Final Cost Outlier Thresholds Effective January 1, 2013

Also available as an Excel Spreadsheet XLS, 34KB

APR-DRG APR-DRG Description Product Line 2013 Cost Outlier Thresholds
001 Liver Transplant Transplant Surgery $1,124,797
002 Heart &/or Lung Transplant Transplant Surgery $1,697,184
003 Bone Marrow Transplant Transplant Surgery $774,489
004 Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure General Surgery $1,036,343
005 Tracheostomy W Long Term Mechanical Ventilation W/O Extensive Procedure General Surgery $695,051
006 Pancreas Transplant Transplant Surgery $181,096
020 Craniotomy for Trauma Trauma $160,434
021 Craniotomy Except for Trauma Neurological Surgery $200,194
022 Ventricular Shunt Procedures Neurological Surgery $269,127
023 Spinal Procedures Neurological Surgery $156,428
024 Extracranial Vascular Procedures Neurological Surgery $134,647
026 Other Nervous System & Related Procedures Neurological Surgery $115,909
040 Spinal Disorders & Injuries Neurology $71,163
041 Nervous System Malignancy Oncology $89,093
042 Degenerative Nervous System Disorders Exc Mult Sclerosis Neurology $51,421
043 Multiple Sclerosis & Other Demyelinating Diseases Neurology $44,022
044 Intracranial Hemorrhage Neurology $126,889
045 CVA & Precerebral Occulusion w/ Infarct Neurology $65,140
046 Nonspecific CVA & Precerebral Occlusion w/o Infarct Neurology $48,251
047 Transient Ischemia Neurology $23,970
048 Peripheral, Cranial & Autonomic Nerve Disorders Neurology $38,212
049 Bacterial & Tuberculous Infections of Nervous System Infectious Disease $176,338
050 Non-bacterial Infections of Nervous System Exc Viral Meningitis Infectious Disease $84,686
051 Viral Meningitis Infectious Disease $40,223
052 Nontraumatic Stupor & Coma Neurology $40,840
053 Seizure Neurology $33,640
054 Migraine & Other Headaches Neurology $25,103
055 Head Trauma w/ Coma > 1 Hr or Hemorrhage Trauma $58,575
056 Brain Contusion/Laceration & Compliated Skull FX, COMA < 1 HR OR No Coma Neurology $42,211
057 Concussion, Closed Skull FX Nos, Uncomplicated Intracranial Injury, Coma <1 Hr or No Coma Neurology $21,395
058 Other Disorders of Nervous System Neurology $40,762
070 Orbital Procedures Ophthalmology Surgery $54,481
073 Eye Procedures Except Orbit Ophthalmology Surgery $42,462
080 Acute Major Eye Infections Ophthalmology $30,756
082 Eye Disorders Except Major Infections Ophthalmology $30,559
089 Major Cranial/Facial Bone Procedures ENT Surgery $113,197
090 Major Larynx & Trachea Procedures ENT Surgery $187,534
091 Other Major Head & Neck Procedures ENT Surgery $215,560
092 Facial Bone Procedures Except Major Cranial/Facial Bone Procedures ENT Surgery $62,617
093 Sinus & Mastoid Procedures ENT Surgery $57,226
095 Cleft Lip & Palate Repair ENT Surgery $34,652
097 Tonsill & Adenoid Procedures ENT Surgery $28,289
098 Other Ear, Nose, Mouth & Throat Procedures ENT Surgery $48,554
110 Ear, Nose, Mouth Throat, Cranial/Facial Malignancies Oncology $90,100
111 Vertigo & Other Labyrinth Disorders Otolaryngology $22,658
113 Infections Of The Upper Respiratory Tract Otolaryngology $24,183
114 Dental & Oral Diseases & Injuries Dental $34,432
115 Other Ear, Nose, Mouth,Throat & Cranial/Facial Diagnoses Otolaryngology $30,973
120 Major Respiratory & Chest Procedures General Surgery $115,395
121 Other Respiratory & Chest Procedures General Surgery $104,951
130 Respiratory System Diagnosis w/ Ventilator Support 96+ Hours Pulmonary $261,151
131 Cystic Fibrosis - Pulmonary Disease Pulmonary $132,416
132 BPD & Oth Chronic Respiratory Dis Arising In Perinatal Period Neonatology $81,557
133 Pulmonary Edema & Respiratory Failure Pulmonary $82,040
