Medicare DRGs Effective 10/1/2005 - 9/30/2006
Source: Federal Register Friday, August 12, 2005
[[Page 47617]]
TABLE 5.--LIST OF DIAGNOSIS-RELATED GROUPS (DRGs), RELATIVE WEIGHTING FACTORS, AND GEOMETRIC AND
			ARTHIMETIC MEAN LENGTH OF STAY (LOS)
				RELATIVE	GEOMETRIC	ARITHMETIC
DRG	MDC	TYPE	DRG TITLE	WEIGHTS	MEAN LOS	MEAN LOS
1	1	SURG	CRANIOTOMY AGE >17 W CC	3.4347	7.6000	10.1
2	1	SURG	CRANIOTOMY AGE >17 W/O CC	1.9587	3.5000	4.6
3	1	SURG	CRANIOTOMY AGE 0-17	1.986	12.7000	12.7
4	1	SURG	NO LONGER VALID	0	0.0000	0.0
5	1	SURG	NO LONGER VALID	0	0.0000	0.0
6	1	SURG	CARPAL TUNNEL RELEASE	0.7878	2.2000	3.0
7	1	SURG	PERIPH & CRANIAL NERVE & OTHER	2.6978	6.7000	9.7
			NERV SYST PROC W CC
8	1	SURG	PERIPH & CRANIAL NERVE & OTHER	1.5635	2.0000	3.0
			NERV SYST PROC W/O CC
9	1	MED	SPINAL DISORDERS & INJURIES	1.4045	4.5000	6.4
10	1	MED	NERVOUS SYSTEM NEOPLASMS W CC	1.2222	4.6000	6.2
11	1	MED	NERVOUS SYSTEM NEOPLASMS W/O CC	0.8736	2.9000	3.8
12	1	MED	DEGENERATIVE NERVOUS SYSTEM	0.8998	4.3000	5.5
			DISORDERS
13	1	MED	MULTIPLE SCLEROSIS & CERE-	0.8575	4.0000	5.0
			BELLAR ATAXIA
14	1	MED	INTRACRANIAL HEMORRHAGE OR	1.2456	4.5000	5.8
			CEREBRAL INFARCTION
15	1	MED	NONSPECIFIC CVA & PRECEREBRAL	0.9421	3.7000	4.6
			OCCLUSION W/O INFARCT
16	1	MED	NONSPECIFIC CEREBROVASCULAR	1.3351	5.0000	6.5
			DISORDERS W CC
17	1	MED	NONSPECIFIC CEREBROVASCULAR	0.7229	2.5000	3.2
			DISORDERS W/O CC
18	1	MED	CRANIAL & PERIPHERAL NERVE DIS-	0.9903	4.1000	5.3
			ORDERS W CC
19	1	MED	CRANIAL & PERIPHERAL NERVE DIS-	0.7077	2.7000	3.5
			ORDERS W/O CC
20	1	MED	NERVOUS SYSTEM INFECTION EX-	2.7865	8.0000	10.4
			CEPT VIRAL MENINGITIS
21	1	MED	VIRAL MENINGITIS	1.4451	4.9000	6.3
22	1	MED	HYPERTENSIVE ENCEPHALOPATHY	1.1304	4.0000	5.2
23	1	MED	NONTRAUMATIC STUPOR & COMA	0.7712	3.0000	3.9
24	1	MED	SEIZURE & HEADACHE AGE >17 W	0.997	3.6000	4.8
			CC
25	1	MED	SEIZURE & HEADACHE AGE >17 W/O	0.618	2.5000	3.1
			CC
26	1	MED	SEIZURE & HEADACHE AGE 0-17	1.8191	3.4000	6.3
27	1	MED	TRAUMATIC STUPOR & COMA, COMA	1.3531	3.2000	5.2
			>1 HR
28	1	MED	TRAUMATIC STUPOR & COMA, COMA	1.3353	4.4000	5.9
			<1 HR AGE >17 W CC
29	1	MED	TRAUMATIC STUPOR & COMA, COMA	0.7212	2.6000	3.4
			<1 HR AGE >17 W/O CC
30	1	MED	TRAUMATIC STUPOR & COMA, COMA	0.3359	2.0000	2.0
			<1 HR AGE 0-17
31	1	MED	CONCUSSION AGE >17 W CC	0.9567	3.0000	4.0
32	1	MED	CONCUSSION AGE >17 W/O CC	0.6194	1.9000	2.4
33	1	MED	CONCUSSION AGE 0-17	0.2109	1.6000	1.6
34	1	MED	OTHER DISORDERS OF NERVOUS	1.0062	3.7000	4.8
			SYSTEM W CC
35	1	MED	OTHER DISORDERS OF NERVOUS	0.6241	2.4000	3.0
			SYSTEM W/O CC
36	2	SURG	RETINAL PROCEDURES	0.7288	1.3000	1.6
