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Fiscal Year 2013 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 2013
    DRG Number Description CHAMPUS Weight Arithmetic Mean
    Length
    of Stay
    Geometric Mean
    Length
    of Stay
    Short Stay
    Threshold
    500 SOFT TISSUE PROCEDURES W MCC 2.9254   8.3 5.4 1
    501 SOFT TISSUE PROCEDURES W CC 1.4938   4.2 3.3 1
    502 SOFT TISSUE PROCEDURES W/O CC/MCC 1.2378   2.5 2.0 1
    503 FOOT PROCEDURES W MCC 2.5537 * 8.7 6.8 1
    504 FOOT PROCEDURES W CC 1.7853   5.0 3.9 1
    505 FOOT PROCEDURES W/O CC/MCC 1.4517   2.1 1.8 1
    506 MAJOR THUMB OR JOINT PROCEDURES 1.0380   3.2 2.6 1
    507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC 2.1415   7.5 4.7 1
    508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC 1.5971   1.6 1.4 1
    509 ARTHROSCOPY 1.4978 * 3.7 2.6 1
    510 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC 4.2959   6.9 4.0 1
    511 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC 1.7998   3.0 2.5 1
    512 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC 1.1618   1.8 1.6 1
    513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 1.7007   3.2 2.6 1
    514 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 0.8842   2.1 1.8 1
    515 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC 3.2384   6.8 5.4 1
    516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 2.2751   4.6 3.7 1
    517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC 1.6483   2.6 2.1 1
    533 FRACTURES OF FEMUR W MCC 1.6345 * 6.1 4.5 1
    534 FRACTURES OF FEMUR W/O MCC 0.5833   2.0 1.7 1
    535 FRACTURES OF HIP & PELVIS W MCC 1.1975   5.2 4.3 1
    536 FRACTURES OF HIP & PELVIS W/O MCC 0.6894   2.9 2.4 1
    537 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC 0.9588 * 4.0 3.4 1
    538 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC 0.7343   1.7 1.6 1
    539 OSTEOMYELITIS W MCC 1.4611   6.2 5.2 1
    540 OSTEOMYELITIS W CC 1.1836   5.6 4.2 1
    541 OSTEOMYELITIS W/O CC/MCC 0.8120   4.1 3.2 1
    542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC 2.9749   10.6 7.2 1
    543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC 1.1955   5.5 4.1 1
    544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC 0.7233   3.2 2.5 1
    545 CONNECTIVE TISSUE DISORDERS W MCC 3.2538   10.1 7.3 1
    546 CONNECTIVE TISSUE DISORDERS W CC 1.2278   5.1 4.0 1
    547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC 0.7740   3.4 2.6 1
    548 SEPTIC ARTHRITIS W MCC 1.9386 * 7.6 5.8 1
    549 SEPTIC ARTHRITIS W CC 0.6441   3.6 3.3 1
    550 SEPTIC ARTHRITIS W/O CC/MCC 0.5845   3.4 3.0 1
    551 MEDICAL BACK PROBLEMS W MCC 1.2926   4.6 3.5 1
    552 MEDICAL BACK PROBLEMS W/O MCC 0.7815   2.9 2.3 1
    553 BONE DISEASES & ARTHROPATHIES W MCC 1.2270   4.4 3.5 1
    554 BONE DISEASES & ARTHROPATHIES W/O MCC 0.6029   2.8 2.2 1
    555 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC 1.0509   3.6 2.9 1
    556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC 0.8039   2.5 2.0 1
    557 TENDONITIS, MYOSITIS & BURSITIS W MCC 1.4791   6.1 4.9 1
    558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC 0.6118   3.2 2.6 1
    559 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 2.0803 * 7.0 5.2 1
    560 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 0.9776   4.8 3.7 1
    561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 0.8642   3.1 2.1 1
    562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W MCC 1.2716   4.4 3.3 1
    563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W/O MCC 0.7391   2.5 1.9 1
    564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC 1.6049 * 6.2 4.7 1
    565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC 0.8115   3.3 2.6 1
    566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 0.4343   2.0 1.6 1
    570 SKIN DEBRIDEMENT W MCC 2.6896   10.6 8.2 2
    571 SKIN DEBRIDEMENT W CC 1.3599   5.9 4.5 1
    572 SKIN DEBRIDEMENT W/O CC/MCC 0.9988   4.2 3.4 1
    573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC 4.2179   19.5 7.6 1
    574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC 2.1130   7.7 5.6 1
    575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.0422   6.0 5.6 2
    576 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC 4.7127 * 12.9 8.5 1
    577 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC 2.2804   3.2 2.2 1
    578 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.6655   2.6 1.9 1
    579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC 2.5143   7.6 5.5 1
    580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 1.7303   3.6 2.8 1
    581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC 1.5381   2.4 2.0 1
    582 MASTECTOMY FOR MALIGNANCY W CC/MCC 2.0199   2.4 2.1 1
    583 MASTECTOMY FOR MALIGNANCY W/O CC/MCC 1.8876   2.1 1.8 1
    584 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC 2.4668   4.1 3.3 1
    585 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC 1.9978   2.5 2.1 1
    592 SKIN ULCERS W MCC 1.4951   7.8 5.8 1
    593 SKIN ULCERS W CC 0.5562   4.1 3.6 1
    594 SKIN ULCERS W/O CC/MCC 0.7528 * 3.9 3.2 2
    595 MAJOR SKIN DISORDERS W MCC 2.3678   7.3 5.3 1
    596 MAJOR SKIN DISORDERS W/O MCC 0.8553   4.0 3.1 1
    597 MALIGNANT BREAST DISORDERS W MCC 1.7789 * 7.2 5.4 1
    598 MALIGNANT BREAST DISORDERS W CC 1.1017   5.7 3.8 1
    599 MALIGNANT BREAST DISORDERS W/O CC/MCC 0.7382 * 3.1 2.3 1