Scott, Lisa M
klutml
2018-12-20T19:20:57Z
2018-12-18T22:21:10Z
2019-01-07T17:19:20Z
12.00
15075
23895
120
30
False
False
While the file below represents our charges for each DRG service historically provided at St. Luke's Des Peres Hospital, the following link: https://www.stlukes-stl.com/pay/average-cost-estimates.html will provide you with the average out-of-pocket costs for our most common DRGs together with additional insights into pricing transparency for our services and frequently asked questions. |
MS DRG |
MS DRG Desc |
Average Charges |
3 |
Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth |
543170.75 |
12 |
Tracheostomy For Face,Mouth Neck Diagnoses W Cc |
57462 |
|
26 |
Craniotomy Endovascular Intracranial Px W Cc |
44463 |
29 |
Spinal Procedures W Cc Or Spinal Neurostimulators |
93778 |
38 |
Extracranial Procedures W Cc |
62460.666666666664 |
39 |
Extracranial Procedures W/O Cc/Mcc |
47509.545454545456 |
65 |
Intracranial Hemorrhage Or Cerebral Infarction Wcc |
21048.5 |
69 |
Transient Ischemia |
47607 |
74 |
Cranial Peripheral Nerve Disorders W/O Mcc |
22958.333333333332 |
92 |
Other Disorders Of Nervous System W Cc |
35964 |
93 |
Other Disorders Of Nervous System W/O Cc/Mcc |
11345 |
103 |
Headaches W/O Mcc |
18335 |
124 |
Other Disorders Of The Eye W Mcc |
30394 |
134 |
Other Ear, Nose, Mouth Throat O.R. Px W/O Cc/Mcc |
22227 |
149 |
Dysequilibrium |
13360.333333333334 |
153 |
Otitis Media Uri W/O Mcc |
3074 |
155 |
Other Ear, Nose, Mouth Throat Diagnoses W Cc |
22737 |
165 |
Major Chest Procedures W/O Cc/Mcc |
70152 |
166 |
Other Resp System O.R. Procedures W Mcc |
119189.5 |
167 |
Other Resp System O.R. Procedures W Cc |
42986 |
168 |
Other Resp System O.R. Procedures W/O Cc/Mcc |
45075 |
175 |
Pulmonary Embolism W Mcc |
40330 |
176 |
Pulmonary Embolism W/O Mcc |
29468 |
177 |
Respiratory Infections Inflammations W Mcc |
44447.6 |
178 |
Respiratory Infections Inflammations W Cc |
33521.333333333336 |
185 |
Major Chest Trauma W/O Cc/Mcc |
21249 |
187 |
Pleural Effusion W Cc |
22203 |
189 |
Pulmonary Edema Respiratory Failure |
36967.4 |
190 |
Chronic Obstructive Pulmonary Disease W Mcc |
36556.75 |
191 |
Chronic Obstructive Pulmonary Disease W Cc |
29557 |
192 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc |
25931.5 |
193 |
Simple Pneumonia Pleurisy W Mcc |
47061.777777777781 |
194 |
Simple Pneumonia Pleurisy W Cc |
28315 |
195 |
Simple Pneumonia Pleurisy W/O Cc/Mcc |
16199.666666666666 |
202 |
Bronchitis Asthma W Cc/Mcc |
38887 |
206 |
Other Respiratory System Diagnoses W/O Mcc |
36770 |
208 |
Respiratory System Dx W Ventilator Support <96 Hrs |
69562.5 |
215 |
Other Heart Assist System Implant |
312889.33333333331 |
221 |
Cardiac Valve Oth Maj Cardiothoracic Px W/O Card |
230381 |
227 |
Cardiac Defibrilator Implant W/O Card Cath W/O Mcc |
109058 |
231 |
Coronary Bypass W Ptca W Mcc |
291251 |
233 |
Coronary Bypass W Cardiac Cath W Mcc |
227147.5 |
234 |
Coronary Bypass W Cardiac Cath W/O Mcc |
207653.25 |
235 |
Coronary Bypass W/O Cardiac Cath W Mcc |
326422.66666666669 |
236 |
Coronary Bypass W/O Cardiac Cath W/O Mcc |
182455.77777777778 |
239 |
Amputat For Circ Sys Dorder Exc Upper Limb Toe W |
166842 |
240 |
Amputat For Circ Sys Dorder Exc Upper Limb Toe W |
78520.75 |
242 |
Permanent Cardiac Pacemaker Implant W Mcc |
109767 |
243 |
Permanent Cardiac Pacemaker Implant W Cc |
83894.666666666672 |
244 |
Permanent Cardiac Pacemaker Implant W/O Cc/Mcc |
83369.666666666672 |
245 |
Aicd Generator Procedures |
278154 |
246 |
Perc Cardiovasc Px W Drugeluting Stent W Mcc Or 4+ |
99149.75 |
247 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc |
85584.305084745763 |
249 |
Perc Cardiovasc Px W Nondrug-Eluting Stent W/O Mcc |
93012.25 |
250 |
Perc Cardiovasc Px W/O Coronary Artery Stent W Mcc |
113569 |
251 |
Perc Cardiovasc Proc W/O Coronary Artery Stent W/O |
59888.2 |
252 |
Other Vascular Procedures W Mcc |
63437 |
253 |
Other Vascular Procedures W Cc |
72033.071428571435 |
254 |
Other Vascular Procedures W/O Cc/Mcc |
70715.25 |
259 |
Cardiac Pacemaker Device Replacement W/O Mcc |
50784 |
260 |
Card Pacemaker Revision Except Device Replace W Mc |
71941 |
261 |
Cardiac Pacemaker Revis Except Dvice Replace W Cc |
78636 |
262 |
Cardiac Pacemaker Revision Except Device Replaceme |
27616 |
264 |
Other Circulatory System O.R. Procedures |
30410 |
269 |
Aortic Heart Assist Px Ex Pulsation Balloon W/O Mc |
109724.54545454546 |
270 |
Other Major Cardiovascular Px W Mcc |
155974 |
271 |
Other Major Cardiovascular Px W CC |
156342.625 |
272 |
Other Major Cardiovascular Px W/O CC/MCC |
89219 |
280 |
Acute Myocardial Infarction Discharged Alive W Mcc |
97976 |
281 |
Acute Myocardial Infarction, Discharged Alive W Cc |
44193 |
282 |
Acute Myocardal Infarcton, Dischg Alive W/O Cc/Mcc |
29925.428571428572 |
283 |
Acute Myocardial Infarction, Expired W Mcc |
60393 |
286 |
Circulatory Disorders Except Ami W Card Cath W Mcc |
63906 |
287 |
Circulatory Disordr Except Ami W Card Cath W/O Mcc |
34035.279999999999 |
291 |
Heart Failure Shock W Mcc |
41419.038461538461 |
292 |
Heart Failure Shock W Cc |
47412.818181818184 |
293 |
Heart Failure Shock W/O Cc/Mcc |
15998 |
296 |
Cardiac Arrest, Unexplained W Mcc |
148922 |
299 |
Peripheral Vascular Disorders W Mcc |
46569.25 |
300 |
Peripheral Vascular Disorders W Cc |
28385.428571428572 |
301 |
Peripheral Vascular Disorders W/O Cc/Mcc |
14418.5 |
303 |
Atherosclerosis W/O Mcc |
28531 |
305 |
Hypertension W/O Mcc |
27171.75 |
306 |
Cardiac Congenital Valvular Disorders W Mcc |
30547 |
308 |
Cardiac Arrhythmia Conduction Disorders W Mcc |
39087.4 |
309 |
Cardiac Arrhythmia Conduction Disorders W Cc |
24862.6 |
310 |
Cardiac Arrhythmia Conduction Disorders W/O Cc/Mc |
15636 |
313 |
Chest Pain |
23947.5 |
315 |
Other Circulatory System Diagnoses W Cc |
32952.666666666664 |
316 |
Other Circulatory System Diagnoses W/O Cc/Mcc |
43639 |
326 |
Stomach, Esophageal Duodenal Proc W Mcc |
54168.5 |
327 |
Stomach, Esophageal Duodenal Proc W Cc |
50065.666666666664 |
328 |
Stomach, Esophageal Duodenal Proc W/O Cc/Mcc |
35341.75 |
329 |
Major Small Large BoWel Procedures W Mcc |
141437.5 |
330 |
Major Small Large BoWel Procedures W Cc |
92171.222222222219 |
331 |
Major Small Large BoWel Procedures W/O Cc/Mcc |
59709.599999999999 |
335 |
Peritoneal Adhesiolysis W Mcc |
115381 |
337 |
Peritoneal Adhesiolysis W/O Cc/Mcc |
61826 |
338 |
Appendectomy W Complicated Principal Diag W Mcc |
43447 |
339 |
Appendectomy W Complicated Principal Diag W Cc |
48216 |
340 |
Appendectomy W Complicated Principal Dx W/O Cc/Mcc |
46217 |
342 |
Appendectomy W/O Complicated Principal Diag W Cc |
44916 |
343 |
Appendectomy W/O Complicated Pdiag W/O Cc/Mcc |
72329 |
349 |
Anal Stomal Procedures W/O Cc/Mcc |
38798 |
353 |
Hernia Procedures Except Inguinal Femoral W Mcc |
64045 |
354 |
Hernia Procedures Except Inguinal Femoral W Cc |
55810.5 |
355 |
Hernia Px Except Inguinal Femoral W/O Cc/Mcc |
38514 |
356 |
Other Digestive System O.R. Procedures W Mcc |
147232 |
357 |
Other Digestive System O.R. Procedures W Cc |
51210.333333333336 |
358 |
Other Digestive System O.R. Procedures W/O Cc/Mcc |
37582 |
372 |
Major Gastroix Disordr Peritoneal Infection W Cc |
23177 |
377 |
G.I. Hemorrhage W Mcc |
61231.8 |
378 |
G.I. Hemorrhage W Cc |
39331.055555555555 |
379 |
G.I. Hemorrhage W/O Cc/Mcc |
30407 |
380 |
Complicated Peptic Ulcer W Mcc |
14087 |
381 |
Complicated Peptic Ulcer W Cc |
51596 |
382 |
Complicated Peptic Ulcer W/O Cc/Mcc |
34671 |
385 |
Inflammatory BoWel Disease W Mcc |
38554.5 |
386 |
Inflammatory BoWel Disease W Cc |
35335.75 |
387 |
Inflammatory BoWel Disease W/O Cc/Mcc |
24663.599999999999 |
388 |
G.I. Obstruction W Mcc |
39270 |
389 |
G.I. Obstruction W Cc |
42582.818181818184 |
390 |
G.I. Obstruction W/O Cc/Mcc |
34615.25 |
391 |
Esophagitis Gastroent Misc Digest Disorder W Mcc |
40947 |
392 |
Esophagitis,Gastroent Misc Digest Dorder W/O Mcc |
33871.076923076922 |
393 |
Other Digestive System Diagnoses W Mcc |
78833 |
394 |
Other Digestive System Diagnoses W Cc |
38616.625 |
395 |
Other Digestive System Diagnoses W/O Cc/Mcc |
8752 |
417 |
Laparoscopic Cholecystectomy W/O C.D.E. W Mcc |
75202 |
418 |
Laparoscopic Cholecystectomy W/O C.D.E. W Cc |
70322.8 |
419 |
Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc |
56374.25 |
432 |
Cirrhosis Alcoholic Hepatitis W Mcc |
79054 |
433 |
Cirrhosis Alcoholic Hepatitis W Cc |
27296 |
434 |
Cirrhosis Alcoholic Hepatitis W/O Cc/Mcc |
33612 |
436 |
Malignancy Of Hepatobiliary System Or Pancreas Wcc |
81786 |
439 |
Disorders Of Pancreas Except Malignancy W Cc |
35274 |
440 |
Disorders Of Pancreas Except Malignancy W/O Cc/Mcc |
33983.571428571428 |
445 |
Disorders Of The Biliary Tract W Cc |
31571.5 |
453 |
Combined Anterior/Posterior Spinal Fusion W Mcc |
184144.6 |
454 |
Combined Anterior/Posterior Spinal Fusion W Cc |
130713.38636363637 |
455 |
Combine Anterior/Posterior Spinal Fusion W/O Cc/Mc |
110428.69346733668 |
457 |
Spinal Fus Exc Cerv W Spinal Curv/Malig/Infec Or 9 |
82370 |
458 |
Spinal Fus Exc Cerv W Spinal Curv/Malig/Infec Or 9 |
136593.5 |
459 |
Spinal Fusion Except Cervical W Mcc |
118218 |
460 |
Spinal Fusion Except Cervical W/O Mcc |
126694.6 |
462 |
Bilater Or Multi Maj Joint Px Of LoW Extrem W/O Mc |
91542 |
463 |
Wnd Debrid Skn Grft Exc Hand, For Muscoconn Tiss |
813677 |
464 |
Wnd Debrid Skn Grft Exc Hand, For Muscoconn Tiss |
145706 |
466 |
Revision Of Hip Or Knee Replacement W Mcc |
321955 |
467 |
Revision Of Hip Or Knee Replacement W Cc |
140067.27272727274 |
468 |
Revision Of Hip Or Knee Replacement W/O Cc/Mcc |
104984.55882352941 |
469 |
Major Joint Replace Or Reattach Of Lower Extremity |
72631.666666666672 |
470 |
Maj Joint Replace Or Reatach Of LoW Extrem W/O Mcc |
66884.689976689973 |
471 |
Cervical Spinal Fusion W Mcc |
102841.5 |
472 |
Cervical Spinal Fusion W Cc |
99034.047619047618 |
473 |
Cervical Spinal Fusion W/O Cc/Mcc |
76617.485714285707 |
474 |
Amputat For Musculoskel Sys Conn Tisue Dis W Mcc |
269236 |
475 |
Amputat For Musculoskel Sys Conn Tissue Dis W Cc |
49657 |
480 |
Hip Femur Procedures Except Major Joint W Mcc |
174959 |
481 |
Hip Femur Procedures Except Major Joint W Cc |
95446.75 |
483 |
Major Joint Limb Reattachment Proc Of Upper Extre |
61730.609756097561 |
485 |
Knee Procedures W Pdx Of Infection W Mcc |
191375 |
486 |
Knee Procedures W Pdx Of Infection W Cc |
105994.875 |
487 |
Knee Procedures W Pdx Of Infection W/O Cc/Mcc |
61052 |
488 |
Knee Procedures W/O Pdx Of Infection W Cc/Mcc |
114579.5 |
489 |
Knee Procedures W/O Pdx Of Infection W/O Cc/Mcc |
48665 |
494 |
LoWer Extrem Humer Px Except Hip,Foot,Femur W/O C |
67839.333333333328 |
496 |
Local Excision Remove Int Fix Devices Exc Hip Fe |
34171 |
497 |
Local Excision Remove Int Fix Devices Exc Hip Fe |
38723 |
501 |
Soft Tissue Procedures W Cc |
57720.333333333336 |
502 |
Soft Tissue Procedures W/O Cc/Mcc |
49727.25 |
503 |
Foot Procedures W Mcc |
36227 |
505 |
Foot Procedures W/O Cc/Mcc |
45945.5 |
513 |
Hand Or Wrist Px, Except Major Thumb Or Joint Px W |
39517 |
516 |
Other Musculoskelet Sys Conn Tiss O.R. Proc W Cc |
67788.399999999994 |
517 |
Other Musculoskel Sys Conn Tiss Or Px W/O Cc/Mcc |
51418.833333333336 |
518 |
Back Neck Proc Exc Spinal Fusion W CC Disc Device/ |
75150.53333333334 |
519 |
Back Neck Proc Exc Spinal Fusion W CC |
72795 |
520 |
Back Neck Proc Exc Spinal Fusion W/O CC/Mcc |
46611.857142857145 |
536 |
Fractures Of Hip Pelvis W/O Mcc |
19657.75 |
540 |
Osteomyelitis W Cc |
23764 |
543 |
Patho Fracts Musculoskel Conn Tiss Malig W Cc |
25301 |
544 |
Patholo Fract Musculoskel Conn Tiss Malig W/O Cc |
4690 |
547 |
Connective Tissue Disorders W/O Cc/Mcc |
30199 |
549 |
Septic Arthritis W Cc |
118227 |
550 |
Septic Arthritis W/O Cc/Mcc |
36162 |
552 |
Medical Back Problems W/O Mcc |
34510.5 |
553 |
Bone Diseases Arthropathies W Mcc |
16821 |
558 |
Tendonitis, Myositis Bursitis W/O Mcc |
10617 |
560 |
Aftercare, Musculoskel Sys Connect Tisue W Cc |
58677 |
561 |
Aftercare Musculoskel Sys Connect Tisue W/O Cc/Mcc |
16131 |
563 |
Fx, Sprn, Strn Disl Except Femur, Hip, Pelvis Th |
13462 |
564 |
Other Musculoskeletal Sys Connect Tisue Dx W Mcc |
31934 |
565 |
Other Muslcoskel Sys Connect Tissue Dx W Cc |
16262 |
571 |
Skin Debridement W CC |
39172 |
572 |
Skin Debridement W/O CC/Mcc |
21997 |
577 |
Skin Graft /Or Debrid Exc For Skin Ulcer Or Cellul |
129448 |
580 |
Other Skin, Subcut Tiss Breast Proc W Cc |
43119 |
581 |
Other Skin, Subcut Tiss Breast Proc W/O Cc/Mcc |
51448 |
602 |
Cellulitis W Mcc |
31984.333333333332 |
603 |
Cellulitis W/O Mcc |
27745.692307692309 |
605 |
Trauma To The Skin, Subcut Tiss Breast W/O Mcc |
33718 |
607 |
Minor Skin Disorders W/O Mcc |
26004 |
616 |
Amputat Of LoWer Limb For Endocrine,Nutrit, Metabo |
81497 |
617 |
Amputat Of LoWer Limb For Endocrine,Nutrit, Metabo |
51341.666666666664 |
619 |
O.R. Procedures For Obesity W Mcc |
75013.166666666672 |
620 |
O.R. Procedures For Obesity W Cc |
50212.388888888891 |
621 |
O.R. Procedures For Obesity W/O Cc/Mcc |
44565.221757322179 |
626 |
Thyroid, Parathyroid Thyroglossal Px W Cc |
81447 |
629 |
Other Endocrine, Nutrit Metab O.R. Proc W Cc |
46700.5 |
637 |
Diabetes W Mcc |
51148 |
638 |
Diabetes W Cc |
22522.888888888891 |
639 |
Diabetes W/O Cc/Mcc |
40983 |
640 |
Nutritional Misc Metabolic Disorders W Mcc |
25995 |
641 |
Nutritional Misc Metabolic Disorders W/O Mcc |
26838.625 |
645 |
Endocrine Disorders W/O Cc/Mcc |
41767 |
654 |
Major Bladder Procedures W Cc |
95104 |
657 |
Kidney Ureter Procedures For Neoplasm W Cc |
126625.5 |
658 |
Kidney Ureter Procedures For Neoplasm W/O Cc/Mcc |
76360 |
660 |
Kidney Ureter Procedures For Non-Neoplasm W Cc |
109208.66666666667 |
663 |
Minor Bladder Procedures W Cc |
80107 |
664 |
Minor Bladder Procedures W/O Cc/Mcc |
60581 |
666 |
Prostatectomy W Cc |
83840 |
669 |
Transurethral Procedures W Cc |
46897.666666666664 |
670 |
Transurethral Procedures W/O Cc/Mcc |
37500 |
673 |
Other Kidney Urinary Tract Procedures W Mcc |
68545 |
682 |
Renal Failure W Mcc |
67053.555555555562 |
683 |
Renal Failure W Cc |
36735.571428571428 |
684 |
Renal Failure W/O Cc/Mcc |
21381.666666666668 |
690 |
Kidney Urinary Tract Infections W/O Mcc |
33654.944444444445 |
694 |
Urinary Stones W/O EsW Lithotripsy W/O Mcc |
45947.666666666664 |
696 |
Kidney Urinary Tract Signs Symptoms W/O Mcc |
17231 |
698 |
Other Kidney Urinary Tract Diagnoses W Mcc |
74454.399999999994 |
699 |
Other Kidney Urinary Tract Diagnoses W Cc |
34182 |
700 |
Other Kidney Urinary Tract Diagnoses W/O Cc/Mcc |
22050 |
707 |
Major Male Pelvic Procedures W Cc/Mcc |
77244 |
708 |
Major Male Pelvic Procedures W/O Cc/Mcc |
67093 |
713 |
Transurethral Prostatectomy W Cc/Mcc |
37929 |
715 |
Oth Male Reproduct Sys Or Px For Malign W Cc/Mcc |
124021 |
726 |
Benign Prostatic Hypertrophy W/O Mcc |
42463 |
728 |
Inflammation Of Male Reproductive System W/O Mcc |
29638 |
730 |
Other Male Reproductive System Dx W/O Cc/Mcc |
11830 |
742 |
Uterine Adnexa Proc For Non-Malignancy W Cc/Mcc |
94067 |
743 |
Uterine Adnexa Px For Non-Malignancy W/O Cc/Mcc |
52007.5 |
749 |
Other Female Reproductive System O.R. Px W Cc/Mcc |
123939 |
755 |
Malignancy, Female Reproductive System W Cc |
42607 |
758 |
Infections, Female Reproductive System W Cc |
42609 |
810 |
Maj Hematol/Immun Dx Exc Sickle Cell Crisis Coagu |
25603 |
811 |
Red Blood Cell Disorders W Mcc |
48418.5 |
812 |
Red Blood Cell Disorders W/O Mcc |
31131.200000000001 |
841 |
Lymphoma Non-Acute Leukemia W Cc |
57369 |
853 |
Infectious Parasitic Diseases W O.R. Px W Mcc |
117572.6 |
854 |
Infectious Parasitic Diseases W O.R. Px W Cc |
53136 |
856 |
Postop Or Post-Trauma Infections W O.R. Proc W Mcc |
69392.5 |
857 |
Postop Or Post-Traumatic Infection W O.R. Px W Cc |
61072 |
858 |
Postop Or Post-Trauma Infect W Or Px W/O Cc/Mcc |
43167 |
863 |
Postoperative Post-Traumatic Infections W/O Mcc |
33081.800000000003 |
864 |
Fever |
18400 |
866 |
Viral Illness W/O Mcc |
44991 |
867 |
Other Infectious Parasitic Diseases Dx W Mcc |
85984 |
870 |
Septicemia Or Severe Sepsis W Mv 96+ Hours |
274609 |
871 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc |
73912.850000000006 |
872 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hrs W/O Mcc |
35534.818181818184 |
897 |
Alcohol/Drug Abuse Or Depend W/O Rehab Therapy W/O |
24715 |
902 |
Wound Debridements For Injuries W Cc |
22053 |
908 |
Other O.R. Procedures For Injuries W Cc |
65607.444444444438 |
909 |
Other O.R. Procedures For Injuries W/O Cc/Mcc |
50070.142857142855 |
916 |
Allergic Reactions W/O Mcc |
54872 |
917 |
Poisoning Toxic Effects Of Drugs W Mcc |
74436 |
918 |
Poisoning Toxic Effects Of Drugs W/O Mcc |
24121.5 |
919 |
Complications Of Treatment W Mcc |
35301.75 |
920 |
Complications Of Treatment W Cc |
35257 |
921 |
Complications Of Treatment W/O Cc/Mcc |
19302.5 |
941 |
Or Px W Dx Of Oth Contact W Health Serv W/O Cc/Mcc |
34958 |
947 |
Signs Symptoms W Mcc |
27000 |
948 |
Signs Symptoms W/O Mcc |
28864.75 |
949 |
Aftercare W Cc/Mcc |
30399 |
951 |
Other Factors Influencing Health Status |
5514 |
963 |
Other Multiple Significant Trauma W Mcc |
92131 |
981 |
Extensive O.R. Px Unrelated To Pdx W Mcc |
118884.5 |
982 |
Extensive O.R. Procedure Unrelated To Pdx W Cc |
84960 |
983 |
Extensive O.R. Px Unrelated To Pdx W/O Cc/Mcc |
45059 |
987 |
Non-Extensive O.R. Proc Unrelated To Pdx W Mcc |
108384 |
988 |
Non-Extensive O.R. Proc Unrelated To Pdx W Cc |
49308.5 |
989 |
Non-Extensive O.R. Px Unrelated To Pdx W/O Cc/Mcc |
49126.75 |
95
600
600
3
9
7
False
False