Final Cost Outlier Thresholds Effective January 1, 2011

Also available as an Excel Spreadsheet XLS, 64KB

APR-DRG APR-DRG Description Product Line 2011 Cost Outlier Thresholds
001 Liver Transplant Transplant Surgery $ 889,728
002 Heart &/or Lung Transplant Transplant Surgery $ 1,535,308
003 Bone Marrow Transplant Transplant Surgery $ 545,232
004 Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure General Surgery $ 1,116,672
005 Tracheostomy W Long Term Mechanical Ventilation W/O Extensive Procedure General Surgery $ 736,830
006 Pancreas Transplant Transplant Surgery $ 562,782
020 Craniotomy for Trauma Trauma $ 228,568
021 Craniotomy Except for Trauma Neurological Surgery $ 212,723
022 Ventricular Shunt Procedures Neurological Surgery $ 129,965
023 Spinal Procedures Neurological Surgery $ 161,293
024 Extracranial Vascular Procedures Neurological Surgery $ 140,274
026 Other Nervous System & Related Procedures Neurological Surgery $ 134,625
040 Spinal Disorders & Injuries Neurology $ 79,364
041 Nervous System Malignancy Oncology $ 91,571
042 Degenerative Nervous System Disorders Exc Mult Sclerosis Neurology $ 57,492
043 Multiple Sclerosis & Other Demyelinating Diseases Neurology $ 50,529
044 Intracranial Hemorrhage Neurology $ 134,805
045 CVA & Precerebral Occulusion w/ Infarct Neurology $ 72,380
046 Nonspecific CVA & Precerebral Occlusion w/o Infarct Neurology $ 59,664
047 Transient Ischemia Neurology $ 28,954
048 Peripheral, Cranial & Autonomic Nerve Disorders Neurology $ 45,404
049 Bacterial & Tuberculous Infections of Nervous System Infectious Disease $ 168,422
050 Non-bacterial Infections of Nervous System Exc Viral Meningitis Infectious Disease $ 107,912
051 Viral Meningitis Infectious Disease $ 38,408
052 Nontraumatic Stupor & Coma Neurology $ 55,128
053 Seizure Neurology $ 38,430
054 Migraine & Other Headaches Neurology $ 29,344
055 Head Trauma w/ Coma > 1 Hr or Hemorrhage Trauma $ 72,051
056 Brain Contusion/Laceration & Compliated Skull FX, COMA < 1 HR OR No Coma Neurology $ 52,611
057 Concussion, Closed Skull FX Nos, Uncomplicated Intracranial Injury, Coma <1 Hr or No Coma Neurology $ 25,751
058 Other Disorders of Nervous System Neurology $ 46,382
070 Orbital Procedures Ophthalmology Surgery $ 60,185
073 Eye Procedures Except Orbit Ophthalmology Surgery $ 48,682
080 Acute Major Eye Infections Ophthalmology $ 36,342
082 Eye Disorders Except Major Infections Ophthalmology $ 34,728
089 Major Cranial/Facial Bone Procedures ENT Surgery $ 145,611
090 Major Larynx & Trachea Procedures ENT Surgery $ 151,561
091 Other Major Head & Neck Procedures ENT Surgery $ 523,694
092 Facial Bone Procedures Except Major Cranial/Facial Bone Procedures ENT Surgery $ 65,219
093 Sinus & Mastoid Procedures ENT Surgery $ 51,396
095 Cleft Lip & Palate Repair ENT Surgery $ 35,698
097 Tonsill & Adenoid Procedures ENT Surgery $ 26,857
098 Other Ear, Nose, Mouth & Throat Procedures ENT Surgery $ 50,111
110 Ear, Nose, Mouth Throat, Cranial/Facial Malignancies Oncology $ 111,519
111 Vertigo & Other Labyrinth Disorders Otolaryngology $ 25,117
113 Infections Of The Upper Respiratory Tract Otolaryngology $ 23,898
