Colorado Department of Health Care Policy and …...MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES Minor 0.8761 National 3.41 9 043 2 MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES

Updated 7/1/2020

Colorado Department of Health Care Policy and Financing

Weights and Trimpoints by All Patient Refined-Diagnosis Related Group (APR-DRG) and Severity of Illness (SOI)

APR_DRG SOI APR_DRG_DESC SOI_DESC DRG_WT WT_SRC ALOS TRIMPOINT

001 1LIVER TRANSPLANT &/OR INTESTINAL

TRANSPLANTMinor 7.5274 National 7.59 13


TRANSPLANTModerate 8.2396 National 8.15 16


TRANSPLANTMajor 10.2679 National 11.88 29


TRANSPLANTExtreme 19.4791 CO Specific 31.88 88

002 1 HEART &/OR LUNG TRANSPLANT Minor 10.2239 National 9.36 17

002 2 HEART &/OR LUNG TRANSPLANT Moderate 11.3855 National 13.05 29

002 3 HEART &/OR LUNG TRANSPLANT Major 14.6867 National 21.04 62

002 4 HEART &/OR LUNG TRANSPLANT Extreme 23.9660 National 35.15 103

003 1 BONE MARROW TRANSPLANT Minor 5.2070 National 16.44 37

003 2 BONE MARROW TRANSPLANT Moderate 7.2395 National 22.39 41

003 3 BONE MARROW TRANSPLANT Major 11.9031 National 32.46 69

003 4 BONE MARROW TRANSPLANT Extreme 22.5934 National 49.40 109

004 1TRACHEOSTOMY W MV 96+ HOURS W

EXTENSIVE PROCEDURE OR ECMOMinor 7.4365 National 19.77 47


EXTENSIVE PROCEDURE OR ECMOModerate 8.2628 National 20.00 48


EXTENSIVE PROCEDURE OR ECMOMajor 11.3120 National 26.00 60


EXTENSIVE PROCEDURE OR ECMOExtreme 20.3580 CO Specific 51.72 130

005 1TRACHEOSTOMY W MV 96+ HOURS W/O

EXTENSIVE PROCEDUREMinor 5.4831 National 17.85 43


EXTENSIVE PROCEDUREModerate 6.0924 National 17.24 40


EXTENSIVE PROCEDUREMajor 7.8994 National 23.00 54


EXTENSIVE PROCEDUREExtreme 14.3369 CO Specific 41.59 101

006 1 PANCREAS TRANSPLANT Minor 7.1555 National 5.33 8

006 2 PANCREAS TRANSPLANT Moderate 9.3729 National 7.89 16

006 3 PANCREAS TRANSPLANT Major 9.6607 National 9.84 20

006 4 PANCREAS TRANSPLANT Extreme 14.9774 National 21.81 48

020 1 CRANIOTOMY FOR TRAUMA Minor 2.0393 National 5.13 13

020 2 CRANIOTOMY FOR TRAUMA Moderate 2.4293 CO Specific 4.86 11

7/1/2020: The Department separated Baby from Mom's claim on 7/1/2020 after three years of stakeholder discussion and involvement.

The resulting change in Weights, Average Length of Stay (ALOS) and TrimPoint to Delivery and Neonate DRGs using the National HSRV file

Ver 33 from 3M and multiplied by a factor of 1.2699 to achieve a budget neutral change in payment for hospitals. Reductions for IPP-

LARCs devices were instituted after the budget neutral changes. DRG's 540, 542 & 560 weights were reduced by .004 to allow for a

separate payment for IPP-LARCs devices. Please see IP/OP Billing Manual for billing instructions.

