Cal. Code Regs. Tit. 8, div. 1, ch. 4.5, subch. 1, art. 5.5, app C

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Appendix C - Ratios Applied to Revise Certain DRG Weights in California

*Number*	*DRG*	*Ratio*

004	Spinal Procs	0.6283
008	Peripheral/Cranial Nerve & Orth OR Nervous Sys. Procs	0.8082
025	Seizures and Headaches: AD WO CC	0.7485
029	Traumatic Stupor and Coma: AD WO CC	1.0025
032	Concussion: AD WO CC	0.8749
042	Intraocular Proc Exc. Retina, Iris and Lens	1.0661
063	Other Ear, Nose, Mouth and Throat OR Procs	0.8753
112	Percutaneous Cardiovascular Procs	0.8409
140	Angina Pectoris	0.7834
143	Chest Pain	0.8417
160	Hernia Proc: AD Exc. Inguinal or Femoral, WO CC	0.9016
162	Hernia Proc: AD Inguinal or Femoral, WO CC	0.8672
209	Major Joints and Limb Reattachment, Lower Extremity	0.9500
210	Hip and Femur, Exc Major joint Proc: AD W CC	1.1800
211	Hip and Femur, Exc Major joint Proc: AD WO CC	0.9726
214	Back and Neck Proc W CC	0.9674
215	Back and Neck Procs WO CC	0.9556
217	Wound Debridement and Skin Graft Exc. Hand	0.5717
218	Lower Extr/Humerous Exc. Hip, Foot and Femur: AD W CC	1.0298
219	Lower Extr/Humer. Exc. Hip, Foot and Femur: AD WO CC	0.9681
221	Knee Proc W CC	0.8177
222	Knee Proc WO CC	1.0382
223	Maj. Shoulder/Elbow Proc/Other Upper Extrem. Proc W CC	0.8850
224	Shoulder/Elbow/Forearm Proc exc. Major Joint Proc WO CC	1.0122
225	Foot Proc	1.0008
227	Soft Tissue Proc WO CC	0.9443
228	Major Thumb/Joint Proc, or Other Hand or Wrist Proc W CC	0.9063
229	Hand and Wrist Proc, Exc. Major joint Proc WO CC	1.0367
231	Local Excision/Removal Int. Fix. Devices Exc. Hip & Femur	0.7341
232	Arthroscopy	0.8166
234	Oth. Musculoskel. Sys/Connective Tissue OR Procs WO CC	0.8133
236	Fracture of Hip and Pelvis	0.9790
243	Medical Back	0.7609
251	Frac, Sprain, Strain, Disloc Forearm, Hand/Foot: AD WO CC	0.9012
254	Frac, Sprain, Strain, Disloc Up Arm/Low Leg ex Foot: AD W CC	1.0031
266	Skin Graft/Debridement Exc. Skin Ulcer or Cellulitis WO CC	1.1306
277	Cellulitis: AD W CC	0.7910
278	Cellulitis: AD WO CC	0.8654
281	Trauma to Skin, Subcutaneous Tiss and Breast: AD WO CC	0.9709
415	Infectious and Parasitic Disease OR Proc	0.4907
418	Postoperative and Post traumatic Infection	0.6801
440	Wound Debridement for Injury	0.7738
441	Hand Proc for Injury	0.9914
443	Other Proc for Injury WO CC	1.0024
445	Traumatic Injury: AD WO CC	0.8112
450	Injury/Poison/Drug: AD WO CC	0.6657
455	Other Injury/Poisoning and Toxic Effect Diagnosis WO CC	0.7483
461	OR Proc with Diagnosis of Other Contact with Health Services	0.9207