DRG Average Price List

DRG DESCRIPTION AVG CHARGE
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 28,685.57
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 24,045.12
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 19,143.32
100 SEIZURES W MCC 30,887.26
101 SEIZURES W/O MCC 18,654.08
153 OTITIS MEDIA & URI W/O MCC 7,527.83
166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC 83,943.47
175 PULMONARY EMBOLISM W MCC 21,653.77
176 PULMONARY EMBOLISM W/O MCC 13,132.60
177 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC 28,907.57
178 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC 23,595.94
189 PULMONARY EDEMA & RESPIRATORY FAILURE 23,826.18
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC 21,284.31
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC 19,227.04
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 13,643.37
193 SIMPLE PNEUMONIA & PLEURISY W MCC 23,930.41
194 SIMPLE PNEUMONIA & PLEURISY W CC 16,467.67
195 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC 12,100.16
202 BRONCHITIS & ASTHMA W CC/MCC 14,084.88
203 BRONCHITIS & ASTHMA W/O CC/MCC 10,527.38
208 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <96 HOURS 48,060.76
243 PERMANENT CARDIAC PACEMAKER IMPLANT W CC 50,582.25
244 PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC 53,680.95
246 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS 71,045.87
247 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC 52,400.49
249 PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC 52,282.16
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES 34,634.58
280 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC 25,853.16
281 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W CC 17,464.47
282 ACUTE MYOCARDIA INFARCTION DISCHARGED ALIVE W/O CC/MCC 16,892.76
283 ACUTE MYOCARDIAL INFARCTION EXPIRED W MCC 35,826.81
286 CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W MCC 37,147.69
287 CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCC 20,054.19
291 HEART FAILURE & SHOCK W MCC 20,239.49
292 HEART FAILURE & SHOCK W CC 16,969.05
293 HEART FAILURE & SHOCK W/O CC/MCC 12,888.27
305 HYPERTENSION W/O MCC 21,768.42
308 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC 25,393.57
309 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC 15,569.32
310 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC 10,097.06
312 SYNCOPE & COLLAPSE 16,338.26
313 CHEST PAIN 15,208.07
314 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC 31,973.04
329 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC 91,628.24
330 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC 55,994.01
331 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC 47,463.25
372 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC 21,540.08
377 G.I. HEMORRHAGE W MCC 33,857.18
378 G.I. HEMORRHAGE W CC 21,862.02
379 G.I. HEMORRHAGE W/O CC/MCC 19,891.86
389 G.I. OBSTRUCTION W CC 16,872.98
390 G.I. OBSTRUCTION W/O CC/MCC 12,310.74
391 ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W MCC 22,923.01
392 ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC 15,910.12
393 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC 35,530.33
394 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC 18,888.11
418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 37,160.48
419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 37,056.85
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 18,663.06
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 12,239.73
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 79,911.94
469 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC 53,565.99
470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 49,151.82
480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC 52,087.39
481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC 39,049.72
482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC 29,323.01
483 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC 50,546.20
493 LOWER EXTREM & HUMER PROC EXCEPT HIP FOOT FEMUR W CC 37,876.65
494 LOWER EXTREM & HUMER PROC EXCEPT HIP FOOT FEMUR W/O CC/MCC 30,735.30
602 CELLULITIS W MCC 24,240.81
603 CELLULITIS W/O MCC 13,752.94
621 O.R. PROCEDURES FOR OBESITY W/O CC/MCC 44,989.99
637 DIABETES W MCC 20,261.22
638 DIABETES W CC 13,904.70
639 DIABETES W/O CC/MCC 8,881.71
640 NUTRITIONAL & MISC METABOLIC DISORDERS W MCC 24,449.26
641 NUTRITIONAL & MISC METABOLIC DISORDERS W/O MCC 13,041.76
682 RENAL FAILURE W MCC 27,327.85
683 RENAL FAILURE W CC 13,804.66
684 RENAL FAILURE W/O CC/MCC 10,236.66
689 KIDNEY & URINARY TRACT INFECTIONS W MCC 17,023.34
690 KIDNEY & URINARY TRACT INFECTIONS W/O MCC 11,936.35
698 OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC 25,200.57
743 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC 24,944.20
765 CESAREAN SECTION W CC/MCC 19,247.38
766 CESAREAN SECTION W/O CC/MCC 17,854.30
767 VAGINAL DELIVERY W STERILIZATION &/OR D&C 19,219.81
768 VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C 14,440.85
774 VAGINAL DELIVERY W COMPLICATING DIAGNOSES 13,193.50
775 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 11,886.84
776 POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE 9,884.78
785 CESAREAN SECTION W/STERILIZATION WO/CC/MCC 18,616.59
787 CESAREAN SECTION WO/STERILIZATION W/CC 23,421.72
788 CESAREAN SECTION WO/STERILIZATION WO/CC/MCC 18,568.87
789 NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 3,777.08
792 PREMATURITY W/O MAJOR PROBLEMS 5,541.40
793 FULL TERM NEONATE W MAJOR PROBLEMS 7,134.09
794 NEONATE W OTHER SIGNIFICANT PROBLEMS 3,670.64
795 NORMAL NEWBORN 2,212.57
806 VAGINAL DELIVERY W/O STERILIZATION W/CC 14,751.60
807 VAGINAL DELIVERY W/O STERILIZATION WO/CC/MCC 12,250.70
811 RED BLOOD CELL DISORDERS W MCC 26,898.56
812 RED BLOOD CELL DISORDERS W/O MCC 16,555.45
853 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC 86,501.29
854 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC 37,545.83
866 VIRAL ILLNESS W/O MCC 6,300.26
870 SEPTICEMIA W MV 96+ HOURS 118,659.08
871 SEPTICEMIA W/O MV 96+ HOURS W MCC 29,941.41
872 SEPTICEMIA W/O MV 96+ HOURS W/O MCC 18,679.03
917 POISONING & TOXIC EFFECTS OF DRUGS W MCC 22,333.54
918 POISONING & TOXIC EFFECTS OF DRUGS W/O MCC 9,427.48
948 SIGNS & SYMPTOMS W/O MCC 13,075.43
981 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC 81,500.40