2014 WC FEE SCHEDULE

Table B: Federal Register Table 5


DRG #
DESCRIPTION OF DRG
RELATIVE
WEIGHT
GEOMETRIC
MEAN
LENGTH OF
STAY
ARITHMETIC
MEAN
LENGTH OF
STAY
OUTLIER
THRESHOLD
 
 
Implied
Decimal 4
Implied Decimal 1
Implied
Decimal 2
(in days)
1 CRANIOTOMY AGE >17 EXCEPT FOR 31565 96 135 3200
2 CRANIOTOMY FOR TRAUMA AGE >17 30968 98 139 3200
3 *CRANIOTOMY AGE 0-17 30398 127 127 3500
4 SPINAL PROCEDURES 23292 72 110 2900
5 EXTRACRANIAL VASCULAR PROCEDURES 15601 44 56 2600
6 CARPAL TUNNEL RELEASE 6339 22 32 2400
7 PERIPH & CRANIAL NERVE & OTHER 25005 101 174 3200
8 PERIPH & CRANIAL NERVE & OTHER 9185 29 47 2500
9 SPINAL DISORDERS & INJURIES 12553 60 88 2800
10 NERVOUS SYSTEM NEOPLASMS W CC 12618 67 97 2900
11 NERVOUS SYSTEM NEOPLASMS W/O CC 7734 38 55 2600
12 DEGENERATIVE NERVOUS SYSTEM 9574 63 90 2800
13 MULTIPLE SCLEROSIS & CEREBELLAR 7813 57 72 2800
14 SPECIFIC CEREBROVASCULAR DISORDERS 11956 64 87 2800
15 TRANSIENT ISCHEMIC ATTACK & 6909 38 49 2600
16 NONSPECIFIC CEREBROVASCULAR 10488 58 78 2800
17 NONSPECIFIC CEREBROVASCULAR 6195 35 46 2600
18 CRANIAL & PERIPHERAL NERVE 9126 55 72 2700
19 CRANIAL & PERIPHERAL NERVE 5925 37 48 2600
20 NERVOUS SYSTEM INFECTION EXCEPT 20828 82 117 3000
21 VIRAL MENINGITIS 14342 64 86 2800
22 HYPERTENSIVE ENCEPHALOPATHY 7806 42 54 2600
23 NONTRAUMATIC STUPOR & COMA 8004 40 56 2600
24 SEIZURE & HEADACHE AGE >17 W CC 9647 48 66 2700
25 SEIZURE & HEADACHE AGE >17 W/O CC 5515 32 41 2500
26 SEIZURE & HEADACHE AGE 0-17 6270 28 43 2500
27 TRAUMATIC STUPOR & COMA, COMA >1 13457 39 74 2600
28 TRAUMATIC STUPOR & COMA, COMA <1 12170 55 83 2700
29 TRAUMATIC STUPOR & COMA, COMA <1 6200 32 46 2500
30 *TRAUMATIC STUPOR & COMA, COMA <1 3687 20 20 1700
31 CONCUSSION AGE >17 W CC 7627 40 56 2600
32 CONCUSSION AGE >17 W/O CC 4635 25 34 2300
33 *CONCUSSION AGE 0-17 2559 16 16 900
34 OTHER DISORDERS OF NERVOUS SYSTEM 10862 53 75 2700
35 OTHER DISORDERS OF NERVOUS SYSTEM 5866 35 49 2600
36 RETINAL PROCEDURES 5989 15 18 800
37 ORBITAL PROCEDURES 8089 26 39 2500
38 PRIMARY IRIS PROCEDURES 4005 20 27 1600
39 LENS PROCEDURES WITH OR WITHOUT 5055 15 19 900
40 EXTRAOCULAR PROCEDURES EXCEPT 6241 23 36 2400
41 *EXTRAOCULAR PROCEDURES EXCEPT 3810 16 16 700
42 INTRAOCULAR PROCEDURES EXCEPT 5687 17 22 1200
43 HYPHEMA 3400 30 36 2000
44 ACUTE MAJOR EYE INFECTIONS 5755 49 60 2700
45 NEUROLOGICAL EYE DISORDERS 6211 35 43 2500
46 OTHER DISORDERS OF THE EYE AGE >17 7553 44 61 2600
47 OTHER DISORDERS OF THE EYE AGE >17 4331 30 39 2500
48 *OTHER DISORDERS OF THE EYE AGE 0- 4186 29 29 2500
