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Fiscal Year 2014 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 2014
    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 7.4025   17.7 12.1 2
    406 PANCREAS, LIVER & SHUNT PROCEDURES W CC 2.7823   7.4 5.8 1
    407 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC 1.9219   4.9 4.2 1
    408 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC 3.6914   10.9 8.7 2
    409 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 1.7706   6.4 5.5 1
    410 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC 1.3973   4.6 3.6 1
    411 CHOLECYSTECTOMY W C.D.E. W MCC 3.9924 * 11.3 9.3 1
    412 CHOLECYSTECTOMY W C.D.E. W CC 2.5217   5.1 4.8 2
    413 CHOLECYSTECTOMY W C.D.E. W/O CC/MCC 1.2713   4.5 3.6 1
    414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC 3.4201   10.1 6.9 1
    415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 1.7785   5.3 4.4 1
    416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC 1.4958   3.9 3.6 1
    417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC 2.0424   5.1 4.2 1
    418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 1.6836   3.8 3.1 1
    419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 1.2375   2.4 2.0 1
    420 HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC 3.9645   10.9 8.3 1
    421 HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC 1.4429   4.0 3.3 1
    422 HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC 1.3514 * 3.9 3.1 2
    423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC 6.7856   17.0 12.8 2
    424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC 2.3469   6.0 4.7 1
    425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC 1.8200 * 4.9 3.8 3
    432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC 1.7374   6.8 5.2 1
    433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC 0.9105   3.8 3.1 1
    434 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC 0.4381   2.4 1.9 1
    435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC 1.8417   6.4 4.8 1
    436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC 1.2198   4.5 3.4 1
    437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC 1.0210   2.9 2.3 1
    438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC 1.9438   7.8 5.6 1
    439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 0.9746   4.5 3.6 1
    440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 0.6959   3.3 2.8 1
    441 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC 2.0566   6.8 4.8 1
    442 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC 0.9735   4.3 3.2 1
    443 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC 0.7270   3.1 2.5 1
    444 DISORDERS OF THE BILIARY TRACT W MCC 1.5002   5.4 4.1 1
    445 DISORDERS OF THE BILIARY TRACT W CC 0.9797   3.4 2.7 1
    446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC 0.7503   2.4 2.0 1
    453 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC 11.0770   9.5 7.7 2
    454 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC 7.9203   5.3 4.5 1
    455 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC 5.6148   3.0 2.7 1
    456 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC 11.2658   13.2 9.9 2
    457 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC 6.8397   6.2 5.3 1
    458 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC 5.4532   3.8 3.5 1
    459 SPINAL FUSION EXCEPT CERVICAL W MCC 5.9121   7.1 5.4 1
    460 SPINAL FUSION EXCEPT CERVICAL W/O MCC 3.9219   2.9 2.5 1
    461 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC 5.5782 * 7.5 6.1 2
    462 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 3.3757   3.7 3.3 1
    463 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC 5.8083   14.9 12.0 3
    464 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC 3.3240   8.5 6.4 1
    465 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC 1.9438   4.1 3.4 1
    466 REVISION OF HIP OR KNEE REPLACEMENT W MCC 4.7596   9.5 7.2 1
    467 REVISION OF HIP OR KNEE REPLACEMENT W CC 3.2288   3.7 3.3 1
    468 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC 2.7482   2.7 2.6 1
    469 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC 3.0145   5.5 4.9 1
    470 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 2.0852   2.8 2.6 1
    471 CERVICAL SPINAL FUSION W MCC 3.7814   4.5 3.0 1
    472 CERVICAL SPINAL FUSION W CC 2.6774   2.1 1.6 1
    473 CERVICAL SPINAL FUSION W/O CC/MCC 2.1417   1.3 1.2 1
    474 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC 3.7592   10.5 8.1 1
    475 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC 2.0155   6.5 5.1 1
    476 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC 1.1799   3.1 2.2 1
    477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 3.8389   10.2 8.5 2
    478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 2.1476   6.1 4.9 1
    479 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 1.1791   3.3 2.7 1
    480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W MCC 3.6432   8.6 7.2 2
    481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC 2.1967   5.3 4.6 1
    482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC/MCC 1.5838   3.1 2.6 1
    483 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC 2.3960   2.4 2.0 1
    484 MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC 2.1720   1.7 1.6 1
    485 KNEE PROCEDURES W PDX OF INFECTION W MCC 1.8918   7.0 6.0 1
    486 KNEE PROCEDURES W PDX OF INFECTION W CC 2.0773   6.0 5.6 2
    487 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC 1.2705   3.8 3.5 1
    488 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC 1.7604   3.9 3.1 1
    489 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC 1.4597   2.1 1.8 1
    490 BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM 1.8786   2.9 2.1 1
    491 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC 1.2720   1.6 1.4 1
    492 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W MCC 3.5095   7.7 6.4 1
    493 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC 2.4219   4.5 3.6 1
    494 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC/MCC 1.5597   2.5 2.0 1
    495 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC 3.5787   9.5 7.2 1
    496 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC 1.7291   4.0 3.0 1
    497 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC 1.3677   2.2 1.7 1
    498 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC 2.2603   6.1 4.0 1
    499 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC 0.9239   1.7 1.4 1