskeletal System & Connective Tissue Diagnoses | $ 30,848 |
361 | Skin Graft for Skin & Subcutaneous Tissue Diagnoses | $ 81,686 |
362 | Mastectomy Procedures | $ 62,823 |
363 | Breast Procedures Except Mastectomy | $ 42,171 |
364 | Other Skin, Subcutaneous Tissue & Related Procedures | $ 49,079 |
380 | Skin Ulcers | $ 49,330 |
381 | Major Skin Disorders | $ 45,976 |
382 | Malignant Breast Disorders | $ 61,360 |
383 | Cellulitis & Other Bacterial Skin Infections | $ 29,279 |
384 | Contusion, Open Wound & Other Trauma To Skin & Subcutaneous Tissue | $ 21,878 |
385 | Other Skin, Subcutaneous Tissue & Breast Disorders | $ 28,214 |
401 | Pituitary & Adrenal Procedures | $ 73,925 |
403 | Procedures for Obesity | $ 39,053 |
404 | Thyroid, Parathyroid & Thyroglossal Procedures | $ 25,521 |
405 | Other Procedures for Endocrine, Nutrititional & Metabolic Disorders | $ 163,409 |
420 | Diabetes | $ 29,772 |
421 | Malnutrition, Failure To Thrive & Other Nutritional Disorders | $ 56,254 |
422 | Hypovolemia & Related Electrolyte Disorders | $ 28,052 |
423 | Inborn Errors of Metabolism | $ 51,648 |
424 | Other Endocrine Disorders | $ 37,211 |
425 | Electrolyte Disorders Except Hypovolemia Related | $ 34,544 |
440 | Kidney Transplant | $ 313,242 |
441 | Major Bladder Procedures | $ 124,443 |
442 | Kidney & Urinary Tract Procedures for Malignancy | $ 59,855 |
443 | Kidney & Urinary Tract Procedures for Nonmalignancy | $ 61,205 |
444 | Renal Dialysis Access Device Procedure Only | $ 119,850 |
445 | Other Bladder Procedures | $ 51,919 |
446 | Urethral & Transurethral Procedures | $ 29,257 |
447 | Other Kidney, Urinary Tract & Related Procedures | $ 103,333 |
460 | Renal Failure | $ 62,686 |
461 | Kidney & Urinary Tract Malignancy | $ 70,653 |
462 | Nephritis & Nephrosis | $ 41,825 |
463 | Kidney & Urinary Tract Infections | $ 28,608 |
465 | Urinary Stones & Acquired Upper Urinary Tract Obstruction | $ 23,172 |
466 | Malfunction, Reaction & Complic of Genitourinary Device Or Proc | $ 62,665 |
468 | Other Kidney & Urinary Tract Diagnoses, Signs & Symptoms | $ 37,806 |
480 | Major Male Pelvic Procedures | $ 40,983 |
481 | Penis Procedures | $ 58,138 |
482 | Transurethral Prostatectomy | $ 26,302 |
483 | Testes & Scrotal Procedures | $ 29,318 |
484 | Other Male Reproductive System & Related Procedures | $ 69,585 |
500 | Malignancy, Male Reproductive System | $ 67,508 |
501 | Male Reproductive System Diagnoses Except Malignancy | $ 28,213 |
510 | Pelvic Evisceration, Radical Hysterectectomy & Radical GYN Procs | $ 57,674 |
511 | Uterine & Adnexa Procedures for Ovarian & Adnexal Malignancy | $ 76,630 |
512 | Uterine & Adnexa Procedures for Non-ovarian & Non-adnexal Malig | $ 41,521 |
513 | Uterine & Adnexa Procedures for Non-Malignancy Except Leiomyoma | $ 27,241 |
514 | Female Reproductive System Reconstructive Procedures | $ 25,454 |
517 | Dilation & Curettage For Non-Obstetric Procedures | $ 25,931 |
518 | Other Female Reproductive System & Related Procedures | $ 35,512 |
519 | Uterine & Adnexa Procedures For Leiomyoma | $ 30,112 |
530 | Female Reproductive System Malignancy | $ 71,738 |
531 | Female Reproductive System Infections | $ 25,936 |
532 | Menstrual & Other Female Reproductive System Disorders | $ 23,556 |