49 MAJOR HEAD & NECK PROCEDURES 17106 49 68 2700
50 SIALOADENECTOMY 7131 19 23 1100
51 SALIVARY GLAND PROCEDURES EXCEPT 6838 20 30 2200
52 CLEFT LIP & PALATE REPAIR 9152 23 30 2000
53 SINUS & MASTOID PROCEDURES AGE >17 8647 22 34 2400
54 *SINUS & MASTOID PROCEDURES AGE 0- 7176 32 32 2200
55 MISCELLANEOUS EAR, NOSE, MOUTH & 6455 18 28 2000
56 RHINOPLASTY 7684 22 31 2400
57 T&A PROC, EXCEPT TONSILLECTOMY &/ 10174 34 52 2500
58 *T&A PROC, EXCEPT TONSILLECTOMY &/ 3227 15 15 400
59 TONSILLECTOMY &/OR ADENOIDECTOMY 4602 15 19 900
60 *TONSILLECTOMY &/OR ADENOIDECTOMY 2724 15 15 400
61 MYRINGOTOMY W TUBE INSERTION AGE > 10019 29 51 2500
62 *MYRINGOTOMY W TUBE INSERTION AGE 3217 13 13 500
63 OTHER EAR, NOSE, MOUTH & THROAT 11047 34 50 2500
64 EAR, NOSE, MOUTH & THROAT 11419 50 84 2700
65 DYSEQUILIBRIUM 5067 30 38 2200
66 EPISTAXIS 5076 31 39 2400
67 EPIGLOTTITIS 8381 38 47 2600
68 OTITIS MEDIA & URI AGE >17 W CC 7100 44 54 2600
69 OTITIS MEDIA & URI AGE >17 W/O CC 5133 35 42 2200
70 OTITIS MEDIA & URI AGE 0-17 5812 36 44 2400
71 LARYNGOTRACHEITIS 6508 35 42 2200
72 NASAL TRAUMA & DEFORMITY 6160 31 44 2500
73 OTHER EAR, NOSE, MOUTH & THROAT 7616 41 55 2600
74 *OTHER EAR, NOSE, MOUTH & THROAT 3571 21 21 2000
75 MAJOR CHEST PROCEDURES 30551 99 124 3200
76 OTHER RESP SYSTEM O.R. PROCEDURES 25126 100 139 3200
77 OTHER RESP SYSTEM O.R. PROCEDURES 10630 40 60 2600
78 PULMONARY EMBOLISM 14211 78 92 3000
79 RESPIRATORY INFECTIONS & 16955 83 107 3000
80 RESPIRATORY INFECTIONS & 9259 59 74 2800
81 RESPIRATORY INFECTIONS & 14323 57 71 2800
82 RESPIRATORY NEOPLASMS 13237 63 89 2800
83 MAJOR CHEST TRAUMA W CC 9530 55 72 2800
84 MAJOR CHEST TRAUMA W/O CC 4996 32 43 2500
85 PLEURAL EFFUSION W CC 11890 62 82 2800
86 PLEURAL EFFUSION W/O CC 6753 38 49 2600
87 PULMONARY EDEMA & RESPIRATORY 13306 55 75 2700
88 CHRONIC OBSTRUCTIVE PULMONARY 10053 56 69 2800
89 SIMPLE PNEUMONIA & PLEURISY AGE > 11317 65 80 2900
90 SIMPLE PNEUMONIA & PLEURISY AGE > 6924 49 57 2700
91 SIMPLE PNEUMONIA & PLEURISY AGE 0- 6834 38 44 2000
92 INTERSTITIAL LUNG DISEASE W CC 12084 64 81 2800
93 INTERSTITIAL LUNG DISEASE W/O CC 7700 45 57 2600
94 PNEUMOTHORAX W CC 12427 65 85 2800
95 PNEUMOTHORAX W/O CC 6146 39 49 2600
96 BRONCHITIS & ASTHMA AGE >17 W CC . 8488 52 62 2700
97 BRONCHITIS & ASTHMA AGE >17 W/O CC 6122 41 49 2400
98 BRONCHITIS & ASTHMA AGE 0-17 5356 31 41 2500
99 RESPIRATORY SIGNS & SYMPTOMS W CC 7019 32 41 2500
100 RESPIRATORY SIGNS & SYMPTOMS W/O 5051 23 28 1500