114 Dental & Oral Diseases & Injuries Dental $ 37,263
115 Other Ear, Nose, Mouth,Throat & Cranial/Facial Diagnoses Otolaryngology $ 31,470
120 Major Respiratory & Chest Procedures General Surgery $ 138,197
121 Other Respiratory & Chest Procedures General Surgery $ 125,114
130 Respiratory System Diagnosis w/ Ventilator Support 96+ Hours Pulmonary $ 295,353
131 Cystic Fibrosis - Pulmonary Disease Pulmonary $ 123,968
132 BPD & Oth Chronic Respiratory Dis Arising In Perinatal Period Neonatology $ 103,878
133 Pulmonary Edema & Respiratory Failure Pulmonary $ 95,529
134 Pulmonary Embolism Pulmonary $ 63,668
135 Major Chest & Respiratory Trauma Trauma $ 42,830
136 Respiratory Malignancy Oncology $ 94,988
137 Major Respiratory Infections & Inflammations Pulmonary $ 100,657
138 Bronchiolitis & RSV Pneumonia Pulmonary $ 31,986
139 Other Pneumonia Pulmonary $ 41,108
140 Chronic Obstructive Pulmonary Disease Pulmonary $ 41,485
141 Asthma Pulmonary $ 29,222
142 Interstitial Lung Disease Pulmonary $ 68,429
143 Other Respiratory Diagnosis Except Signs, Symptoms & Minor Diagnoses Pulmonary $ 57,271
144 Respiratory System Signs, Symptoms & Other Diagnoses Pulmonary $ 29,716
160 Major Cardiothoracic Repair of Heart Anomaly Open Heart Surgery $ 272,392
161 Cardiac Defibrillator & Heart Assist Anomaly Open Heart Surgery $ 313,098
162 Cardiac Valve Procedures w/ Cardiac Catheterization Open Heart Surgery $ 292,753
163 Cardiac Valve Procedures w/o Cardiac Catheterization Open Heart Surgery $ 209,451
165 Coronary Bypass w/ Cardiac Cath Or Percutaneous Cardiac Procedure Open Heart Surgery $ 189,344
166 Coronary Bypass w/o Cardiac Cath Or Percutaneous Cardiac Procedure Open Heart Surgery $ 145,894
167 Other Cardiothoracic Procedures Cardiovascular Surgery $ 187,181
169 Major Thoracic & Abdominal Vascular Procedures Cardiovascular Surgery $ 215,467
170 Permanent Cardiac Pacemaker Implant w/ AMI, Heart Failure or Shock Cardiovascular Surgery $ 153,549
171 Perm Cardiac Pacemaker Implant w/o AMI, Heart Failure or Shock Cardiovascular Surgery $ 111,142
173 Other Vascular Procedures Cardiovascular Surgery $ 157,147
174 Percutaneous Cardiovascular Procedures w/ AMI Cardiovascular Surgery $ 106,733
175 Percutaneous Cardiovascular Procedures w/o AMI Cardiovascular Surgery $ 78,106
176 Cardiac Pacemaker & Defibrillator Device Replacement Cardiovascular Surgery $ 201,164
177 Cardiac Pacemaker & Defibrillator Revision Except Device Replacement Cardiovascular Surgery $ 129,695
180 Other Circulatory System Procedures Cardiovascular Surgery $ 178,439
190 Acute Myocardial Infarction Cardiology $ 75,385
191 Cardiac Catheterization w/ Circ Disord Exc Ischemic Heart Disease Cardiac Catheter $ 81,719
192 Cardiac Catheterization for Ischemic Heart Disease Cardiac Catheter $ 40,427
193 Acute & Subacute Endocarditis Cardiology $ 116,569
194 Heart Failure Cardiology $ 59,808
196 Cardiac Arrest Cardiology $ 82,875
197 Peripheral & Other Vascular Disorders Cardiology $ 56,810
198 Angina Pectoris & Coronary Atherosclerosis Cardiology $ 28,229
199 Hypertension Cardiology $ 28,988
200 Cardiac Congenital & Valvular Disorders Cardiology $ 57,479
