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Fiscal Year 2011 DRG Weights and Rates
for DRG Numbers Between 1 and 99
Notes:
  • * = low volume DRG with fewer than 10 cases. The Medicare weights and LOS are used for these DRGs.
  • # = PM-DRGs with fewer than 10 cases. An average weight over the past 5 years were used for these DRGs.
  • w cc = with Complications and Comorbidities.
  • w/o cc = without Complications or Comorbidities
  • CHAMPUS Weight and Threshold Summary for FY 2011
    DRG Number Description CHAMPUS Weight Arithmetic Mean
    Length
    of Stay
    Geometric Mean
    Length
    of Stay
    Short Stay
    Threshold
    1 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC 25.3823   39.1 29.7 5
    2 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC 12.5238   20.0 18.0 7
    3 ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. 19.5904   37.7 28.7 6
    4 TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. 12.1023   28.6 22.7 5
    5 LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT 11.5308   23.1 15.9 3
    6 LIVER TRANSPLANT W/O MCC 5.4189   10.9 8.1 2
    7 LUNG TRANSPLANT 11.5846   22.4 16.5 3
    8 SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT 5.5092 * 11.7 10.1 7
    10 PANCREAS TRANSPLANT 4.1992 * 9.7 8.6 5
    11 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC 4.7145   13.0 11.2 3
    12 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC 3.2815   9.4 7.2 1
    13 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC 2.6885   7.3 6.3 2
    14 ALLOGENEIC BONE MARROW TRANSPLANT 12.8826   36.2 25.5 3
    15 AUTOLOGOUS BONE MARROW TRANSPLANT 5.5725   18.8 16.8 6
    20 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC 8.9093   17.6 15.8 6
    21 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC 6.5751   14.4 12.7 4
    22 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC 4.3378   9.3 8.3 2
    23 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT 6.5113   13.3 9.2 1
    24 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC 4.2771   10.2 6.7 1
    25 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W MCC 4.6711   9.7 7.4 1
    26 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W CC 3.1019   6.0 4.7 1
    27 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W/O CC/MCC 2.5609   3.7 2.9 1
    28 SPINAL PROCEDURES W MCC 4.8236   8.7 6.7 1
    29 SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS 3.2920   5.7 4.1 1
    30 SPINAL PROCEDURES W/O CC/MCC 1.9829   3.4 2.5 1
    31 VENTRICULAR SHUNT PROCEDURES AGE >17 W MCC 4.7668   13.5 9.7 1
    32 VENTRICULAR SHUNT PROCEDURES AGE >17 W CC 1.9328   5.1 3.6 1
    33 VENTRICULAR SHUNT PROCEDURES AGE >17 W/O CC/MCC 1.4864   3.0 2.0 1
    34 CAROTID ARTERY STENT PROCEDURE W MCC 3.9119 * 7.0 4.7 2
    35 CAROTID ARTERY STENT PROCEDURE W CC 2.5844   2.9 1.9 1
    36 CAROTID ARTERY STENT PROCEDURE W/O CC/MCC 2.0574   1.9 1.4 1
    37 EXTRACRANIAL PROCEDURES W MCC 3.6395   6.7 4.4 1
    38 EXTRACRANIAL PROCEDURES W CC 1.9728   3.5 2.4 1
    39 EXTRACRANIAL PROCEDURES W/O CC/MCC 1.2017   1.6 1.4 1
    40 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC 3.9935   10.5 7.3 1
    41 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM 1.9283   5.4 3.7 1
    42 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC 1.6866   2.5 1.9 1
    52 SPINAL DISORDERS & INJURIES W CC/MCC 2.2852   10.1 5.5 1
    53 SPINAL DISORDERS & INJURIES W/O CC/MCC 0.7293   2.8 2.1 1
    54 NERVOUS SYSTEM NEOPLASMS W MCC 1.5480   5.7 4.1 1
    55 NERVOUS SYSTEM NEOPLASMS W/O MCC 1.0733   3.9 2.8 1
    56 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC 1.6042   8.7 5.9 1
    57 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC 1.1134   5.3 3.6 1
    58 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC 1.3830   4.9 4.3 1
    59 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC 1.0089   4.4 3.7 1
    60 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC 0.8473   3.5 2.9 1
    61 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC 2.5349   6.0 4.3 1
    62 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC 2.1396   5.4 4.8 1
    63 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC 1.4879   2.6 2.3 1
    64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 2.3332   7.0 5.0 1
    65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 1.3357   4.4 3.6 1
    66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 1.0142   2.9 2.4 1
    67 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC 1.2752   3.3 3.0 1
    68 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC 1.0983   2.9 2.3 1
    69 TRANSIENT ISCHEMIA 0.8274   2.2 1.8 1
    70 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC 2.6668   9.4 5.8 1
    71 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 1.0971   4.7 3.4 1
    72 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC 0.8831   2.9 2.1 1
    73 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC 2.4019   9.1 4.9 1
    74 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC 0.9380   3.6 2.8 1
    75 VIRAL MENINGITIS W CC/MCC 1.1859   4.3 3.5 1
    76 VIRAL MENINGITIS W/O CC/MCC 0.6387   2.9 2.4 1
    77 HYPERTENSIVE ENCEPHALOPATHY W MCC 1.5557   5.5 4.0 1
    78 HYPERTENSIVE ENCEPHALOPATHY W CC 0.9252   2.8 2.4 1
    79 HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC 1.0987   3.2 2.8 1
    80 NONTRAUMATIC STUPOR & COMA W MCC 1.2587   3.2 2.8 1
    81 NONTRAUMATIC STUPOR & COMA W/O MCC 0.7918   2.7 1.9 1
    82 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC 2.8355   7.5 4.8 1
    83 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC 1.4891   3.8 2.7 1
    84 TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC 0.7787   2.4 1.9 1
    85 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W MCC 2.3770   7.4 5.0 1
    86 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC 1.3150   4.2 3.1 1
    87 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC/MCC 0.7635   2.2 1.8 1
    88 CONCUSSION AGE >17 W MCC 1.8122   3.1 2.2 1
    89 CONCUSSION AGE >17 W CC 1.0514   2.0 1.8 1
    90 CONCUSSION AGE >17 W/O CC/MCC 0.8941   1.5 1.3 1
    91 OTHER DISORDERS OF NERVOUS SYSTEM W MCC 1.8320   6.5 3.9 1
    92 OTHER DISORDERS OF NERVOUS SYSTEM W CC 0.9635   3.7 2.6 1
    93 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC 0.7885   2.4 2.0 1
    94 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC 4.5099   13.3 9.2 1
    95 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC 3.3418   7.3 5.9 1
    96 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC 2.2474   5.8 4.5 1
    97 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC 2.8527   9.2 7.9 2
    98 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC 2.7084   10.0 6.4 1
    99 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC 1.1026   4.2 3.3 1