101 OTHER RESPIRATORY SYSTEM DIAGNOSES 9055 46 62 2700
102 OTHER RESPIRATORY SYSTEM DIAGNOSES 5339 30 40 2500
103 HEART TRANSPLANT 135495 254 358 4700
104 CARDIAC VALVE PROCEDURES W CARDIAC 76076 152 180 3700
105 CARDIAC VALVE PROCEDURES W/O 57656 110 130 3300
106 CORONARY BYPASS W CARDIAC CATH 56683 121 136 3400
107 CORONARY BYPASS W/O CARDIAC CATH 41974 93 104 3100
108 OTHER CARDIOTHORACIC PROCEDURES 61081 114 147 3300
109 NO LONGER VALID 0 0 0 0
110 MAJOR CARDIOVASCULAR PROCEDURES W 40796 91 122 3100
111 MAJOR CARDIOVASCULAR PROCEDURES W/ 23024 65 75 2800
112 PERCUTANEOUS CARDIOVASCULAR 19881 39 53 2600
113 AMPUTATION FOR CIRC SYSTEM 27765 127 172 3500
114 UPPER LIMB & TOE AMPUTATION FOR 15385 79 109 3000
115 PERM CARDIAC PACEMAKER IMPLANT W 35936 104 127 3200
116 OTH PERM CARDIAC PACEMAKER IMPLANT 24514 47 65 2700
117 CARDIAC PACEMAKER REVISION EXCEPT 11671 33 49 2500
118 CARDIAC PACEMAKER DEVICE 15582 23 35 2400
119 VEIN LIGATION & STRIPPING 9949 33 56 2500
120 OTHER CIRCULATORY SYSTEM O.R. 19616 63 107 2800
121 CIRCULATORY DISORDERS W AMI & C.V. 16022 70 86 2900
122 CIRCULATORY DISORDERS W AMI W/O 11292 49 60 2700
123 CIRCULATORY DISORDERS W AMI, 14286 29 51 2500
124 CIRCULATORY DISORDERS EXCEPT AMI, 12657 42 55 2600
125 CIRCULATORY DISORDERS EXCEPT AMI, 8451 24 32 2300
126 ACUTE & SUBACUTE ENDOCARDITIS 27724 137 184 3600
127 HEART FAILURE & SHOCK 10239 55 71 2700
128 DEEP VEIN THROMBOPHLEBITIS 7820 67 75 2900
129 CARDIAC ARREST, UNEXPLAINED 11308 21 38 2400
130 PERIPHERAL VASCULAR DISORDERS W CC 9177 58 74 2800
131 PERIPHERAL VASCULAR DISORDERS W/O 5889 45 56 2700
132 ATHEROSCLEROSIS W CC 7296 36 47 2600
133 ATHEROSCLEROSIS W/O CC 5348 27 35 2100
134 HYPERTENSION 5761 35 44 2500
135 CARDIAC CONGENITAL & VALVULAR 8507 43 58 2600
136 CARDIAC CONGENITAL & VALVULAR 5600 29 37 2300
137 *CARDIAC CONGENITAL & VALVULAR 6578 33 33 2500
138 CARDIAC ARRHYTHMIA & CONDUCTION 7964 39 52 2600
139 CARDIAC ARRHYTHMIA & CONDUCTION 4939 26 33 2000
140 ANGINA PECTORIS 6258 32 40 2300
141 SYNCOPE & COLLAPSE W CC 7025 39 51 2600
142 SYNCOPE & COLLAPSE W/O CC 5174 29 36 2100
143 CHEST PAIN 5169 24 30 1600
144 OTHER CIRCULATORY SYSTEM DIAGNOSES 10580 45 64 2700
145 OTHER CIRCULATORY SYSTEM DIAGNOSES 6155 28 37 2500
146 RECTAL RESECTION W CC 25367 107 122 3300
147 RECTAL RESECTION W/O CC 15469 74 80 2800
148 MAJOR SMALL & LARGE BOWEL 32220 122 147 3400
149 MAJOR SMALL & LARGE BOWEL 15022 76 82 2600
150 PERITONEAL ADHESIOLYSIS W CC 25652 105 128 3200
151 PERITONEAL ADHESIOLYSIS W/O CC 11814 55 68 2700
