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Fiscal Year 2012 DRG Weights and Rates
for DRG Numbers Between 100 and 199
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
    100 SEIZURES AGE >17 W MCC 1.4414   5.1 3.7 1
    101 SEIZURES AGE >17 W/O MCC 0.7762   2.8 2.3 1
    102 HEADACHES AGE >17 W MCC 0.8403   3.3 2.6 1
    103 HEADACHES AGE >17 W/O MCC 0.7545   2.9 2.2 1
    104 CRANIOTOMY, VENTRICULAR SHUNT & ENDOVASC INTRACRANIAL PROC AGE 0-17 2.4070   5.6 3.4 1
    105 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17 0.4723   2.0 1.6 1
    106 CONCUSSION AGE 0-17 0.5466   1.4 1.2 1
    107 SEIZURES & HEADACHES AGE 0-17 0.5421   2.4 1.9 1
    108 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17 0.6972   2.4 2.1 1
    109 OTHER DISORDERS OF THE EYE AGE 0-17 0.3481   2.1 1.8 1
    110 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES AGE 0-17 0.7506   2.1 1.6 1
    111 SINUS & MASTOID PROCEDURES AGE 0-17 1.5915 # 5.6 3.7 1
    112 OTITIS MEDIA & URI AGE 0-17 0.3103   2.0 1.8 1
    113 ORBITAL PROCEDURES W CC/MCC 2.2828   5.7 4.0 1
    114 ORBITAL PROCEDURES W/O CC/MCC 1.0836   2.2 1.7 1
    115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17 0.8840   3.3 2.6 1
    116 INTRAOCULAR PROCEDURES W CC/MCC 1.4410 * 4.5 3.0 1
    117 INTRAOCULAR PROCEDURES W/O CC/MCC 0.9140   3.2 2.4 1
    118 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17 0.4711   2.3 1.9 1
    119 DENTAL & ORAL DISEASES AGE 0-17 0.6166   2.4 1.9 1
    120 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17 1.8446   8.3 6.1 1
    121 ACUTE MAJOR EYE INFECTIONS W CC/MCC 0.4114   3.4 2.9 1
    122 ACUTE MAJOR EYE INFECTIONS W/O CC/MCC 0.4251   3.1 2.7 1
    123 NEUROLOGICAL EYE DISORDERS 0.8529   2.8 2.4 1
    124 OTHER DISORDERS OF THE EYE AGE >17 W MCC 0.8325 # 3.4 2.6 1
    125 OTHER DISORDERS OF THE EYE AGE >17 W/O MCC 0.7238   2.7 2.1 1
    129 MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE 2.1762   4.6 3.4 1
    130 MAJOR HEAD & NECK PROCEDURES W/O CC/MCC 1.3125   2.1 1.8 1
    131 CRANIAL/FACIAL PROCEDURES W CC/MCC 2.1811   3.8 2.9 1
    132 CRANIAL/FACIAL PROCEDURES W/O CC/MCC 1.5298   1.8 1.5 1
    133 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES AGE >17 W CC/MCC 1.4535   3.2 2.3 1
    134 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES AGE >17 W/O CC/MCC 0.8817   1.7 1.4 1
    135 SINUS & MASTOID PROCEDURES AGE >17 W CC/MCC 2.6940   5.3 3.8 1
    136 SINUS & MASTOID PROCEDURES AGE >17 W/O CC/MCC 1.4012   2.3 1.7 1
    137 MOUTH PROCEDURES W CC/MCC 1.1419   3.8 2.9 1
    138 MOUTH PROCEDURES W/O CC/MCC 0.7514   2.7 2.1 1
    139 SALIVARY GLAND PROCEDURES 1.0766   1.6 1.3 1
    140 SIMPLE PNEUMONIA & PLEURISY AGE 0-17 0.4580   2.7 2.3 1
    141 BRONCHITIS & ASTHMA AGE 0-17 0.3857   2.4 2.0 1
    142 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17 0.4628   2.8 2.1 1
    143 STOMACH, ESOPHAGEAL & DUODENAL PROC AGE 0-17 1.2306   4.9 3.0 1
    144 HERNIA PROCEDURES AGE 0-17 0.6865   1.7 1.4 1
    145 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17 0.4004   2.4 1.9 1
    146 EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC 2.2943 * 8.4 5.9 1
    147 EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC 0.9580   4.7 3.4 1
    148 EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC 0.8348 * 3.2 2.2 1
    149 DYSEQUILIBRIUM 0.7258   2.0 1.7 1
