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Fiscal Year 2013 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 2013
    DRG Number Description CHAMPUS Weight Arithmetic Mean
    Length
    of Stay
    Geometric Mean
    Length
    of Stay
    Short Stay
    Threshold
    100 SEIZURES AGE >17 W MCC 1.6692   5.8 3.9 1
    101 SEIZURES AGE >17 W/O MCC 0.7616   2.9 2.4 1
    102 HEADACHES AGE >17 W MCC 1.1384   4.2 3.1 1
    103 HEADACHES AGE >17 W/O MCC 0.7395   2.7 2.2 1
    104 CRANIOTOMY, VENTRICULAR SHUNT & ENDOVASC INTRACRANIAL PROC AGE 0-17 2.4125   5.8 3.5 1
    105 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17 0.6394   2.3 1.7 1
    106 CONCUSSION AGE 0-17 0.4506   1.3 1.2 1
    107 SEIZURES & HEADACHES AGE 0-17 0.5409   2.4 1.9 1
    108 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17 1.1115   4.7 1.9 1
    109 OTHER DISORDERS OF THE EYE AGE 0-17 0.3950   2.3 1.9 1
    110 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES AGE 0-17 0.7068   2.2 1.7 1
    111 SINUS & MASTOID PROCEDURES AGE 0-17 3.8129   8.8 5.8 1
    112 OTITIS MEDIA & URI AGE 0-17 0.3098   2.0 1.7 1
    113 ORBITAL PROCEDURES W CC/MCC 1.9464   4.3 3.3 1
    114 ORBITAL PROCEDURES W/O CC/MCC 1.0517   2.2 1.7 1
    115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17 1.6687   3.9 2.8 1
    116 INTRAOCULAR PROCEDURES W CC/MCC 1.6674 * 5.1 3.5 1
    117 INTRAOCULAR PROCEDURES W/O CC/MCC 0.8030 * 2.3 1.7 1
    118 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17 0.5414   2.7 1.9 1
    119 DENTAL & ORAL DISEASES AGE 0-17 0.6632   3.2 2.3 1
    120 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17 1.9549   9.2 7.0 1
    121 ACUTE MAJOR EYE INFECTIONS W CC/MCC 0.7577   3.7 3.1 1
    122 ACUTE MAJOR EYE INFECTIONS W/O CC/MCC 0.4273   2.9 2.5 1
    123 NEUROLOGICAL EYE DISORDERS 0.7856   2.4 2.0 1
    124 OTHER DISORDERS OF THE EYE AGE >17 W MCC 1.2921 # 4.1 3.2 1
    125 OTHER DISORDERS OF THE EYE AGE >17 W/O MCC 0.6461   2.3 2.0 1
    129 MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE 2.3159   4.2 2.9 1
    130 MAJOR HEAD & NECK PROCEDURES W/O CC/MCC 1.1889   2.2 1.8 1
    131 CRANIAL/FACIAL PROCEDURES W CC/MCC 2.1670   3.8 2.9 1
    132 CRANIAL/FACIAL PROCEDURES W/O CC/MCC 1.5133   1.7 1.5 1
    133 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES AGE >17 W CC/MCC 1.5840   3.6 2.8 1
    134 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES AGE >17 W/O CC/MCC 0.9109   1.7 1.4 1
    135 SINUS & MASTOID PROCEDURES AGE >17 W CC/MCC 2.5317   8.9 6.6 1
    136 SINUS & MASTOID PROCEDURES AGE >17 W/O CC/MCC 1.3267 # 2.2 1.7 1
    137 MOUTH PROCEDURES W CC/MCC 0.9506   3.1 2.5 1
    138 MOUTH PROCEDURES W/O CC/MCC 0.8581   2.1 1.8 1
    139 SALIVARY GLAND PROCEDURES 1.0985   1.4 1.3 1
    140 SIMPLE PNEUMONIA & PLEURISY AGE 0-17 0.4325   2.6 2.1 1
    141 BRONCHITIS & ASTHMA AGE 0-17 0.3769   2.3 1.9 1
    142 CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17 0.7799   5.6 3.1 1
    143 STOMACH, ESOPHAGEAL & DUODENAL PROC AGE 0-17 1.0319   3.8 2.7 1
    144 HERNIA PROCEDURES AGE 0-17 0.7784   2.0 1.6 1
    145 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17 0.3886   2.4 1.9 1
    146 EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC 2.4805 * 9.1 6.3 1
    147 EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC 2.1772   7.9 5.5 1
    148 EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC 0.7880   3.7 2.2 1