201 Cardiac Arrhythmia & Conduction Disorders Cardiology $ 32,936
203 Chest Pain Cardiology $ 21,318
204 Syncope & Collapse Cardiology $ 28,527
205 Cardiomyopathy Cardiology $ 47,204
206 Malfunction, Reaction & Comp of Cardiac or Vasc Device or Proc Cardiology $ 79,055
207 Other Circulatory System Diagnoses Cardiology $ 43,569
220 Major Stomach, Esophageal & Duodenal Procedures General Surgery $ 177,343
221 Major Small & Large Bowel Procedures General Surgery $ 110,661
222 Minor Stomach, Esophageal & Duodenal Procedures General Surgery $ 57,743
223 Minor Small & Large Bowel Procedures General Surgery $ 80,292
224 Peritoneal Adhesiolysis General Surgery $ 88,346
225 Appendectomy General Surgery $ 35,625
226 Anal Procedures General Surgery $ 33,056
227 Hernia Procedures Except Inguinal, Femoral & Umbilical General Surgery $ 58,506
228 Inguinal, Femoral & Umbilical Hernia Procedures General Surgery $ 38,577
229 Other Digestive System & Abdominal Procedures General Surgery $ 117,807
240 Digestive Malignancy Oncology $ 105,585
241 Peptic Ulcer & Gastritis Gastroenterology $ 41,376
242 Major Esophageal Disorders Gastroenterology $ 68,070
243 Other Esophageal Disorders Gastroenterology $ 31,286
244 Diverticulitis & Diverticulosis Gastroenterology $ 29,755
245 Inflammatory Bowel Disease Gastroenterology $ 50,540
246 Gastrointestinal Vascular Insufficiency Gastroenterology $ 39,694
247 Intestinal Obstruction Gastroenterology $ 32,541
248 Major Gastrointestinal & Peritoneal Infections Gastroenterology $ 58,222
249 Non-Bacterial Gastroenteritis, Nausea & Vomiting Gastroenterology $ 26,883
251 Abdominal Pain Gastroenterology $ 29,008
252 Malfunction, Reaction & Complication Of G.I. Device Or Procedure Gastroenterology $ 56,042
253 Other & Unspecified Gastrointestinal Hemorrhage Gastroenterology $ 55,726
254 Other Digestive System Diagnoses Gastroenterology $ 38,895
260 Major Pancreas, Liver & Shunt Procedures General Surgery $ 201,152
261 Major Biliary Tract Procedures General Surgery $ 187,997
262 Cholecystectomy Except Laparoscopic General Surgery $ 89,086
263 Laparoscopic Cholecystectomy General Surgery $ 47,957
264 Other Hepatobiliary, Pancreas & Abdominal Procedures General Surgery $ 167,879
279 Hepatic Coma & Other Major Acute Liver Disorders Gastroenterology $ 100,083
280 Alcoholic Liver Disease Gastroenterology $ 76,122
281 Malignancy of Hepatobiliary System & Pancreas Oncology $ 103,927
282 Disorders of Pancreas Except Malignancy Gastroenterology $ 43,838
283 Other Disorders Of The Liver Gastroenterology $ 66,185
284 Disorders of the Gallbladder & Biliary Tract Gastroenterology $ 47,620
301 Hip Joint Replacement Orthopedic Surgery $ 76,516
302 Knee Joint Replacement Orthopedic Surgery $ 79,030
303 Dorsal & Lumbar Fusion Proc for Curvature of Back Orthopedic Surgery $ 297,098
304 Dorsal & Lumbar Fusion Proc Except for Curvature of Back Orthopedic Surgery $ 195,732
305 Amputation of Lower Limb Except Toes Orthopedic Surgery $ 202,967
308 Hip & Femur Procedures for Trauma Except Joint Replacement Trauma $ 88,016
309 Hip & Femur Procedures for Non-Trauma Except Joint Replacement Orthopedic Surgery $ 104,930