134 Pulmonary Embolism Pulmonary $57,012
135 Major Chest & Respiratory Trauma Trauma $39,835
136 Respiratory Malignancy Oncology $84,941
137 Major Respiratory Infections & Inflammations Pulmonary $85,596
138 Bronchiolitis & RSV Pneumonia Pulmonary $31,534
139 Other Pneumonia Pulmonary $37,058
140 Chronic Obstructive Pulmonary Disease Pulmonary $37,309
141 Asthma Pulmonary $27,233
142 Interstitial Lung Disease Pulmonary $62,048
143 Other Respiratory Diagnosis Except Signs, Symptoms & Minor Diagnoses Pulmonary $51,443
144 Respiratory System Signs, Symptoms & Other Diagnoses Pulmonary $27,787
160 Major Cardiothoracic Repair of Heart Anomaly Open Heart Surgery $263,693
161 Cardiac Defibrillator & Heart Assist Anomaly Open Heart Surgery $278,850
162 Cardiac Valve Procedures w/ Cardiac Catheterization Open Heart Surgery $233,149
163 Cardiac Valve Procedures w/o Cardiac Catheterization Open Heart Surgery $198,883
165 Coronary Bypass w/ Cardiac Cath Or Percutaneous Cardiac Procedure Open Heart Surgery $167,413
166 Coronary Bypass w/o Cardiac Cath Or Percutaneous Cardiac Procedure Open Heart Surgery $141,179
167 Other Cardiothoracic Procedures Cardiovascular Surgery $164,922
169 Major Thoracic & Abdominal Vascular Procedures Cardiovascular Surgery $206,814
170 Permanent Cardiac Pacemaker Implant w/ AMI, Heart Failure or Shock Cardiovascular Surgery $160,896
171 Perm Cardiac Pacemaker Implant w/o AMI, Heart Failure or Shock Cardiovascular Surgery $92,627
173 Other Vascular Procedures Cardiovascular Surgery $139,709
174 Percutaneous Cardiovascular Procedures w/ AMI Cardiovascular Surgery $102,075
175 Percutaneous Cardiovascular Procedures w/o AMI Cardiovascular Surgery $72,133
176 Cardiac Pacemaker & Defibrillator Device Replacement Cardiovascular Surgery $162,250
177 Cardiac Pacemaker & Defibrillator Revision Except Device Replacement Cardiovascular Surgery $163,605
180 Other Circulatory System Procedures Cardiovascular Surgery $155,043
190 Acute Myocardial Infarction Cardiology $73,180
191 Cardiac Catheterization w/ Circ Disord Exc Ischemic Heart Disease Cardiac Catheter $81,744
192 Cardiac Catheterization for Ischemic Heart Disease Cardiac Catheter $38,339
193 Acute & Subacute Endocarditis Cardiology $141,104
194 Heart Failure Cardiology $55,651
196 Cardiac Arrest Cardiology $56,931
197 Peripheral & Other Vascular Disorders Cardiology $49,095
198 Angina Pectoris & Coronary Atherosclerosis Cardiology $24,124
199 Hypertension Cardiology $26,357
200 Cardiac Congenital & Valvular Disorders Cardiology $53,926
201 Cardiac Arrhythmia & Conduction Disorders Cardiology $30,101
203 Chest Pain Cardiology $19,518
204 Syncope & Collapse Cardiology $24,955
205 Cardiomyopathy Cardiology $41,545
206 Malfunction, Reaction & Comp of Cardiac or Vasc Device or Proc Cardiology $71,804
207 Other Circulatory System Diagnoses Cardiology $40,896
220 Major Stomach, Esophageal & Duodenal Procedures General Surgery $144,099
221 Major Small & Large Bowel Procedures General Surgery $100,270
222 Minor Stomach, Esophageal & Duodenal Procedures General Surgery $49,095
223 Minor Small & Large Bowel Procedures General Surgery $76,334
224 Peritoneal Adhesiolysis General Surgery $79,143
225 Appendectomy General Surgery $31,709
226 Anal Procedures General Surgery $33,335
227 Hernia Procedures Except Inguinal, Femoral & Umbilical General Surgery $55,240
228 Inguinal, Femoral & Umbilical Hernia Procedures General Surgery $36,984
229 Other Digestive System & Abdominal Procedures General Surgery $107,145
240 Digestive Malignancy Oncology $95,993
241 Peptic Ulcer & Gastritis Gastroenterology $35,309