37	2	SURG	ORBITAL PROCEDURES	1.1858	2.7000	4.2
38	2	SURG	PRIMARY IRIS PROCEDURES	0.6975	2.5000	3.5
39	2	SURG	LENS PROCEDURES WITH OR WITH-	0.7108	1.7000	2.4
			OUT VITRECTOMY
40	2	SURG	EXTRAOCULAR PROCEDURES EX-	0.9627	3.0000	4.1
			CEPT ORBIT AGE >17
41	2	SURG	EXTRAOCULAR PROCEDURES EX-	0.3419	1.6000	1.6
			CEPT ORBIT AGE 0-17
42	2	SURG	INTRAOCULAR PROCEDURES EX-	0.7852	2.0000	2.8
			CEPT RETINA, IRIS & LENS
43	2	MED	HYPHEMA	0.6141	2.4000	3.1
44	2	MED	ACUTE MAJOR EYE INFECTIONS	0.6874	3.9000	4.8
45	2	MED	NEUROLOGICAL EYE DISORDERS	0.7474	2.5000	3.1
46	2	MED	OTHER DISORDERS OF THE EYE	0.7524	3.2000	4.2
			AGE >17 W CC
47	2	MED	OTHER DISORDERS OF THE EYE	0.5203	2.3000	2.9
			AGE >17 W/O CC
48	2	MED	OTHER DISORDERS OF THE EYE	0.3012	2.9000	2.9
			AGE 0-17
49	3	SURG	MAJOR HEAD & NECK PROCEDURES	1.6361	3.1000	4.4
50	3	SURG	SIALOADENECTOMY	0.869	1.5000	1.8
51	3	SURG	SALIVARY GLAND PROCEDURES EX-	0.8809	1.9000	2.8
			CEPT SIALOADENECTOMY
52	3	SURG	CLEFT LIP & PALATE REPAIR	0.8348	1.5000	1.9
53	3	SURG	SINUS & MASTOID PROCEDURES	1.3269	2.4000	3.9
			AGE >17
54	3	SURG	SINUS & MASTOID PROCEDURES	0.4882	3.2000	3.2
			AGE 0-17
55	3	SURG	MISCELLANEOUS EAR, NOSE,	0.9597	2.0000	3.1
			MOUTH & THROAT PROCEDURES
56	3	SURG	RHINOPLASTY	0.8711	1.8000	2.6
57	3	SURG	T&A PROC, EXCEPT TONSILLECTOMY	1.0428	2.3000	3.6
			&/OR ADENOIDECTOMY ONLY, AGE
			>17
58	3	SURG	T&A PROC, EXCEPT TONSILLECTOMY	0.2772	1.5000	1.5
			&/OR ADENOIDECTOMY ONLY, AGE
			0-17
59	3	SURG	TONSILLECTOMY &/OR	0.8082	1.8000	2.6
			ADENOIDECTOMY ONLY, AGE >17
60	3	SURG	TONSILLECTOMY &/OR	0.211	1.5000	1.5
			ADENOIDECTOMY ONLY, AGE 0-17
61	3	SURG	MYRINGOTOMY W TUBE INSERTION	1.2867	3.3000	5.4
			AGE >17
62	3	SURG	MYRINGOTOMY W TUBE INSERTION	0.2989	1.3000	1.3
			AGE 0-17
63	3	SURG	OTHER EAR, NOSE, MOUTH &	1.3983	3.0000	4.5
			THROAT O  R   PROCEDURES
64	3	MED	EAR, NOSE, MOUTH & THROAT MA-	1.1663	4.1000	6.1
			LIGNANCY
65	3	MED	DYSEQUILIBRIUM	0.5991	2.3000	2.8
66	3	MED	EPISTAXIS	0.5958	2.4000	3.1
67	3	MED	EPIGLOTTITIS	0.7725	2.9000	3.7
68	3	MED	OTITIS MEDIA & URI AGE >17 W CC	0.6611	3.2000	4.0
69	3	MED	OTITIS MEDIA & URI AGE >17 W/O	0.485	2.5000	3.0
			CC
70	3	MED	OTITIS MEDIA & URI AGE 0-17	0.421	2.1000	2.3
71	3	MED	LARYNGOTRACHEITIS	0.7524	3.2000	4.0
72	3	MED	NASAL TRAUMA & DEFORMITY	0.7449	2.6000	3.4
73	3	MED	OTHER EAR, NOSE, MOUTH &	0.8527	3.3000	4.4
			THROAT DIAGNOSES AGE >17
74	3	MED	OTHER EAR, NOSE, MOUTH &	0.3398	2.1000	2.1
			THROAT DIAGNOSES AGE 0-17
75	4	SURG	MAJOR CHEST PROCEDURES	3.0732	7.6000	9.9
76	4	SURG	OTHER RESP SYSTEM O  R   PROCE-	2.883	8.4000	11.1
			DURES W CC
77	4	SURG	OTHER RESP SYSTEM O  R   PROCE-	1.1857	3.3000	4.7