Updated 7/1/2020









020 3 CRANIOTOMY FOR TRAUMA Major 4.0685 National 10.03 26

020 4 CRANIOTOMY FOR TRAUMA Extreme 7.7847 National 17.35 47

021 1 CRANIOTOMY EXCEPT FOR TRAUMA Minor 2.0983 CO Specific 3.92 10

021 2 CRANIOTOMY EXCEPT FOR TRAUMA Moderate 2.8613 CO Specific 6.38 19

021 3 CRANIOTOMY EXCEPT FOR TRAUMA Major 4.5268 CO Specific 12.05 34

021 4 CRANIOTOMY EXCEPT FOR TRAUMA Extreme 8.9449 CO Specific 26.94 76

022 1 VENTRICULAR SHUNT PROCEDURES Minor 1.2364 CO Specific 2.24 7

022 2 VENTRICULAR SHUNT PROCEDURES Moderate 1.4570 CO Specific 2.88 11

022 3 VENTRICULAR SHUNT PROCEDURES Major 4.0668 National 10.50 32

022 4 VENTRICULAR SHUNT PROCEDURES Extreme 8.1305 National 19.64 54

023 1 SPINAL PROCEDURES Minor 1.1858 CO Specific 2.90 8

023 2 SPINAL PROCEDURES Moderate 2.2593 National 5.43 16

023 3 SPINAL PROCEDURES Major 4.6124 National 9.71 26

023 4 SPINAL PROCEDURES Extreme 7.9598 National 18.82 49

024 1 EXTRACRANIAL VASCULAR PROCEDURES Minor 1.1750 National 1.43 4

024 2 EXTRACRANIAL VASCULAR PROCEDURES Moderate 1.6503 National 2.67 9

024 3 EXTRACRANIAL VASCULAR PROCEDURES Major 3.3010 National 6.97 19

024 4 EXTRACRANIAL VASCULAR PROCEDURES Extreme 6.8915 National 13.69 35

026 1OTHER NERVOUS SYSTEM & RELATED

PROCEDURESMinor 1.3505 CO Specific 2.23 6


PROCEDURESModerate 1.7658 CO Specific 3.05 8


PROCEDURESMajor 2.8356 National 8.14 23


PROCEDURESExtreme 6.6156 National 19.39 56

040 1 SPINAL DISORDERS & INJURIES Minor 1.0040 National 3.32 10

040 2 SPINAL DISORDERS & INJURIES Moderate 1.2446 National 4.48 13

040 3 SPINAL DISORDERS & INJURIES Major 1.6653 National 6.46 20

040 4 SPINAL DISORDERS & INJURIES Extreme 3.8818 National 12.92 41

041 1 NERVOUS SYSTEM MALIGNANCY Minor 0.8585 National 2.73 8

041 2 NERVOUS SYSTEM MALIGNANCY Moderate 0.9121 National 3.59 11

041 3 NERVOUS SYSTEM MALIGNANCY Major 1.2916 National 5.63 17

041 4 NERVOUS SYSTEM MALIGNANCY Extreme 2.4458 National 9.10 29

042 1DEGENERATIVE NERVOUS SYSTEM DISORDERS

EXC MULT SCLEROSISMinor 0.6210 National 4.18 14


EXC MULT SCLEROSISModerate 0.7721 National 7.82 23

Updated 7/1/2020










EXC MULT SCLEROSISMajor 1.1434 National 8.11 25


EXC MULT SCLEROSISExtreme 3.1887 National 11.96 32

043 1MULTIPLE SCLEROSIS & OTHER DEMYELINATING

DISEASESMinor 0.8761 National 3.41 9


DISEASESModerate 1.1195 National 4.37 11


DISEASESMajor 1.6936 National 6.99 20


DISEASESExtreme 3.8711 National 12.10 33

044 1 INTRACRANIAL HEMORRHAGE Minor 0.8597 National 3.27 10

044 2 INTRACRANIAL HEMORRHAGE Moderate 1.1341 National 4.38 12

044 3 INTRACRANIAL HEMORRHAGE Major 1.5515 National 5.09 16

044 4 INTRACRANIAL HEMORRHAGE Extreme 2.8650 National 8.27 30

045 1 CVA & PRECEREBRAL OCCLUSION W INFARCT Minor 0.7931 CO Specific 2.34 6

045 2 CVA & PRECEREBRAL OCCLUSION W INFARCT Moderate 1.1781 CO Specific 4.66 16

045 3 CVA & PRECEREBRAL OCCLUSION W INFARCT Major 2.0643 CO Specific 10.62 40

045 4 CVA & PRECEREBRAL OCCLUSION W INFARCT Extreme 3.1094 National 10.75 30

046 1NONSPECIFIC CVA & PRECEREBRAL OCCLUSION

W/O INFARCTMinor 0.7579 CO Specific 2.31 6


W/O INFARCTModerate 0.8615 CO Specific 2.14 5


W/O INFARCTMajor 1.1754 CO Specific 4.47 12


W/O INFARCTExtreme 2.5573 CO Specific 8.53 26

047 1 TRANSIENT ISCHEMIA Minor 0.5771 CO Specific 1.45 3

047 2 TRANSIENT ISCHEMIA Moderate 0.7183 CO Specific 1.91 4

047 3 TRANSIENT ISCHEMIA Major 0.8235 CO Specific 2.64 7

047 4 TRANSIENT ISCHEMIA Extreme 2.1354 National 7.87 22

048 1PERIPHERAL, CRANIAL & AUTONOMIC NERVE

DISORDERSMinor 0.6112 CO Specific 2.37 6


DISORDERSModerate 0.6341 CO Specific 2.88 7


DISORDERSMajor 0.8915 CO Specific 4.41 13

Updated 7/1/2020










DISORDERSExtreme 2.9388 National 12.24 35

049 1BACTERIAL & TUBERCULOUS INFECTIONS OF

NERVOUS SYSTEMMinor 0.9952 National 5.13 14


NERVOUS SYSTEMModerate 2.0647 National 6.16 16


NERVOUS SYSTEMMajor 2.7300 National 10.11 27


NERVOUS SYSTEMExtreme 5.0117 National 15.95 41

050 1NON-BACTERIAL INFECTIONS OF NERVOUS

SYSTEM EXC VIRAL MENINGITISMinor 0.7166 National 3.72 11


SYSTEM EXC VIRAL MENINGITISModerate 1.2372 National 5.16 15


SYSTEM EXC VIRAL MENINGITISMajor 2.0375 National 8.42 22


SYSTEM EXC VIRAL MENINGITISExtreme 5.1991 National 15.67 41

051 1 VIRAL MENINGITIS Minor 0.5300 CO Specific 2.39 5

051 2 VIRAL MENINGITIS Moderate 0.7110 CO Specific 2.97 6

051 3 VIRAL MENINGITIS Major 1.4808 National 6.17 16

051 4 VIRAL MENINGITIS Extreme 3.7481 National 12.43 33

052 1 NONTRAUMATIC STUPOR & COMA Minor 0.4550 CO Specific 1.55 3

052 2 NONTRAUMATIC STUPOR & COMA Moderate 0.5510 CO Specific 2.12 6

052 3 NONTRAUMATIC STUPOR & COMA Major 0.9098 CO Specific 3.93 13

052 4 NONTRAUMATIC STUPOR & COMA Extreme 2.7837 National 10.25 30

053 1 SEIZURE Minor 0.5744 CO Specific 2.13 6

053 2 SEIZURE Moderate 0.6253 CO Specific 2.20 6

053 3 SEIZURE Major 0.9153 CO Specific 3.15 10

053 4 SEIZURE Extreme 1.7848 CO Specific 5.43 17

054 1 MIGRAINE & OTHER HEADACHES Minor 0.5736 CO Specific 2.27 6

054 2 MIGRAINE & OTHER HEADACHES Moderate 0.6552 CO Specific 2.49 6

054 3 MIGRAINE & OTHER HEADACHES Major 0.8964 National 3.61 11

054 4 MIGRAINE & OTHER HEADACHES Extreme 2.0645 National 6.62 23

055 1HEAD TRAUMA W COMA >1 HR OR

HEMORRHAGEMinor 0.7522 CO Specific 2.36 7


HEMORRHAGEModerate 1.1710 CO Specific 3.91 12

Updated 7/1/2020










HEMORRHAGEMajor 2.2882 CO Specific 8.96 28


HEMORRHAGEExtreme 3.8221 National 11.37 32

056 1

BRAIN CONTUSION/LACERATION &

COMPLICATED SKULL FX, COMA < 1 HR OR NO

COMA

Minor 0.7444 National 2.15 6

056 2



COMA

Moderate 1.0588 National 3.36 10

056 3



COMA

Major 1.6619 National 5.56 16

056 4



COMA

Extreme 4.1978 National 12.84 34

057 1

CONCUSSION, CLOSED SKULL FX

NOS,UNCOMPLICATED INTRACRANIAL INJURY,

COMA < 1 HR OR NO COMA


057 2




Moderate 0.8018 CO Specific 2.24 6

057 3





057 4





058 1 OTHER DISORDERS OF NERVOUS SYSTEM Minor 0.5955 CO Specific 2.05 6

058 2 OTHER DISORDERS OF NERVOUS SYSTEM Moderate 0.8046 CO Specific 2.80 8

058 3 OTHER DISORDERS OF NERVOUS SYSTEM Major 1.2725 CO Specific 5.31 19

058 4 OTHER DISORDERS OF NERVOUS SYSTEM Extreme 2.6762 National 10.53 34

070 1 ORBITAL PROCEDURES Minor 0.9663 National 2.01 6

070 2 ORBITAL PROCEDURES Moderate 1.3845 National 3.55 10

070 3 ORBITAL PROCEDURES Major 2.4916 National 5.80 16

070 4 ORBITAL PROCEDURES Extreme 4.8129 National 12.36 31

073 1 EYE PROCEDURES EXCEPT ORBIT Minor 0.8181 National 2.12 7

073 2 EYE PROCEDURES EXCEPT ORBIT Moderate 1.0269 National 2.80 9

Updated 7/1/2020









073 3 EYE PROCEDURES EXCEPT ORBIT Major 1.6647 National 5.23 18

073 4 EYE PROCEDURES EXCEPT ORBIT Extreme 3.4555 National 9.81 29

080 1 ACUTE MAJOR EYE INFECTIONS Minor 0.4316 National 2.80 7

080 2 ACUTE MAJOR EYE INFECTIONS Moderate 0.6330 National 3.66 10

080 3 ACUTE MAJOR EYE INFECTIONS Major 1.0742 National 5.60 15

080 4 ACUTE MAJOR EYE INFECTIONS Extreme 2.9343 National 10.27 24

082 1 EYE DISORDERS EXCEPT MAJOR INFECTIONS Minor 0.5300 National 2.18 6

082 2 EYE DISORDERS EXCEPT MAJOR INFECTIONS Moderate 0.6826 National 2.58 7

082 3 EYE DISORDERS EXCEPT MAJOR INFECTIONS Major 0.9455 National 3.84 11

082 4 EYE DISORDERS EXCEPT MAJOR INFECTIONS Extreme 3.5164 National 11.19 41

089 1 MAJOR CRANIAL/FACIAL BONE PROCEDURES Minor 1.7641 CO Specific 2.35 5

089 2 MAJOR CRANIAL/FACIAL BONE PROCEDURES Moderate 1.9628 CO Specific 3.54 8

089 3 MAJOR CRANIAL/FACIAL BONE PROCEDURES Major 3.9150 National 8.17 23

089 4 MAJOR CRANIAL/FACIAL BONE PROCEDURES Extreme 7.6045 National 16.12 44

090 1 MAJOR LARYNX & TRACHEA PROCEDURES Minor 0.7670 National 2.45 8

090 2 MAJOR LARYNX & TRACHEA PROCEDURES Moderate 2.5776 National 7.65 20

090 3 MAJOR LARYNX & TRACHEA PROCEDURES Major 4.0950 National 12.66 34

090 4 MAJOR LARYNX & TRACHEA PROCEDURES Extreme 8.1559 National 23.69 60

091 1 OTHER MAJOR HEAD & NECK PROCEDURES Minor 1.5447 National 2.96 9

091 2 OTHER MAJOR HEAD & NECK PROCEDURES Moderate 2.3377 National 4.34 13

091 3 OTHER MAJOR HEAD & NECK PROCEDURES Major 4.3468 National 9.20 23

091 4 OTHER MAJOR HEAD & NECK PROCEDURES Extreme 7.0751 National 16.98 40

092 1FACIAL BONE PROCEDURES EXCEPT MAJOR

CRANIAL/FACIAL BONE PROCEDURESMinor 1.1153 CO Specific 2.13 5


CRANIAL/FACIAL BONE PROCEDURESModerate 1.5050 CO Specific 2.72 7


CRANIAL/FACIAL BONE PROCEDURESMajor 2.8220 National 5.40 17


CRANIAL/FACIAL BONE PROCEDURESExtreme 6.1742 National 13.93 37

093 1 SINUS & MASTOID PROCEDURES Minor 1.1616 National 2.18 7

093 2 SINUS & MASTOID PROCEDURES Moderate 1.5364 National 3.48 11

093 3 SINUS & MASTOID PROCEDURES Major 2.1897 CO Specific 4.73 10

093 4 SINUS & MASTOID PROCEDURES Extreme 3.5191 National 10.97 31

095 1 CLEFT LIP & PALATE REPAIR Minor 0.6990 CO Specific 1.39 4

095 2 CLEFT LIP & PALATE REPAIR Moderate 0.8385 CO Specific 1.50 3

095 3 CLEFT LIP & PALATE REPAIR Major 1.4334 CO Specific 3.29 11

095 4 CLEFT LIP & PALATE REPAIR Extreme 3.0212 CO Specific 6.95 20

Updated 7/1/2020









097 1 TONSIL & ADENOID PROCEDURES Minor 0.6077 CO Specific 1.56 4

097 2 TONSIL & ADENOID PROCEDURES Moderate 0.8574 CO Specific 2.37 6

097 3 TONSIL & ADENOID PROCEDURES Major 1.5942 National 5.30 18

097 4 TONSIL & ADENOID PROCEDURES Extreme 4.5689 National 14.94 41

098 1OTHER EAR, NOSE, MOUTH & THROAT








110 1EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL

MALIGNANCIESMinor 0.6743 National 2.67 9


MALIGNANCIESModerate 0.9081 National 3.89 12


MALIGNANCIESMajor 1.3524 National 6.20 18


MALIGNANCIESExtreme 2.9154 National 11.95 33

111 1 VERTIGO & OTHER LABYRINTH DISORDERS Minor 0.5578 National 1.93 5

111 2 VERTIGO & OTHER LABYRINTH DISORDERS Moderate 0.6365 CO Specific 2.26 6

111 3 VERTIGO & OTHER LABYRINTH DISORDERS Major 0.8006 National 3.32 9

111 4 VERTIGO & OTHER LABYRINTH DISORDERS Extreme 1.5079 National 6.84 20

113 1 INFECTIONS OF UPPER RESPIRATORY TRACT Minor 0.3645 CO Specific 1.79 4

113 2 INFECTIONS OF UPPER RESPIRATORY TRACT Moderate 0.5044 CO Specific 2.09 5

113 3 INFECTIONS OF UPPER RESPIRATORY TRACT Major 0.7416 CO Specific 2.81 7

113 4 INFECTIONS OF UPPER RESPIRATORY TRACT Extreme 1.7824 National 6.75 20

114 1 DENTAL & ORAL DISEASES & INJURIES Minor 0.5273 CO Specific 1.99 4

114 2 DENTAL & ORAL DISEASES & INJURIES Moderate 0.7252 CO Specific 2.86 7

114 3 DENTAL & ORAL DISEASES & INJURIES Major 1.1497 National 5.16 15

114 4 DENTAL & ORAL DISEASES & INJURIES Extreme 2.5930 National 10.20 30

115 1OTHER EAR, NOSE, MOUTH,THROAT &

CRANIAL/FACIAL DIAGNOSESMinor 0.4931 National 2.16 6


CRANIAL/FACIAL DIAGNOSESModerate 0.7348 CO Specific 2.49 7


CRANIAL/FACIAL DIAGNOSESMajor 1.0161 National 4.45 13

Updated 7/1/2020










CRANIAL/FACIAL DIAGNOSESExtreme 2.2981 National 8.81 25

120 1 MAJOR RESPIRATORY & CHEST PROCEDURES Minor 1.6034 CO Specific 4.48 9

120 2 MAJOR RESPIRATORY & CHEST PROCEDURES Moderate 2.2641 CO Specific 5.81 13

120 3 MAJOR RESPIRATORY & CHEST PROCEDURES Major 3.4982 CO Specific 11.16 28

120 4 MAJOR RESPIRATORY & CHEST PROCEDURES Extreme 6.7357 National 18.91 45

121 1 OTHER RESPIRATORY & CHEST PROCEDURES Minor 1.2877 National 3.25 9

121 2 OTHER RESPIRATORY & CHEST PROCEDURES Moderate 1.6111 CO Specific 5.21 15

121 3 OTHER RESPIRATORY & CHEST PROCEDURES Major 2.6952 CO Specific 9.74 29

121 4 OTHER RESPIRATORY & CHEST PROCEDURES Extreme 6.2505 National 18.11 46

130 1RESPIRATORY SYSTEM DIAGNOSIS W

VENTILATOR SUPPORT 96+ HOURSMinor 3.3629 National 10.87 22


VENTILATOR SUPPORT 96+ HOURSModerate 4.6043 CO Specific 12.38 24


VENTILATOR SUPPORT 96+ HOURSMajor 5.3240 CO Specific 16.62 45


VENTILATOR SUPPORT 96+ HOURSExtreme 6.7266 CO Specific 21.62 62

131 1 CYSTIC FIBROSIS - PULMONARY DISEASE Minor 1.8017 CO Specific 6.65 18

131 2 CYSTIC FIBROSIS - PULMONARY DISEASE Moderate 2.1779 CO Specific 8.94 20

131 3 CYSTIC FIBROSIS - PULMONARY DISEASE Major 2.8822 CO Specific 11.15 24

131 4 CYSTIC FIBROSIS - PULMONARY DISEASE Extreme 4.0550 CO Specific 12.73 33

132 1BPD & OTH CHRONIC RESPIRATORY DISEASES

ARISING IN PERINATAL PERIODMinor 0.4734 National 2.90 8


ARISING IN PERINATAL PERIODModerate 0.6348 CO Specific 2.53 6


ARISING IN PERINATAL PERIODMajor 1.0176 National 5.68 21


ARISING IN PERINATAL PERIODExtreme 2.0316 National 7.99 31

133 1 PULMONARY EDEMA & RESPIRATORY FAILURE Minor 0.6025 National 2.37 7

133 2 PULMONARY EDEMA & RESPIRATORY FAILURE Moderate 0.7939 CO Specific 3.20 9

133 3 PULMONARY EDEMA & RESPIRATORY FAILURE Major 1.2009 CO Specific 4.66 14

133 4 PULMONARY EDEMA & RESPIRATORY FAILURE Extreme 2.3559 CO Specific 7.67 27

134 1 PULMONARY EMBOLISM Minor 0.6248 CO Specific 2.20 6

134 2 PULMONARY EMBOLISM Moderate 0.8074 CO Specific 3.13 8

134 3 PULMONARY EMBOLISM Major 1.0958 CO Specific 4.44 12

134 4 PULMONARY EMBOLISM Extreme 2.0457 CO Specific 7.56 22

Updated 7/1/2020









135 1 MAJOR CHEST & RESPIRATORY TRAUMA Minor 0.7851 CO Specific 2.56 6

135 2 MAJOR CHEST & RESPIRATORY TRAUMA Moderate 1.0045 CO Specific 3.26 9

135 3 MAJOR CHEST & RESPIRATORY TRAUMA Major 1.3774 National 5.46 14

135 4 MAJOR CHEST & RESPIRATORY TRAUMA Extreme 2.5504 National 7.97 23

136 1 RESPIRATORY MALIGNANCY Minor 0.6750 National 2.87 9

136 2 RESPIRATORY MALIGNANCY Moderate 0.8826 National 3.95 11

136 3 RESPIRATORY MALIGNANCY Major 1.4239 National 6.25 18

136 4 RESPIRATORY MALIGNANCY Extreme 2.3399 National 8.93 26

137 1MAJOR RESPIRATORY INFECTIONS &

INFLAMMATIONSMinor 0.7408 National 4.13 12


INFLAMMATIONSModerate 0.8502 CO Specific 3.84 10


INFLAMMATIONSMajor 1.2313 CO Specific 5.15 14


INFLAMMATIONSExtreme 2.3913 CO Specific 8.99 25

138 1 BRONCHIOLITIS & RSV PNEUMONIA Minor 0.4292 CO Specific 2.47 6

138 2 BRONCHIOLITIS & RSV PNEUMONIA Moderate 0.6362 CO Specific 3.08 8

138 3 BRONCHIOLITIS & RSV PNEUMONIA Major 1.1363 CO Specific 4.80 12

138 4 BRONCHIOLITIS & RSV PNEUMONIA Extreme 2.2677 National 8.30 23

139 1 OTHER PNEUMONIA Minor 0.4555 CO Specific 2.19 6

139 2 OTHER PNEUMONIA Moderate 0.6167 CO Specific 2.71 6

139 3 OTHER PNEUMONIA Major 0.9995 CO Specific 4.09 11

139 4 OTHER PNEUMONIA Extreme 1.9406 CO Specific 6.74 18

140 1 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Minor 0.5343 CO Specific 2.39 6

140 2 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Moderate 0.6574 CO Specific 2.90 7

140 3 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Major 0.8266 CO Specific 3.56 9

140 4 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Extreme 2.0086 National 8.39 22