310 Intervertebral Disc Excision & Decompression Orthopedic Surgery $ 44,200
312 Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses Orthopedic Surgery $ 204,022
313 Knee & Lower Leg Procedures Except Foot Orthopedic Surgery $ 67,718
314 Foot & Toe Procedures Orthopedic Surgery $ 80,263
315 Shoulder, Upper Arm & Forearm Procedures Orthopedic Surgery $ 66,093
316 Hand & Wrist Procedures Orthopedic Surgery $ 42,762
317 Tendon, Muscle & Other Soft Tissue Procedures Orthopedic Surgery $ 59,427
320 Other Musculoskeletel System & Connective Tissue Procedures Orthopedic Surgery $ 86,796
321 Cervical Spinal Fusion & Other Back/Neck Proc Exc Disc Excis/Decomp Orthopedic Surgery $ 90,530
340 Fractures of Femur Orthopedics $ 49,330
341 Fracture of Pelvis or Dislocation of Hip Orthopedics $ 40,665
342 Fracture or Dislocation Except Femur, Pelvis & Back Orthopedics $ 34,539
343 Musculoskeletal Malignancy & Pathol Fractures D/T Muscskel Malig Oncology $ 114,870
344 Osteomyelitis, Septic Arthritis & Other Musculoskeletal Infections Infectious Disease $ 91,642
346 Connective Tissue Disorders Orthopedics $ 69,190
347 Other Back & Neck Disorders, Fractures & Injuries Orthopedics $ 38,170
349 Malfunction, Reaction & Comp of Orthopedic Device or Procedure Orthopedics $ 65,920
351 Other Musculoskeletal System & Connective Tissue Diagnoses Rheumatology $ 36,638
361 Skin Graft for Skin & Subcutaneous Tissue Diagnoses General Surgery $ 109,801
362 Mastectomy Procedures General Surgery $ 83,205
363 Breast Procedures Except Mastectomy General Surgery $ 48,933
364 Other Skin, Subcutaneous Tissue & Related Procedures General Surgery $ 59,110
380 Skin Ulcers Dermatology $ 61,278
381 Major Skin Disorders Dermatology $ 57,429
382 Malignant Breast Disorders Oncology $ 97,822
383 Cellulitis & Other Bacterial Skin Infections Infectious Disease $ 35,893
384 Contusion, Open Wound & Other Trauma To Skin & Subcutaneous Tissue Dermatology $ 27,725
385 Other Skin, Subcutaneous Tissue & Breast Disorders Dermatology $ 33,589
401 Pituitary & Adrenal Procedures General Surgery $ 85,927
403 Procedures for Obesity General Surgery $ 46,468
404 Thyroid, Parathyroid & Thyroglossal Procedures General Surgery $ 30,029
405 Other Procedures for Endocrine, Nutrititional & Metabolic Disorders General Surgery $ 159,426
420 Diabetes Endocrinology $ 37,525
421 Malnutrition, Failure To Thrive & Other Nutritional Disorders Endocrinology $ 74,415
422 Hypovolemia & Related Electrolyte Disorders Endocrinology $ 34,932
423 Inborn Errors of Metabolism Endocrinology $ 66,672
424 Other Endocrine Disorders Endocrinology $ 43,344
425 Electrolyte Disorders Except Hypovolemia Related Endocrinology $ 43,606
440 Kidney Transplant Transplant Surgery $ 251,765
441 Major Bladder Procedures Urologic/Nephrologic Surgery $ 166,472
442 Kidney & Urinary Tract Procedures for Malignancy Urologic/Nephrologic Surgery $ 76,772
443 Kidney & Urinary Tract Procedures for Nonmalignancy Urologic/Nephrologic Surgery $ 71,992
444 Renal Dialysis Access Device Procedure Only Urologic/Nephrologic Surgery $ 163,213
445 Other Bladder Procedures Urologic/Nephrologic Surgery $ 57,689