    150 EPISTAXIS W MCC 1.4544 * 5.2 3.8 1
    151 EPISTAXIS W/O MCC 0.6576   2.5 2.1 1
    152 OTITIS MEDIA & URI AGE >17 W MCC 0.8685   3.7 2.9 1
    153 OTITIS MEDIA & URI AGE >17 W/O MCC 0.5864   2.5 2.0 1
    154 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 W MCC 1.3815   5.5 4.3 1
    155 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 W CC 0.9677   3.7 2.8 1
    156 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 W/O CC/MCC 0.4462   2.0 1.7 1
    157 DENTAL & ORAL DISEASES AGE >17 W MCC 0.8474   3.4 3.0 1
    158 DENTAL & ORAL DISEASES AGE >17 W CC 0.9077   3.7 2.7 1
    159 DENTAL & ORAL DISEASES AGE >17 W/O CC/MCC 0.6051   2.1 1.8 1
    160 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 0.5360   2.6 1.9 1
    161 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17 1.3680   2.8 2.3 1
    162 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17 0.8950   1.7 1.5 1
    163 MAJOR CHEST PROCEDURES W MCC 4.7510   12.7 10.6 3
    164 MAJOR CHEST PROCEDURES W CC 2.5199   6.3 5.3 1
    165 MAJOR CHEST PROCEDURES W/O CC/MCC 1.6761   4.1 3.4 1
    166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC 3.5991   11.1 8.8 2
    167 OTHER RESP SYSTEM O.R. PROCEDURES W CC 1.9582   5.9 4.7 1
    168 OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC 1.4859   4.0 3.1 1
    169 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE 0-17 0.4116   1.6 1.3 1
    170 CELLULITIS AGE 0-17 0.3959   2.4 2.1 1
    171 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17 0.4456   1.4 1.3 1
    172 MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES 0-17 0.3238   2.5 1.9 1
    173 URETHRAL PROCEDURES AGE 0-17 0.8866 # 3.0 2.6 1
    174 KIDNEY & URINARY TRACT INFECTIONS AGE 0-17 0.4086   2.9 2.4 1
    175 PULMONARY EMBOLISM W MCC 1.6070   5.9 5.0 1
    176 PULMONARY EMBOLISM W/O MCC 0.9493   3.9 3.3 1
    177 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W MCC 2.4290   9.3 7.0 1
    178 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC 1.6802   6.5 5.2 1
    179 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC/MCC 1.1225   5.1 3.8 1
    180 RESPIRATORY NEOPLASMS W MCC 1.7652   6.7 5.2 1
    181 RESPIRATORY NEOPLASMS W CC 1.2112   4.6 3.5 1
    182 RESPIRATORY NEOPLASMS W/O CC/MCC 0.9674   3.2 2.5 1
    183 MAJOR CHEST TRAUMA W MCC 1.4775   4.8 3.6 1
    184 MAJOR CHEST TRAUMA W CC 1.0666   3.4 2.6 1
    185 MAJOR CHEST TRAUMA W/O CC/MCC 0.9122   2.7 2.0 1
    186 PLEURAL EFFUSION W MCC 1.5998   5.5 4.2 1
    187 PLEURAL EFFUSION W CC 1.1116   4.5 3.4 1
    188 PLEURAL EFFUSION W/O CC/MCC 0.5957   2.5 2.0 1
    189 PULMONARY EDEMA & RESPIRATORY FAILURE 1.2253   4.7 3.7 1
    190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC 1.1323   4.9 4.0 1
    191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC 0.9804   4.1 3.4 1
    192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 0.7324   3.2 2.7 1
    193 SIMPLE PNEUMONIA & PLEURISY AGE >17 W MCC 1.4819   6.0 4.8 1
    194 SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC 0.9475   4.0 3.3 1
    195 SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC/MCC 0.6832   3.0 2.6 1
    196 INTERSTITIAL LUNG DISEASE W MCC 1.6261   5.8 4.6 1
    197 INTERSTITIAL LUNG DISEASE W CC 1.2211   5.0 3.8 1
    198 INTERSTITIAL LUNG DISEASE W/O CC/MCC 0.7877   3.2 2.8 1
    199 PNEUMOTHORAX W MCC 1.4782   6.1 4.5 1