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MS-DRGs Standard Charges - John Muir-Walnut Creek
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Based off CMS Adjudicated Claims through 3/31/18 (Machine-Readable Format)
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MS-DRGDescriptionAverage Standard Charge
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003
ECMO or tracheostomy with mechanical ventilation 96+ hours with majo
$1,291,140
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004
Trach w MV 96+ hrs or PDX exc face, mouth & neck without maj O.R.
$1,065,849
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012Tracheostomy for face, mouth & neck diagnoses with complications$131,394
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020
Intracranial vascular procedures with PDX hemorrhage with major comp
$1,038,775
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023Craniotomy with major device implant with major complications$450,988
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024Craniotomy with major device implant without complications$257,596
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025
Craniotomy & endovascular intracranial procedures with major complic
$440,494
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026
Craniotomy & endovascular intracranial procedures with complications
$357,415
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027
Craniotomy & endovascular intracranial procedures without complicati
$289,021
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028Spinal procedures with major complications$564,528
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029Spinal procedures with complications or spinal neurostimulators$226,432
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030Spinal procedures without complications$189,720
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031Ventricular shunt procedures with major complications$472,444
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032Ventricular shunt procedures with complications$132,622
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033Ventricular shunt procedures without complications$136,253
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034Carotid artery stent procedure with major complications$357,930
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035Carotid artery stent procedure with complications$387,299
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037Extracranial procedures with major complications$402,017
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038Extracranial procedures with complications$202,148
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039Extracranial procedures without complications$95,111
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040Periph/cranial nerve & other nerv syst proc with major complications$328,606
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041Periph/cranial nerve & other nerv syst proc with complications or pe$248,266
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042Periph/cranial nerve & other nerv syst proc without complications$49,501
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052Spinal disorders & injuries with major complications$192,692
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053Spinal disorders & injuries without complications$71,802
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054Nervous system neoplasms with major complications$125,001
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055Nervous system neoplasms without major complications$114,478
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056Degenerative nervous system disorders with major complications$170,494
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057Degenerative nervous system disorders without complications$149,872
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058Multiple sclerosis & cerebellar ataxia with major complications$90,159
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059Multiple sclerosis & cerebellar ataxia with complications$140,449
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060Multiple sclerosis & cerebellar ataxia without complications$147,926
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061
Acute ischemic stroke w use of thrombolytic agent with major complic
$338,319
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062
Acute ischemic stroke w use of thrombolytic agent with complications
$240,769
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063
Acute ischemic stroke w use of thrombolytic agent without complicati
$227,817
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064Stroke with major complications$176,431
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065Stroke with complications$99,643
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066Intracranial hemorrhage or cerebral infarction without complications$63,341
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067Nonspecific CVA & precerebral occlusion without infarct with major c$105,500
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068Nonspecific CVA & precerebral occlusion without infarct without majo$54,543
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069Transient ischemia$69,451
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070Nonspecific cerebrovascular disorders with major complications$118,372
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071Nonspecific cerebrovascular disorders with complications$83,172
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072Nonspecific cerebrovascular disorders without complications$49,484
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073Cranial & peripheral nerve disorders with major complications$97,883
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074Cranial & peripheral nerve disorders without major complications$74,111
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075Viral meningitis with major complications$38,327
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077Hypertensive encephalopathy with major complications$56,493
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081Nontraumatic stupor & coma without major complications$81,488
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082Traumatic stupor & coma, coma >1 hr with major complications$193,582
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083Traumatic stupor & coma, coma >1 hr with complications$124,015
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084Coma more than 1 hour without complications$66,943
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085Traumatic stupor & coma, coma <1 hr with major complications$169,550
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086Traumatic stupor & coma, coma <1 hr with complications$111,200
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087Traumatic stupor & coma, coma <1 hr without complications$70,437
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088Concussion with major complications$95,636
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089Concussion with complications$92,315
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090Concussion without complications$76,331
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091Other disorders of nervous system with major complications$104,258
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092Other disorders of nervous system with complications$96,930
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093Other disorders of nervous system without complications$75,792
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094
Bacterial & tuberculous infections of nervous system with major comp
$188,647
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095Bacterial & tuberculous infections of nervous system with complicati$168,967
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098Non-bacterial infect of nervous sys exc viral meningitis with compli$180,747
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100Seizures with major complications$175,933
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101Seizures without major complications$87,494
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102Headaches with major complications$114,173
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103Headaches without major complications$63,540
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113Orbital procedures with major complications$123,194
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115Extraocular procedures except orbit$61,912
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117Intraocular procedures without complications$71,573
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121Acute major eye infections with major complications$39,434
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123Neurological eye disorders$61,068
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124Other disorders of the eye with major complications$78,005
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125Other disorders of the eye without major complications$109,989
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131Cranial/facial procedures with major complications$131,838
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133
Other ear, nose, mouth & throat O.R. procedures with major complicat
$192,535
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134
Other ear, nose, mouth & throat O.R. procedures without complication
$105,587
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137Mouth procedures with major complications$98,889
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138Mouth procedures without complications$73,628
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149Dysequilibrium$48,699
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150Epistaxis with major complications$149,963
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151Epistaxis without major complications$32,629
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152Otitis media & URI with major complications$93,381
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153Otitis media & URI without major complications$55,683
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154Other ear, nose, mouth & throat diagnoses with major complications$62,086
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155Other ear, nose, mouth & throat diagnoses with complications$59,956
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156Other ear, nose, mouth & throat diagnoses without complications$60,028
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157Dental & oral diseases with major complications$82,603
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158Dental & oral diseases with complications$61,168
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159Dental & oral diseases without complications$25,554
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163Major chest procedures with major complications$434,493
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164Major chest procedures with complications$202,142
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165Major chest procedures without complications$160,128
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166Other respiratory system O.R. procedures with major complications$323,424
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167Other respiratory system O.R. procedures with complications$157,492
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