446 Urethral & Transurethral Procedures Urologic/Nephrologic Surgery $ 33,053
447 Other Kidney, Urinary Tract & Related Procedures Urologic/Nephrologic Surgery $ 126,472
460 Renal Failure Urology/Nephrology $ 77,683
461 Kidney & Urinary Tract Malignancy Oncology $ 81,726
462 Nephritis & Nephrosis Urology/Nephrology $ 53,349
463 Kidney & Urinary Tract Infections Urology/Nephrology $ 36,773
465 Urinary Stones & Acquired Upper Urinary Tract Obstruction Urology/Nephrology $ 30,384
466 Malfunction, Reaction & Complic of Genitourinary Device Or Proc Urology/Nephrology $ 75,225
468 Other Kidney & Urinary Tract Diagnoses, Signs & Symptoms Urology/Nephrology $ 48,703
480 Major Male Pelvic Procedures Urologic/Nephrologic Surgery $ 50,556
481 Penis Procedures Urologic/Nephrologic Surgery $ 84,312
482 Transurethral Prostatectomy Urologic/Nephrologic Surgery $ 29,586
483 Testes & Scrotal Procedures Urologic/Nephrologic Surgery $ 36,055
484 Other Male Reproductive System & Related Procedures Urologic/Nephrologic Surgery $ 79,024
500 Malignancy, Male Reproductive System Oncology $ 75,981
501 Male Reproductive System Diagnoses Except Malignancy Urology/Nephrology $ 34,774
510 Pelvic Evisceration, Radical Hysterectectomy & Radical GYN Procs Gynecology Surgery $ 70,258
511 Uterine & Adnexa Procedures for Ovarian & Adnexal Malignancy Gynecology Surgery $ 83,618
512 Uterine & Adnexa Procedures for Non-ovarian & Non-adnexal Malig Gynecology Surgery $ 57,368
513 Uterine & Adnexa Procedures for Non-Malignancy Except Leiomyoma Gynecology Surgery $ 34,586
514 Female Reproductive System Reconstructive Procedures Gynecology Surgery $ 35,867
517 Dilation & Curettage For Non-Obstetric Procedures Gynecology Surgery $ 33,229
518 Other Female Reproductive System & Related Procedures Gynecology Surgery $ 49,883
519 Uterine & Adnexa Procedures For Leiomyoma Gynecology Surgery $ 39,938
530 Female Reproductive System Malignancy Oncology $ 82,370
531 Female Reproductive System Infections Gynecology $ 34,833
532 Menstrual & Other Female Reproductive System Disorders Gynecology $ 26,766
540 Cesarean Delivery Obstetrics/Delivery $ 33,214
541 Vaginal Delivery w/ Sterilization &/or D&C Obstetrics/Delivery $ 28,537
542 Vaginal Delivery w/ Complicating Procedures Exc Sterilization &/or D&C Obstetrics/Delivery $ 25,455
544 D&C, Aspiration Curettage or Hysterotomy For Obstetric Diagnoses Other Obstetrics $ 23,832
545 Ectopic Pregnancy Procedure Gynecology Surgery $ 32,947
546 Other O.R. Proc For Obstetric Diagnoses Except Delivery Diagnoses Other Obstetrics $ 40,276
560 Vaginal Delivery Obstetrics/Delivery $ 22,643
561 Postpartum & Post Abortion Diagnoses w/o Procedure Other Obstetrics $ 24,421
563 Threatened Abortion Other Obstetrics $ 21,379
564 Abortion w/o D&C, Aspiration Curettage or Hysterotomy Other Obstetrics $ 22,913
565 False Labor Other Obstetrics $ 10,054
566 Other Antepartum Diagnoses Other Obstetrics $ 21,672
580 Neonate, Transferred <5 Days Old, Not Born Here Neonatology $ 53,053
581 Neonate, Transferred <5 Days Old, Born Here Neonatology $ 8,936
583 Neonate, w/ ECMO Neonatology $ 880,523
588 Neonate BWT <1500G W Major Procedure Neonatology $ 1,242,175
589 Neonate BWT < 500G Neonatology $ 22,583
591 Neonate, Birthwt 500-749G w/o Major Procedure Neonatology $ 1,362,446
593 Neonate, Birthwt 750-999G w/o Major Procedure Neonatology $ 724,761
602 Neonate, Birthwt 1000-1249G w/ Resp Dist Synd/Oth Maj Resp Or Maj Anom Neonatology $ 554,610
603 Neonate, Birthwt 1000-1249G W OR W/O Other Significant Condition Neonatology $ 519,173
607 Neonate, BWT 1250-1499G W Resp Dist Synd/Oth Maj Resp Or Maj Anom Neonatology $ 417,732
608 Neonate, Birthwt 1250-1499G W OR W/O Other Significant Condition Neonatology $ 296,421
609 Neonate, BWT 1500-2499G W Major Procedure Neonatology $ 807,460
611 Neonate, Birthwt 1500-1999G W Major Anomaly Neonatology $ 303,805
612 Neonate, BWT 1500-1999G W Resp Dist Synd/Oth Maj Resp Cond Neonatology $ 280,683
613 Neonate, Birthwt 1500-1999G W Congenital/Perinatal Infection Neonatology $ 232,464
614 Neonate, Birthwt 1500-1999G W OR W/O Other Significant Condition Neonatology $ 158,847
621 Neonate, BWT 2000-2499G W Major Anomaly Neonatology $ 180,966
622 Neonate, BWT 2000-2499G W Resp Dist Synd/Oth Maj Resp Cond Neonatology $ 149,345
623 Neonate, Birthwt 2000-2499G W Congenital/Perinatal Infection Neonatology $ 119,354
625 Neonate, Birthwt 2000-2499G W Other Significant Condition Neonatology $ 125,006
626 Neonate, BWT 2000-2499G, Normal Newborn Or Neonate W Other Problem Neonatology $ 19,857
630 Neonate, Birthwt > 2499g w/ Major Cardiovasc Procedure Neonatology $ 498,531
631 Neonate, Birthwt > 2499g w/ Other Major Procedure Neonatology $ 352,482
633 Neonate, Birthwt > 2499g w/ Major Anomaly Neonatology $ 51,812
634 Neonate, Birthwt > 2499g W Resp Dist Synd/Oth Maj Resp Cond Neonatology $ 94,524
636 Neonate, Birthwt > 2499g W Congenital/Perinatal Infection Neonatology $ 68,348
639 Neonate, Birthwt > 2499g W Other Significant Condition Neonatology $ 46,647
640 Neonate, Bwt > 2499g, Normal Newborn Or Neonate W Other Problem Neonatology $ 8,832
650 Splenectomy General Surgery $ 108,128
651 Other Procedures of Blood & Blood Forming Organs General Surgery $ 68,394
660 Major Hematologic/Immunologic Diag Exc Sickle Cell Crisis & Coagul Hematology $ 85,636
661 Coagulation & Platelet Disorders Hematology $ 74,738
662 Sickle Cell Anemia Crisis Hematology $ 64,228
663 Other Anemia & Disorders Of Blood & Blood Forming Organs Hematology $ 41,297
680 Major O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms General Surgery $ 217,699
681 Other O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms General Surgery $ 144,166
690 Acute Leukemia Oncology $ 528,995
691 Lymphoma & Non-acute Leukemia Oncology $ 159,757
692 Radiotherapy Oncology $ 68,650
693 Chemotherapy Oncology $ 66,677
694 Lymphatic & Other Malignancies & Neoplasms Of Uncertain Behavior Oncology $ 99,543
710 Infectious & Parasitic Diseases Including HIV W O.R. Procedure General Surgery $ 319,221
711 Post-Op,Post-Trauma, Other Device Infections W O.R. Procedure General Surgery $ 140,322
720 Septicemia & Disseminated Infections Infectious Disease $ 138,764
721 Post-Operative, Post-Traumatic, Other Device Infections General Medicine $ 66,154
722 Fever General Medicine $ 32,836
