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Fiscal Year 2013 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 2013
    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 6.1605   16.1 11.8 2
    406 PANCREAS, LIVER & SHUNT PROCEDURES W CC 2.9212   8.4 6.5 1
    407 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC 2.0204   5.3 4.7 1
    408 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC 4.0473   12.9 10.4 2
    409 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 2.0456   5.5 5.1 2
    410 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC 1.7247   4.6 3.9 1
    411 CHOLECYSTECTOMY W C.D.E. W MCC 4.2224 * 11.7 9.7 1
    412 CHOLECYSTECTOMY W C.D.E. W CC 2.8848 * 8.2 7.0 1
    413 CHOLECYSTECTOMY W C.D.E. W/O CC/MCC 2.0626 * 5.3 4.6 1
    414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC 3.3234   8.8 6.6 1
    415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 2.2231   6.1 5.1 1
    416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC 1.3475   3.5 3.1 1
    417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC 2.0817   5.2 4.2 1
    418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 1.6280   3.9 3.1 1
    419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 1.2710   2.4 2.0 1
    420 HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC 4.2745 * 12.3 8.7 1
    421 HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC 2.1475   6.2 3.9 1
    422 HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC 1.4437 * 4.0 3.2 2
    423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC 4.8567   16.9 12.2 2
    424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC 2.6730 * 8.3 6.3 1
    425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC 1.7489 * 4.9 3.8 2
    432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC 1.8633   6.5 4.8 1
    433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC 0.9789   4.2 3.4 1
    434 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC 0.5243   2.8 2.2 1
    435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC 1.9013   6.6 5.2 1
    436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC 1.2823   4.7 3.6 1
    437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC 1.1497   3.2 2.6 1
    438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC 2.3578   8.2 5.6 1
    439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 1.0894   4.7 3.6 1
    440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 0.7241   3.3 2.7 1
    441 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC 1.9927   7.3 5.0 1
    442 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC 0.9673   4.2 3.3 1
    443 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC 0.7001   3.2 2.5 1
    444 DISORDERS OF THE BILIARY TRACT W MCC 1.7531   5.8 4.3 1
    445 DISORDERS OF THE BILIARY TRACT W CC 0.9606   3.2 2.5 1
    446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC 0.7511   2.4 2.0 1
    453 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC 8.9163   11.9 9.4 2
    454 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC 8.1279   5.7 4.8 1
    455 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC 5.4382   3.3 2.8 1
    456 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC 8.8842   11.1 8.9 2
    457 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC 7.0927   5.6 4.9 1
    458 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC 5.6355   4.4 4.1 1
    459 SPINAL FUSION EXCEPT CERVICAL W MCC 6.7023   8.4 6.1 1
    460 SPINAL FUSION EXCEPT CERVICAL W/O MCC 4.0188   2.9 2.5 1
    461 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC 5.4459 * 7.7 6.4 2
    462 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 3.2753   3.9 3.6 1
    463 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC 5.6156   16.6 12.4 2
    464 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC 3.4703   8.2 5.8 1
    465 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC 2.0092   4.5 3.5 1
    466 REVISION OF HIP OR KNEE REPLACEMENT W MCC 5.2293   8.8 7.3 2
    467 REVISION OF HIP OR KNEE REPLACEMENT W CC 3.3087   4.1 3.6 1
    468 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC 2.6994   2.9 2.7 1
    469 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC 2.8705   5.5 4.7 1
    470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 2.1258   3.0 2.8 1
    471 CERVICAL SPINAL FUSION W MCC 4.6793   7.5 4.7 1
    472 CERVICAL SPINAL FUSION W CC 2.6183   2.2 1.7 1
    473 CERVICAL SPINAL FUSION W/O CC/MCC 2.1335   1.3 1.2 1
    474 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC 4.7632   13.7 9.7 1
    475 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC 1.8460   6.4 4.9 1
    476 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC 1.1979   3.2 2.5 1
    477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 4.0867   11.5 7.7 1
    478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 2.1381   6.6 5.1 1
    479 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 1.6126   3.1 2.3 1
    480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W MCC 3.7023   8.1 6.7 2
    481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC 2.3095   5.4 4.7 1
    482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC/MCC 1.6720   3.2 2.7 1
    483 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC 2.4007   2.6 2.2 1
    484 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC 2.1079   1.8 1.6 1
    485 KNEE PROCEDURES W PDX OF INFECTION W MCC 3.3947 * 10.3 8.6 4
    486 KNEE PROCEDURES W PDX OF INFECTION W CC 1.8627   5.7 4.6 1
    487 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC 1.4995   5.5 4.1 1
    488 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC 2.0681   3.9 3.0 1
    489 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC 1.4570   2.3 1.9 1
    490 BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM 2.0971   3.2 2.3 1
    491 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC 1.2526   1.6 1.3 1
    492 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W MCC 2.8255   7.4 6.0 1
    493 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC 2.3352   4.4 3.5 1
    494 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC/MCC 1.5190   2.4 2.0 1
    495 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC 3.0608   9.1 5.9 1
    496 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC 1.5950   3.9 3.1 1
    497 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC 1.2101   2.0 1.7 1
    498 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC 1.2511   4.0 3.2 1
    499 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC 1.0594   1.7 1.5 1