242 Major Esophageal Disorders Gastroenterology $56,731
243 Other Esophageal Disorders Gastroenterology $29,394
244 Diverticulitis & Diverticulosis Gastroenterology $26,340
245 Inflammatory Bowel Disease Gastroenterology $43,863
246 Gastrointestinal Vascular Insufficiency Gastroenterology $35,809
247 Intestinal Obstruction Gastroenterology $28,739
248 Major Gastrointestinal & Peritoneal Infections Gastroenterology $52,848
249 Non-Bacterial Gastroenteritis, Nausea & Vomiting Gastroenterology $23,503
251 Abdominal Pain Gastroenterology $23,887
252 Malfunction, Reaction & Complication Of G.I. Device Or Procedure Gastroenterology $52,821
253 Other & Unspecified Gastrointestinal Hemorrhage Gastroenterology $46,674
254 Other Digestive System Diagnoses Gastroenterology $33,078
260 Major Pancreas, Liver & Shunt Procedures General Surgery $162,432
261 Major Biliary Tract Procedures General Surgery $136,527
262 Cholecystectomy Except Laparoscopic General Surgery $82,147
263 Laparoscopic Cholecystectomy General Surgery $43,675
264 Other Hepatobiliary, Pancreas & Abdominal Procedures General Surgery $166,207
279 Hepatic Coma & Other Major Acute Liver Disorders Gastroenterology $91,647
280 Alcoholic Liver Disease Gastroenterology $72,155
281 Malignancy of Hepatobiliary System & Pancreas Oncology $83,405
282 Disorders of Pancreas Except Malignancy Gastroenterology $38,306
283 Other Disorders Of The Liver Gastroenterology $56,403
284 Disorders of the Gallbladder & Biliary Tract Gastroenterology $41,035
301 Hip Joint Replacement Orthopedic Surgery $76,311
302 Knee Joint Replacement Orthopedic Surgery $76,744
303 Dorsal & Lumbar Fusion Proc for Curvature of Back Orthopedic Surgery $240,067
304 Dorsal & Lumbar Fusion Proc Except for Curvature of Back Orthopedic Surgery $154,659
305 Amputation of Lower Limb Except Toes Orthopedic Surgery $164,840
308 Hip & Femur Procedures for Trauma Except Joint Replacement Trauma $86,785
309 Hip & Femur Procedures for Non-Trauma Except Joint Replacement Orthopedic Surgery $96,707
310 Intervertebral Disc Excision & Decompression Orthopedic Surgery $42,366
312 Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses Orthopedic Surgery $181,118
313 Knee & Lower Leg Procedures Except Foot Orthopedic Surgery $70,332
314 Foot & Toe Procedures Orthopedic Surgery $81,740
315 Shoulder, Upper Arm & Forearm Procedures Orthopedic Surgery $58,724
316 Hand & Wrist Procedures Orthopedic Surgery $41,681
317 Tendon, Muscle & Other Soft Tissue Procedures Orthopedic Surgery $51,233
320 Other Musculoskeletel System & Connective Tissue Procedures Orthopedic Surgery $79,950
321 Cervical Spinal Fusion & Other Back/Neck Proc Exc Disc Excis/Decomp Orthopedic Surgery $78,566
340 Fractures of Femur Orthopedics $37,813
341 Fracture of Pelvis or Dislocation of Hip Orthopedics $36,383
342 Fracture or Dislocation Except Femur, Pelvis & Back Orthopedics $30,478
343 Musculoskeletal Malignancy & Pathol Fractures D/T Muscskel Malig Oncology $108,523
344 Osteomyelitis, Septic Arthritis & Other Musculoskeletal Infections Infectious Disease $85,391
346 Connective Tissue Disorders Orthopedics $64,010
347 Other Back & Neck Disorders, Fractures & Injuries Orthopedics $34,055
349 Malfunction, Reaction & Comp of Orthopedic Device or Procedure Orthopedics $58,842
351 Other Musculoskeletal System & Connective Tissue Diagnoses Rheumatology $32,978
361 Skin Graft for Skin & Subcutaneous Tissue Diagnoses General Surgery $96,998
362 Mastectomy Procedures General Surgery $77,694
363 Breast Procedures Except Mastectomy General Surgery $52,444