    149 DYSEQUILIBRIUM 0.6974   2.0 1.7 1
    150 EPISTAXIS W MCC 1.5418 * 5.2 3.8 1
    151 EPISTAXIS W/O MCC 0.6042   2.4 2.0 1
    152 OTITIS MEDIA & URI AGE >17 W MCC 0.7849   2.9 2.6 1
    153 OTITIS MEDIA & URI AGE >17 W/O MCC 0.5646   2.4 2.0 1
    154 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 W MCC 2.1853   6.7 4.9 1
    155 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 W CC 0.8701   3.0 2.4 1
    156 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 W/O CC/MCC 0.5873   2.3 1.9 1
    157 DENTAL & ORAL DISEASES AGE >17 W MCC 1.7645   6.2 4.7 1
    158 DENTAL & ORAL DISEASES AGE >17 W CC 0.8637   3.5 2.7 1
    159 DENTAL & ORAL DISEASES AGE >17 W/O CC/MCC 0.6853   2.1 1.7 1
    160 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 0.6115   3.2 1.9 1
    161 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17 1.2502   2.7 2.2 1
    162 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17 1.0161   1.9 1.6 1
    163 MAJOR CHEST PROCEDURES W MCC 4.3810   12.1 10.1 3
    164 MAJOR CHEST PROCEDURES W CC 2.5697   6.1 4.8 1
    165 MAJOR CHEST PROCEDURES W/O CC/MCC 1.7089   4.2 3.5 1
    166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC 3.7524   10.8 8.3 2
    167 OTHER RESP SYSTEM O.R. PROCEDURES W CC 2.2841   6.5 4.8 1
    168 OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC 1.4078   3.6 2.9 1
    169 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE 0-17 0.3641   1.5 1.3 1
    170 CELLULITIS AGE 0-17 0.3614   2.4 2.1 1
    171 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17 0.4491   1.5 1.3 1
    172 MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES 0-17 0.3750   2.7 2.1 1
    173 URETHRAL PROCEDURES AGE 0-17 0.9659 # 2.9 2.3 1
    174 KIDNEY & URINARY TRACT INFECTIONS AGE 0-17 0.3700   2.6 2.3 1
    175 PULMONARY EMBOLISM W MCC 1.4649   5.5 4.5 1
    176 PULMONARY EMBOLISM W/O MCC 0.9164   3.9 3.2 1
    177 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W MCC 2.2711   9.4 6.7 1
    178 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC 1.5403   6.5 5.2 1
    179 RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC/MCC 0.9356   4.2 3.1 1
    180 RESPIRATORY NEOPLASMS W MCC 1.9045   6.9 5.5 1
    181 RESPIRATORY NEOPLASMS W CC 1.2097   6.0 3.5 1
    182 RESPIRATORY NEOPLASMS W/O CC/MCC 0.9386   3.0 2.5 1
    183 MAJOR CHEST TRAUMA W MCC 1.2288   5.1 4.1 1
    184 MAJOR CHEST TRAUMA W CC 0.8578   3.2 2.7 1
    185 MAJOR CHEST TRAUMA W/O CC/MCC 0.7083   2.1 1.7 1
    186 PLEURAL EFFUSION W MCC 1.4466   5.4 4.2 1
    187 PLEURAL EFFUSION W CC 0.8409   3.4 2.8 1
    188 PLEURAL EFFUSION W/O CC/MCC 0.7008   3.4 2.6 1
    189 PULMONARY EDEMA & RESPIRATORY FAILURE 1.2580   4.7 3.7 1
    190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC 1.1946   5.0 4.0 1
    191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC 0.9892   4.1 3.4 1
    192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 0.7146   3.2 2.7 1
    193 SIMPLE PNEUMONIA & PLEURISY AGE >17 W MCC 1.5431   5.6 4.5 1
    194 SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC 0.9779   4.0 3.3 1
    195 SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC/MCC 0.6484   2.8 2.4 1
    196 INTERSTITIAL LUNG DISEASE W MCC 1.5452   5.8 4.6 1
    197 INTERSTITIAL LUNG DISEASE W CC 0.9873   3.9 3.3 1
    198 INTERSTITIAL LUNG DISEASE W/O CC/MCC 0.6921   3.0 2.4 1
    199 PNEUMOTHORAX W MCC 1.7150   7.0 5.7 1