540 | Cesarean Delivery | $ 26,613 |
541 | Vaginal Delivery w/ Sterilization &/or D&C | $ 23,722 |
542 | Vaginal Delivery w/ Complicating Procedures Exc Sterilization &/or D&C | $ 18,206 |
544 | D&C, Aspiration Curettage or Hysterotomy For Obstetric Diagnoses | $ 20,065 |
545 | Ectopic Pregnancy Procedure | $ 26,481 |
546 | Other O.R. Proc For Obstetric Diagnoses Except Delivery Diagnoses | $ 30,101 |
560 | Vaginal Delivery | $ 16,387 |
561 | Postpartum & Post Abortion Diagnoses w/o Procedure | $ 23,430 |
563 | Threatened Abortion | $ 18,955 |
564 | Abortion w/o D&C, Aspiration Curettage or Hysterotomy | $ 15,869 |
565 | False Labor | $ 8,099 |
566 | Other Antepartum Diagnoses | $ 21,557 |
580 | Neonate, Transferred <5 Days Old, Not Born Here | $ 37,407 |
581 | Neonate, Transferred <5 Days Old, Born Here | $ 7,269 |
583 | Neonate, w/ ECMO | $ 1,812,166 |
588 | Neonate BWT <1500G W Major Procedure | $ 1,365,643 |
589 | Neonate BWT < 500G | $ 17,645 |
591 | Neonate, Birthwt 500-749G w/o Major Procedure | $ 1,202,483 |
593 | Neonate, Birthwt 750-999G w/o Major Procedure | $ 643,591 |
602 | Neonate, Birthwt 1000-1249G w/ Resp Dist Synd/Oth Maj Resp Or Maj Anom | $ 467,269 |
603 | Neonate, Birthwt 1000-1249G W OR W/O Other Significant Condition | $ 380,905 |
607 | Neonate, BWT 1250-1499G W Resp Dist Synd/Oth Maj Resp Or Maj Anom | $ 350,137 |
608 | Neonate, Birthwt 1250-1499G W OR W/O Other Significant Condition | $ 204,074 |
609 | Neonate, BWT 1500-2499G W Major Procedure | $ 549,565 |
611 | Neonate, Birthwt 1500-1999G W Major Anomaly | $ 261,139 |
612 | Neonate, BWT 1500-1999G W Resp Dist Synd/Oth Maj Resp Cond | $ 228,389 |
613 | Neonate, Birthwt 1500-1999G W Congenital/Perinatal Infection | $ 176,654 |
614 | Neonate, Birthwt 1500-1999G W OR W/O Other Significant Condition | $ 123,799 |
621 | Neonate, BWT 2000-2499G W Major Anomaly | $ 154,340 |
622 | Neonate, BWT 2000-2499G W Resp Dist Synd/Oth Maj Resp Cond | $ 108,530 |
623 | Neonate, Birthwt 2000-2499G W Congenital/Perinatal Infection | $ 91,827 |
625 | Neonate, Birthwt 2000-2499G W Other Significant Condition | $ 102,563 |
626 | Neonate, BWT 2000-2499G, Normal Newborn Or Neonate W Other Problem | $ 37,043 |
630 | Neonate, Birthwt > 2499g w/ Major Cardiovasc Procedure | $ 417,996 |
631 | Neonate, Birthwt > 2499g w/ Other Major Procedure | $ 520,799 |
633 | Neonate, Birthwt > 2499g w/ Major Anomaly | $ 52,864 |
634 | Neonate, Birthwt > 2499g W Resp Dist Synd/Oth Maj Resp Cond | $ 76,755 |
636 | Neonate, Birthwt > 2499g W Congenital/Perinatal Infection | $ 51,248 |
639 | Neonate, Birthwt > 2499g W Other Significant Condition | $ 38,908 |
640 | Neonate, Bwt > 2499g, Normal Newborn Or Neonate W Other Problem | $ 6,835 |
650 | Splenectomy | $ 76,562 |
651 | Other Procedures of Blood & Blood Forming Organs | $ 64,011 |
660 | Major Hematologic/Immunologic Diag Exc Sickle Cell Crisis & Coagul | $ 65,791 |
661 | Coagulation & Platelet Disorders | $ 67,194 |
662 | Sickle Cell Anemia Crisis | $ 48,262 |
663 | Other Anemia & Disorders Of Blood & Blood Forming Organs | $ 33,178 |
680 | Major O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms | $ 180,596 |
681 | Other O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms | $ 96,573 |
690 | Acute Leukemia | $ 449,551 |