364 Other Skin, Subcutaneous Tissue & Related Procedures General Surgery $50,592
380 Skin Ulcers Dermatology $55,380
381 Major Skin Disorders Dermatology $55,001
382 Malignant Breast Disorders Oncology $81,411
383 Cellulitis & Other Bacterial Skin Infections Infectious Disease $32,123
384 Contusion, Open Wound & Other Trauma To Skin & Subcutaneous Tissue Dermatology $25,012
385 Other Skin, Subcutaneous Tissue & Breast Disorders Dermatology $31,663
401 Pituitary & Adrenal Procedures General Surgery $106,149
403 Procedures for Obesity General Surgery $55,621
404 Thyroid, Parathyroid & Thyroglossal Procedures General Surgery $26,087
405 Other Procedures for Endocrine, Nutrititional & Metabolic Disorders General Surgery $178,401
420 Diabetes Endocrinology $32,589
421 Malnutrition, Failure To Thrive & Other Nutritional Disorders Endocrinology $73,888
422 Hypovolemia & Related Electrolyte Disorders Endocrinology $30,597
423 Inborn Errors of Metabolism Endocrinology $72,840
424 Other Endocrine Disorders Endocrinology $40,322
425 Electrolyte Disorders Except Hypovolemia Related Endocrinology $38,765
440 Kidney Transplant Transplant Surgery $184,092
441 Major Bladder Procedures Urologic/Nephrologic Surgery $147,121
442 Kidney & Urinary Tract Procedures for Malignancy Urologic/Nephrologic Surgery $79,430
443 Kidney & Urinary Tract Procedures for Nonmalignancy Urologic/Nephrologic Surgery $65,241
444 Renal Dialysis Access Device Procedure Only Urologic/Nephrologic Surgery $147,566
445 Other Bladder Procedures Urologic/Nephrologic Surgery $63,700
446 Urethral & Transurethral Procedures Urologic/Nephrologic Surgery $29,350
447 Other Kidney, Urinary Tract & Related Procedures Urologic/Nephrologic Surgery $104,933
460 Renal Failure Urology/Nephrology $61,609
461 Kidney & Urinary Tract Malignancy Oncology $69,819
462 Nephritis & Nephrosis Urology/Nephrology $53,242
463 Kidney & Urinary Tract Infections Urology/Nephrology $32,390
465 Urinary Stones & Acquired Upper Urinary Tract Obstruction Urology/Nephrology $26,759
466 Malfunction, Reaction & Complic of Genitourinary Device Or Proc Urology/Nephrology $72,190
468 Other Kidney & Urinary Tract Diagnoses, Signs & Symptoms Urology/Nephrology $44,175
480 Major Male Pelvic Procedures Urologic/Nephrologic Surgery $36,886
481 Penis Procedures Urologic/Nephrologic Surgery $65,768
482 Transurethral Prostatectomy Urologic/Nephrologic Surgery $25,328
483 Testes & Scrotal Procedures Urologic/Nephrologic Surgery $28,250
484 Other Male Reproductive System & Related Procedures Urologic/Nephrologic Surgery $62,806
500 Malignancy, Male Reproductive System Oncology $78,743
501 Male Reproductive System Diagnoses Except Malignancy Urology/Nephrology $28,874
510 Pelvic Evisceration, Radical Hysterectectomy & Radical GYN Procs Gynecology Surgery $84,811
511 Uterine & Adnexa Procedures for Ovarian & Adnexal Malignancy Gynecology Surgery $80,844
512 Uterine & Adnexa Procedures for Non-ovarian & Non-adnexal Malig Gynecology Surgery $52,420
513 Uterine & Adnexa Procedures for Non-Malignancy Except Leiomyoma Gynecology Surgery $34,149
514 Female Reproductive System Reconstructive Procedures Gynecology Surgery $35,571
517 Dilation & Curettage For Non-Obstetric Procedures Gynecology Surgery $29,638
518 Other Female Reproductive System & Related Procedures Gynecology Surgery $41,463
519 Uterine & Adnexa Procedures For Leiomyoma Gynecology Surgery $34,535
530 Female Reproductive System Malignancy Oncology $67,179
531 Female Reproductive System Infections Gynecology $30,184
532 Menstrual & Other Female Reproductive System Disorders Gynecology $21,693
540 Cesarean Delivery Obstetrics/Delivery $30,061