			DURES W/O CC
78	4	MED	PULMONARY EMBOLISM	1.2427	5.4000	6.4
79	4	MED	RESPIRATORY INFECTIONS & IN-	1.6238	6.7000	8.5
			FLAMMATIONS AGE >17 W CC
80	4	MED	RESPIRATORY INFECTIONS & IN-	0.8947	4.4000	5.5
			FLAMMATIONS AGE >17 W/O CC
81	4	MED	RESPIRATORY INFECTIONS & IN-	1.5383	6.1000	6.1
			FLAMMATIONS AGE 0-17
82	4	MED	RESPIRATORY NEOPLASMS	1.3936	5.1000	6.8
83	4	MED	MAJOR CHEST TRAUMA W CC	0.9828	4.2000	5.3
84	4	MED	MAJOR CHEST TRAUMA W/O CC	0.5799	2.6000	3.2
85	4	MED	PLEURAL EFFUSION W CC	1.2405	4.8000	6.3
86	4	MED	PLEURAL EFFUSION W/O CC	0.6974	2.8000	3.6
87	4	MED	PULMONARY EDEMA & RES-	1.3654	4.9000	6.4
			PIRATORY FAILURE
88	4	MED	CHRONIC OBSTRUCTIVE PUL-	0.8778	4.0000	4.9
			MONARY DISEASE
89	4	MED	SIMPLE PNEUMONIA & PLEURISY	1.032	4.7000	5.7
			AGE >17 W CC
90	4	MED	SIMPLE PNEUMONIA & PLEURISY	0.6104	3.2000	3.8
			AGE >17 W/O CC
91	4	MED	SIMPLE PNEUMONIA & PLEURISY	0.8124	3.4000	4.4
			AGE 0-17
92	4	MED	INTERSTITIAL LUNG DISEASE W CC	1.1853	4.8000	6.1
93	4	MED	INTERSTITIAL LUNG DISEASE W/O CC	0.715	3.1000	3.9
94	4	MED	PNEUMOTHORAX W CC	1.1354	4.6000	6.2
95	4	MED	PNEUMOTHORAX W/O CC	0.6035	2.9000	3.6
96	4	MED	BRONCHITIS & ASTHMA AGE >17 W	0.7303	3.6000	4.4
			CC
97	4	MED	BRONCHITIS & ASTHMA AGE >17 W/O	0.5364	2.8000	3.4
			CC
98	4	MED	BRONCHITIS & ASTHMA AGE 0-17	0.556	3.7000	3.7
99	4	MED	RESPIRATORY SIGNS & SYMPTOMS	0.7094	2.4000	3.1
			W CC
100	4	MED	RESPIRATORY SIGNS & SYMPTOMS	0.5382	1.7000	2.1
			W/O CC
101	4	MED	OTHER RESPIRATORY SYSTEM DIAG-	0.8733	3.3000	4.3
			NOSES W CC
102	4	MED	OTHER RESPIRATORY SYSTEM DIAG-	0.5402	2.0000	2.5
			NOSES W/O CC
103		SURG	HEART TRANSPLANT OR IMPLANT OF	18.5617	23.7000	37.7
			HEART ASSIST SYSTEM
104	5	SURG	CARDIAC VALVE & OTH MAJOR	8.2201	12.7000	14.9
			CARDIOTHORACIC PROC W CARD
			CATH
105	5	SURG	CARDIAC VALVE & OTH MAJOR	6.0192	8.4000	10.2
			CARDIOTHORACIC PROC W/O
			CARD CATH
106	5	SURG	CORONARY BYPASS W PTCA	7.0346	9.5000	11.2
107	5	SURG	NO LONGER VALID	0	13.5000	13.5
108	5	SURG	OTHER CARDIOTHORACIC PROCE-	5.8789	8.6000	11.0
			DURES
109	5	SURG	NO LONGER VALID	0	12.1000	12.1
110	5	SURG	MAJOR CARDIOVASCULAR PROCE-	3.8417	5.7000	8.4
			DURES W CC
111	5	SURG	MAJOR CARDIOVASCULAR PROCE-	2.484	2.6000	3.4
			DURES W/O CC
112	5	SURG	NO LONGER VALID	0	0.0000	0.0
113	5	SURG	AMPUTATION FOR CIRC SYSTEM DIS-	3.1682	10.8000	13.7
			ORDERS EXCEPT UPPER LIMB &
			TOE
114	5	SURG	UPPER LIMB & TOE AMPUTATION	1.7354	6.7000	8.9
			FOR CIRC SYSTEM DISORDERS
115	5	SURG	NO LONGER VALID	0	15.8000	15.8
116	5	SURG	NO LONGER VALID	0	9.3000	9.3
117	5	SURG	CARDIAC PACEMAKER REVISION EX-	1.3223	2.6000	4.2
			CEPT DEVICE REPLACEMENT