141 1 ASTHMA Minor 0.4818 CO Specific 1.86 4

141 2 ASTHMA Moderate 0.6358 CO Specific 2.25 6

141 3 ASTHMA Major 0.9168 CO Specific 3.20 8

141 4 ASTHMA Extreme 1.5946 National 5.21 14

142 1 INTERSTITIAL & ALVEOLAR LUNG DISEASES Minor 0.7021 National 3.10 9

142 2 INTERSTITIAL & ALVEOLAR LUNG DISEASES Moderate 0.8427 National 3.98 11

142 3 INTERSTITIAL & ALVEOLAR LUNG DISEASES Major 1.2345 National 5.89 16

142 4 INTERSTITIAL & ALVEOLAR LUNG DISEASES Extreme 2.4269 National 9.97 26

143 1OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS,

SYMPTOMS & MINOR DIAGNOSESMinor 0.5473 CO Specific 2.46 6

Updated 7/1/2020










SYMPTOMS & MINOR DIAGNOSESModerate 0.7403 CO Specific 3.03 9


SYMPTOMS & MINOR DIAGNOSESMajor 1.0143 CO Specific 4.04 13


SYMPTOMS & MINOR DIAGNOSESExtreme 2.1533 National 7.68 25

144 1RESPIRATORY SIGNS, SYMPTOMS & MINOR

DIAGNOSESMinor 0.4872 CO Specific 1.96 4


DIAGNOSESModerate 0.5574 CO Specific 2.21 6


DIAGNOSESMajor 0.8841 National 3.99 11


DIAGNOSESExtreme 1.6859 National 6.78 22

160 1MAJOR CARDIOTHORACIC REPAIR OF HEART

ANOMALYMinor 3.2069 National 4.63 10


ANOMALYModerate 4.4350 CO Specific 5.94 11


ANOMALYMajor 5.8042 CO Specific 8.89 25


ANOMALYExtreme 11.7235 National 22.69 66

161 1CARDIAC DEFIBRILLATOR & HEART ASSIST

IMPLANTMinor 3.6715 CO Specific 3.46 10


IMPLANTModerate 4.4843 CO Specific 8.06 22


IMPLANTMajor 7.9290 CO Specific 15.73 40


IMPLANTExtreme 23.9046 National 30.04 68

162 1CARDIAC VALVE PROCEDURES W CARDIAC

CATHETERIZATIONMinor 4.6230 National 7.87 16


CATHETERIZATIONModerate 5.3526 National 9.01 18


CATHETERIZATIONMajor 6.3844 CO Specific 13.84 33


CATHETERIZATIONExtreme 11.5739 National 20.97 46

Updated 7/1/2020









163 1CARDIAC VALVE PROCEDURES W/O CARDIAC

CATHETERIZATIONMinor 3.5767 CO Specific 5.33 9


CATHETERIZATIONModerate 4.0493 CO Specific 6.21 12


CATHETERIZATIONMajor 4.8081 CO Specific 7.12 15


CATHETERIZATIONExtreme 10.7707 National 17.94 45

165 1CORONARY BYPASS W CARDIAC CATH OR

PERCUTANEOUS CARDIAC PROCEDUREMinor 3.8109 National 6.63 12


PERCUTANEOUS CARDIAC PROCEDUREModerate 4.3958 CO Specific 8.78 16


PERCUTANEOUS CARDIAC PROCEDUREMajor 5.1126 CO Specific 10.86 23


PERCUTANEOUS CARDIAC PROCEDUREExtreme 6.4221 CO Specific 14.21 32

166 1CORONARY BYPASS W/O CARDIAC CATH OR

PERCUTANEOUS CARDIAC PROCEDUREMinor 2.8619 CO Specific 5.27 7


PERCUTANEOUS CARDIAC PROCEDUREModerate 3.3031 CO Specific 6.24 13


PERCUTANEOUS CARDIAC PROCEDUREMajor 4.3506 CO Specific 7.70 16


PERCUTANEOUS CARDIAC PROCEDUREExtreme 7.6004 CO Specific 15.40 37

167 1 OTHER CARDIOTHORACIC PROCEDURES Minor 2.6697 CO Specific 3.81 7

167 2 OTHER CARDIOTHORACIC PROCEDURES Moderate 3.5820 National 5.54 13

167 3 OTHER CARDIOTHORACIC PROCEDURES Major 3.8240 CO Specific 6.10 15

167 4 OTHER CARDIOTHORACIC PROCEDURES Extreme 8.9018 National 17.23 46

169 1MAJOR THORACIC & ABDOMINAL VASCULAR

PROCEDURESMinor 1.8371 National 4.18 10







170 1PERMANENT CARDIAC PACEMAKER IMPLANT W

AMI, HEART FAILURE OR SHOCKMinor 2.4661 National 4.06 12

Updated 7/1/2020










AMI, HEART FAILURE OR SHOCKModerate 2.5701 National 5.03 14


AMI, HEART FAILURE OR SHOCKMajor 3.1839 National 8.67 20


AMI, HEART FAILURE OR SHOCKExtreme 5.3462 National 15.44 35

171 1PERM CARDIAC PACEMAKER IMPLANT W/O AMI,

HEART FAILURE OR SHOCKMinor 1.7030 CO Specific 2.56 6


HEART FAILURE OR SHOCKModerate 1.7141 CO Specific 3.32 8


HEART FAILURE OR SHOCKMajor 2.6197 National 6.22 16


HEART FAILURE OR SHOCKExtreme 4.8978 National 12.56 33

173 1 OTHER VASCULAR PROCEDURES Minor 1.8096 CO Specific 2.87 8

173 2 OTHER VASCULAR PROCEDURES Moderate 2.2462 CO Specific 4.03 11

173 3 OTHER VASCULAR PROCEDURES Major 3.0336 CO Specific 7.17 23

173 4 OTHER VASCULAR PROCEDURES Extreme 5.6836 CO Specific 16.30 49

174 1PERCUTANEOUS CARDIOVASCULAR PROCEDURES

W AMIMinor 1.7578 CO Specific 2.01 5


W AMIModerate 1.8193 CO Specific 2.36 5


W AMIMajor 2.2973 CO Specific 3.71 8


W AMIExtreme 4.2554 CO Specific 8.21 22


W/O AMIMinor 1.7101 CO Specific 1.89 5


W/O AMIModerate 1.9339 CO Specific 2.33 6


W/O AMIMajor 2.4206 CO Specific 5.16 15


W/O AMIExtreme 4.9962 National 9.68 28

176 1CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE

REPLACEMENTMinor 1.5182 National 2.76 8


REPLACEMENTModerate 2.9286 National 2.32 8

Updated 7/1/2020










REPLACEMENTMajor 3.2363 National 4.15 13


REPLACEMENTExtreme 5.7625 National 12.48 36

177 1CARDIAC PACEMAKER & DEFIBRILLATOR

REVISION EXCEPT DEVICE REPLACEMENTMinor 1.2742 National 2.40 7


REVISION EXCEPT DEVICE REPLACEMENTModerate 1.6346 National 3.85 11


REVISION EXCEPT DEVICE REPLACEMENTMajor 2.5678 National 7.16 20


REVISION EXCEPT DEVICE REPLACEMENTExtreme 5.2600 National 15.49 40

180 1 OTHER CIRCULATORY SYSTEM PROCEDURES Minor 1.2364 National 3.80 12

180 2 OTHER CIRCULATORY SYSTEM PROCEDURES Moderate 1.6783 National 5.51 16

180 3 OTHER CIRCULATORY SYSTEM PROCEDURES Major 2.6214 National 9.14 23

180 4 OTHER CIRCULATORY SYSTEM PROCEDURES Extreme 5.1654 National 15.45 40

190 1 ACUTE MYOCARDIAL INFARCTION Minor 0.7953 CO Specific 1.95 4

190 2 ACUTE MYOCARDIAL INFARCTION Moderate 0.9615 CO Specific 2.66 6

190 3 ACUTE MYOCARDIAL INFARCTION Major 1.0689 CO Specific 3.50 9

190 4 ACUTE MYOCARDIAL INFARCTION Extreme 2.6008 National 8.27 23

191 1CARDIAC CATHETERIZATION W CIRC DISORD EXC

ISCHEMIC HEART DISEASEMinor 0.9331 CO Specific 2.35 6


ISCHEMIC HEART DISEASEModerate 1.1687 CO Specific 2.87 7


ISCHEMIC HEART DISEASEMajor 1.5680 CO Specific 5.08 13


ISCHEMIC HEART DISEASEExtreme 3.9827 National 11.62 31

192 1CARDIAC CATHETERIZATION FOR ISCHEMIC

HEART DISEASEMinor 0.7752 CO Specific 1.45 3


HEART DISEASEModerate 0.9060 CO Specific 2.04 5


HEART DISEASEMajor 1.0977 CO Specific 2.61 7


HEART DISEASEExtreme 3.0235 National 8.62 23

193 1 ACUTE & SUBACUTE ENDOCARDITIS Minor 0.9799 National 4.92 15

193 2 ACUTE & SUBACUTE ENDOCARDITIS Moderate 1.2283 National 6.52 21

Updated 7/1/2020









193 3 ACUTE & SUBACUTE ENDOCARDITIS Major 2.0119 National 9.55 28

193 4 ACUTE & SUBACUTE ENDOCARDITIS Extreme 3.5017 National 14.42 40

194 1 HEART FAILURE Minor 0.6066 CO Specific 2.67 6

194 2 HEART FAILURE Moderate 0.7069 CO Specific 3.26 8

194 3 HEART FAILURE Major 1.0105 CO Specific 4.86 13

194 4 HEART FAILURE Extreme 1.9909 CO Specific 8.39 24

196 1 CARDIAC ARREST Minor 0.4218 National 1.55 5

196 2 CARDIAC ARREST Moderate 0.5556 National 2.16 7

196 3 CARDIAC ARREST Major 0.8564 National 2.24 9

196 4 CARDIAC ARREST Extreme 1.9889 National 4.46 17

197 1 PERIPHERAL & OTHER VASCULAR DISORDERS Minor 0.5291 National 3.07 8

197 2 PERIPHERAL & OTHER VASCULAR DISORDERS Moderate 0.7649 CO Specific 3.19 9

197 3 PERIPHERAL & OTHER VASCULAR DISORDERS Major 0.9440 CO Specific 3.93 11

197 4 PERIPHERAL & OTHER VASCULAR DISORDERS Extreme 2.5971 National 9.74 28

198 1ANGINA PECTORIS & CORONARY

ATHEROSCLEROSISMinor 0.4537 CO Specific 1.47 3


ATHEROSCLEROSISModerate 0.4886 CO Specific 1.59 4


ATHEROSCLEROSISMajor 0.6814 CO Specific 2.31 6


ATHEROSCLEROSISExtreme 1.8583 National 6.93 22

199 1 HYPERTENSION Minor 0.5183 CO Specific 1.65 4

199 2 HYPERTENSION Moderate 0.6741 CO Specific 2.40 6

199 3 HYPERTENSION Major 0.9091 CO Specific 3.29 8

199 4 HYPERTENSION Extreme 1.9951 National 7.44 21

200 1 CARDIAC STRUCTURAL & VALVULAR DISORDERS Minor 0.5896 National 2.23 7

200 2 CARDIAC STRUCTURAL & VALVULAR DISORDERS Moderate 0.6830 National 2.95 8

200 3 CARDIAC STRUCTURAL & VALVULAR DISORDERS Major 1.0120 National 4.75 14

200 4 CARDIAC STRUCTURAL & VALVULAR DISORDERS Extreme 2.5715 National 9.43 34

201 1CARDIAC ARRHYTHMIA & CONDUCTION








Updated 7/1/2020









203 1 CHEST PAIN Minor 0.4515 CO Specific 1.37 3

203 2 CHEST PAIN Moderate 0.5447 CO Specific 1.74 4

203 3 CHEST PAIN Major 0.7254 CO Specific 2.67 8

203 4 CHEST PAIN Extreme 1.7582 National 6.82 23

204 1 SYNCOPE & COLLAPSE Minor 0.4560 CO Specific 1.47 3

204 2 SYNCOPE & COLLAPSE Moderate 0.5910 CO Specific 2.09 6

204 3 SYNCOPE & COLLAPSE Major 0.7076 CO Specific 3.15 10

204 4 SYNCOPE & COLLAPSE Extreme 1.8974 National 8.12 25

205 1 CARDIOMYOPATHY Minor 0.5037 National 2.13 6

205 2 CARDIOMYOPATHY Moderate 0.6643 National 2.82 8

205 3 CARDIOMYOPATHY Major 1.0189 National 4.56 14

205 4 CARDIOMYOPATHY Extreme 2.8744 National 9.70 26

206 1MALFUNCTION,REACTION,COMPLICATION OF

CARDIAC/VASC DEVICE OR PROCEDUREMinor 0.5855 National 2.06 6


CARDIAC/VASC DEVICE OR PROCEDUREModerate 0.7337 National 3.17 9


CARDIAC/VASC DEVICE OR PROCEDUREMajor 1.2167 National 5.15 15


CARDIAC/VASC DEVICE OR PROCEDUREExtreme 2.8177 National 10.67 30

207 1 OTHER CIRCULATORY SYSTEM DIAGNOSES Minor 0.5737 CO Specific 1.84 4

207 2 OTHER CIRCULATORY SYSTEM DIAGNOSES Moderate 0.7192 CO Specific 2.47 6

207 3 OTHER CIRCULATORY SYSTEM DIAGNOSES Major 0.9721 CO Specific 3.68 10

207 4 OTHER CIRCULATORY SYSTEM DIAGNOSES Extreme 2.2014 National 7.84 23

220 1MAJOR STOMACH, ESOPHAGEAL & DUODENAL





PROCEDURESMajor 3.0366 CO Specific 9.32 23



221 1 MAJOR SMALL & LARGE BOWEL PROCEDURES Minor 1.4670 CO Specific 4.65 9

221 2 MAJOR SMALL & LARGE BOWEL PROCEDURES Moderate 1.8654 CO Specific 6.58 15

221 3 MAJOR SMALL & LARGE BOWEL PROCEDURES Major 2.8491 CO Specific 10.74 27

221 4 MAJOR SMALL & LARGE BOWEL PROCEDURES Extreme 5.9768 CO Specific 18.90 45

222 1OTHER STOMACH, ESOPHAGEAL & DUODENAL


Updated 7/1/2020















223 1 OTHER SMALL & LARGE BOWEL PROCEDURES Minor 1.0738 CO Specific 4.11 10

223 2 OTHER SMALL & LARGE BOWEL PROCEDURES Moderate 1.5270 CO Specific 6.05 15

223 3 OTHER SMALL & LARGE BOWEL PROCEDURES Major 2.7244 National 10.53 26

223 4 OTHER SMALL & LARGE BOWEL PROCEDURES Extreme 5.9227 National 18.61 47

224 1 PERITONEAL ADHESIOLYSIS Minor 1.2044 CO Specific 4.52 12

224 2 PERITONEAL ADHESIOLYSIS Moderate 1.4952 CO Specific 5.56 13

224 3 PERITONEAL ADHESIOLYSIS Major 2.3746 CO Specific 9.93 25

224 4 PERITONEAL ADHESIOLYSIS Extreme 5.1358 National 17.29 41

225 1 APPENDECTOMY Minor 0.6908 CO Specific 1.34 3

225 2 APPENDECTOMY Moderate 1.2059 CO Specific 3.76 9

