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Fiscal Year 2013 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 2013
    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 24.0501   40.4 31.6 8
    2 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC 13.3797   15.7 12.5 2
    3 ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. 19.1928   38.6 29.4 6
    4 TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. 12.1863   31.1 24.3 6
    5 LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT 11.5961   23.7 16.9 3
    6 LIVER TRANSPLANT W/O MCC 5.2787   8.9 8.0 3
    7 LUNG TRANSPLANT 9.8823   16.5 15.1 6
    8 SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT 5.6732 * 11.4 9.8 3
    10 PANCREAS TRANSPLANT 4.3239 * 8.6 8.0 2
    11 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC 3.1080   12.6 10.4 3
    12 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC 3.2246   9.4 8.1 2
    13 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC 1.8406   6.0 5.1 1
    14 ALLOGENEIC BONE MARROW TRANSPLANT 13.2505   37.2 30.0 8
    16 AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC 6.1859   19.8 18.5 8
    17 AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC 4.5521   13.9 12.4 4
    20 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC 9.3496   17.4 14.6 4
    21 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC 7.0083   13.4 11.9 4
    22 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC 6.3945   9.7 7.4 1
    23 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT 4.8918   11.0 7.9 1
    24 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC 3.7586   6.6 4.5 1
    25 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W MCC 4.4508   9.0 6.8 1
    26 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W CC 3.1051   5.4 4.1 1
    27 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 W/O CC/MCC 2.5154   3.2 2.6 1
    28 SPINAL PROCEDURES W MCC 4.0132   9.6 7.0 1
    29 SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS 2.9432   4.5 3.3 1
    30 SPINAL PROCEDURES W/O CC/MCC 1.8255   3.1 2.3 1
    31 VENTRICULAR SHUNT PROCEDURES AGE >17 W MCC 4.0158   9.9 8.1 2
    32 VENTRICULAR SHUNT PROCEDURES AGE >17 W CC 1.7030   4.8 3.3 1
    33 VENTRICULAR SHUNT PROCEDURES AGE >17 W/O CC/MCC 1.4522   2.4 1.8 1
    34 CAROTID ARTERY STENT PROCEDURE W MCC 4.0979 * 7.0 4.7 1
    35 CAROTID ARTERY STENT PROCEDURE W CC 1.8603   2.3 1.7 1
    36 CAROTID ARTERY STENT PROCEDURE W/O CC/MCC 1.7871   1.6 1.3 1
    37 EXTRACRANIAL PROCEDURES W MCC 4.7614   11.0 7.4 1
    38 EXTRACRANIAL PROCEDURES W CC 2.1588   3.2 2.3 1
    39 EXTRACRANIAL PROCEDURES W/O CC/MCC 1.2502   1.5 1.3 1
    40 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC 3.1115   7.8 5.3 1
    41 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM 2.1175   4.9 3.5 1
    42 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC 1.8474   2.5 1.9 1
    52 SPINAL DISORDERS & INJURIES W CC/MCC 1.7698   7.9 4.4 1
    53 SPINAL DISORDERS & INJURIES W/O CC/MCC 0.9711   2.3 1.9 1
    54 NERVOUS SYSTEM NEOPLASMS W MCC 1.5253   5.4 3.8 1
    55 NERVOUS SYSTEM NEOPLASMS W/O MCC 1.1637   4.0 2.8 1
    56 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC 2.5277   8.5 5.9 1
    57 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC 1.1429   5.3 3.6 1
    58 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC 1.6693   5.8 4.3 1
    59 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC 1.0543   4.3 3.6 1
    60 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC 0.9128   3.3 2.7 1
    61 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC 3.6047   9.1 6.6 1
    62 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC 2.3620   4.1 3.5 1
    63 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC 2.1336   3.5 2.6 1
    64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 2.2075   6.9 4.7 1
    65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 1.2757   4.3 3.4 1
    66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 1.0002   2.8 2.3 1
    67 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC 1.6732 * 5.4 4.1 2
    68 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC 1.0105   2.4 2.0 1
    69 TRANSIENT ISCHEMIA 0.8214   1.9 1.6 1
    70 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC 1.8151   6.2 4.3 1
    71 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 0.8513   3.8 2.7 1
    72 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC 0.8064   2.4 1.9 1
    73 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC 1.1432   5.3 4.2 1
    74 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC 0.9560   3.6 2.9 1
    75 VIRAL MENINGITIS W CC/MCC 1.2998   4.9 4.0 1
    76 VIRAL MENINGITIS W/O CC/MCC 0.6505   2.9 2.5 1
    77 HYPERTENSIVE ENCEPHALOPATHY W MCC 2.3578   6.7 4.0 1
    78 HYPERTENSIVE ENCEPHALOPATHY W CC 1.2860   3.8 3.2 1
    79 HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC 0.9087   2.1 1.8 1
    80 NONTRAUMATIC STUPOR & COMA W MCC 1.1235   4.3 3.2 1
    81 NONTRAUMATIC STUPOR & COMA W/O MCC 0.6754   2.6 2.0 1
    82 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC 2.6542   6.2 3.7 1
    83 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC 1.1642   3.4 2.6 1
    84 TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC 0.8645   2.3 1.8 1
    85 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W MCC 2.0096   6.8 4.5 1
    86 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC 1.0552   3.4 2.6 1
    87 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC/MCC 0.8864   2.3 1.8 1
    88 CONCUSSION AGE >17 W MCC 1.6754   3.8 2.4 1
    89 CONCUSSION AGE >17 W CC 1.0422   2.3 1.9 1
    90 CONCUSSION AGE >17 W/O CC/MCC 0.8348   1.4 1.3 1
    91 OTHER DISORDERS OF NERVOUS SYSTEM W MCC 1.8945   6.1 4.0 1
    92 OTHER DISORDERS OF NERVOUS SYSTEM W CC 0.8077   3.2 2.4 1
    93 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC 0.6896   2.1 1.8 1
    94 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC 5.0402   15.1 11.1 2
    95 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC 3.9503   10.5 7.3 1
    96 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC 2.0713   5.7 5.0 1
    97 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC 3.4688   10.9 8.3 1
    98 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC 1.5833   6.3 5.0 1
    99 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC 1.0505   4.5 3.6 1