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Fiscal Year 2011 DRG Weights and Rates
for DRG Numbers Between 400 and 499
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
    405 PANCREAS, LIVER & SHUNT PROCEDURES W MCC 6.1788   15.8 10.8 1
    406 PANCREAS, LIVER & SHUNT PROCEDURES W CC 3.0704   7.4 6.2 1
    407 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC 1.8368   4.4 3.7 1
    408 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC 3.8154   10.0 8.3 2
    409 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 2.2683   6.7 5.9 2
    410 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC 1.7087   5.8 5.2 2
    411 CHOLECYSTECTOMY W C.D.E. W MCC 4.0868 * 11.8 9.9 4
    412 CHOLECYSTECTOMY W C.D.E. W CC 1.8713   5.9 4.5 1
    413 CHOLECYSTECTOMY W C.D.E. W/O CC/MCC 1.4260   4.0 3.4 1
    414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC 3.0202   8.6 7.4 2
    415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 2.0853   5.9 5.1 1
    416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC 1.3041   3.8 3.3 1
    417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC 1.9923   5.0 4.0 1
    418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 1.6894   4.0 3.2 1
    419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 1.2641   2.5 2.1 1
    420 HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC 4.4135   16.6 10.6 1
    421 HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC 2.5789   8.7 5.6 1
    422 HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC 1.2179   3.7 3.4 1
    423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC 5.9921   16.2 12.3 2
    424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC 2.1920   6.7 5.4 1
    425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC 1.8063 * 5.7 4.4 7
    432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC 2.0890   7.3 5.1 1
    433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC 1.0872   5.3 4.0 1
    434 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC 0.6829 * 3.2 2.5 3
    435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC 1.5301   5.5 4.2 1
    436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC 1.2586   4.9 3.7 1
    437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC 1.2584   4.7 3.3 1
    438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC 2.2308   8.1 5.9 1
    439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 1.0707   4.9 3.9 1
    440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 0.7411   3.3 2.7 1
    441 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC 2.5374   8.5 5.7 1
    442 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC 1.1311   4.6 3.5 1
    443 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC 0.6564   3.0 2.5 1
    444 DISORDERS OF THE BILIARY TRACT W MCC 1.4515   4.8 3.6 1
    445 DISORDERS OF THE BILIARY TRACT W CC 0.9631   3.5 2.9 1
    446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC 0.6916   2.3 1.9 1
    453 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC 11.3232   14.2 11.0 3
    454 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC 7.2705   5.2 4.4 1
    455 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC 5.3617   3.1 2.6 1
    456 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC 7.6248   10.4 8.4 2
    457 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC 6.6520   6.2 5.5 2
    458 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC 5.8243   4.3 4.0 1
    459 SPINAL FUSION EXCEPT CERVICAL W MCC 6.2512   7.1 6.2 2
    460 SPINAL FUSION EXCEPT CERVICAL W/O MCC 4.0602   3.1 2.7 1
    461 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC 5.4817 * 8.2 6.7 3
    462 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 3.3359   4.0 3.8 1
    463 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC 7.1312   20.8 13.6 2
    464 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC 3.4541   8.7 6.6 1
    465 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC 1.9088   4.3 3.4 1
    466 REVISION OF HIP OR KNEE REPLACEMENT W MCC 5.4345   8.8 6.9 1
    467 REVISION OF HIP OR KNEE REPLACEMENT W CC 3.0888   4.0 3.6 1
    468 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC 2.5388   3.2 2.9 1
    469 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC 3.1526   6.1 5.2 1
    470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 2.1474   3.1 2.9 1
    471 CERVICAL SPINAL FUSION W MCC 4.0914   6.0 4.1 1
    472 CERVICAL SPINAL FUSION W CC 2.6255   2.3 1.7 1
    473 CERVICAL SPINAL FUSION W/O CC/MCC 2.0714   1.3 1.2 1
    474 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC 3.9748   13.8 11.1 2
    475 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC 1.8618   7.1 5.5 1
    476 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC 1.1273   2.9 2.2 1
    477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 4.2174   16.5 10.6 1
    478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 2.5175   6.9 4.9 1
    479 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 1.7830   3.7 2.6 1
    480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W MCC 3.3865   7.2 5.9 1
    481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC 2.2378   5.3 4.6 1
    482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC/MCC 1.5555   3.2 2.6 1
    483 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC 2.7277   3.0 2.5 1
    484 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC 1.9641   1.9 1.7 1
    485 KNEE PROCEDURES W PDX OF INFECTION W MCC 2.6631   8.2 7.3 2
    486 KNEE PROCEDURES W PDX OF INFECTION W CC 2.3673   7.3 5.9 1
    487 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC 1.2637   4.2 3.8 1
    488 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC 1.4872   3.1 2.8 1
    489 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC 1.2966   2.1 1.8 1
    490 BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM 2.0928   3.1 2.2 1
    491 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC 1.1762   1.5 1.3 1
    492 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W MCC 3.7089   8.5 6.5 1
    493 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC 2.1035   4.3 3.5 1
    494 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC/MCC 1.4121   2.6 2.2 1
    495 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC 3.8876   9.8 5.2 1
    496 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC 1.5981   4.0 3.1 1
    497 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC 1.1749   2.1 1.6 1
    498 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC 1.9931   4.8 3.5 1
    499 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC 0.9457   2.0 1.6 1