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Fiscal Year 2011 DRG Weights and Rates
for DRG Numbers Between 500 and 599
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
    500 SOFT TISSUE PROCEDURES W MCC 3.1836   8.6 6.2 1
    501 SOFT TISSUE PROCEDURES W CC 1.3571   4.3 3.2 1
    502 SOFT TISSUE PROCEDURES W/O CC/MCC 1.1277   2.3 1.9 1
    503 FOOT PROCEDURES W MCC 2.5318 * 8.5 6.5 2
    504 FOOT PROCEDURES W CC 1.8619   4.3 3.6 1
    505 FOOT PROCEDURES W/O CC/MCC 1.2984   2.5 2.0 1
    506 MAJOR THUMB OR JOINT PROCEDURES 1.1377   2.4 2.0 1
    507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC 1.3731   3.6 3.3 1
    508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC 1.3648   2.0 1.6 1
    509 ARTHROSCOPY 1.4594 * 3.5 2.3 1
    510 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC 2.4005   4.8 3.9 1
    511 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC 1.6780   2.6 2.2 1
    512 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC 1.1713   1.7 1.5 1
    513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 1.0886   2.7 2.1 1
    514 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 0.9068   2.3 1.8 1
    515 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC 3.2624   8.7 5.1 1
    516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 2.3921   5.4 4.0 1
    517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC 1.5681   2.7 2.2 1
    533 FRACTURES OF FEMUR W MCC 1.7379 * 6.5 4.9 2
    534 FRACTURES OF FEMUR W/O MCC 0.5409   1.9 1.6 1
    535 FRACTURES OF HIP & PELVIS W MCC 0.9346   3.9 3.1 1
    536 FRACTURES OF HIP & PELVIS W/O MCC 0.6984   2.9 2.4 1
    537 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC 0.9185 * 4.1 3.5 1
    538 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC 0.7157   2.0 1.6 1
    539 OSTEOMYELITIS W MCC 2.0049   8.6 7.4 2
    540 OSTEOMYELITIS W CC 1.4770   7.0 5.1 1
    541 OSTEOMYELITIS W/O CC/MCC 0.7539   4.0 3.2 1
    542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC 3.5084   12.1 8.2 1
    543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC 1.4344   6.0 4.3 1
    544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC 0.9903   3.7 2.9 1
    545 CONNECTIVE TISSUE DISORDERS W MCC 3.7800   11.2 6.8 1
    546 CONNECTIVE TISSUE DISORDERS W CC 1.2652   4.9 3.8 1
    547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC 0.8528   3.3 2.5 1
    548 SEPTIC ARTHRITIS W MCC 2.1809 * 8.8 6.7 3
    549 SEPTIC ARTHRITIS W CC 0.9696   4.8 4.0 1
    550 SEPTIC ARTHRITIS W/O CC/MCC 0.6160   3.7 3.2 1
    551 MEDICAL BACK PROBLEMS W MCC 1.6331   5.4 3.9 1
    552 MEDICAL BACK PROBLEMS W/O MCC 0.7354   2.8 2.3 1
    553 BONE DISEASES & ARTHROPATHIES W MCC 1.2604 * 5.5 4.3 3
    554 BONE DISEASES & ARTHROPATHIES W/O MCC 0.7529   2.9 2.4 1
    555 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC 0.8099   3.1 2.5 1
    556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC 0.6979   2.7 2.0 1
    557 TENDONITIS, MYOSITIS & BURSITIS W MCC 1.1567   5.7 4.3 1
    558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC 0.6780   3.3 2.6 1
    559 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 1.5719   5.8 4.1 1
    560 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 0.6897   3.6 2.6 1
    561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 0.6111   2.0 1.6 1
    562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W MCC 1.6984   6.0 4.1 1
    563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W/O MCC 0.7768   2.6 2.0 1
    564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC 2.4093   7.7 4.3 1
    565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC 0.9419   3.4 2.6 1
    566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 0.5162   2.0 1.7 1
    573 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W MCC 2.7862   11.4 8.4 1
    574 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC 1.8453   7.7 5.9 1
    575 SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC/MCC 1.0051   4.1 3.4 1
    576 SKIN GRAFT &/OR DEBRID EXC FOR SKIN ULCER OR CELLULITIS W MCC 4.3565 * 13.0 9.1 2
    577 SKIN GRAFT &/OR DEBRID EXC FOR SKIN ULCER OR CELLULITIS W CC 2.3029   6.4 4.7 1
    578 SKIN GRAFT &/OR DEBRID EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.4190   2.8 2.1 1
    579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC 2.5010   8.4 6.3 1
    580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 1.5354   3.8 2.7 1
    581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC 1.3973   2.3 1.9 1
    582 MASTECTOMY FOR MALIGNANCY W CC/MCC 1.7358   2.3 1.9 1
    583 MASTECTOMY FOR MALIGNANCY W/O CC/MCC 1.6393   1.9 1.7 1
    584 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC 1.8496   3.4 2.5 1
    585 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC 1.5306   2.2 1.8 1
    592 SKIN ULCERS W MCC 1.1412   5.2 4.2 1
    593 SKIN ULCERS W CC 0.9183   5.3 4.4 1
    594 SKIN ULCERS W/O CC/MCC 0.7913   3.5 3.0 1
    595 MAJOR SKIN DISORDERS W MCC 2.0746 * 7.8 5.9 3
    596 MAJOR SKIN DISORDERS W/O MCC 0.7335   4.0 3.0 1
    597 MALIGNANT BREAST DISORDERS W MCC 1.3925   7.9 6.4 1
    598 MALIGNANT BREAST DISORDERS W CC 0.8670   4.7 3.4 1
    599 MALIGNANT BREAST DISORDERS W/O CC/MCC 0.6954 * 3.2 2.5 3