225 3 APPENDECTOMY Major 1.8978 CO Specific 6.40 17

225 4 APPENDECTOMY Extreme 4.2098 National 12.90 32

226 1 ANAL PROCEDURES Minor 0.7025 CO Specific 2.44 7

226 2 ANAL PROCEDURES Moderate 0.9688 National 3.83 11

226 3 ANAL PROCEDURES Major 1.6594 National 6.86 19

226 4 ANAL PROCEDURES Extreme 3.3772 National 12.62 33

227 1HERNIA PROCEDURES EXCEPT INGUINAL,

FEMORAL & UMBILICALMinor 1.0394 CO Specific 3.11 8


FEMORAL & UMBILICALModerate 1.2994 CO Specific 3.94 9


FEMORAL & UMBILICALMajor 2.4132 National 7.70 19


FEMORAL & UMBILICALExtreme 5.0875 National 14.59 36

228 1INGUINAL, FEMORAL & UMBILICAL HERNIA








Updated 7/1/2020









229 1OTHER DIGESTIVE SYSTEM & ABDOMINAL








240 1 DIGESTIVE MALIGNANCY Minor 0.7540 National 3.20 9

240 2 DIGESTIVE MALIGNANCY Moderate 0.8879 National 3.97 11

240 3 DIGESTIVE MALIGNANCY Major 1.0849 CO Specific 5.11 15

240 4 DIGESTIVE MALIGNANCY Extreme 2.8717 National 11.51 32

241 1 PEPTIC ULCER & GASTRITIS Minor 0.5680 CO Specific 2.13 5

241 2 PEPTIC ULCER & GASTRITIS Moderate 0.6774 CO Specific 2.57 6

241 3 PEPTIC ULCER & GASTRITIS Major 1.0138 CO Specific 3.71 9

241 4 PEPTIC ULCER & GASTRITIS Extreme 2.8813 National 9.83 27

242 1 MAJOR ESOPHAGEAL DISORDERS Minor 0.5704 National 2.18 6

242 2 MAJOR ESOPHAGEAL DISORDERS Moderate 0.6501 CO Specific 2.26 6

242 3 MAJOR ESOPHAGEAL DISORDERS Major 0.9374 CO Specific 3.44 9

242 4 MAJOR ESOPHAGEAL DISORDERS Extreme 2.9652 National 9.71 26

243 1 OTHER ESOPHAGEAL DISORDERS Minor 0.4426 CO Specific 1.69 4

243 2 OTHER ESOPHAGEAL DISORDERS Moderate 0.7024 CO Specific 2.80 7

243 3 OTHER ESOPHAGEAL DISORDERS Major 0.9028 CO Specific 3.49 10

243 4 OTHER ESOPHAGEAL DISORDERS Extreme 2.4420 National 9.66 27

244 1 DIVERTICULITIS & DIVERTICULOSIS Minor 0.6218 CO Specific 2.84 6

244 2 DIVERTICULITIS & DIVERTICULOSIS Moderate 0.6879 CO Specific 3.15 8

244 3 DIVERTICULITIS & DIVERTICULOSIS Major 0.8165 CO Specific 3.98 10

244 4 DIVERTICULITIS & DIVERTICULOSIS Extreme 2.5380 National 10.10 25

245 1 INFLAMMATORY BOWEL DISEASE Minor 0.6642 CO Specific 2.91 6

245 2 INFLAMMATORY BOWEL DISEASE Moderate 0.7816 CO Specific 3.65 10

245 3 INFLAMMATORY BOWEL DISEASE Major 1.0941 CO Specific 4.81 12

245 4 INFLAMMATORY BOWEL DISEASE Extreme 2.3548 National 11.43 31

246 1 GASTROINTESTINAL VASCULAR INSUFFICIENCY Minor 0.6859 National 3.02 7

246 2 GASTROINTESTINAL VASCULAR INSUFFICIENCY Moderate 0.8197 CO Specific 3.66 8

246 3 GASTROINTESTINAL VASCULAR INSUFFICIENCY Major 1.2539 National 5.70 15

246 4 GASTROINTESTINAL VASCULAR INSUFFICIENCY Extreme 2.8148 National 10.58 29

247 1 INTESTINAL OBSTRUCTION Minor 0.5319 CO Specific 2.42 6

247 2 INTESTINAL OBSTRUCTION Moderate 0.6573 CO Specific 3.07 8

Updated 7/1/2020









247 3 INTESTINAL OBSTRUCTION Major 0.9309 CO Specific 4.51 11

247 4 INTESTINAL OBSTRUCTION Extreme 2.5720 National 10.68 29

248 1MAJOR GASTROINTESTINAL & PERITONEAL

INFECTIONSMinor 0.5760 CO Specific 2.66 6


INFECTIONSModerate 0.7895 CO Specific 3.85 9


INFECTIONSMajor 1.0653 CO Specific 5.10 13


INFECTIONSExtreme 2.7243 National 11.71 32

249 1NON-BACTERIAL GASTROENTERITIS, NAUSEA &

VOMITINGMinor 0.4350 CO Specific 1.90 4


VOMITINGModerate 0.5676 CO Specific 2.37 6


VOMITINGMajor 0.7678 CO Specific 3.35 9


VOMITINGExtreme 2.0925 National 8.84 26

251 1 ABDOMINAL PAIN Minor 0.5631 CO Specific 2.10 6

251 2 ABDOMINAL PAIN Moderate 0.6479 CO Specific 2.62 6

251 3 ABDOMINAL PAIN Major 0.7896 CO Specific 3.33 9

251 4 ABDOMINAL PAIN Extreme 1.9298 National 7.36 24

252 1MALFUNCTION, REACTION & COMPLICATION OF

GI DEVICE OR PROCEDUREMinor 0.5926 CO Specific 2.52 7


GI DEVICE OR PROCEDUREModerate 0.6899 CO Specific 2.90 7


GI DEVICE OR PROCEDUREMajor 1.0842 CO Specific 4.85 13


GI DEVICE OR PROCEDUREExtreme 2.8699 National 11.09 33

253 1OTHER & UNSPECIFIED GASTROINTESTINAL

HEMORRHAGEMinor 0.5556 CO Specific 1.87 4


HEMORRHAGEModerate 0.6406 CO Specific 2.30 6


HEMORRHAGEMajor 0.9245 CO Specific 3.51 10


HEMORRHAGEExtreme 2.5256 National 8.92 24

Updated 7/1/2020









254 1 OTHER DIGESTIVE SYSTEM DIAGNOSES Minor 0.5599 CO Specific 2.43 6

254 2 OTHER DIGESTIVE SYSTEM DIAGNOSES Moderate 0.6973 CO Specific 3.17 9

254 3 OTHER DIGESTIVE SYSTEM DIAGNOSES Major 0.9506 CO Specific 4.08 12

254 4 OTHER DIGESTIVE SYSTEM DIAGNOSES Extreme 2.4767 National 9.55 30

260 1 MAJOR PANCREAS, LIVER & SHUNT PROCEDURES Minor 1.8429 National 4.51 12

260 2 MAJOR PANCREAS, LIVER & SHUNT PROCEDURES Moderate 2.1866 CO Specific 6.60 15

260 3 MAJOR PANCREAS, LIVER & SHUNT PROCEDURES Major 3.7253 National 10.49 26

260 4 MAJOR PANCREAS, LIVER & SHUNT PROCEDURES Extreme 8.5761 National 21.13 58

261 1 MAJOR BILIARY TRACT PROCEDURES Minor 1.4034 National 4.40 11

261 2 MAJOR BILIARY TRACT PROCEDURES Moderate 2.0348 National 6.73 16

261 3 MAJOR BILIARY TRACT PROCEDURES Major 3.0256 National 10.86 27

261 4 MAJOR BILIARY TRACT PROCEDURES Extreme 6.1295 National 18.69 44

262 1 CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC Minor 1.2381 CO Specific 4.00 10

262 2 CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC Moderate 1.5738 CO Specific 5.58 12

262 3 CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC Major 2.1370 CO Specific 7.46 17

262 4 CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC Extreme 5.4894 National 16.43 41

263 1 LAPAROSCOPIC CHOLECYSTECTOMY Minor 0.8168 CO Specific 1.86 4

263 2 LAPAROSCOPIC CHOLECYSTECTOMY Moderate 1.0328 CO Specific 2.82 6

263 3 LAPAROSCOPIC CHOLECYSTECTOMY Major 1.5068 CO Specific 4.96 12

263 4 LAPAROSCOPIC CHOLECYSTECTOMY Extreme 4.2052 National 13.08 32

264 1OTHER HEPATOBILIARY, PANCREAS &

ABDOMINAL PROCEDURESMinor 1.5182 National 4.13 12


ABDOMINAL PROCEDURESModerate 1.6677 National 5.09 15


ABDOMINAL PROCEDURESMajor 2.8448 National 9.92 28


ABDOMINAL PROCEDURESExtreme 7.0084 National 21.01 57

279 1HEPATIC COMA & OTHER MAJOR ACUTE LIVER

DISORDERSMinor 0.5483 National 2.63 7






DISORDERSExtreme 2.7422 CO Specific 11.60 34

280 1 ALCOHOLIC LIVER DISEASE Minor 0.5880 National 2.67 8

280 2 ALCOHOLIC LIVER DISEASE Moderate 0.6514 CO Specific 2.88 7

Updated 7/1/2020









280 3 ALCOHOLIC LIVER DISEASE Major 1.0052 CO Specific 4.65 13

280 4 ALCOHOLIC LIVER DISEASE Extreme 2.2363 CO Specific 9.71 29

281 1MALIGNANCY OF HEPATOBILIARY SYSTEM &

PANCREASMinor 0.7488 National 2.96 9


PANCREASModerate 0.9514 National 3.96 11


PANCREASMajor 1.2307 CO Specific 5.36 14


PANCREASExtreme 2.4825 National 9.15 26

282 1 DISORDERS OF PANCREAS EXCEPT MALIGNANCY Minor 0.5900 CO Specific 2.79 6

282 2 DISORDERS OF PANCREAS EXCEPT MALIGNANCY Moderate 0.7046 CO Specific 3.33 8

282 3 DISORDERS OF PANCREAS EXCEPT MALIGNANCY Major 1.0583 CO Specific 5.05 13

282 4 DISORDERS OF PANCREAS EXCEPT MALIGNANCY Extreme 3.6917 National 13.48 37

283 1 OTHER DISORDERS OF THE LIVER Minor 0.5962 National 2.69 8

283 2 OTHER DISORDERS OF THE LIVER Moderate 0.6774 CO Specific 2.76 6

283 3 OTHER DISORDERS OF THE LIVER Major 0.9422 CO Specific 3.93 10

283 4 OTHER DISORDERS OF THE LIVER Extreme 2.5985 National 8.59 26

284 1 DISORDERS OF GALLBLADDER & BILIARY TRACT Minor 0.5399 CO Specific 1.89 4

284 2 DISORDERS OF GALLBLADDER & BILIARY TRACT Moderate 0.7301 CO Specific 2.64 6

284 3 DISORDERS OF GALLBLADDER & BILIARY TRACT Major 0.9520 CO Specific 3.81 9

284 4 DISORDERS OF GALLBLADDER & BILIARY TRACT Extreme 2.8102 National 10.17 28

301 1 HIP JOINT REPLACEMENT Minor 1.5324 CO Specific 2.66 6

301 2 HIP JOINT REPLACEMENT Moderate 1.5799 CO Specific 3.09 8

301 3 HIP JOINT REPLACEMENT Major 2.0020 CO Specific 4.40 12

301 4 HIP JOINT REPLACEMENT Extreme 4.4733 National 12.50 30

302 1 KNEE JOINT REPLACEMENT Minor 1.4564 CO Specific 2.50 5

302 2 KNEE JOINT REPLACEMENT Moderate 1.6523 CO Specific 2.95 5

302 3 KNEE JOINT REPLACEMENT Major 2.1685 CO Specific 4.21 11

302 4 KNEE JOINT REPLACEMENT Extreme 4.3574 CO Specific 12.35 31

303 1DORSAL & LUMBAR FUSION PROC FOR

CURVATURE OF BACKMinor 4.7961 CO Specific 4.25 8


CURVATURE OF BACKModerate 5.2130 CO Specific 5.26 10


CURVATURE OF BACKMajor 6.0059 CO Specific 5.74 14


CURVATURE OF BACKExtreme 11.9113 National 15.46 43

Updated 7/1/2020









304 1DORSAL & LUMBAR FUSION PROC EXCEPT FOR

CURVATURE OF BACKMinor 2.3040 CO Specific 3.03 7


CURVATURE OF BACKModerate 2.9670 CO Specific 4.30 10


CURVATURE OF BACKMajor 4.0917 CO Specific 7.14 19


CURVATURE OF BACKExtreme 9.9628 National 17.05 44

305 1 AMPUTATION OF LOWER LIMB EXCEPT TOES Minor 1.1353 National 5.08 14

305 2 AMPUTATION OF LOWER LIMB EXCEPT TOES Moderate 1.6217 CO Specific 7.49 21

305 3 AMPUTATION OF LOWER LIMB EXCEPT TOES Major 2.4164 CO Specific 11.10 29

305 4 AMPUTATION OF LOWER LIMB EXCEPT TOES Extreme 5.4270 National 18.88 49

308 1HIP & FEMUR PROCEDURES FOR TRAUMA

EXCEPT JOINT REPLACEMENTMinor 1.2516 CO Specific 3.15 8


EXCEPT JOINT REPLACEMENTModerate 1.5975 CO Specific 4.42 12


EXCEPT JOINT REPLACEMENTMajor 2.3513 CO Specific 7.33 20


EXCEPT JOINT REPLACEMENTExtreme 4.2440 National 12.29 30

309 1HIP & FEMUR PROCEDURES FOR NON-TRAUMA

EXCEPT JOINT REPLACEMENTMinor 1.6186 CO Specific 2.51 5


EXCEPT JOINT REPLACEMENTModerate 1.9717 CO Specific 3.48 8


EXCEPT JOINT REPLACEMENTMajor 2.3646 CO Specific 5.20 15


EXCEPT JOINT REPLACEMENTExtreme 5.3232 National 17.46 52

310 1INTERVERTEBRAL DISC EXCISION &

DECOMPRESSIONMinor 0.8882 CO Specific 2.08 6


DECOMPRESSIONModerate 1.3012 CO Specific 3.87 11


DECOMPRESSIONMajor 1.9161 National 5.86 15


DECOMPRESSIONExtreme 5.1528 National 15.31 42

Updated 7/1/2020









312 1

SKIN GRAFT, EXCEPT HAND, FOR

MUSCULOSKELETAL & CONNECTIVE TISSUE

DIAGNOSES


312 2



DIAGNOSES


312 3



DIAGNOSES


312 4



DIAGNOSES


313 1 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT Minor 1.1634 CO Specific 2.37 6

313 2 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT Moderate 1.5771 CO Specific 3.53 10

313 3 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT Major 2.3631 CO Specific 7.29 23

313 4 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT Extreme 5.4486 National 16.04 44