691 | Lymphoma & Non-acute Leukemia | $ 130,970 |
692 | Radiotherapy | $ 55,851 |
693 | Chemotherapy | $ 52,347 |
694 | Lymphatic & Other Malignancies & Neoplasms Of Uncertain Behavior | $ 78,355 |
710 | Infectious & Parasitic Diseases Including HIV W O.R. Procedure | $ 293,318 |
711 | Post-Op,Post-Trauma, Other Device Infections W O.R. Procedure | $ 115,396 |
720 | Septicemia & Disseminated Infections | $ 105,463 |
721 | Post-Operative, Post-Traumatic, Other Device Infections | $ 47,266 |
722 | Fever | $ 26,738 |
723 | Viral Illness | $ 23,249 |
724 | Other Infectious & Parasitic Diseases | $ 50,565 |
740 | Mental Illness Diagnosis W O.R. Procedure | $ 127,079 |
750 | Schizophrenia | $ 38,518 |
751 | Major Depressive Disorders & Other/Unspecified Psychoses | $ 52,044 |
752 | Disorders of Personality & Impulse Control | $ 7,567 |
753 | Bipolar Disorders | $ 21,720 |
754 | Depression Except Major Depressive Disorder | $ 12,561 |
755 | Adjustment Disorders & Neuroses Except Depressive Diagnoses | $ 14,262 |
756 | Acute Anxiety & Delirium States | $ 19,250 |
757 | Organic Mental Health Disturbances | $ 55,407 |
758 | Childhood Behavioral Disorders | $ 21,778 |
759 | Eating Disorders | $ 80,589 |
760 | Other Mental Health Disorders | $ 30,769 |
770 | Drug & Alcohol Abuse or Dependence, Left Against Medical Advice | $ 17,247 |
772 | Alcohol & Drug Dependence w/ Rehab/Detox Therapy | $ 33,014 |
773 | Opioid Abuse & Dependence | $ 30,541 |
774 | Cocaine Abuse & Dependence | $ 31,363 |
775 | Alcohol Abuse & Dependence | $ 28,419 |
776 | Other Drug Abuse & Dependence | $ 35,151 |
791 | O.R. Procedure For Other Complications Of Treatment | $ 71,659 |
811 | Allergic Reactions | $ 16,328 |
812 | Poisoning Of Medicinal Agents | $ 26,303 |
813 | Other Complications of Treatment | $ 34,142 |
815 | Other Injury, Poisoning & Toxic Effect Diagnoses | $ 28,341 |
816 | Toxic Effects Of Non-Medicinal Substances | $ 30,189 |
841 | Extensive 3rd Degree Burns W Skin Graft | $ 1,216,922 |
842 | Full Thickness Burns W Skin Graft | $ 232,033 |
843 | Extensive 3rd Degree Or Full Thickness Burns W/O Skin Graft | $ 96,967 |
844 | Partial Thickness Burns W Or W/O Skin Graft | $ 97,005 |
850 | Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service | $ 76,084 |
860 | Rehabilitation | $ 65,810 |
861 | Signs, Symptoms & Other Factors Influencing Health Status | $ 29,809 |
862 | Other Aftercare & Convalescence | $ 67,325 |
863 | Neonatal Aftercare | $ 123,793 |
890 | HIV W Multiple Major HIV Related Conditions | $ 213,372 |
892 | HIV W Major HIV Related Condition | $ 85,989 |
893 | HIV W Multiple Significant HIV Related Conditions | $ 73,871 |
894 | HIV W One Signif HIV Cond Or W/O Signif Related Cond | $ 43,109 |
910 | Craniotomy For Multiple Significant Trauma | $ 231,236 |
911 | Extensive Abdominal/Thoraic Procedures For Mult Significant Trauma | $ 290,996 |
912 | Musculoskeletal & Other Procedures For Multiple Significant Trauma | $ 285,639 |
930 | Multiple Significant Trauma W/O O.R. Procedure | $ 72,064 |
950 | Extensive Procedure Unrelated To Principal Diagnosis | $ 209,195 |
951 | Moderately Extensive Procedure Unrelated To Principal Diagnosis | $ 112,237 |
952 | Nonextensive Procedure Unrelated To Principal Diagnosis | $ 67,746 |