2024 WC FEE SCHEDULE

Table B, Part III: 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)
401	LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC	24043	92	137	3100
402	LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC	9212	32	48	2500
403	LYMPHOMA & NON-ACUTE LEUKEMIA W CC	16956	74	107	2900
404	LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC	7571	37	52	2600
405	ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17	10840	49	49	2700
406	MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC	26496	94	128	3100
407	MYELOPROLIF DISRD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/OCC	11262	41	53	2600
408	MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC	15586	50	84	2700
409	RADIOTHERAPY	9785	54	77	2700
410	CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS	6749	27	33	2000
411	HISTORY OF MALIGNANCY W/O ENDOSCOPY	4476	27	37	2500
412	HISTORY OF MALIGNANCY W ENDOSCOPY	4515	21	30	2100
413	OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC	13595	68	99	2900
414	OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC	6704	37	54	2600
415	O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES	35136	134	187	3500
416	SEPTICEMIA AGE >17	14927	69	95	2900
417	SEPTICEMIA AGE 0-17	14250	52	75	2700
418	POSTOPERATIVE & POST-TRAUMATIC INFECTIONS	9628	60	76	2800
419	FEVER OF UNKNOWN ORIGIN AGE >17 W CC	9293	52	66	2700
420	FEVER OF UNKNOWN ORIGIN AGE > 17 W/O CC	6368	40	49	2600
421	VIRAL ILLNESS AGE >17	6868	40	51	2600
422	VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17	5859	34	43	2500
423	OTHER INFEECTIOUS & PARASITIC DISEASES DIAGNOSES	15846	71	100	2900
424	O.R. PROCEDURE W PRINCIPLA DIAGNOSES OF MENTAL ILLNESS	25573	135	226	3600
425	ACUTE ADJUST REACT & DISTURBANCES OF PSYCHOSOCIAL DYSFUNCT	7079	41	57	2600
426	DEPRESSIVE NEUROSES	5960	46	65	2700
427	NEUROSES EXCEPT DEPRESSIVE	5969	44	64	2600
428	DISORDERS OF PERSONALITY & IMPLUSE CONTROL	7521	57	94	2800
429	ORGANIC DISTURBANCES & MENTAL RETARDATION	9269	70	104	2900
430	PSYCHOSES	8980	80	115	3000
431	CHILDHOOD MENTAL DISORDERS	6316	52	76	2700
432	OTHER MENTAL DISORDER DIAGNOSES	7538	46	72	2700
433	ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA	3356	28	41	2500
434	ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W CC	7235	49	67	2700
435	ALC/DRUG ABUSE OR DEPEND, DETOX OR OTH SYMPT TREAT W/O CC	4372	41	55	2600
436	ALC/DRUG DEPENDENCE W REHABILITATION THERAPY	9156	145	172	3600
437	ALC/DRUG DEPENDENCE, COMBINED REHAB & DETOX THERAPY	9021	115	136	3400
438	NO LONGER VALID	0	0	0	0
439	SKIN GRAFTS FOR INJURIES	13295	56	89	2800
440	WOUND DEBRIDEMENTS FOR INJURIES	17495	70	112	2900
441	HAND PROCEDURES FOR INJURIES	7840	23	35	2400
442	OTHER O.R. PROCEDURES FOR INJURIES W CC	20135	58	95	2800
443	OTHER O.R. PROCEDURES FOR INJURIES W/O CC	7547	24	33	2400
444	TRAUMATIC INJURY AGE >17 W CC	7399	46	62	2700
445	TRAUMATIC INJURY AGE >17 W/O CC	4640	31	40	2500
446	TRAUMATIC INJURY 0-17	4995	24	24	2200
447	ALLERGIC REACTIONS AGE >17	4676	23	31	2000
448	ALLERGIC REACTIONS AGE 0-17	3614	29	29	1700
449	POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC	7801	35	51	2600
450	POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC	4168	20	27	1700
451	POISIONING & TOXIC EFFECTS OF DRUGS AGE 0-17	10341	21	21	1700
452	COMPLICATIONS OF TREATMENT W CC	8577	40	56	2600
453	COMPLICATIONS OF TREATMENT W/O CC	4355	26	34	2200
454	OTHER INJURY, POISIONING & TOXIC EFFECT DIAG W CC	8864	41	64	2600
455	OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC	4379	22	32	2400
456	BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY	21721	52	102	2700
457	EXTENSIVE BURNS W/O O.R. PROCEDURE	16307	30	56	2500
458	NON-EXTENSIVE BURNS W SKIN GRAFT	35089	140	198	3600
459	NON-EXTENSIVE BURNS W WOUND DEBRIDEMENT OR OTHER O.R. PROC	17543	85	125	3000
460	NON-EXTENSIVE BURNS W/O O.R. PROCEDURE	10023	56	80	2800
461	O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES	9432	25	52	2400
462	REHABILITATION	16623	134	167	3500
463	SIGNS & SYMPTOMS W CC	7170	45	60	2600
464	SIGNS & SYMPTOMS W/O CC	4740	31	41	2500
465	AFTERCARE W HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS	4464	20	32	2300
466	AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS	5319	24	49	2400
467	OTHER FACTORS INFLUENCING HEALTH STATUS	3722	26	51	2500
468	EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS	35769	124	177	3400
469	PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS	0	0	0	0
470	UNGROUPABLE	0	0	0	0
471	BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY	37499	94	110	3100
472	EXTENSIVE BURNS W O.R. PROCEDURE	116375	159	304	3800
473	ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17	36120	93	163	3100
474	NO LONGER VALID	0	0	0	0
475	RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT	37005	95	137	3100
476	PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS	22327	123	156	3400
477	NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIP DIAGNOSIS	15221	58	95	2800
478	OTHER VASCULAR PROCEDURES W CC	22227	63	95	2800
479	OTHER VASCULAR PROCEDURES W/O CC	13503	39	51	2600
480	LIVER TRANSPLANT	182581	271	347	4900
481	BONE MARROW TRANSPLANT	153076	355	394	5700
482	TRACHEOSTOMY FOR FACE, MOUTH & NECK DIAGNOSES	36730	130	174	3500
483	TRACHEOSTOMY EXCEPT FOR FACE, MOUTH & NECK DIAGNOSES	168772	419	541	6400
484	CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA	59807	125	202	3500
485	LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIP SIGNIF TRAUMA	31540	114	144	3300
486	OTHER O.R. PROCED FOR MULTIPLE SIGNIFICANT TRAUMA	49514	105	168	3200
487	OTHER MULTIPLE SIGNIFICANT TRAUMA	19336	69	102	2900
488	HIV W EXTENSIVE O.R. PROCEDURE	43854	151	215	3700
489	HIV W MAJOR RELATED CONDITION	18158	83	125	3000
490	HIV W OR W/O OTHER RELATED CONDITION	10630	51	80	2700
491	MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREM	16235	44	53	2400
492	CHEMOTHERAPY W ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS	36804	107	169	3300
493	LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC	15813	43	61	2600
494	LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC	8462	17	23	1400
495	LUNG TRANSPLANT	128346	202	263	4200

Table B, Part III: Federal Register Table 5

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