314 1 FOOT & TOE PROCEDURES Minor 1.0920 CO Specific 1.77 4

314 2 FOOT & TOE PROCEDURES Moderate 1.2104 CO Specific 4.52 11

314 3 FOOT & TOE PROCEDURES Major 1.5949 CO Specific 6.82 18

314 4 FOOT & TOE PROCEDURES Extreme 4.1519 National 14.60 37

315 1SHOULDER, UPPER ARM & FOREARM








316 1 HAND & WRIST PROCEDURES Minor 0.7816 CO Specific 2.38 6

316 2 HAND & WRIST PROCEDURES Moderate 1.0756 CO Specific 3.52 8

316 3 HAND & WRIST PROCEDURES Major 2.0709 National 6.72 19

316 4 HAND & WRIST PROCEDURES Extreme 4.2982 National 13.97 39

317 1TENDON, MUSCLE & OTHER SOFT TISSUE






Updated 7/1/2020











320 1OTHER MUSCULOSKELETAL SYSTEM &

CONNECTIVE TISSUE PROCEDURESMinor 1.0382 CO Specific 2.28 6


CONNECTIVE TISSUE PROCEDURESModerate 1.3560 CO Specific 3.92 10


CONNECTIVE TISSUE PROCEDURESMajor 2.5147 National 8.24 23


CONNECTIVE TISSUE PROCEDURESExtreme 5.1236 National 16.67 44

321 1CERVICAL SPINAL FUSION & OTHER BACK/NECK

PROC EXC DISC EXCIS/DECOMPMinor 1.4857 CO Specific 1.87 5


PROC EXC DISC EXCIS/DECOMPModerate 1.9789 CO Specific 3.34 11


PROC EXC DISC EXCIS/DECOMPMajor 2.9353 CO Specific 7.38 26


PROC EXC DISC EXCIS/DECOMPExtreme 8.1410 National 17.29 44

340 1 FRACTURE OF FEMUR Minor 0.4517 National 2.66 8

340 2 FRACTURE OF FEMUR Moderate 0.5726 National 3.18 10

340 3 FRACTURE OF FEMUR Major 0.8901 National 4.70 14

340 4 FRACTURE OF FEMUR Extreme 1.8382 National 6.61 21

341 1 FRACTURE OF PELVIS OR DISLOCATION OF HIP Minor 0.5093 National 2.85 7

341 2 FRACTURE OF PELVIS OR DISLOCATION OF HIP Moderate 0.6059 National 3.48 8

341 3 FRACTURE OF PELVIS OR DISLOCATION OF HIP Major 0.8618 National 4.53 12

341 4 FRACTURE OF PELVIS OR DISLOCATION OF HIP Extreme 2.5393 National 9.76 25

342 1FRACTURES & DISLOCATIONS EXCEPT FEMUR,

PELVIS & BACKMinor 0.5755 CO Specific 2.03 6


PELVIS & BACKModerate 0.8151 CO Specific 3.18 11


PELVIS & BACKMajor 1.0339 CO Specific 5.07 15


PELVIS & BACKExtreme 2.6189 National 10.51 29

343 1MUSCULOSKELETAL MALIGNANCY & PATHOL

FRACTURE D/T MUSCSKEL MALIGMinor 0.7790 National 3.45 10


FRACTURE D/T MUSCSKEL MALIGModerate 0.9642 National 4.33 12

Updated 7/1/2020










FRACTURE D/T MUSCSKEL MALIGMajor 1.5616 National 7.11 20


FRACTURE D/T MUSCSKEL MALIGExtreme 2.9336 National 12.36 34

344 1OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER

MUSCULOSKELETAL INFECTIONSMinor 0.7317 National 4.08 12


MUSCULOSKELETAL INFECTIONSModerate 0.9559 CO Specific 4.31 11


MUSCULOSKELETAL INFECTIONSMajor 1.6421 National 9.27 28


MUSCULOSKELETAL INFECTIONSExtreme 3.1516 National 16.36 48

346 1 CONNECTIVE TISSUE DISORDERS Minor 0.8433 CO Specific 2.64 6

346 2 CONNECTIVE TISSUE DISORDERS Moderate 0.8786 CO Specific 3.45 9

346 3 CONNECTIVE TISSUE DISORDERS Major 1.5566 National 6.80 19

346 4 CONNECTIVE TISSUE DISORDERS Extreme 4.5379 National 14.96 43

347 1OTHER BACK & NECK DISORDERS, FRACTURES &

INJURIESMinor 0.6261 CO Specific 2.39 6


INJURIESModerate 0.8012 CO Specific 3.38 10


INJURIESMajor 1.2310 CO Specific 4.98 17


INJURIESExtreme 2.9123 National 11.45 30

349 1MALFUNCTION, REACTION, COMPLIC OF

ORTHOPEDIC DEVICE OR PROCEDUREMinor 0.5001 National 2.09 6


ORTHOPEDIC DEVICE OR PROCEDUREModerate 0.7624 National 3.95 12


ORTHOPEDIC DEVICE OR PROCEDUREMajor 1.2812 National 6.42 19


ORTHOPEDIC DEVICE OR PROCEDUREExtreme 2.8325 National 12.66 37


CONNECTIVE TISSUE DIAGNOSESMinor 0.5987 CO Specific 2.10 6


CONNECTIVE TISSUE DIAGNOSESModerate 0.6929 CO Specific 3.08 9


CONNECTIVE TISSUE DIAGNOSESMajor 0.9855 CO Specific 4.67 15

Updated 7/1/2020










CONNECTIVE TISSUE DIAGNOSESExtreme 2.4894 National 10.72 30

361 1SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE

DIAGNOSESMinor 1.3597 National 3.66 13


DIAGNOSESModerate 1.8345 National 6.74 22





362 1 MASTECTOMY PROCEDURES Minor 1.4469 CO Specific 1.67 4

362 2 MASTECTOMY PROCEDURES Moderate 1.4750 CO Specific 1.94 4

362 3 MASTECTOMY PROCEDURES Major 2.1977 National 5.49 16

362 4 MASTECTOMY PROCEDURES Extreme 5.5277 National 12.96 33

363 1 BREAST PROCEDURES EXCEPT MASTECTOMY Minor 1.0464 National 1.88 6

363 2 BREAST PROCEDURES EXCEPT MASTECTOMY Moderate 1.8009 National 3.02 7

363 3 BREAST PROCEDURES EXCEPT MASTECTOMY Major 2.1964 National 4.80 13

363 4 BREAST PROCEDURES EXCEPT MASTECTOMY Extreme 4.8629 National 17.06 49

364 1OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED








380 1 SKIN ULCERS Minor 0.5989 National 3.68 10

380 2 SKIN ULCERS Moderate 0.7195 National 4.40 12

380 3 SKIN ULCERS Major 1.1090 National 6.51 19

380 4 SKIN ULCERS Extreme 2.5600 National 14.42 44

381 1 MAJOR SKIN DISORDERS Minor 0.4843 National 2.80 8

381 2 MAJOR SKIN DISORDERS Moderate 0.6978 National 3.94 11

381 3 MAJOR SKIN DISORDERS Major 1.2660 National 6.23 17

381 4 MAJOR SKIN DISORDERS Extreme 4.6220 National 13.15 37

382 1 MALIGNANT BREAST DISORDERS Minor 0.5378 National 2.45 8

382 2 MALIGNANT BREAST DISORDERS Moderate 0.7505 National 3.87 12

382 3 MALIGNANT BREAST DISORDERS Major 1.2583 National 5.94 18

382 4 MALIGNANT BREAST DISORDERS Extreme 2.3832 National 9.23 28

Updated 7/1/2020









383 1 CELLULITIS & OTHER BACTERIAL SKIN INFECTIONS Minor 0.5153 CO Specific 2.42 6

383 2 CELLULITIS & OTHER BACTERIAL SKIN INFECTIONS Moderate 0.6531 CO Specific 3.16 8

383 3 CELLULITIS & OTHER BACTERIAL SKIN INFECTIONS Major 1.0405 CO Specific 5.25 16

383 4 CELLULITIS & OTHER BACTERIAL SKIN INFECTIONS Extreme 2.5632 National 11.28 31