152 MINOR SMALL & LARGE BOWEL 17829 83 97 3000
153 MINOR SMALL & LARGE BOWEL 11151 60 67 2600
154 STOMACH, ESOPHAGEAL & DUODENAL 41740 133 170 3500
155 STOMACH, ESOPHAGEAL & DUODENAL 13898 61 72 2800
156 *STOMACH, ESOPHAGEAL & DUODENAL 8732 60 60 2800
157 ANAL & STOMAL PROCEDURES W CC 10320 44 61 2600
158 ANAL & STOMAL PROCEDURES W/O CC 5445 23 30 1800
159 HERNIA PROCEDURES EXCEPT INGUINAL 11066 43 56 2600
160 HERNIA PROCEDURES EXCEPT INGUINAL 6574 25 31 1800
161 INGUINAL & FEMORAL HERNIA 9053 32 46 2500
162 INGUINAL & FEMORAL HERNIA 5156 18 22 1100
163 HERNIA PROCEDURES AGE 0-17 7275 39 48 2400
164 APPENDECTOMY W COMPLICATED 21645 88 102 3100
165 APPENDECTOMY W COMPLICATED 11976 57 63 2400
166 APPENDECTOMY W/O COMPLICATED 13465 52 63 2700
167 APPENDECTOMY W/O COMPLICATED 7828 32 37 1600
168 MOUTH PROCEDURES W CC 10856 35 54 2500
169 MOUTH PROCEDURES W/O CC 6149 21 27 1600
170 OTHER DIGESTIVE SYSTEM O.R. 27813 98 146 3200
171 OTHER DIGESTIVE SYSTEM O.R. 10638 43 59 2600
172 DIGESTIVE MALIGNANCY W CC 12990 65 94 2900
173 DIGESTIVE MALIGNANCY W/O CC 6262 32 46 2500
174 G.I. HEMORRHAGE W CC 9726 49 62 2700
175 G.I. HEMORRHAGE W/O CC 5359 33 39 1900
176 COMPLICATED PEPTIC ULCER 10436 53 69 2700
177 UNCOMPLICATED PEPTIC ULCER W CC 8062 45 56 2700
178 UNCOMPLICATED PEPTIC ULCER W/O CC 5807 33 39 1900
179 INFLAMMATORY BOWEL DISEASE 11143 64 82 2800
180 G.I. OBSTRUCTION W CC 9139 52 68 2700
181 G.I. OBSTRUCTION W/O CC 4975 34 42 2300
182 ESOPHAGITIS, GASTROENT & MISC 7685 43 56 2600
183 ESOPHAGITIS, GASTROENT & MISC 5356 31 38 2200
184 ESOPHAGITIS, GASTROENT & MISC 4240 26 34 2100
185 DENTAL & ORAL DIS EXCEPT 8312 41 57 2600
186 *DENTAL & ORAL DIS EXCEPT 4282 29 29 2300
187 DENTAL EXTRACTIONS & RESTORATIONS 6350 28 38 2500
188 OTHER DIGESTIVE SYSTEM DIAGNOSES 10201 49 68 2700
189 OTHER DIGESTIVE SYSTEM DIAGNOSES 5027 27 37 2500
190 OTHER DIGESTIVE SYSTEM DIAGNOSES 6707 32 45 2500
191 PANCREAS, LIVER & SHUNT PROCEDURES 44176 136 182 3600
192 PANCREAS, LIVER & SHUNT PROCEDURES 17609 69 89 2900
193 BILIARY TRACT PROC EXCEPT ONLY 31497 129 157 3500
194 BILIARY TRACT PROC EXCEPT ONLY 16562 73 92 2900
195 CHOLECYSTECTOMY W C.D.E. W CC 24576 97 114 3200
196 CHOLECYSTECTOMY W C.D.E. W/O CC 14861 65 75 2900
197 CHOLECYSTECTOMY EXCEPT BY 20796 81 97 3000
198 CHOLECYSTECTOMY EXCEPT BY 10930 46 53 2400
199 HEPATOBILIARY DIAGNOSTIC PROCEDURE 23603 99 132 3200
200 HEPATOBILIARY DIAGNOSTIC PROCEDURE 29698 84 131 3000
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