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Fiscal Year 2014 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 2014
    DRG Number Description CHAMPUS Weight Arithmetic Mean
    Length
    of Stay
    Geometric Mean
    Length
    of Stay
    Short Stay
    Threshold
    500 SOFT TISSUE PROCEDURES W MCC 3.8455   9.0 7.0 1
    501 SOFT TISSUE PROCEDURES W CC 1.5544   4.5 3.4 1
    502 SOFT TISSUE PROCEDURES W/O CC/MCC 1.2023   2.5 2.0 1
    503 FOOT PROCEDURES W MCC 2.5068 * 7.8 6.3 1
    504 FOOT PROCEDURES W CC 1.6431   3.8 3.0 1
    505 FOOT PROCEDURES W/O CC/MCC 1.3178   2.5 2.0 1
    506 MAJOR THUMB OR JOINT PROCEDURES 1.1630   3.3 2.4 1
    507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC 1.7319   3.3 2.6 1
    508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC 1.4747   1.7 1.5 1
    509 ARTHROSCOPY 1.4702 * 3.5 2.7 1
    510 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC 2.9703   5.8 4.9 1
    511 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC 1.6992   3.2 2.5 1
    512 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC 1.2473   1.8 1.6 1
    513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 1.3473   3.2 2.4 1
    514 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 0.9600   2.4 2.0 1
    515 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC 3.9471   8.1 5.0 1
    516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 2.2288   4.5 3.3 1
    517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC 1.5966   2.4 1.9 1
    533 FRACTURES OF FEMUR W MCC 1.5272 * 5.6 4.3 1
    534 FRACTURES OF FEMUR W/O MCC 0.6090   2.0 1.6 1
    535 FRACTURES OF HIP & PELVIS W MCC 1.6312   5.8 4.5 1
    536 FRACTURES OF HIP & PELVIS W/O MCC 0.6315   3.2 2.5 1
    537 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC 0.9550 * 4.0 3.4 1
    538 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC 0.6591   2.4 2.0 1
    539 OSTEOMYELITIS W MCC 1.7385   8.2 6.2 1
    540 OSTEOMYELITIS W CC 0.9633   5.4 4.2 1
    541 OSTEOMYELITIS W/O CC/MCC 0.6271   3.2 2.7 1
    542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC 2.4124   10.5 7.7 1
    543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC 1.3284   5.7 4.3 1
    544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC 0.9007   2.9 2.5 1
    545 CONNECTIVE TISSUE DISORDERS W MCC 2.7008   9.8 6.8 1
    546 CONNECTIVE TISSUE DISORDERS W CC 1.3145   4.9 3.8 1
    547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC 1.0608   3.7 2.7 1
    548 SEPTIC ARTHRITIS W MCC 1.9770 * 7.6 5.9 1
    549 SEPTIC ARTHRITIS W CC 0.9466   4.5 3.9 1
    550 SEPTIC ARTHRITIS W/O CC/MCC 0.6716   2.6 2.1 1
    551 MEDICAL BACK PROBLEMS W MCC 1.2548   4.5 3.5 1
    552 MEDICAL BACK PROBLEMS W/O MCC 0.8015   2.9 2.3 1
    553 BONE DISEASES & ARTHROPATHIES W MCC 1.6532   4.2 3.1 1
    554 BONE DISEASES & ARTHROPATHIES W/O MCC 0.6939   3.1 2.5 1
    555 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC 2.6215   4.4 3.2 1
    556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC 0.7092   2.4 1.9 1
    557 TENDONITIS, MYOSITIS & BURSITIS W MCC 1.7709   6.6 4.8 1
    558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC 0.5996   3.3 2.7 1
    559 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 2.5485   10.7 6.3 1
    560 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 1.1023   4.9 3.6 1
    561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 0.6516   2.6 2.0 1
    562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W MCC 1.6636   4.9 3.8 1
    563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH AGE >17 W/O MCC 0.7114   2.4 1.8 1
    564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC 2.4293   8.4 5.7 1
    565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC 0.9035   3.6 2.7 1
    566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 0.6997   2.4 1.9 1
    570 SKIN DEBRIDEMENT W MCC 1.9871   7.2 5.6 1
    571 SKIN DEBRIDEMENT W CC 1.6306   5.9 4.6 1
    572 SKIN DEBRIDEMENT W/O CC/MCC 0.9565   3.7 3.1 1
    573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC 4.0494   21.3 10.5 1
    574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC 2.7780   8.9 6.2 1
    575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.5957 * 5.4 4.2 1
    576 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC 4.7649 * 12.3 7.9 1
    577 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC 2.8715   5.5 3.7 1
    578 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 1.8834   3.5 2.5 1
    579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC 4.4432   10.8 7.0 1
    580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 1.8762   3.8 2.9 1
    581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC 1.5726   2.4 2.0 1
    582 MASTECTOMY FOR MALIGNANCY W CC/MCC 2.4873   3.1 2.2 1
    583 MASTECTOMY FOR MALIGNANCY W/O CC/MCC 2.1091   2.1 1.8 1
    584 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC 2.5419   3.7 3.1 1
    585 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC 2.1354   2.5 2.1 1
    592 SKIN ULCERS W MCC 1.2676   6.8 5.5 1
    593 SKIN ULCERS W CC 0.7745   4.5 4.0 1
    594 SKIN ULCERS W/O CC/MCC 0.7564 * 3.9 3.1 2
    595 MAJOR SKIN DISORDERS W MCC 2.0400   9.3 7.1 1
    596 MAJOR SKIN DISORDERS W/O MCC 0.7423   3.7 2.8 1
    597 MALIGNANT BREAST DISORDERS W MCC 1.3936   6.9 5.1 1
    598 MALIGNANT BREAST DISORDERS W CC 1.0743   3.9 3.0 1
    599 MALIGNANT BREAST DISORDERS W/O CC/MCC 0.7267 * 3.1 2.5 1