541 Vaginal Delivery w/ Sterilization &/or D&C Obstetrics/Delivery $26,708
542 Vaginal Delivery w/ Complicating Procedures Exc Sterilization &/or D&C Obstetrics/Delivery $21,418
544 D&C, Aspiration Curettage or Hysterotomy For Obstetric Diagnoses Other Obstetrics $23,447
545 Ectopic Pregnancy Procedure Gynecology Surgery $30,613
546 Other O.R. Proc For Obstetric Diagnoses Except Delivery Diagnoses Other Obstetrics $36,057
560 Vaginal Delivery Obstetrics/Delivery $19,988
561 Postpartum & Post Abortion Diagnoses w/o Procedure Other Obstetrics $20,099
563 Threatened Abortion Other Obstetrics $20,280
564 Abortion w/o D&C, Aspiration Curettage or Hysterotomy Other Obstetrics $18,409
565 False Labor Other Obstetrics $10,366
566 Other Antepartum Diagnoses Other Obstetrics $20,516
580 Neonate, Transferred <5 Days Old, Not Born Here Neonatology $42,889
581 Neonate, Transferred <5 Days Old, Born Here Neonatology $8,563
583 Neonate, w/ ECMO Neonatology $1,156,666
588 Neonate BWT <1500G W Major Procedure Neonatology $1,662,283
589 Neonate BWT < 500G Neonatology $22,076
591 Neonate, Birthwt 500-749G w/o Major Procedure Neonatology $1,594,593
593 Neonate, Birthwt 750-999G w/o Major Procedure Neonatology $930,843
602 Neonate, Birthwt 1000-1249G w/ Resp Dist Synd/Oth Maj Resp Or Maj Anom Neonatology $691,294
603 Neonate, Birthwt 1000-1249G W OR W/O Other Significant Condition Neonatology $431,147
607 Neonate, BWT 1250-1499G W Resp Dist Synd/Oth Maj Resp Or Maj Anom Neonatology $471,667
608 Neonate, Birthwt 1250-1499G W OR W/O Other Significant Condition Neonatology $408,170
609 Neonate, BWT 1500-2499G W Major Procedure Neonatology $1,040,778
611 Neonate, Birthwt 1500-1999G W Major Anomaly Neonatology $390,076
612 Neonate, BWT 1500-1999G W Resp Dist Synd/Oth Maj Resp Cond Neonatology $275,789
613 Neonate, Birthwt 1500-1999G W Congenital/Perinatal Infection Neonatology $188,659
614 Neonate, Birthwt 1500-1999G W OR W/O Other Significant Condition Neonatology $194,977
621 Neonate, BWT 2000-2499G W Major Anomaly Neonatology $176,294
622 Neonate, BWT 2000-2499G W Resp Dist Synd/Oth Maj Resp Cond Neonatology $143,295
623 Neonate, Birthwt 2000-2499G W Congenital/Perinatal Infection Neonatology $104,476
625 Neonate, Birthwt 2000-2499G W Other Significant Condition Neonatology $121,487
626 Neonate, BWT 2000-2499G, Normal Newborn Or Neonate W Other Problem Neonatology $20,942
630 Neonate, Birthwt > 2499g w/ Major Cardiovasc Procedure Neonatology $694,073
631 Neonate, Birthwt > 2499g w/ Other Major Procedure Neonatology $391,656
633 Neonate, Birthwt > 2499g w/ Major Anomaly Neonatology $46,986
634 Neonate, Birthwt > 2499g W Resp Dist Synd/Oth Maj Resp Cond Neonatology $84,522
636 Neonate, Birthwt > 2499g W Congenital/Perinatal Infection Neonatology $62,176
639 Neonate, Birthwt > 2499g W Other Significant Condition Neonatology $45,914
640 Neonate, Bwt > 2499g, Normal Newborn Or Neonate W Other Problem Neonatology $8,250
650 Splenectomy General Surgery $100,360
651 Other Procedures of Blood & Blood Forming Organs General Surgery $72,635
660 Major Hematologic/Immunologic Diag Exc Sickle Cell Crisis & Coagul Hematology $72,517
661 Coagulation & Platelet Disorders Hematology $73,555
662 Sickle Cell Anemia Crisis Hematology $55,449
663 Other Anemia & Disorders Of Blood & Blood Forming Organs Hematology $33,429
680 Major O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms General Surgery $236,866
681 Other O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms General Surgery $151,492
690 Acute Leukemia Oncology $489,639
691 Lymphoma & Non-acute Leukemia Oncology $179,420