384 1CONTUSION, OPEN WOUND & OTHER TRAUMA

TO SKIN & SUBCUTANEOUS TISSUEMinor 0.5868 CO Specific 1.88 4


TO SKIN & SUBCUTANEOUS TISSUEModerate 0.6890 CO Specific 2.23 6


TO SKIN & SUBCUTANEOUS TISSUEMajor 1.0387 National 4.50 13


TO SKIN & SUBCUTANEOUS TISSUEExtreme 2.6425 National 10.31 29

385 1OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST





DISORDERSMajor 0.9765 National 5.12 15



401 1 PITUITARY & ADRENAL PROCEDURES Minor 1.5756 National 2.87 8

401 2 PITUITARY & ADRENAL PROCEDURES Moderate 2.0868 National 4.00 11

401 3 PITUITARY & ADRENAL PROCEDURES Major 3.5204 National 8.04 22

401 4 PITUITARY & ADRENAL PROCEDURES Extreme 8.6090 National 21.52 63

403 1 PROCEDURES FOR OBESITY Minor 1.1537 CO Specific 2.00 3

403 2 PROCEDURES FOR OBESITY Moderate 1.3226 CO Specific 2.41 6

403 3 PROCEDURES FOR OBESITY Major 2.4117 National 4.45 13

403 4 PROCEDURES FOR OBESITY Extreme 7.4970 National 17.34 52

404 1THYROID, PARATHYROID & THYROGLOSSAL






Updated 7/1/2020











405 1OTHER PROCEDURES FOR ENDOCRINE,

NUTRITIONAL & METABOLIC DISORDERSMinor 1.4259 National 3.51 11


NUTRITIONAL & METABOLIC DISORDERSModerate 1.6772 National 5.18 16


NUTRITIONAL & METABOLIC DISORDERSMajor 2.5701 National 8.90 26


NUTRITIONAL & METABOLIC DISORDERSExtreme 6.3946 National 21.06 57

420 1 DIABETES Minor 0.4669 CO Specific 1.99 5

420 2 DIABETES Moderate 0.6172 CO Specific 2.04 6

420 3 DIABETES Major 0.8912 CO Specific 3.24 9

420 4 DIABETES Extreme 1.8361 CO Specific 6.89 19

421 1MALNUTRITION, FAILURE TO THRIVE & OTHER

NUTRITIONAL DISORDERSMinor 0.5969 CO Specific 3.17 8


NUTRITIONAL DISORDERSModerate 0.8962 CO Specific 4.68 14


NUTRITIONAL DISORDERSMajor 1.3968 CO Specific 7.26 25


NUTRITIONAL DISORDERSExtreme 2.4680 National 12.35 37

422 1HYPOVOLEMIA & RELATED ELECTROLYTE








423 1 INBORN ERRORS OF METABOLISM Minor 0.6196 National 2.47 7

423 2 INBORN ERRORS OF METABOLISM Moderate 0.7721 National 3.28 10

423 3 INBORN ERRORS OF METABOLISM Major 1.1869 National 5.29 17

423 4 INBORN ERRORS OF METABOLISM Extreme 4.2396 National 14.46 48

424 1 OTHER ENDOCRINE DISORDERS Minor 0.5086 CO Specific 2.19 6

424 2 OTHER ENDOCRINE DISORDERS Moderate 0.7201 CO Specific 3.30 10

424 3 OTHER ENDOCRINE DISORDERS Major 1.0536 CO Specific 4.31 12

424 4 OTHER ENDOCRINE DISORDERS Extreme 2.7018 National 10.83 30

Updated 7/1/2020









425 1ELECTROLYTE DISORDERS EXCEPT HYPOVOLEMIA

RELATEDMinor 0.3803 CO Specific 2.02 5


RELATEDModerate 0.4817 CO Specific 2.05 6


RELATEDMajor 0.7620 CO Specific 1.54 4


RELATEDExtreme 1.8688 CO Specific 8.85 26

440 1 KIDNEY TRANSPLANT Minor 5.3167 CO Specific 4.45 8

440 2 KIDNEY TRANSPLANT Moderate 5.8907 CO Specific 4.81 7

440 3 KIDNEY TRANSPLANT Major 7.0200 CO Specific 8.13 20

440 4 KIDNEY TRANSPLANT Extreme 12.1795 CO Specific 18.74 50

441 1 MAJOR BLADDER PROCEDURES Minor 0.6396 CO Specific 1.75 4

441 2 MAJOR BLADDER PROCEDURES Moderate 2.1572 CO Specific 5.55 12

441 3 MAJOR BLADDER PROCEDURES Major 3.2575 National 9.42 21

441 4 MAJOR BLADDER PROCEDURES Extreme 7.0308 National 20.93 48

442 1KIDNEY & URINARY TRACT PROCEDURES FOR

MALIGNANCYMinor 1.2752 CO Specific 2.94 7


MALIGNANCYModerate 1.5875 CO Specific 4.00 11


MALIGNANCYMajor 2.6236 National 7.64 19


MALIGNANCYExtreme 6.2888 National 16.37 45


NONMALIGNANCYMinor 0.9990 CO Specific 2.00 5


NONMALIGNANCYModerate 1.1723 CO Specific 3.08 9


NONMALIGNANCYMajor 2.2144 National 7.55 20


NONMALIGNANCYExtreme 5.2853 National 16.44 45

444 1RENAL DIALYSIS ACCESS DEVICE PROCEDURE

ONLYMinor 1.1976 National 2.44 8


ONLYModerate 1.5543 National 4.13 13


ONLYMajor 2.5683 National 8.44 23

Updated 7/1/2020










ONLYExtreme 4.7624 National 15.28 39

445 1 OTHER BLADDER PROCEDURES Minor 0.8366 CO Specific 2.17 5

445 2 OTHER BLADDER PROCEDURES Moderate 1.3151 National 3.00 10

445 3 OTHER BLADDER PROCEDURES Major 1.9243 National 7.52 21

445 4 OTHER BLADDER PROCEDURES Extreme 3.9083 National 13.48 35

446 1 URETHRAL & TRANSURETHRAL PROCEDURES Minor 0.7035 CO Specific 1.50 3

446 2 URETHRAL & TRANSURETHRAL PROCEDURES Moderate 0.9188 CO Specific 1.86 4

446 3 URETHRAL & TRANSURETHRAL PROCEDURES Major 1.5578 CO Specific 5.78 17

446 4 URETHRAL & TRANSURETHRAL PROCEDURES Extreme 3.3078 CO Specific 12.64 33

447 1OTHER KIDNEY, URINARY TRACT & RELATED



PROCEDURESModerate 1.5952 National 3.29 10





460 1 RENAL FAILURE Minor 0.5656 CO Specific 2.61 8

460 2 RENAL FAILURE Moderate 0.7003 CO Specific 2.48 7

460 3 RENAL FAILURE Major 0.8812 CO Specific 3.68 11

460 4 RENAL FAILURE Extreme 2.5369 CO Specific 10.62 29

461 1 KIDNEY & URINARY TRACT MALIGNANCY Minor 0.6065 National 2.45 7

461 2 KIDNEY & URINARY TRACT MALIGNANCY Moderate 0.7271 National 3.37 10

461 3 KIDNEY & URINARY TRACT MALIGNANCY Major 1.1439 National 5.59 16

461 4 KIDNEY & URINARY TRACT MALIGNANCY Extreme 2.4834 National 10.44 32

462 1 NEPHRITIS & NEPHROSIS Minor 0.4629 National 2.47 7

462 2 NEPHRITIS & NEPHROSIS Moderate 0.6352 National 3.49 10

462 3 NEPHRITIS & NEPHROSIS Major 1.1553 National 6.06 18

462 4 NEPHRITIS & NEPHROSIS Extreme 2.8844 National 13.11 34

463 1 KIDNEY & URINARY TRACT INFECTIONS Minor 0.4989 CO Specific 2.27 5

463 2 KIDNEY & URINARY TRACT INFECTIONS Moderate 0.5860 CO Specific 2.76 7

463 3 KIDNEY & URINARY TRACT INFECTIONS Major 0.8845 CO Specific 4.17 12

463 4 KIDNEY & URINARY TRACT INFECTIONS Extreme 1.7772 National 8.50 23

465 1URINARY STONES & ACQUIRED UPPER URINARY

TRACT OBSTRUCTIONMinor 0.4931 CO Specific 1.62 4


TRACT OBSTRUCTIONModerate 0.5624 CO Specific 1.74 4

Updated 7/1/2020










TRACT OBSTRUCTIONMajor 0.9830 National 3.61 10


TRACT OBSTRUCTIONExtreme 2.1426 National 8.12 23


GENITOURINARY DEVICE OR PROCMinor 0.4590 National 1.93 5


GENITOURINARY DEVICE OR PROCModerate 0.6874 National 3.21 9


GENITOURINARY DEVICE OR PROCMajor 0.8455 CO Specific 4.16 11


GENITOURINARY DEVICE OR PROCExtreme 2.2942 National 9.08 25

468 1OTHER KIDNEY & URINARY TRACT DIAGNOSES,

SIGNS & SYMPTOMSMinor 0.3516 CO Specific 1.32 3


SIGNS & SYMPTOMSModerate 0.4780 CO Specific 1.39 3


SIGNS & SYMPTOMSMajor 0.7105 CO Specific 1.41 4


SIGNS & SYMPTOMSExtreme 1.6514 CO Specific 9.66 28

480 1 MAJOR MALE PELVIC PROCEDURES Minor 1.1236 CO Specific 1.79 4

480 2 MAJOR MALE PELVIC PROCEDURES Moderate 1.3989 National 2.28 7

480 3 MAJOR MALE PELVIC PROCEDURES Major 2.3057 National 5.74 16

480 4 MAJOR MALE PELVIC PROCEDURES Extreme 5.3282 National 14.59 38

481 1 PENIS PROCEDURES Minor 0.8012 National 2.08 7

481 2 PENIS PROCEDURES Moderate 1.3904 National 2.29 8

481 3 PENIS PROCEDURES Major 2.1438 National 8.02 25

481 4 PENIS PROCEDURES Extreme 5.3457 National 18.63 53

482 1 TRANSURETHRAL PROSTATECTOMY Minor 0.6381 National 1.62 4

482 2 TRANSURETHRAL PROSTATECTOMY Moderate 0.8316 National 2.54 8

482 3 TRANSURETHRAL PROSTATECTOMY Major 1.6751 National 6.75 19

482 4 TRANSURETHRAL PROSTATECTOMY Extreme 3.3770 National 12.54 30

483 1 TESTES & SCROTAL PROCEDURES Minor 0.7105 National 1.82 6

483 2 TESTES & SCROTAL PROCEDURES Moderate 1.3164 National 4.90 15

483 3 TESTES & SCROTAL PROCEDURES Major 2.5395 National 10.02 27

483 4 TESTES & SCROTAL PROCEDURES Extreme 5.7880 National 19.25 55

484 1OTHER MALE REPRODUCTIVE SYSTEM & RELATED


Updated 7/1/2020










PROCEDURESModerate 1.2972 National 1.84 6





500 1 MALIGNANCY, MALE REPRODUCTIVE SYSTEM Minor 0.5876 National 2.38 7

500 2 MALIGNANCY, MALE REPRODUCTIVE SYSTEM Moderate 0.7680 National 3.96 12

500 3 MALIGNANCY, MALE REPRODUCTIVE SYSTEM Major 1.1430 National 5.66 16

500 4 MALIGNANCY, MALE REPRODUCTIVE SYSTEM Extreme 2.2989 National 10.10 30

501 1MALE REPRODUCTIVE SYSTEM DIAGNOSES

EXCEPT MALIGNANCYMinor 0.4725 National 2.48 7


EXCEPT MALIGNANCYModerate 0.6315 National 3.33 9


EXCEPT MALIGNANCYMajor 0.9656 National 4.97 13


EXCEPT MALIGNANCYExtreme 2.2847 National 10.63 31

510 1PELVIC EVISCERATION, RADICAL HYSTERECTOMY

& OTHER RADICAL GYN PROCSMinor 1.2826 National 2.35 6


& OTHER RADICAL GYN PROCSModerate 1.6184 National 3.69 10


& OTHER RADICAL GYN PROCSMajor 3.1626 National 8.75 22


& OTHER RADICAL GYN PROCSExtreme 7.1236 National 17.07 42

511 1UTERINE & ADNEXA PROCEDURES FOR OVARIAN

& ADNEXAL MALIGNANCYMinor 1.3112 National 3.17 7


& ADNEXAL MALIGNANCYModerate 1.5747 CO Specific 4.96 9


& ADNEXAL MALIGNANCYMajor 2.5297 National 8.34 20


& ADNEXAL MALIGNANCYExtreme 5.6654 National 17.11 43

512 1UTERINE & ADNEXA PROCEDURES FOR NON-

OVARIAN & NON-ADNEXAL MALIGMinor 1.0646 CO Specific 2.40 6


OVARIAN & NON-ADNEXAL MALIGModerate 1.1930 CO Specific 3.12 8

Updated 7/1/2020










OVARIAN & NON-ADNEXAL MALIGMajor 2.2479 National 6.50 18


OVARIAN & NON-ADNEXAL MALIGExtreme 5.5218 National 15.65 41


MALIGNANCY EXCEPT LEIOMYOMAMinor 0.7762 CO Specific 1.92 4


MALIGNANCY EXCEPT LEIOMYOMAModerate 0.9867 CO Specific 2.62 6


MALIGNANCY EXCEPT LEIOMYOMAMajor 1.7836 National 5.27 15


MALIGNANCY EXCEPT LEIOMYOMAExtreme 4.9457 National 13.92 37

514 1FEMALE REPRODUCTIVE SYSTEM

RECONSTRUCTIVE PROCEDURESMinor 0.8838 CO Specific 1.83 4


RECONSTRUCTIVE PROCEDURESModerate 1.0416 CO Specific 1.92 3


RECONSTRUCTIVE PROCEDURESMajor 1.7668 National 4.69 14


RECONSTRUCTIVE PROCEDURESExtreme 5.6012 National 14.30 46

517 1DILATION & CURETTAGE FOR NON-OBSTETRIC








518 1OTHER FEMALE REPRODUCTIVE SYSTEM &

RELATED PROCEDURESMinor 0.6995 CO Specific 2.16 5


RELATED PROCEDURESModerate 1.0060 CO Specific 3.45 10


RELATED PROCEDURESMajor 2.1998 National 8.00 23


RELATED PROCEDURESExtreme 5.5635 National 18.13 47

519 1UTERINE & ADNEXA PROCEDURES FOR

LEIOMYOMAMinor 0.8069 CO Specific 2.16 4

Updated 7/1/2020










LEIOMYOMAModerate 0.9942 CO Specific 2.55 5


LEIOMYOMAMajor 1.9270 National 5.72 16


LEIOMYOMAExtreme 5.1022 National 13.78 33

530 1 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY Minor 0.5542 National 2.36 7

530 2 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY Moderate 0.7381 National 3.56 10

530 3 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY Major 1.2461 National 5.87 17

530 4 FEMALE REPRODUCTIVE SYSTEM MALIGNANCY Extreme 2.6310 National 10.66 31

531 1 FEMALE REPRODUCTIVE SYSTEM INFECTIONS Minor 0.5621 CO Specific 2.47 6

531 2 FEMALE REPRODUCTIVE SYSTEM INFECTIONS Moderate 0.6631 CO Specific 2.82 6

531 3 FEMALE REPRODUCTIVE SYSTEM INFECTIONS Major 1.1874 National 6.01 16

531 4 FEMALE REPRODUCTIVE SYSTEM INFECTIONS Extreme 2.5813 National 11.13 29

532 1MENSTRUAL & OTHER FEMALE REPRODUCTIVE

SYSTEM DISORDERSMinor 0.4995 CO Specific 1.61 4


SYSTEM DISORDERSModerate 0.5735 National 2.23 6


SYSTEM DISORDERSMajor 0.9374 National 4.07 12


SYSTEM DISORDERSExtreme 2.0838 National 8.43 25

540 1 CESAREAN DELIVERY Minor 0.4580 Policy Adjusted 2.96 5

540 2 CESAREAN DELIVERY Moderate 0.8675National HSRV

adj to CO Wts3.62 10

540 3 CESAREAN DELIVERY Major 1.1839National HSRV


540 4 CESAREAN DELIVERY Extreme 3.0079National HSRV


541 1 VAGINAL DELIVERY W STERILIZATION &/OR D&C Minor 0.6228 CO Specific 2.01 4

541 2 VAGINAL DELIVERY W STERILIZATION &/OR D&C Moderate 0.6875 CO Specific 2.38 5

