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Fiscal Year 2012 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 2012
    DRG Number Description CHAMPUS Weight Arithmetic Mean
    Length
    of Stay
    Geometric Mean
    Length
    of Stay
    Short Stay
    Threshold
    500 SOFT TISSUE PROCEDURES W MCC 2.8792   7.4 5.7 1
    501 SOFT TISSUE PROCEDURES W CC 1.7493   5.7 4.0 1
    502 SOFT TISSUE PROCEDURES W/O CC/MCC 1.1552   2.5 1.9 1
    503 FOOT PROCEDURES W MCC 3.9925   9.4 7.1 1
    504 FOOT PROCEDURES W CC 1.7496   5.4 4.1 1
    505 FOOT PROCEDURES W/O CC/MCC 1.1685   2.3 1.9 1
    506 MAJOR THUMB OR JOINT PROCEDURES 1.0308   2.6 2.3 1
    507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC 1.8532   4.0 3.1 1
    508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC 1.2293   1.7 1.4 1
    509 ARTHROSCOPY 1.3125   3.3 2.6 1
    510 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC 2.4085   5.5 4.8 1
    511 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC 1.7906   3.2 2.6 1
    512 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC 1.1322   1.6 1.5 1
    513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 1.3815   3.9 2.7 1
    514 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 0.9095   1.9 1.6 1
    515 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC 2.9347   8.7 7.2 2
    516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 2.4691   5.1 3.9 1
    517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC 1.6266   2.5 2.0 1
    533 FRACTURES OF FEMUR W MCC 1.7924 * 6.3 4.6 1
    534 FRACTURES OF FEMUR W/O MCC 0.5306   1.9 1.6 1
    535 FRACTURES OF HIP & PELVIS W MCC 0.9896   4.8 4.1 1
    536 FRACTURES OF HIP & PELVIS W/O MCC 0.7938   3.7 2.8 1
    537 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC 0.9348 * 4.0 3.4 1
    538 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC 0.6960 * 3.1 2.6 1
    539 OSTEOMYELITIS W MCC 1.7751   9.0 6.4 1
    540 OSTEOMYELITIS W CC 1.0645   5.9 4.1 1
    541 OSTEOMYELITIS W/O CC/MCC 0.7929   3.4 2.9 1
    542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC 3.4657   12.9 8.9 1
    543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC 1.3769   6.3 4.5 1
    544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC 0.9603   3.1 2.6 1
    545 CONNECTIVE TISSUE DISORDERS W MCC 3.5397   9.4 6.3 1
    546 CONNECTIVE TISSUE DISORDERS W CC 1.4341   5.3 4.1 1
    547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC 0.8735   3.4 2.7 1
    548 SEPTIC ARTHRITIS W MCC 2.0936 * 8.2 6.5 1
    549 SEPTIC ARTHRITIS W CC 1.0882   5.6 4.3 1
    550 SEPTIC ARTHRITIS W/O CC/MCC 0.7240   3.2 2.9 1
    551 MEDICAL BACK PROBLEMS W MCC 1.4189   5.0 4.1 1
    552 MEDICAL BACK PROBLEMS W/O MCC 0.7391   2.8 2.2 1
    553 BONE DISEASES & ARTHROPATHIES W MCC 1.3212 * 5.5 4.4 1
    554 BONE DISEASES & ARTHROPATHIES W/O MCC 0.6618   3.0 2.3 1
    555 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC 1.1478   3.8 2.8 1
    556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC 0.7679   2.7 2.1 1
    557 TENDONITIS, MYOSITIS & BURSITIS W MCC 1.6483   6.7 5.2 1
    558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC 0.5977   3.1 2.5 1
    559 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 1.3852   5.3 3.7 1
    560 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 1.0471   5.8 4.1 1
    561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 0.6445   2.5 2.0 1
    562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W MCC 1.2673   5.0 3.7 1
    563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W/O MCC 0.6983   2.3 1.8 1
    564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC 1.2224   4.2 3.8 1
    565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC 0.8870   4.2 2.9 1
    566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 0.5476   2.1 1.8 1
    570 SKIN DEBRIDEMENT W MCC 4.5104   13.5 11.1 2
    571 SKIN DEBRIDEMENT W CC 1.6072   6.0 4.9 1
    572 SKIN DEBRIDEMENT W/O CC/MCC 0.9430   3.7 3.1 1
    573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC 3.5384   16.0 11.3 2
    574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC 1.9895   10.5 6.7 1
    575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.4225   4.1 3.5 1
    576 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC 3.8779 * 10.7 7.1 1
    577 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC 2.6513   7.0 4.4 1
    578 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.7871   3.4 2.4 1
    579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC 2.5644   7.5 5.6 1
    580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 1.4865   3.7 2.7 1
    581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC 1.4874   2.4 1.9 1
    582 MASTECTOMY FOR MALIGNANCY W CC/MCC 1.5892   2.2 1.7 1
    583 MASTECTOMY FOR MALIGNANCY W/O CC/MCC 1.7476   2.0 1.7 1
    584 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC 2.4794   4.4 3.4 1
    585 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC 1.6717   2.2 1.8 1
    592 SKIN ULCERS W MCC 1.5229   8.3 6.5 1
    593 SKIN ULCERS W CC 0.8367   4.9 4.1 1
    594 SKIN ULCERS W/O CC/MCC 0.7749 * 4.1 3.3 2
    595 MAJOR SKIN DISORDERS W MCC 2.1796 * 7.9 5.7 1
    596 MAJOR SKIN DISORDERS W/O MCC 0.7716   3.8 3.1 1
    597 MALIGNANT BREAST DISORDERS W MCC 1.8415 * 7.5 5.5 1
    598 MALIGNANT BREAST DISORDERS W CC 0.9353   4.4 3.4 1
    599 MALIGNANT BREAST DISORDERS W/O CC/MCC 0.7546 * 3.4 2.4 1