Final Cost Outlier Thresholds Effective January 1, 2012

Also available as an Excel Spreadsheet XLS, 34KB

APR-DRG APR-DRG Description Product Line 2012 Cost Outlier Thresholds
001 Liver Transplant Transplant Surgery   $ 813,617
002 Heart &/or Lung Transplant Transplant Surgery   $ 1,923,806
003 Bone Marrow Transplant Transplant Surgery   $ 549,836
004 Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure General Surgery   $ 1,144,648
005 Tracheostomy W Long Term Mechanical Ventilation W/O Extensive Procedure General Surgery   $ 754,666
006 Pancreas Transplant Transplant Surgery   $ 536,033
020 Craniotomy for Trauma Trauma   $ 201,962
021 Craniotomy Except for Trauma Neurological Surgery   $ 214,927
022 Ventricular Shunt Procedures Neurological Surgery   $ 309,650
023 Spinal Procedures Neurological Surgery   $ 181,446
024 Extracranial Vascular Procedures Neurological Surgery   $ 159,575
026 Other Nervous System & Related Procedures Neurological Surgery   $ 130,036
040 Spinal Disorders & Injuries Neurology   $ 88,373
041 Nervous System Malignancy Oncology   $ 99,961
042 Degenerative Nervous System Disorders Exc Mult Sclerosis Neurology   $ 47,804
043 Multiple Sclerosis & Other Demyelinating Diseases Neurology   $ 54,758
044 Intracranial Hemorrhage Neurology   $ 139,518
045 CVA & Precerebral Occulusion w/ Infarct Neurology   $ 70,166
046 Nonspecific CVA & Precerebral Occlusion w/o Infarct Neurology   $ 55,400
047 Transient Ischemia Neurology   $ 30,236
048 Peripheral, Cranial & Autonomic Nerve Disorders Neurology   $ 45,820
049 Bacterial & Tuberculous Infections of Nervous System Infectious Disease   $ 194,812
050 Non-bacterial Infections of Nervous System Exc Viral Meningitis Infectious Disease   $ 106,546
051 Viral Meningitis Infectious Disease   $ 41,003
052 Nontraumatic Stupor & Coma Neurology   $ 39,551
053 Seizure Neurology   $ 41,492
054 Migraine & Other Headaches Neurology   $ 31,296
055 Head Trauma w/ Coma > 1 Hr or Hemorrhage Trauma   $ 68,591
056 Brain Contusion/Laceration & Compliated Skull FX, COMA < 1 HR OR No Coma Neurology   $ 58,203
057 Concussion, Closed Skull FX Nos, Uncomplicated Intracranial Injury, Coma <1 Hr or No Coma Neurology   $ 28,058
058 Other Disorders of Nervous System Neurology   $ 48,289
070 Orbital Procedures Ophthalmology Surgery   $ 68,297
073 Eye Procedures Except Orbit Ophthalmology Surgery   $ 52,164
080 Acute Major Eye Infections Ophthalmology   $ 34,196
082 Eye Disorders Except Major Infections Ophthalmology   $ 34,951
089 Major Cranial/Facial Bone Procedures ENT Surgery   $ 159,484
090 Major Larynx & Trachea Procedures ENT Surgery   $ 227,320
091 Other Major Head & Neck Procedures ENT Surgery   $ 309,592
092 Facial Bone Procedures Except Major Cranial/Facial Bone Procedures ENT Surgery   $ 67,683
093 Sinus & Mastoid Procedures ENT Surgery   $ 61,098
095 Cleft Lip & Palate Repair ENT Surgery   $ 37,815
097 Tonsill & Adenoid Procedures ENT Surgery   $ 29,677
098 Other Ear, Nose, Mouth & Throat Procedures ENT Surgery   $ 46,631
110 Ear, Nose, Mouth Throat, Cranial/Facial Malignancies Oncology   $ 103,834
111 Vertigo & Other Labyrinth Disorders Otolaryngology   $ 26,495
113 Infections Of The Upper Respiratory Tract Otolaryngology   $ 25,767
114 Dental & Oral Diseases & Injuries Dental   $ 33,863
115 Other Ear, Nose, Mouth,Throat & Cranial/Facial Diagnoses Otolaryngology   $ 30,565
120 Major Respiratory & Chest Procedures General Surgery   $ 146,944
121 Other Respiratory & Chest Procedures General Surgery   $ 130,688
130 Respiratory System Diagnosis w/ Ventilator Support 96+ Hours Pulmonary   $ 289,264
131 Cystic Fibrosis - Pulmonary Disease Pulmonary   $ 135,884
132 BPD & Oth Chronic Respiratory Dis Arising In Perinatal Period Neonatology   $ 86,381
133 Pulmonary Edema & Respiratory Failure Pulmonary   $ 97,818
134 Pulmonary Embolism Pulmonary   $ 64,167
135 Major Chest & Respiratory Trauma Trauma   $ 47,038
136 Respiratory Malignancy Oncology   $ 104,410
137 Major Respiratory Infections & Inflammations Pulmonary   $ 100,909
138 Bronchiolitis & RSV Pneumonia Pulmonary   $ 35,618
139 Other Pneumonia Pulmonary   $ 42,130
140 Chronic Obstructive Pulmonary Disease Pulmonary   $ 43,213
141 Asthma Pulmonary   $ 30,238
142 Interstitial Lung Disease Pulmonary   $ 63,320
143 Other Respiratory Diagnosis Except Signs, Symptoms & Minor Diagnoses Pulmonary   $ 59,705
144 Respiratory System Signs, Symptoms & Other Diagnoses Pulmonary   $ 30,540
160 Major Cardiothoracic Repair of Heart Anomaly Open Heart Surgery   $ 329,840
161 Cardiac Defibrillator & Heart Assist Anomaly Open Heart Surgery   $ 325,857
162 Cardiac Valve Procedures w/ Cardiac Catheterization Open Heart Surgery   $ 320,148
163 Cardiac Valve Procedures w/o Cardiac Catheterization Open Heart Surgery   $ 255,169
165 Coronary Bypass w/ Cardiac Cath Or Percutaneous Cardiac Procedure Open Heart Surgery   $ 208,687
166 Coronary Bypass w/o Cardiac Cath Or Percutaneous Cardiac Procedure Open Heart Surgery   $ 172,957
167 Other Cardiothoracic Procedures Cardiovascular Surgery   $ 221,422
169 Major Thoracic & Abdominal Vascular Procedures Cardiovascular Surgery   $ 254,383
170 Permanent Cardiac Pacemaker Implant w/ AMI, Heart Failure or Shock Cardiovascular Surgery   $ 167,596
171 Perm Cardiac Pacemaker Implant w/o AMI, Heart Failure or Shock Cardiovascular Surgery   $ 123,925
173 Other Vascular Procedures Cardiovascular Surgery   $ 172,752
174 Percutaneous Cardiovascular Procedures w/ AMI Cardiovascular Surgery   $ 116,347
175 Percutaneous Cardiovascular Procedures w/o AMI Cardiovascular Surgery   $ 83,550
176 Cardiac Pacemaker & Defibrillator Device Replacement Cardiovascular Surgery   $ 210,208
177 Cardiac Pacemaker & Defibrillator Revision Except Device Replacement Cardiovascular Surgery   $ 140,312
180 Other Circulatory System Procedures Cardiovascular Surgery   $ 176,556
190 Acute Myocardial Infarction Cardiology   $ 77,655
191 Cardiac Catheterization w/ Circ Disord Exc Ischemic Heart Disease Cardiac Catheter   $ 86,447
192 Cardiac Catheterization for Ischemic Heart Disease Cardiac Catheter   $ 40,772
193 Acute & Subacute Endocarditis Cardiology   $ 148,667
194 Heart Failure Cardiology   $ 61,597
196 Cardiac Arrest Cardiology   $ 72,456
197 Peripheral & Other Vascular Disorders Cardiology   $ 56,208
198 Angina Pectoris & Coronary Atherosclerosis Cardiology   $ 28,124
199 Hypertension Cardiology   $ 30,154
200 Cardiac Congenital & Valvular Disorders Cardiology   $ 52,947
201 Cardiac Arrhythmia & Conduction Disorders Cardiology   $ 34,599
203 Chest Pain Cardiology   $ 22,080
204 Syncope & Collapse Cardiology   $ 29,600
205 Cardiomyopathy Cardiology   $ 41,254
206 Malfunction, Reaction & Comp of Cardiac or Vasc Device or Proc Cardiology   $ 87,144
207 Other Circulatory System Diagnoses Cardiology   $ 42,143
220 Major Stomach, Esophageal & Duodenal Procedures General Surgery   $ 163,225
221 Major Small & Large Bowel Procedures General Surgery   $ 116,977
222 Minor Stomach, Esophageal & Duodenal Procedures General Surgery   $ 57,032
223 Minor Small & Large Bowel Procedures General Surgery   $ 78,877
224 Peritoneal Adhesiolysis General Surgery   $ 94,260
225 Appendectomy General Surgery   $ 34,529
226 Anal Procedures General Surgery   $ 35,956
227 Hernia Procedures Except Inguinal, Femoral & Umbilical General Surgery   $ 64,313
228 Inguinal, Femoral & Umbilical Hernia Procedures General Surgery   $ 37,203
229 Other Digestive System & Abdominal Procedures General Surgery   $ 110,516
240 Digestive Malignancy Oncology   $ 102,121
241 Peptic Ulcer & Gastritis Gastroenterology   $ 41,372
242 Major Esophageal Disorders Gastroenterology   $ 64,131
243 Other Esophageal Disorders Gastroenterology   $ 32,738
244 Diverticulitis & Diverticulosis Gastroenterology   $ 31,814
245 Inflammatory Bowel Disease Gastroenterology   $ 53,340
246 Gastrointestinal Vascular Insufficiency Gastroenterology   $ 39,884
247 Intestinal Obstruction Gastroenterology   $ 33,982
248 Major Gastrointestinal & Peritoneal Infections Gastroenterology   $ 59,897
249 Non-Bacterial Gastroenteritis, Nausea & Vomiting  Gastroenterology   $ 26,843
251 Abdominal Pain Gastroenterology   $ 27,901
252 Malfunction, Reaction & Complication Of G.I. Device Or Procedure Gastroenterology   $ 57,669
253 Other & Unspecified Gastrointestinal Hemorrhage Gastroenterology   $ 59,058
254 Other Digestive System Diagnoses Gastroenterology   $ 37,572
260 Major Pancreas, Liver & Shunt Procedures General Surgery   $ 205,330
261 Major Biliary Tract Procedures General Surgery   $ 142,908
262 Cholecystectomy Except Laparoscopic General Surgery   $ 98,994
263 Laparoscopic Cholecystectomy General Surgery   $ 49,433
264 Other Hepatobiliary, Pancreas & Abdominal Procedures General Surgery   $ 206,209
279 Hepatic Coma & Other Major Acute Liver Disorders Gastroenterology   $ 94,964
280 Alcoholic Liver Disease Gastroenterology   $ 85,010
281 Malignancy of Hepatobiliary System & Pancreas Oncology   $ 98,214
282 Disorders of Pancreas Except Malignancy Gastroenterology   $ 45,342
283 Other Disorders Of The Liver Gastroenterology   $ 65,697
284 Disorders of the Gallbladder & Biliary Tract Gastroenterology   $ 48,931
301 Hip Joint Replacement Orthopedic Surgery   $ 82,030
302 Knee Joint Replacement Orthopedic Surgery   $ 86,518
303 Dorsal & Lumbar Fusion Proc for Curvature of Back Orthopedic Surgery   $ 370,801
304 Dorsal & Lumbar Fusion Proc Except for Curvature of Back Orthopedic Surgery   $ 206,325
305 Amputation of Lower Limb Except Toes Orthopedic Surgery   $ 198,350
308 Hip & Femur Procedures for Trauma Except Joint Replacement Trauma   $ 99,741
309 Hip & Femur Procedures for Non-Trauma Except Joint Replacement Orthopedic Surgery   $ 105,657
310 Intervertebral Disc Excision & Decompression Orthopedic Surgery   $ 52,274
312 Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses Orthopedic Surgery   $ 231,334
313 Knee & Lower Leg Procedures Except Foot Orthopedic Surgery   $ 77,180
314 Foot & Toe Procedures Orthopedic Surgery   $ 83,817
315 Shoulder, Upper Arm & Forearm Procedures Orthopedic Surgery   $ 69,878
316 Hand & Wrist Procedures Orthopedic Surgery   $ 46,023
317 Tendon, Muscle & Other Soft Tissue Procedures Orthopedic Surgery   $ 62,272
320 Other Musculoskeletel System & Connective Tissue Procedures Orthopedic Surgery   $ 100,277
321 Cervical Spinal Fusion & Other Back/Neck Proc Exc Disc Excis/Decomp Orthopedic Surgery   $ 97,061
340 Fractures of Femur Orthopedics   $ 41,583
341 Fracture of Pelvis or Dislocation of Hip Orthopedics   $ 47,833
342 Fracture or Dislocation Except Femur, Pelvis & Back Orthopedics   $ 36,684
343 Musculoskeletal Malignancy & Pathol Fractures D/T Muscskel Malig Oncology   $ 122,292
344 Osteomyelitis, Septic Arthritis & Other Musculoskeletal Infections Infectious Disease   $ 89,584
346 Connective Tissue Disorders Orthopedics   $ 79,195
347 Other Back & Neck Disorders, Fractures & Injuries Orthopedics   $ 38,790
349 Malfunction, Reaction & Comp of Orthopedic Device or Procedure Orthopedics   $ 63,897
351 Other Musculoskeletal System & Connective Tissue Diagnoses Rheumatology   $ 36,776
361 Skin Graft for Skin & Subcutaneous Tissue Diagnoses General Surgery   $ 109,910
362 Mastectomy Procedures General Surgery   $ 99,410
363 Breast Procedures Except Mastectomy General Surgery   $ 59,069
364 Other Skin, Subcutaneous Tissue & Related Procedures General Surgery   $ 58,328
380 Skin Ulcers Dermatology   $ 63,513
381 Major Skin Disorders Dermatology   $ 56,102
382 Malignant Breast Disorders Oncology   $ 107,015
383 Cellulitis & Other Bacterial Skin Infections Infectious Disease   $ 36,278
384 Contusion, Open Wound & Other Trauma To Skin & Subcutaneous Tissue Dermatology   $ 26,807
385 Other Skin, Subcutaneous Tissue & Breast Disorders Dermatology   $ 36,014
401 Pituitary & Adrenal Procedures General Surgery   $ 108,148
403 Procedures for Obesity General Surgery   $ 51,519
404 Thyroid, Parathyroid & Thyroglossal Procedures General Surgery   $ 33,563
405 Other Procedures for Endocrine, Nutrititional & Metabolic Disorders General Surgery   $ 194,744
420 Diabetes Endocrinology   $ 37,903
421 Malnutrition, Failure To Thrive & Other Nutritional Disorders Endocrinology   $ 74,381
422 Hypovolemia & Related Electrolyte Disorders Endocrinology   $ 33,447
423 Inborn Errors of Metabolism Endocrinology   $ 72,453
424 Other Endocrine Disorders Endocrinology   $ 47,343
425 Electrolyte Disorders Except Hypovolemia Related Endocrinology   $ 43,164
440 Kidney Transplant Transplant Surgery   $ 261,930
441 Major Bladder Procedures Urologic/Nephrologic Surgery   $ 164,618
442 Kidney & Urinary Tract Procedures for Malignancy Urologic/Nephrologic Surgery   $ 88,018
443 Kidney & Urinary Tract Procedures for Nonmalignancy Urologic/Nephrologic Surgery   $ 73,863
444 Renal Dialysis Access Device Procedure Only Urologic/Nephrologic Surgery   $ 176,421
445 Other Bladder Procedures Urologic/Nephrologic Surgery   $ 69,688