541 3 VAGINAL DELIVERY W STERILIZATION &/OR D&C Major 0.9075 CO Specific 3.11 8

541 4 VAGINAL DELIVERY W STERILIZATION &/OR D&C Extreme 2.7081 National 7.96 24

542 1VAGINAL DELIVERY W COMPLICATING

PROCEDURES EXC STERILIZATION &/OR D&CMinor 0.4652

National HSRV

adj to CO Wts2.15 6


PROCEDURES EXC STERILIZATION &/OR D&CModerate 0.5861

National HSRV

adj to CO Wts2.47 6

Updated 7/1/2020










PROCEDURES EXC STERILIZATION &/OR D&CMajor 1.0844

National HSRV



PROCEDURES EXC STERILIZATION &/OR D&CExtreme 4.5923

National HSRV


544 1D&C, ASPIRATION CURETTAGE OR

HYSTEROTOMY FOR OBSTETRIC DIAGNOSESMinor 0.4457 CO Specific 1.25 3


HYSTEROTOMY FOR OBSTETRIC DIAGNOSESModerate 0.5914 CO Specific 2.02 6


HYSTEROTOMY FOR OBSTETRIC DIAGNOSESMajor 1.2667 National 3.61 12


HYSTEROTOMY FOR OBSTETRIC DIAGNOSESExtreme 3.1222 National 7.38 22

545 1 ECTOPIC PREGNANCY PROCEDURE Minor 0.6972 CO Specific 1.89 4

545 2 ECTOPIC PREGNANCY PROCEDURE Moderate 0.7780 CO Specific 2.05 5

545 3 ECTOPIC PREGNANCY PROCEDURE Major 1.1300 National 2.55 7

545 4 ECTOPIC PREGNANCY PROCEDURE Extreme 1.7158 National 4.49 11

546 1OTHER O.R. PROC FOR OBSTETRIC DIAGNOSES

EXCEPT DELIVERY DIAGNOSESMinor 0.6386 CO Specific 3.28 9


EXCEPT DELIVERY DIAGNOSESModerate 0.8726 National 3.40 12


EXCEPT DELIVERY DIAGNOSESMajor 1.7309 National 6.71 27


EXCEPT DELIVERY DIAGNOSESExtreme 5.0212 National 13.46 36

560 1 VAGINAL DELIVERY Minor 0.4580 Policy Adjusted 2.00 3

560 2 VAGINAL DELIVERY Moderate 0.5346 Policy Adjusted 2.28 5

560 3 VAGINAL DELIVERY Major 0.7502 Policy Adjusted 3.35 18

560 4 VAGINAL DELIVERY Extreme 2.0998 Policy Adjusted 7.61 37

561 1POSTPARTUM & POST ABORTION DIAGNOSES

W/O PROCEDUREMinor 0.3512 CO Specific 1.71 3


W/O PROCEDUREModerate 0.4496 CO Specific 2.15 5


W/O PROCEDUREMajor 0.6988 CO Specific 2.79 7


W/O PROCEDUREExtreme 1.9428 National 6.38 18

563 1 PRETERM LABOR Minor 0.3458 CO Specific 2.35 8

563 2 PRETERM LABOR Moderate 0.4831 CO Specific 3.42 13

Updated 7/1/2020









563 3 PRETERM LABOR Major 0.7849 National 6.53 31

563 4 PRETERM LABOR Extreme 1.1911 National 8.50 15

564 1ABORTION W/O D&C, ASPIRATION CURETTAGE

OR HYSTEROTOMYMinor 0.2934 CO Specific 1.24 3


OR HYSTEROTOMYModerate 0.3041 CO Specific 1.36 3


OR HYSTEROTOMYMajor 0.5509 National 2.55 8


OR HYSTEROTOMYExtreme 2.7626 National 5.05 20

565 1 FALSE LABOR Minor 0.1880 CO Specific 1.13 3

565 2 FALSE LABOR Moderate 0.2238 National 1.63 6

565 3 FALSE LABOR Major 0.3558 National 4.59 26

565 4 FALSE LABOR Extreme 0.3914 National 5.05 6

566 1 OTHER ANTEPARTUM DIAGNOSES Minor 0.3283 CO Specific 1.89 4

566 2 OTHER ANTEPARTUM DIAGNOSES Moderate 0.4263 CO Specific 2.54 7

566 3 OTHER ANTEPARTUM DIAGNOSES Major 0.6281 CO Specific 3.68 12

566 4 OTHER ANTEPARTUM DIAGNOSES Extreme 1.9761 National 8.06 24

580 1NEONATE, TRANSFERRED <5 DAYS OLD, NOT

BORN HEREMinor 0.3044

National HSRV

adj to CO Wts1.44 4


BORN HEREModerate 0.4075

National HSRV

adj to CO Wts1.59 4


BORN HEREMajor 0.6362

National HSRV

adj to CO Wts1.82 4


BORN HEREExtreme 1.0808

National HSRV

adj to CO Wts1.65 4

581 1NEONATE, TRANSFERRED < 5 DAYS OLD, BORN

HEREMinor 0.1246

National HSRV

adj to CO Wts1.24 4


HEREModerate 0.1874

National HSRV

adj to CO Wts1.28 4


HEREMajor 0.3000

National HSRV

adj to CO Wts1.26 4


HEREExtreme 0.5598

National HSRV

adj to CO Wts1.35 4

583 1 NEONATE W ECMO Minor 12.6660National HSRV


583 2 NEONATE W ECMO Moderate 20.0003National HSRV


Updated 7/1/2020









583 3 NEONATE W ECMO Major 22.0004National HSRV


583 4 NEONATE W ECMO Extreme 30.5910National HSRV


588 1 NEONATE BWT <1500G W MAJOR PROCEDURE Minor 6.1475National HSRV


588 2 NEONATE BWT <1500G W MAJOR PROCEDURE Moderate 8.8936National HSRV


588 3 NEONATE BWT <1500G W MAJOR PROCEDURE Major 18.1473National HSRV


588 4 NEONATE BWT <1500G W MAJOR PROCEDURE Extreme 27.5135National HSRV


589 1 NEONATE BWT <500G OR GA <24 WEEKS Minor 14.6632National HSRV


589 2 NEONATE BWT <500G OR GA <24 WEEKS Moderate 13.3303National HSRV


589 3 NEONATE BWT <500G OR GA <24 WEEKS Major 12.1185National HSRV


589 4 NEONATE BWT <500G OR GA <24 WEEKS Extreme 0.5655National HSRV


591 1NEONATE BIRTHWT 500-749G W/O MAJOR

PROCEDUREMinor 0.1999

National HSRV

adj to CO Wts1.00 9


PROCEDUREModerate 7.0698

National HSRV



PROCEDUREMajor 11.2109

National HSRV



PROCEDUREExtreme 16.7990

National HSRV




National HSRV




National HSRV




National HSRV




National HSRV


602 1NEONATE BWT 1000-1249G W RESP DIST

SYND/OTH MAJ RESP OR MAJ ANOMMinor 3.7632

National HSRV


Updated 7/1/2020










SYND/OTH MAJ RESP OR MAJ ANOMModerate 7.4551

National HSRV



SYND/OTH MAJ RESP OR MAJ ANOMMajor 9.8534

National HSRV



SYND/OTH MAJ RESP OR MAJ ANOMExtreme 13.2999

National HSRV


603 1NEONATE BIRTHWT 1000-1249G W OR W/O

OTHER SIGNIFICANT CONDITIONMinor 2.1871

National HSRV



OTHER SIGNIFICANT CONDITIONModerate 5.4002

National HSRV



OTHER SIGNIFICANT CONDITIONMajor 8.3289

National HSRV



OTHER SIGNIFICANT CONDITIONExtreme 8.9844

National HSRV



SYND/OTH MAJ RESP OR MAJ ANOMMinor 3.4926

National HSRV



SYND/OTH MAJ RESP OR MAJ ANOMModerate 6.0301

National HSRV



SYND/OTH MAJ RESP OR MAJ ANOMMajor 7.8585

National HSRV



SYND/OTH MAJ RESP OR MAJ ANOMExtreme 10.0967

National HSRV


608 1NEONATE BWT 1250-1499G W OR W/O OTHER

SIGNIFICANT CONDITIONMinor 2.7039

National HSRV



SIGNIFICANT CONDITIONModerate 4.5776

National HSRV



SIGNIFICANT CONDITIONMajor 6.6903

National HSRV



SIGNIFICANT CONDITIONExtreme 7.6732

National HSRV


609 1NEONATE BWT 1500-2499G W MAJOR


National HSRV




National HSRV




National HSRV




National HSRV


Updated 7/1/2020









611 1NEONATE BIRTHWT 1500-1999G W MAJOR

ANOMALYMinor 1.4958

National HSRV



ANOMALYModerate 3.1948

National HSRV



ANOMALYMajor 5.1502

National HSRV



ANOMALYExtreme 6.6595

National HSRV



SYND/OTH MAJ RESP CONDMinor 2.7784

National HSRV



SYND/OTH MAJ RESP CONDModerate 4.0920

National HSRV



SYND/OTH MAJ RESP CONDMajor 5.9435

National HSRV



SYND/OTH MAJ RESP CONDExtreme 7.9110

National HSRV


613 1NEONATE BIRTHWT 1500-1999G W

CONGENITAL/PERINATAL INFECTIONMinor 2.1071

National HSRV



CONGENITAL/PERINATAL INFECTIONModerate 3.4071

National HSRV



CONGENITAL/PERINATAL INFECTIONMajor 4.7750

National HSRV



CONGENITAL/PERINATAL INFECTIONExtreme 6.2005

National HSRV




National HSRV




National HSRV




National HSRV




National HSRV


621 1 NEONATE BWT 2000-2499G W MAJOR ANOMALY Minor 0.7722National HSRV


621 2 NEONATE BWT 2000-2499G W MAJOR ANOMALY Moderate 1.9529National HSRV


621 3 NEONATE BWT 2000-2499G W MAJOR ANOMALY Major 3.4548National HSRV


Updated 7/1/2020









621 4 NEONATE BWT 2000-2499G W MAJOR ANOMALY Extreme 4.8383National HSRV




National HSRV




National HSRV




National HSRV




National HSRV


623 1NEONATE BWT 2000-2499G W


National HSRV




National HSRV




National HSRV




National HSRV


625 1NEONATE BWT 2000-2499G W OTHER


National HSRV




National HSRV




National HSRV




National HSRV


626 1NEONATE BWT 2000-2499G, NORMAL NEWBORN

OR NEONATE W OTHER PROBLEMMinor 0.1760

National HSRV

adj to CO Wts2.63 8


OR NEONATE W OTHER PROBLEMModerate 0.3284

National HSRV



OR NEONATE W OTHER PROBLEMMajor 0.9752

National HSRV



OR NEONATE W OTHER PROBLEMExtreme 2.8978

National HSRV


630 1NEONATE BIRTHWT >2499G W MAJOR

CARDIOVASCULAR PROCEDUREMinor 2.5991

National HSRV



CARDIOVASCULAR PROCEDUREModerate 4.1761

National HSRV


Updated 7/1/2020










CARDIOVASCULAR PROCEDUREMajor 6.6351

National HSRV



CARDIOVASCULAR PROCEDUREExtreme 14.2319

National HSRV


631 1NEONATE BIRTHWT >2499G W OTHER MAJOR


National HSRV




National HSRV




National HSRV




National HSRV


633 1 NEONATE BIRTHWT >2499G W MAJOR ANOMALY Minor 0.2503National HSRV


633 2 NEONATE BIRTHWT >2499G W MAJOR ANOMALY Moderate 0.7363National HSRV


633 3 NEONATE BIRTHWT >2499G W MAJOR ANOMALY Major 1.7640National HSRV


633 4 NEONATE BIRTHWT >2499G W MAJOR ANOMALY Extreme 5.0449National HSRV


634 1NEONATE, BIRTHWT >2499G W RESP DIST


National HSRV




National HSRV




National HSRV




National HSRV


636 1NEONATE BIRTHWT >2499G W


National HSRV




National HSRV




National HSRV




National HSRV


639 1NEONATE BIRTHWT >2499G W OTHER


National HSRV


Updated 7/1/2020











National HSRV




National HSRV




National HSRV


640 1NEONATE BIRTHWT >2499G, NORMAL

NEWBORN OR NEONATE W OTHER PROBLEMMinor 0.1285

National HSRV

adj to CO Wts2.07 4


NEWBORN OR NEONATE W OTHER PROBLEMModerate 0.1717

National HSRV

adj to CO Wts2.35 5


NEWBORN OR NEONATE W OTHER PROBLEMMajor 0.3636

National HSRV



NEWBORN OR NEONATE W OTHER PROBLEMExtreme 1.8701

National HSRV


650 1 SPLENECTOMY Minor 1.3773 National 3.37 9

650 2 SPLENECTOMY Moderate 1.9123 National 5.08 13

650 3 SPLENECTOMY Major 2.8742 National 8.26 22

650 4 SPLENECTOMY Extreme 6.2141 National 15.14 40

651 1OTHER PROCEDURES OF BLOOD & BLOOD-

FORMING ORGANSMinor 1.0960 National 3.08 9


FORMING ORGANSModerate 1.5495 National 4.54 12


FORMING ORGANSMajor 2.4988 National 8.63 25


FORMING ORGANSExtreme 6.8202 National 22.85 66

660 1MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG

EXC SICKLE CELL CRISIS & COAGULMinor 0.6964 National 2.86 8


EXC SICKLE CELL CRISIS & COAGULModerate 0.8987 CO Specific 3.64 9


EXC SICKLE CELL CRISIS & COAGULMajor 1.4677 CO Specific 5.29 15


EXC SICKLE CELL CRISIS & COAGULExtreme 4.3277 National 13.32 39

661 1 COAGULATION & PLATELET DISORDERS Minor 0.9372 National 2.58 7

661 2 COAGULATION & PLATELET DISORDERS Moderate 1.1479 National 3.49 10

661 3 COAGULATION & PLATELET DISORDERS Major 2.1007 National 5.11 15

661 4 COAGULATION & PLATELET DISORDERS Extreme 4.3315 National 11.63 37

Updated 7/1/2020









662 1 SICKLE CELL ANEMIA CRISIS Minor 0.7471 CO Specific 3.44 8

662 2 SICKLE CELL ANEMIA CRISIS Moderate 0.9835 CO Specific 4.76 13

662 3 SICKLE CELL ANEMIA CRISIS Major 1.2845 National 7.26 20

662 4 SICKLE CELL ANEMIA CRISIS Extreme 3.2866 National 12.73 33

663 1OTHER ANEMIA & DISORDERS OF BLOOD &

BLOOD-FORMING ORGANSMinor 0.5401 CO Specific 2.09 6


BLOOD-FORMING ORGANSModerate 0.6396 CO Specific 2.33 6


BLOOD-FORMING ORGANSMajor 1.0065 CO Specific 3.65 10


BLOOD-FORMING ORGANSExtreme 2.1179 National 8.12 24

680 1

MAJOR O.R. PROCEDURES FOR

LYMPHATIC/HEMATOPOIETIC/OTHER

NEOPLASMS


680 2



NEOPLASMS


680 3



NEOPLASMS


680 4



NEOPLASMS


681 1

OTHER O.R. PROCEDURES FOR


NEOPLASMS


681 2



NEOPLASMS

Moderate 1.4601 CO Specific 4.08 11

681 3



NEOPLASMS


681 4



NEOPLASMS


690 1 ACUTE LEUKEMIA Minor 1.1641 National 4.31 16

690 2 ACUTE LEUKEMIA Moderate 1.7931 National 6.73 25

Updated 7/1/2020









690 3 ACUTE LEUKEMIA Major 3.6991 National 14.03 46

690 4 ACUTE LEUKEMIA Extreme 8.2286 National 25.36 67

691 1LYMPHOMA, MYELOMA & NON-ACUTE

LEUKEMIAMinor 0.9878 National 3.47 11


LEUKEMIAModerate 1.2904 National 5.09 15


LEUKEMIAMajor 2.0051 National 8.05 23


LEUKEMIAExtreme 4.6075 National 15.27 45

692 1 RADIOTHERAPY Minor 0.9472 National 3.29 9

692 2 RADIOTHERAPY Moderate 1.7950 National 4.42 12

692 3 RADIOTHERAPY Major 2.5562 National 8.16 24

692 4 RADIOTHERAPY Extreme 4.5713 National 13.29 37

693 1 CHEMOTHERAPY Minor 0.8323 National 2.74 7

693 2 CHEMOTHERAPY Moderate 1.0117 CO Specific 3.56 7

693 3 CHEMOTHERAPY Major 1.9175 CO Specific 6.91 24

693 4 CHEMOTHERAPY Extreme 6.6777 National 23.39 59

694 1LYMPHATIC & OTHER MALIGNANCIES &

NEOPLASMS OF UNCERTAIN BEHAVIORMinor 0.6492 National 2.71 8


NEOPLASMS OF UNCERTAIN BEHAVIORModerate 0.8421 National 3.73 11


NEOPLASMS OF UNCERTAIN BEHAVIORMajor 1.3842 National 6.19 18


NEOPLASMS OF UNCERTAIN BEHAVIORExtreme 2.9964 National 11.14 33

710 1INFECTIOUS & PARASITIC DISEASES INCLUDING

HIV W O.R. PROCEDUREMinor 1.2008 National 4.26 12


HIV W O.R. PROCEDUREModerate 1.3431 CO Specific 5.14 12


HIV W O.R. PROCEDUREMajor 2.1782 CO Specific 8.73 24


HIV W O.R. PROCEDUREExtreme 6.0298 CO Specific 20.83 62

711 1POST-OP, POST-TRAUMA, OTHER DEVICE

INFECTIONS W O.R. PROCEDUREMinor 0.9086 CO Specific 3.40 8


INFECTIONS W O.R. PROCEDUREModerate 1.2281 CO Specific 4.73 11

Updated 7/1/2020










INFECTIONS W O.R. PROCEDUREMajor 2.8738 National 10.51 28


INFECTIONS W O.R. PROCEDUREExtreme 6.8434 National 20.18 55

720 1 SEPTICEMIA & DISSEMINATED INFECTIONS Minor 0.5646 CO Specific 2.57 6

720 2 SEPTICEMIA & DISSEMINATED INFECTIONS Moderate 0.7305 CO Specific 3.19 8

720 3 SEPTICEMIA & DISSEMINATED INFECTIONS Major 1.1461 CO Specific 4.83 13

720 4 SEPTICEMIA & DISSEMINATED INFECTIONS Extreme 2.8843 CO Specific 9.82 30

721 1POST-OPERATIVE, POST-TRAUMATIC, OTHER

DEVICE INFECTIONSMinor 0.6161 CO Specific 2.82 6


DEVICE INFECTIONSModerate 0.7695 CO Specific 3.53 9


DEVICE INFECTIONSMajor 1.4654 CO Specific 6.40 18


DEVICE INFECTIONSExtreme 2.8665 National 10.70 29

722 1 FEVER Minor 0.4430 CO Specific 1.99 3

722 2 FEVER Moderate 0.5854 CO Specific 2.30 6

722 3 FEVER Major 0.8915 National 4.05 11

722 4 FEVER Extreme 1.6956 National 6.72 22

723 1 VIRAL ILLNESS Minor 0.4141 CO Specific 1.85 4

723 2 VIRAL ILLNESS Moderate 0.5699 CO Specific 2.35 6

723 3 VIRAL ILLNESS Major 0.8318 CO Specific 3.37 9

723 4 VIRAL ILLNESS Extreme 3.3068 National 11.96 34

724 1 OTHER INFECTIOUS & PARASITIC DISEASES Minor 0.6626 National 3.72 11

724 2 OTHER INFECTIOUS & PARASITIC DISEASES Moderate 0.8060 National 4.37 12

724 3 OTHER INFECTIOUS & PARASITIC DISEASES Major 1.3201 National 6.30 17

724 4 OTHER INFECTIOUS & PARASITIC DISEASES Extreme 3.3932 National 12.51 35

740 1 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE Minor 1.5256 National 4.92 20

740 2 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE Moderate 1.5561 National 11.08 40

740 3 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE Major 2.9257 National 16.87 61

740 4 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE Extreme 4.2699 National 20.58 48

