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Fiscal Year 2012 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 2012
    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 23.8227   35.5 26.2 5
    2 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC 14.1653   22.7 21.0 9
    3 ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. 17.7953   35.7 27.1 6
    4 TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. 12.7083   31.2 24.3 6
    5 LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT 9.8649   18.9 14.2 3
    6 LIVER TRANSPLANT W/O MCC 5.2323   7.9 7.4 3
    7 LUNG TRANSPLANT 11.9422   19.1 16.3 5
    8 SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT 5.6805 * 12.0 10.1 3
    10 PANCREAS TRANSPLANT 4.3179 * 9.9 8.5 2
    11 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC 5.4244   16.2 13.4 4
    12 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC 2.6479   8.7 7.1 1
    13 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC 2.1009   6.9 5.8 1
    14 ALLOGENEIC BONE MARROW TRANSPLANT 11.8322   33.7 28.8 10
    16 AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC 5.5424   19.6 17.7 6
    17 AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC 4.1768   13.5 8.9 1
    20 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC 10.1552   16.7 13.7 3
    21 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC 6.5743   15.9 14.5 5
    22 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC 6.7975   13.0 10.9 2
    23 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT 6.2999   11.3 7.3 1
    24 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC 3.7964   6.8 4.3 1
    25 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W MCC 4.7974   9.8 7.2 1
    26 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W CC 3.2495   6.2 4.7 1
    27 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W/O CC/MCC 2.4323   3.4 2.7 1
    28 SPINAL PROCEDURES W MCC 5.3179   12.5 9.5 2
    29 SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS 2.9689   5.3 3.9 1
    30 SPINAL PROCEDURES W/O CC/MCC 1.9508   3.2 2.5 1
    31 VENTRICULAR SHUNT PROCEDURES AGE >17 W MCC 3.8322   14.2 7.4 1
    32 VENTRICULAR SHUNT PROCEDURES AGE >17 W CC 1.6015   3.7 2.8 1
    33 VENTRICULAR SHUNT PROCEDURES AGE >17 W/O CC/MCC 1.5260   2.6 1.9 1
    34 CAROTID ARTERY STENT PROCEDURE W MCC 3.8853 * 6.9 4.5 1
    35 CAROTID ARTERY STENT PROCEDURE W CC 2.6219   3.6 2.2 1
    36 CAROTID ARTERY STENT PROCEDURE W/O CC/MCC 2.0807   1.4 1.2 1
    37 EXTRACRANIAL PROCEDURES W MCC 4.2306   9.5 6.7 1
    38 EXTRACRANIAL PROCEDURES W CC 2.1466   3.8 2.7 1
    39 EXTRACRANIAL PROCEDURES W/O CC/MCC 1.3347   1.6 1.3 1
    40 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC 3.2505   10.1 6.6 1
    41 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM 1.8436   5.0 3.5 1
    42 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC 1.9560   3.1 2.0 1
    52 SPINAL DISORDERS & INJURIES W CC/MCC 3.0387   14.0 5.6 1
    53 SPINAL DISORDERS & INJURIES W/O CC/MCC 0.9309   2.8 2.3 1
    54 NERVOUS SYSTEM NEOPLASMS W MCC 1.2746   5.2 3.4 1
    55 NERVOUS SYSTEM NEOPLASMS W/O MCC 1.0708   3.7 2.6 1
    56 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC 2.0624   6.5 4.7 1
    57 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC 1.1177   5.3 3.6 1
    58 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC 3.5944   13.8 7.6 1
    59 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC 1.2926   4.6 3.8 1
    60 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC 0.8079   3.3 2.7 1
    61 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC 3.4352   9.0 5.9 1
    62 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC 2.4220   5.2 4.4 1
    63 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC 1.9858   2.9 2.5 1
    64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 2.0835   6.4 4.6 1
    65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 1.3524   4.6 3.7 1
    66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 1.0424   2.8 2.3 1
    67 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC 1.6856   4.8 3.5 1
    68 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC 1.0889   2.8 2.5 1
    69 TRANSIENT ISCHEMIA 0.8491   2.1 1.8 1
    70 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC 1.6778   6.2 4.3 1
    71 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 1.2539   4.7 3.3 1
    72 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC 0.7593   2.3 1.8 1
    73 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC 1.1944   5.5 4.5 1
    74 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC 0.9537   3.5 2.8 1
    75 VIRAL MENINGITIS W CC/MCC 1.1887   4.8 3.8 1
    76 VIRAL MENINGITIS W/O CC/MCC 0.6173   2.7 2.4 1
    77 HYPERTENSIVE ENCEPHALOPATHY W MCC 2.6480   9.0 7.3 2
    78 HYPERTENSIVE ENCEPHALOPATHY W CC 1.3362   3.9 3.3 1
    79 HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC 0.8012 * 2.9 2.4 1
    80 NONTRAUMATIC STUPOR & COMA W MCC 1.3659   5.5 3.0 1
    81 NONTRAUMATIC STUPOR & COMA W/O MCC 0.7150   2.6 2.2 1
    82 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC 2.7337   6.3 3.9 1
    83 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC 1.0469   3.6 2.8 1
    84 TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC 0.9003   2.6 1.9 1
    85 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W MCC 2.3395   7.7 5.4 1
    86 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC 1.0581   3.5 2.8 1
    87 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC/MCC 0.7020   2.1 1.7 1
    88 CONCUSSION AGE >17 W MCC 1.3581   3.4 2.6 1
    89 CONCUSSION AGE >17 W CC 1.0550   2.4 1.9 1
    90 CONCUSSION AGE >17 W/O CC/MCC 0.7981   1.4 1.2 1
    91 OTHER DISORDERS OF NERVOUS SYSTEM W MCC 1.7212   6.7 4.1 1
    92 OTHER DISORDERS OF NERVOUS SYSTEM W CC 0.8882   3.4 2.5 1
    93 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC 0.7034   2.3 1.9 1
    94 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC 3.9242   12.6 10.4 2
    95 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC 2.4297   7.3 6.0 1
    96 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC 2.1944   5.6 4.9 1
    97 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC 2.9578   8.9 6.4 1
    98 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC 1.9919   7.6 5.3 1
    99 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC 1.1069   4.2 3.3 1