446 Urethral & Transurethral Procedures Urologic/Nephrologic Surgery   $ 35,407
447 Other Kidney, Urinary Tract & Related Procedures Urologic/Nephrologic Surgery   $ 158,525
460 Renal Failure Urology/Nephrology   $ 78,558
461 Kidney & Urinary Tract Malignancy Oncology   $ 84,352
462 Nephritis & Nephrosis Urology/Nephrology   $ 55,078
463 Kidney & Urinary Tract Infections Urology/Nephrology   $ 35,897
465 Urinary Stones & Acquired Upper Urinary Tract Obstruction Urology/Nephrology   $ 31,459
466 Malfunction, Reaction & Complic of Genitourinary Device Or Proc Urology/Nephrology   $ 77,013
468 Other Kidney & Urinary Tract Diagnoses, Signs & Symptoms Urology/Nephrology   $ 46,894
480 Major Male Pelvic Procedures Urologic/Nephrologic Surgery   $ 45,891
481 Penis Procedures Urologic/Nephrologic Surgery   $ 84,231
482 Transurethral Prostatectomy Urologic/Nephrologic Surgery   $ 31,850
483 Testes & Scrotal Procedures Urologic/Nephrologic Surgery   $ 32,788
484 Other Male Reproductive System & Related Procedures Urologic/Nephrologic Surgery   $ 86,453
500 Malignancy, Male Reproductive System Oncology   $ 68,117
501 Male Reproductive System Diagnoses Except Malignancy Urology/Nephrology   $ 36,743
510 Pelvic Evisceration, Radical Hysterectectomy & Radical GYN Procs Gynecology Surgery   $ 83,425
511 Uterine & Adnexa Procedures for Ovarian & Adnexal Malignancy Gynecology Surgery   $ 88,080
512 Uterine & Adnexa Procedures for Non-ovarian & Non-adnexal Malig Gynecology Surgery   $ 60,148
513 Uterine & Adnexa Procedures for Non-Malignancy Except Leiomyoma Gynecology Surgery   $ 37,649
514 Female Reproductive System Reconstructive Procedures Gynecology Surgery   $ 38,123
517 Dilation & Curettage For Non-Obstetric Procedures Gynecology Surgery   $ 37,474
518 Other Female Reproductive System & Related Procedures Gynecology Surgery   $ 51,917
519 Uterine & Adnexa Procedures For Leiomyoma Gynecology Surgery   $ 40,773
530 Female Reproductive System Malignancy Oncology   $ 91,686
531 Female Reproductive System Infections Gynecology   $ 34,671
532 Menstrual & Other Female Reproductive System Disorders Gynecology   $ 28,093
540 Cesarean Delivery Obstetrics/Delivery   $ 33,589
541 Vaginal Delivery w/ Sterilization &/or D&C Obstetrics/Delivery   $ 29,808
542 Vaginal Delivery w/ Complicating Procedures Exc Sterilization &/or D&C Obstetrics/Delivery   $ 22,144
544 D&C, Aspiration Curettage or Hysterotomy For Obstetric Diagnoses Other Obstetrics   $ 24,969
545 Ectopic Pregnancy Procedure Gynecology Surgery   $ 35,249
546 Other O.R. Proc For Obstetric Diagnoses Except Delivery Diagnoses Other Obstetrics   $ 43,687
560 Vaginal Delivery Obstetrics/Delivery   $ 23,824
561 Postpartum & Post Abortion Diagnoses w/o Procedure Other Obstetrics   $ 25,051
563 Threatened Abortion Other Obstetrics   $ 22,597
564 Abortion w/o D&C, Aspiration Curettage or Hysterotomy Other Obstetrics   $ 24,659
565 False Labor Other Obstetrics   $ 11,707
566 Other Antepartum Diagnoses Other Obstetrics   $ 23,292
580 Neonate, Transferred <5 Days Old, Not Born Here Neonatology   $ 41,368
581 Neonate, Transferred <5 Days Old, Born Here Neonatology   $ 9,936
583 Neonate, w/ ECMO Neonatology   $ 1,180,832
588 Neonate BWT <1500G W Major Procedure Neonatology   $ 1,224,414
589 Neonate BWT < 500G Neonatology   $ 12,174
591 Neonate, Birthwt 500-749G w/o Major Procedure Neonatology   $ 1,574,916
593 Neonate, Birthwt 750-999G w/o Major Procedure Neonatology   $ 916,047
602 Neonate, Birthwt 1000-1249G w/ Resp Dist Synd/Oth Maj Resp Or Maj Anom Neonatology   $ 583,232
603 Neonate, Birthwt 1000-1249G W OR W/O Other Significant Condition Neonatology   $ 645,648
607 Neonate, BWT 1250-1499G W Resp Dist Synd/Oth Maj Resp Or Maj Anom Neonatology   $ 427,775
608 Neonate, Birthwt 1250-1499G W OR W/O Other Significant Condition Neonatology   $ 389,752
609 Neonate, BWT 1500-2499G W Major Procedure Neonatology   $ 684,469
611 Neonate, Birthwt 1500-1999G W Major Anomaly Neonatology   $ 343,623
612 Neonate, BWT 1500-1999G W Resp Dist Synd/Oth Maj Resp Cond Neonatology   $ 312,264
613 Neonate, Birthwt 1500-1999G W Congenital/Perinatal Infection Neonatology   $ 274,822
614 Neonate, Birthwt 1500-1999G W OR W/O Other Significant Condition Neonatology   $ 183,749
621 Neonate, BWT 2000-2499G W Major Anomaly Neonatology   $ 234,748
622 Neonate, BWT 2000-2499G W Resp Dist Synd/Oth Maj Resp Cond Neonatology   $ 163,080
623 Neonate, Birthwt 2000-2499G W Congenital/Perinatal Infection Neonatology   $ 131,252
625 Neonate, Birthwt 2000-2499G W Other Significant Condition Neonatology   $ 135,918
626 Neonate, BWT 2000-2499G, Normal Newborn Or Neonate W Other Problem Neonatology   $ 21,646
630 Neonate, Birthwt > 2499g w/ Major Cardiovasc Procedure Neonatology   $ 612,860
631 Neonate, Birthwt > 2499g w/ Other Major Procedure Neonatology   $ 514,239
633 Neonate, Birthwt > 2499g w/ Major Anomaly Neonatology   $ 53,480
634 Neonate, Birthwt > 2499g W Resp Dist Synd/Oth Maj Resp Cond Neonatology   $ 101,108
636 Neonate, Birthwt > 2499g W Congenital/Perinatal Infection Neonatology   $ 69,169
639 Neonate, Birthwt > 2499g W Other Significant Condition Neonatology   $ 48,346
640 Neonate, Bwt > 2499g, Normal Newborn Or Neonate W Other Problem Neonatology   $ 9,283
650 Splenectomy General Surgery   $ 102,025
651 Other Procedures of Blood & Blood Forming Organs General Surgery   $ 84,451
660 Major Hematologic/Immunologic Diag Exc Sickle Cell Crisis & Coagul Hematology   $ 89,240
661 Coagulation & Platelet Disorders Hematology   $ 87,697
662 Sickle Cell Anemia Crisis Hematology   $ 63,619
663 Other Anemia & Disorders Of Blood & Blood Forming Organs Hematology   $ 38,142
680 Major O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms General Surgery   $ 243,767
681 Other O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms General Surgery   $ 138,656
690 Acute Leukemia Oncology   $ 581,517
691 Lymphoma & Non-acute Leukemia Oncology   $ 161,397
692 Radiotherapy Oncology   $ 59,818
693 Chemotherapy Oncology   $ 67,943
694 Lymphatic & Other Malignancies & Neoplasms Of Uncertain Behavior Oncology   $ 103,523
710 Infectious & Parasitic Diseases Including HIV W O.R. Procedure General Surgery   $ 328,673
711 Post-Op,Post-Trauma, Other Device Infections W O.R. Procedure General Surgery   $ 151,193
720 Septicemia & Disseminated Infections Infectious Disease   $ 132,345
721 Post-Operative, Post-Traumatic, Other Device Infections General Medicine   $ 74,485
722 Fever General Medicine   $ 33,616
723 Viral Illness Infectious Disease   $ 30,011
724 Other Infectious & Parasitic Diseases Infectious Disease   $ 59,380
740 Mental Illness Diagnosis W O.R. Procedure General Surgery   $ 101,720
750 Schizophrenia Mental Health   $ 51,877
751 Major Depressive Disorders & Other/Unspecified Psychoses Mental Health   $ 41,373
752 Disorders of Personality & Impulse Control Mental Health   $ 44,782
753 Bipolar Disorders Mental Health   $ 33,891
754 Depression Except Major Depressive Disorder Mental Health   $ 24,771
755 Adjustment Disorders & Neuroses Except Depressive Diagnoses Mental Health   $ 33,263
756 Acute Anxiety & Delirium States Mental Health   $ 20,179
757 Organic Mental Health Disturbances Mental Health   $ 51,403
758 Childhood Behavioral Disorders Mental Health   $ 24,785
759 Eating Disorders Mental Health   $ 46,002
760 Other Mental Health Disorders Mental Health   $ 29,825
770 Drug & Alcohol Abuse or Dependence, Left Against Medical Advice Substance Abuse   $ 14,378
772 Alcohol & Drug Dependence w/ Rehab/Detox Therapy Substance Abuse   $ 43,354
773 Opioid Abuse & Dependence Substance Abuse   $ 9,049
774 Cocaine Abuse & Dependence Substance Abuse   $ 20,516
775 Alcohol Abuse & Dependence Substance Abuse   $ 29,584
776 Other Drug Abuse & Dependence Substance Abuse   $ 32,093
791 O.R. Procedure For Other Complications Of Treatment General Surgery   $ 100,279
811 Allergic Reactions General Medicine   $ 23,184
812 Poisoning Of Medicinal Agents General Medicine   $ 34,861
813 Other Complications of Treatment General Medicine   $ 46,483
815 Other Injury, Poisoning & Toxic Effect Diagnoses General Medicine   $ 32,573
816 Toxic Effects Of Non-Medicinal Substances General Medicine   $ 41,022
841 Extensive 3rd Degree Burns W Skin Graft General Surgery   $ 2,281,993
842 Full Thickness Burns W Skin Graft General Surgery   $ 499,241
843 Extensive 3rd Degree Or Full Thickness Burns W/O Skin Graft General Medicine   $ 148,308
844 Partial Thickness Burns W Or W/O Skin Graft General Medicine   $ 173,931
850 Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service General Surgery   $ 106,437
860 Rehabilitation Rehabilitation   $ 126,864
861 Signs, Symptoms & Other Factors Influencing Health Status General Medicine   $ 38,353
862 Other Aftercare & Convalescence General Medicine   $ 79,643
863 Neonatal Aftercare Neonatology   $ 125,270
890 HIV W Multiple Major HIV Related Conditions HIV   $ 265,552
892 HIV W Major HIV Related Condition HIV   $ 100,412
893 HIV W Multiple Significant HIV Related Conditions HIV   $ 76,959
894 HIV W One Signif HIV Cond Or W/O Signif Related Cond HIV   $ 50,245
910 Craniotomy For Multiple Significant Trauma Trauma   $ 514,259
911 Extensive Abdominal/Thoraic Procedures For Mult Significant Trauma Trauma   $ 448,296
912 Musculoskeletal & Other Procedures For Multiple Significant Trauma Trauma   $ 390,547
930 Multiple Significant Trauma W/O O.R. Procedure Trauma   $ 120,333
950 Extensive Procedure Unrelated To Principal Diagnosis General Surgery   $ 267,279
951 Moderately Extensive Procedure Unrelated To Principal Diagnosis General Surgery   $ 151,799
952 Nonextensive Procedure Unrelated To Principal Diagnosis General Surgery   $ 93,207

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