692 Radiotherapy Oncology $47,314
693 Chemotherapy Oncology $64,780
694 Lymphatic & Other Malignancies & Neoplasms Of Uncertain Behavior Oncology $78,209
710 Infectious & Parasitic Diseases Including HIV W O.R. Procedure General Surgery $285,815
711 Post-Op,Post-Trauma, Other Device Infections W O.R. Procedure General Surgery $133,544
720 Septicemia & Disseminated Infections Infectious Disease $111,569
721 Post-Operative, Post-Traumatic, Other Device Infections General Medicine $66,452
722 Fever General Medicine $31,676
723 Viral Illness Infectious Disease $28,949
724 Other Infectious & Parasitic Diseases Infectious Disease $55,345
740 Mental Illness Diagnosis W O.R. Procedure General Surgery $124,733
750 Schizophrenia Mental Health $40,980
751 Major Depressive Disorders & Other/Unspecified Psychoses Mental Health $28,123
752 Disorders of Personality & Impulse Control Mental Health $23,562
753 Bipolar Disorders Mental Health $27,560
754 Depression Except Major Depressive Disorder Mental Health $19,435
755 Adjustment Disorders & Neuroses Except Depressive Diagnoses Mental Health $16,950
756 Acute Anxiety & Delirium States Mental Health $18,313
757 Organic Mental Health Disturbances Mental Health $41,643
758 Childhood Behavioral Disorders Mental Health $9,333
759 Eating Disorders Mental Health $27,439
760 Other Mental Health Disorders Mental Health $17,750
770 Drug & Alcohol Abuse or Dependence, Left Against Medical Advice Substance Abuse $14,772
772 Alcohol & Drug Dependence w/ Rehab/Detox Therapy Substance Abuse $47,312
773 Opioid Abuse & Dependence Substance Abuse $27,411
774 Cocaine Abuse & Dependence Substance Abuse $21,454
775 Alcohol Abuse & Dependence Substance Abuse $31,589
776 Other Drug Abuse & Dependence Substance Abuse $29,873
791 O.R. Procedure For Other Complications Of Treatment General Surgery $88,130
811 Allergic Reactions General Medicine $16,893
812 Poisoning Of Medicinal Agents General Medicine $31,314
813 Other Complications of Treatment General Medicine $41,285
815 Other Injury, Poisoning & Toxic Effect Diagnoses General Medicine $26,638
816 Toxic Effects Of Non-Medicinal Substances General Medicine $37,838
841 Extensive 3rd Degree Burns W Skin Graft General Surgery $966,458
842 Full Thickness Burns W Skin Graft General Surgery $193,319
843 Extensive 3rd Degree Or Full Thickness Burns W/O Skin Graft General Medicine $108,130
844 Partial Thickness Burns W Or W/O Skin Graft General Medicine $85,449
850 Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service General Surgery $89,261
860 Rehabilitation Rehabilitation $77,774
861 Signs, Symptoms & Other Factors Influencing Health Status General Medicine $32,254
862 Other Aftercare & Convalescence General Medicine $55,769
863 Neonatal Aftercare Neonatology $106,852
890 HIV W Multiple Major HIV Related Conditions HIV $211,281
892 HIV W Major HIV Related Condition HIV $77,367
893 HIV W Multiple Significant HIV Related Conditions HIV $55,694
894 HIV W One Signif HIV Cond Or W/O Signif Related Cond HIV $42,130
910 Craniotomy For Multiple Significant Trauma Trauma $234,086
911 Extensive Abdominal/Thoraic Procedures For Mult Significant Trauma Trauma $310,814
912 Musculoskeletal & Other Procedures For Multiple Significant Trauma Trauma $295,913
930 Multiple Significant Trauma W/O O.R. Procedure Trauma $96,568
950 Extensive Procedure Unrelated To Principal Diagnosis General Surgery $231,074
951 Moderately Extensive Procedure Unrelated To Principal Diagnosis General Surgery $135,085
952 Nonextensive Procedure Unrelated To Principal Diagnosis General Surgery $82,707

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