750 1 SCHIZOPHRENIA Minor 0.7322 National 9.08 30

750 2 SCHIZOPHRENIA Moderate 0.8104 National 9.97 32

750 3 SCHIZOPHRENIA Major 1.1713 National 13.07 41

750 4 SCHIZOPHRENIA Extreme 2.1597 National 23.33 64

751 1MAJOR DEPRESSIVE DISORDERS &

OTHER/UNSPECIFIED PSYCHOSESMinor 0.4029 National 4.73 13

Updated 7/1/2020










OTHER/UNSPECIFIED PSYCHOSESModerate 0.7484 CO Specific 6.69 16


OTHER/UNSPECIFIED PSYCHOSESMajor 0.9234 National 9.39 28


OTHER/UNSPECIFIED PSYCHOSESExtreme 1.8129 National 18.69 50

752 1DISORDERS OF PERSONALITY & IMPULSE

CONTROLMinor 0.3663 National 4.47 15


CONTROLModerate 0.4901 National 5.39 18


CONTROLMajor 1.0502 National 10.16 37


CONTROLExtreme 1.1269 National 5.00 5

753 1 BIPOLAR DISORDERS Minor 0.4470 National 5.34 15

753 2 BIPOLAR DISORDERS Moderate 0.6010 National 7.14 21

753 3 BIPOLAR DISORDERS Major 0.9726 National 10.41 32

753 4 BIPOLAR DISORDERS Extreme 1.6517 National 17.35 47

754 1DEPRESSION EXCEPT MAJOR DEPRESSIVE

DISORDERMinor 0.3225 National 3.70 11


DISORDERModerate 0.4297 National 4.85 14


DISORDERMajor 0.6421 National 6.42 20


DISORDERExtreme 1.4179 National 13.92 47

755 1ADJUSTMENT DISORDERS & NEUROSES EXCEPT

DEPRESSIVE DIAGNOSESMinor 0.2890 National 3.43 11


DEPRESSIVE DIAGNOSESModerate 0.4592 National 5.40 16


DEPRESSIVE DIAGNOSESMajor 0.7037 National 7.99 24


DEPRESSIVE DIAGNOSESExtreme 1.0618 National 9.00 18

756 1 ACUTE ANXIETY & DELIRIUM STATES Minor 0.4565 National 2.89 10

756 2 ACUTE ANXIETY & DELIRIUM STATES Moderate 0.5774 National 3.38 11

756 3 ACUTE ANXIETY & DELIRIUM STATES Major 0.7229 National 4.00 13

756 4 ACUTE ANXIETY & DELIRIUM STATES Extreme 1.6658 National 6.90 22

Updated 7/1/2020









757 1 ORGANIC MENTAL HEALTH DISTURBANCES Minor 0.6485 National 7.25 23

757 2 ORGANIC MENTAL HEALTH DISTURBANCES Moderate 0.7271 National 7.96 24

757 3 ORGANIC MENTAL HEALTH DISTURBANCES Major 0.9450 National 8.88 28

757 4 ORGANIC MENTAL HEALTH DISTURBANCES Extreme 1.7780 National 12.86 39

758 1 CHILDHOOD BEHAVIORAL DISORDERS Minor 0.4865 National 5.92 19

758 2 CHILDHOOD BEHAVIORAL DISORDERS Moderate 0.6238 National 7.93 27

758 3 CHILDHOOD BEHAVIORAL DISORDERS Major 0.8995 National 11.01 43

758 4 CHILDHOOD BEHAVIORAL DISORDERS Extreme 1.1887 National 11.00 23

759 1 EATING DISORDERS Minor 0.9312 National 12.43 35

759 2 EATING DISORDERS Moderate 0.9878 National 10.90 34

759 3 EATING DISORDERS Major 1.3920 National 12.44 39

759 4 EATING DISORDERS Extreme 2.3733 National 18.42 60

760 1 OTHER MENTAL HEALTH DISORDERS Minor 0.6134 National 6.04 21

760 2 OTHER MENTAL HEALTH DISORDERS Moderate 0.7237 National 6.56 22

760 3 OTHER MENTAL HEALTH DISORDERS Major 0.9434 National 7.45 25

760 4 OTHER MENTAL HEALTH DISORDERS Extreme 1.6159 National 9.33 26

770 1DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT

AGAINST MEDICAL ADVICEMinor 0.2432 National 2.10 7


AGAINST MEDICAL ADVICEModerate 0.5289 CO Specific 2.21 6


AGAINST MEDICAL ADVICEMajor 0.6671 National 3.00 10


AGAINST MEDICAL ADVICEExtreme 2.4510 National 7.30 23

772 1ALCOHOL & DRUG DEPENDENCE W REHAB OR

REHAB/DETOX THERAPYMinor 1.4409 Policy Adjusted 13.51 31


REHAB/DETOX THERAPYModerate 1.6718 Policy Adjusted 14.48 31


REHAB/DETOX THERAPYMajor 1.7444 Policy Adjusted 11.72 34


REHAB/DETOX THERAPYExtreme 6.0065 Policy Adjusted 21.08 53

773 1 OPIOID ABUSE & DEPENDENCE Minor 0.5818 CO Specific 3.91 9

773 2 OPIOID ABUSE & DEPENDENCE Moderate 0.7108 CO Specific 4.55 13

773 3 OPIOID ABUSE & DEPENDENCE Major 0.9419 CO Specific 4.20 13

773 4 OPIOID ABUSE & DEPENDENCE Extreme 2.0787 National 8.94 24

774 1 COCAINE ABUSE & DEPENDENCE Minor 0.3611 National 3.15 9

774 2 COCAINE ABUSE & DEPENDENCE Moderate 0.6099 CO Specific 3.72 10

Updated 7/1/2020









774 3 COCAINE ABUSE & DEPENDENCE Major 0.7522 National 4.32 12

774 4 COCAINE ABUSE & DEPENDENCE Extreme 2.5785 National 10.01 29

775 1 ALCOHOL ABUSE & DEPENDENCE Minor 0.5467 CO Specific 3.32 9

775 2 ALCOHOL ABUSE & DEPENDENCE Moderate 0.6987 CO Specific 3.49 10

775 3 ALCOHOL ABUSE & DEPENDENCE Major 1.0848 CO Specific 4.91 15

775 4 ALCOHOL ABUSE & DEPENDENCE Extreme 2.6541 CO Specific 10.61 33

776 1 OTHER DRUG ABUSE & DEPENDENCE Minor 0.3657 National 3.45 10

776 2 OTHER DRUG ABUSE & DEPENDENCE Moderate 0.6013 CO Specific 3.39 10

776 3 OTHER DRUG ABUSE & DEPENDENCE Major 0.8445 National 4.59 13

776 4 OTHER DRUG ABUSE & DEPENDENCE Extreme 1.9595 National 8.31 23

791 1O.R. PROCEDURE FOR OTHER COMPLICATIONS

OF TREATMENTMinor 1.0243 CO Specific 3.28 10


OF TREATMENTModerate 1.1963 CO Specific 3.79 10


OF TREATMENTMajor 2.6952 National 8.86 26


OF TREATMENTExtreme 6.3863 National 18.81 55

811 1 ALLERGIC REACTIONS Minor 0.3194 National 1.47 4

811 2 ALLERGIC REACTIONS Moderate 0.4452 National 1.91 6

811 3 ALLERGIC REACTIONS Major 0.9866 National 3.69 10

811 4 ALLERGIC REACTIONS Extreme 2.7968 National 8.72 24

812 1 POISONING OF MEDICINAL AGENTS Minor 0.4527 CO Specific 1.61 4

812 2 POISONING OF MEDICINAL AGENTS Moderate 0.5664 CO Specific 2.05 6

812 3 POISONING OF MEDICINAL AGENTS Major 0.8970 CO Specific 2.93 7

812 4 POISONING OF MEDICINAL AGENTS Extreme 1.9363 CO Specific 5.68 16

813 1 OTHER COMPLICATIONS OF TREATMENT Minor 0.5293 National 2.37 7

813 2 OTHER COMPLICATIONS OF TREATMENT Moderate 0.6444 CO Specific 3.10 9

813 3 OTHER COMPLICATIONS OF TREATMENT Major 1.1940 National 5.05 15

813 4 OTHER COMPLICATIONS OF TREATMENT Extreme 2.7773 National 10.71 34

815 1OTHER INJURY, POISONING & TOXIC EFFECT








Updated 7/1/2020









816 1 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES Minor 0.6090 National 1.59 4

816 2 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES Moderate 0.6437 CO Specific 2.20 6

816 3 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES Major 0.9389 CO Specific 2.96 8

816 4 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES Extreme 1.8751 CO Specific 5.72 20

841 1 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT Minor 4.9525 National 22.00 22

841 2 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT Moderate 5.0366 National 9.67 17

841 3 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT Major 6.8002 National 22.44 54

841 4 EXTENSIVE 3RD DEGREE BURNS W SKIN GRAFT Extreme 20.1687 National 41.36 106

842 1 FULL THICKNESS BURNS W SKIN GRAFT Minor 1.6378 National 7.05 19

842 2 FULL THICKNESS BURNS W SKIN GRAFT Moderate 2.4147 National 10.10 25

842 3 FULL THICKNESS BURNS W SKIN GRAFT Major 4.4977 National 16.37 41

842 4 FULL THICKNESS BURNS W SKIN GRAFT Extreme 11.1319 National 28.12 67

843 1EXTENSIVE 3RD DEGREE OR FULL THICKNESS

BURNS W/O SKIN GRAFTMinor 0.6222 National 3.10 10


BURNS W/O SKIN GRAFTModerate 0.8584 National 4.33 14


BURNS W/O SKIN GRAFTMajor 1.5676 National 6.50 23


BURNS W/O SKIN GRAFTExtreme 4.2291 National 9.00 41

844 1PARTIAL THICKNESS BURNS W OR W/O SKIN

GRAFTMinor 0.5765 National 2.81 10


GRAFTModerate 0.9432 National 4.55 15


GRAFTMajor 1.6613 National 7.04 22


GRAFTExtreme 6.7140 National 18.61 48

850 1PROCEDURE W DIAG OF REHAB, AFTERCARE OR

OTH CONTACT W HEALTH SERVICEMinor 1.4998 National 2.38 7


OTH CONTACT W HEALTH SERVICEModerate 1.7004 National 4.57 18


OTH CONTACT W HEALTH SERVICEMajor 3.2225 National 14.89 48


OTH CONTACT W HEALTH SERVICEExtreme 6.8534 National 29.86 95

860 1 REHABILITATION Minor 0.8574 National 8.74 20

860 2 REHABILITATION Moderate 1.5256 CO Specific 11.75 26

Updated 7/1/2020









860 3 REHABILITATION Major 2.1410 CO Specific 15.36 39

860 4 REHABILITATION Extreme 2.4919 National 17.44 44

861 1SIGNS, SYMPTOMS & OTHER FACTORS

INFLUENCING HEALTH STATUSMinor 0.4857 CO Specific 1.99 4


INFLUENCING HEALTH STATUSModerate 0.6734 CO Specific 3.04 9


INFLUENCING HEALTH STATUSMajor 0.9217 CO Specific 4.24 13


INFLUENCING HEALTH STATUSExtreme 2.0033 National 8.66 29

862 1 OTHER AFTERCARE & CONVALESCENCE Minor 0.4019 National 5.69 21

862 2 OTHER AFTERCARE & CONVALESCENCE Moderate 0.7050 National 9.06 29

862 3 OTHER AFTERCARE & CONVALESCENCE Major 1.1069 National 11.16 36

862 4 OTHER AFTERCARE & CONVALESCENCE Extreme 1.9797 National 14.95 47

863 1 NEONATAL AFTERCARE Minor 0.8678 National 8.14 22

863 2 NEONATAL AFTERCARE Moderate 2.4530 National 17.56 47

863 3 NEONATAL AFTERCARE Major 4.3914 National 26.98 64

863 4 NEONATAL AFTERCARE Extreme 10.4916 National 46.57 120

890 1HIV W MULTIPLE MAJOR HIV RELATED

CONDITIONSMinor 1.2212 National 1.67 5


CONDITIONSModerate 1.4151 National 6.23 19


CONDITIONSMajor 2.0155 National 8.48 25


CONDITIONSExtreme 4.5260 National 14.48 42

892 1 HIV W MAJOR HIV RELATED CONDITION Minor 0.7281 National 5.25 17

892 2 HIV W MAJOR HIV RELATED CONDITION Moderate 1.0320 National 4.65 14

892 3 HIV W MAJOR HIV RELATED CONDITION Major 1.3966 National 6.19 18

892 4 HIV W MAJOR HIV RELATED CONDITION Extreme 2.7041 National 10.47 30

893 1HIV W MULTIPLE SIGNIFICANT HIV RELATED

CONDITIONSMinor 0.9886 National 4.24 12


CONDITIONSModerate 1.0585 National 4.69 13


CONDITIONSMajor 1.6264 National 6.98 20


CONDITIONSExtreme 2.8302 National 12.45 42

Updated 7/1/2020









894 1HIV W ONE SIGNIF HIV COND OR W/O SIGNIF

RELATED CONDMinor 0.6618 National 3.02 8


RELATED CONDModerate 0.8138 National 3.59 10


RELATED CONDMajor 1.1695 National 5.29 15


RELATED CONDExtreme 2.3263 National 8.69 27

910 1CRANIOTOMY FOR MULTIPLE SIGNIFICANT

TRAUMAMinor 4.6404 Policy Adjusted 11.00 11


TRAUMAModerate 5.1442 Policy Adjusted 7.87 20


TRAUMAMajor 7.2732 Policy Adjusted 10.71 29


TRAUMAExtreme 14.9083 Policy Adjusted 21.23 58

911 1EXTENSIVE ABDOMINAL/THORACIC PROCEDURES

FOR MULT SIGNIFICANT TRAUMAMinor 2.0607 Policy Adjusted 5.11 12


FOR MULT SIGNIFICANT TRAUMAModerate 3.2408 Policy Adjusted 6.26 14


FOR MULT SIGNIFICANT TRAUMAMajor 4.6919 Policy Adjusted 8.21 20


FOR MULT SIGNIFICANT TRAUMAExtreme 12.4659 Policy Adjusted 18.19 52

912 1MUSCULOSKELETAL & OTHER PROCEDURES FOR

MULTIPLE SIGNIFICANT TRAUMAMinor 3.2563 Policy Adjusted 5.58 12


MULTIPLE SIGNIFICANT TRAUMAModerate 3.6560 Policy Adjusted 6.39 15


MULTIPLE SIGNIFICANT TRAUMAMajor 5.7370 Policy Adjusted 10.76 31


MULTIPLE SIGNIFICANT TRAUMAExtreme 12.0648 Policy Adjusted 22.98 63

930 1MULTIPLE SIGNIFICANT TRAUMA W/O O.R.

PROCEDUREMinor 1.3150 Policy Adjusted 2.87 9


PROCEDUREModerate 1.5728 Policy Adjusted 3.20 7


PROCEDUREMajor 2.9819 Policy Adjusted 7.18 23

Updated 7/1/2020










PROCEDUREExtreme 6.9991 Policy Adjusted 13.17 35

950 1EXTENSIVE PROCEDURE UNRELATED TO

PRINCIPAL DIAGNOSISMinor 1.6041 National 3.18 9


PRINCIPAL DIAGNOSISModerate 2.4200 National 5.85 17


PRINCIPAL DIAGNOSISMajor 3.8372 National 11.18 29


PRINCIPAL DIAGNOSISExtreme 7.7037 National 21.60 56

951 1MODERATELY EXTENSIVE PROCEDURE

UNRELATED TO PRINCIPAL DIAGNOSISMinor 1.1364 National 2.81 9


UNRELATED TO PRINCIPAL DIAGNOSISModerate 1.2900 CO Specific 3.97 12


UNRELATED TO PRINCIPAL DIAGNOSISMajor 2.4469 CO Specific 9.14 28


UNRELATED TO PRINCIPAL DIAGNOSISExtreme 5.9154 National 18.12 49

952 1NONEXTENSIVE PROCEDURE UNRELATED TO

PRINCIPAL DIAGNOSISMinor 0.6776 CO Specific 2.09 5


PRINCIPAL DIAGNOSISModerate 1.3346 National 4.65 14


PRINCIPAL DIAGNOSISMajor 2.3613 National 8.93 24


PRINCIPAL DIAGNOSISExtreme 5.0632 National 16.98 46

955 0PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE

DIAGNOSIS0.0000 National 0.00 0

956 0 UNGROUPABLE 0.0000 National 0.00 0

Documents

Colorado Department of Health Care Policy and …...MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES Minor 0.8761 National 3.41 9 043 2 MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES