Belton Regional Medical Center
| DRG | Plain Language Description | Average Charge |
|---|---|---|
| 871 | Septicemia or severe sepsis without MV >96 hours with complication | $13,530 |
| 872 | Septicemia or severe sepsis without MV >96 hours without complication | $10,147 |
| 392 | Esophagitis, gastroenteritis and miscellaneous digestive disorders without complication | $7,955 |
| 189 | Pulmonary edema and respiratory failure | $9,218 |
| 682 | Renal failure with complication | $10,427 |
| 291 | Heart failure and shock with complication | $7,496 |
| 683 | Renal failure with comorbidity | $5,715 |
| 638 | Diabetes with comorbidity | $9,030 |
| 305 | Hypertension without complication | $6,079 |
| 690 | Kidney and urinary tract infections without complication | $5,941 |
| 193 | Simple pneumonia and pleurisy with complication | $8,596 |
| 177 | Respiratory infections and inflammations with complication | $12,834 |
| 312 | Syncope and collapse | $6,127 |
| 309 | Cardiac arrhythmia and conduction disorders with comorbidity | $6,363 |
| 641 | Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without complication | $4,378 |
| 698 | Other kidney and urinary tract diagnoses with complication | $11,302 |
| 853 | Infectious and parasitic diseases with O.R. procedures with complication | $42,649 |
| 418 | Laparoscopic cholecystectomy without C.D.E. with comorbidity | $17,429 |
| 552 | Medical back problems without complication | $12,032 |
| 603 | Cellulitis without complication | $5,501 |
| 389 | Gastrointestinal obstruction with comorbidity | $7,261 |
| 689 | Kidney and urinary tract infections with complication | $8,389 |
| 637 | Diabetes with complication | $8,697 |
| 640 | Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with complication | $7,788 |
| 897 | Alcohol, drug abuse or dependence without rehabilitation therapy without complication | $7,695 |
| 310 | Cardiac arrhythmia and conduction disorders without comorbidity/complication | $4,810 |
| 065 | Intracranial hemorrhage or cerebral infarction with comorbidity or tPA in 24 hours | $6,917 |
| 378 | Gastrointestinal hemorrhage with comorbidity | $6,801 |
| 419 | Laparoscopic cholecystectomy without C.D.E. without comorbidity/complication | $12,217 |
| 699 | Other kidney and urinary tract diagnoses with comorbidity | $7,062 |
| 812 | Red blood cell disorders without complication | $6,120 |
| 439 | Disorders of pancreas except malignancy with comorbidity | $11,376 |
| 481 | Hip and femur procedures except major joint with comorbidity | $13,602 |
| 308 | Cardiac arrhythmia and conduction disorders with complication | $8,138 |
| 854 | Infectious and parasitic diseases with O.R. procedures with comorbidity | $33,506 |
| 280 | Acute myocardial infarction, discharged alive with complication | $8,082 |
| 470 | Major hip and knee joint replacement or reattachment of lower extremity without complication | $23,452 |
| 300 | Peripheral vascular disorders with comorbidity | $7,024 |
| 331 | Major small and large bowel procedures without comorbidity/complication | $14,246 |
| 522 | Hip replacement with principal diagnosis of hip fracture without complication | $12,913 |
| 394 | Other digestive system diagnoses with comorbidity | $6,009 |
| 918 | Poisoning and toxic effects of drugs without complication | $10,142 |
| 945 | Rehabilitation with comorbidity/complication | $10,382 |
| 438 | Disorders of pancreas except malignancy with complication | $10,000 |
| 480 | Hip and femur procedures except major joint with complication | $21,350 |
| 884 | Organic disturbances and intellectual disability | $7,599 |
| 330 | Major small and large bowel procedures with comorbidity | $17,702 |
| 175 | Pulmonary embolism with complication or acute cor pulmonale | $9,851 |
| 377 | Gastrointestinal hemorrhage with complication | $16,081 |
| 811 | Red blood cell disorders with complication | $8,126 |
| 069 | Transient ischemia without thrombolytic | $4,737 |
| 208 | Respiratory system diagnosis with ventilator support <=96 hours | $14,765 |
| 639 | Diabetes without comorbidity/complication | $5,131 |
| 896 | Alcohol, drug abuse or dependence without rehabilitation therapy with complication | $18,306 |
| 391 | Esophagitis, gastroenteritis and miscellaneous digestive disorders with complication | $9,782 |
| 313 | Chest pain | $7,321 |
| 304 | Hypertension with complication | $9,173 |
| 917 | Poisoning and toxic effects of drugs with complication | $9,396 |
| 299 | Peripheral vascular disorders with complication | $11,484 |
| 440 | Disorders of pancreas except malignancy without comorbidity/complication | $6,235 |
| 563 | Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without complication | $4,330 |
| 493 | Lower extremity and humerus procedures except hip, foot and femur with comorbidity | $20,549 |
| 694 | Urinary stones without complication | $5,325 |
| 445 | Disorders of the biliary tract with comorbidity | $9,537 |
| 393 | Other digestive system diagnoses with complication | $7,959 |
| 482 | Hip and femur procedures except major joint without comorbidity/complication | $9,869 |
| 194 | Simple pneumonia and pleurisy with comorbidity | $4,563 |
| 558 | Tendonitis, myositis and bursitis without complication | $7,616 |
| 191 | Chronic obstructive pulmonary disease with comorbidity | $4,830 |
| 074 | Cranial and peripheral nerve disorders without complication | $8,924 |
| 390 | Gastrointestinal obstruction without comorbidity/complication | $4,979 |
| 281 | Acute myocardial infarction, discharged alive with comorbidity | $7,442 |
| 176 | Pulmonary embolism without complication | $6,946 |
| 057 | Degenerative nervous system disorders without complication | $5,968 |
| 661 | Kidney and ureter procedures for non-neoplasm without comorbidity/complication | $10,037 |
| 375 | Digestive malignancy with comorbidity | $5,488 |
| 092 | Other disorders of nervous system with comorbidity | $10,942 |
| 343 | Appendectomy without complicated principal diagnosis without comorbidity/complication | $14,075 |
| 329 | Major small and large bowel procedures with complication | $71,643 |
| 064 | Intracranial hemorrhage or cerebral infarction with complication | $7,760 |
| 617 | Amputation of lower limb for endocrine, nutritional and metabolic disorders with comorbidity | $22,282 |
| 386 | Inflammatory bowel disease with comorbidity | $7,908 |
| 602 | Cellulitis with complication | $8,758 |
| 314 | Other circulatory system diagnoses with complication | $11,963 |
| 062 | Ischemic stroke, precerebral ocomorbiditylusion or transient ischemia with thrombolytic agent with comorbidity | $22,004 |
| 554 | Bone diseases and arthropathies without complication | $4,359 |
| 433 | Cirrhosis and alcoholic hepatitis with comorbidity | $14,570 |
| 521 | Hip replacement with principal diagnosis of hip fracture with complication | $17,777 |
| 863 | Postoperative and post-traumatic infections without complication | $7,693 |
| 432 | Cirrhosis and alcoholic hepatitis with complication | $15,008 |
| 556 | Signs and symptoms of musculoskeletal system and connective tissue without complication | $4,530 |
| 536 | Fractures of hip and pelvis without complication | $5,326 |
| 184 | Major chest trauma with comorbidity | $5,731 |
| 190 | Chronic obstructive pulmonary disease with complication | $6,322 |
| 551 | Medical back problems with complication | $9,204 |
| 857 | Postoperative or post-traumatic infections with O.R. procedures with comorbidity | $19,189 |
| 467 | Revision of hip or knee replacement with comorbidity | $19,270 |
| 178 | Respiratory infections and inflammations with comorbidity | $8,150 |
| 200 | Pneumothorax with comorbidity | $15,714 |
| 894 | Alcohol, drug abuse or dependence, left AMA | $3,694 |
| 565 | Other musculoskeletal system and connective tissue diagnoses with comorbidity | $5,396 |
| 417 | Laparoscopic cholecystectomy without C.D.E. with complication | $27,968 |
| 381 | Complicated peptic ulcer with comorbidity | $4,967 |
| 605 | Trauma to the skin, subcutaneous tissue and breast without complication | $6,060 |
| 355 | Hernia procedures except inguinal and femoral without comorbidity/complication | $12,798 |
| 880 | Acute adjustment reaction and psychosocial dysfunction | $10,002 |
| 101 | Seizures without complication | $5,836 |
| 315 | Other circulatory system diagnoses with comorbidity | $6,155 |
| 179 | Respiratory infections and inflammations without comorbidity/complication | $8,282 |
CPT® copyright 2022 American Medical Association