723 Viral Illness Infectious Disease $ 29,187
724 Other Infectious & Parasitic Diseases Infectious Disease $ 63,623
740 Mental Illness Diagnosis W O.R. Procedure General Surgery $ 187,673
750 Schizophrenia Mental Health $ 73,720
751 Major Depressive Disorders & Other/Unspecified Psychoses Mental Health $ 45,908
752 Disorders of Personality & Impulse Control Mental Health $ 21,784
753 Bipolar Disorders Mental Health $ 44,799
754 Depression Except Major Depressive Disorder Mental Health $ 24,219
755 Adjustment Disorders & Neuroses Except Depressive Diagnoses Mental Health $ 43,931
756 Acute Anxiety & Delirium States Mental Health $ 22,952
757 Organic Mental Health Disturbances Mental Health $ 43,398
758 Childhood Behavioral Disorders Mental Health $ 46,199
759 Eating Disorders Mental Health $ 112,981
760 Other Mental Health Disorders Mental Health $ 54,442
770 Drug & Alcohol Abuse or Dependence, Left Against Medical Advice Substance Abuse $ 13,434
772 Alcohol & Drug Dependence w/ Rehab/Detox Therapy Substance Abuse $ 44,659
773 Opioid Abuse & Dependence Substance Abuse $ 9,161
774 Cocaine Abuse & Dependence Substance Abuse $ 17,549
775 Alcohol Abuse & Dependence Substance Abuse $ 25,375
776 Other Drug Abuse & Dependence Substance Abuse $ 23,520
791 O.R. Procedure For Other Complications Of Treatment General Surgery $ 93,212
811 Allergic Reactions General Medicine $ 19,015
812 Poisoning Of Medicinal Agents General Medicine $ 34,091
813 Other Complications of Treatment General Medicine $ 42,213
815 Other Injury, Poisoning & Toxic Effect Diagnoses General Medicine $ 45,117
816 Toxic Effects Of Non-Medicinal Substances General Medicine $ 37,376
841 Extensive 3rd Degree Burns W Skin Graft General Surgery $ 2,097,961
842 Full Thickness Burns W Skin Graft General Surgery $ 402,972
843 Extensive 3rd Degree Or Full Thickness Burns W/O Skin Graft General Medicine $ 156,093
844 Partial Thickness Burns W Or W/O Skin Graft General Medicine $ 191,267
850 Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service General Surgery $ 88,865
860 Rehabilitation Rehabilitation $ 92,884
861 Signs, Symptoms & Other Factors Influencing Health Status General Medicine $ 36,849
862 Other Aftercare & Convalescence General Medicine $ 77,966
863 Neonatal Aftercare Neonatology $ 132,762
890 HIV W Multiple Major HIV Related Conditions HIV $ 271,817
892 HIV W Major HIV Related Condition HIV $ 96,934
893 HIV W Multiple Significant HIV Related Conditions HIV $ 72,728
894 HIV W One Signif HIV Cond Or W/O Signif Related Cond HIV $ 49,628
910 Craniotomy For Multiple Significant Trauma Trauma $ 490,889
911 Extensive Abdominal/Thoraic Procedures For Mult Significant Trauma Trauma $ 288,146
912 Musculoskeletal & Other Procedures For Multiple Significant Trauma Trauma $ 322,439
930 Multiple Significant Trauma W/O O.R. Procedure Trauma $ 97,558
950 Extensive Procedure Unrelated To Principal Diagnosis General Surgery $ 302,555
951 Moderately Extensive Procedure Unrelated To Principal Diagnosis General Surgery $ 130,077
952 Nonextensive Procedure Unrelated To Principal Diagnosis General Surgery $ 82,315

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