Florida Medicaid DRG Pricing...

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This spreadsheet includes data obtained through the use of proprietary computer software created, owned and licensed by the 3M Company. All copyrights in and to the 3M TM Software are owned by 3M. All rights reserved. This DRG pricing calculator spreadsheet was prepared by Navigant Healthcare, a consultant for the Agency for Health Care Administration (AHCA). The basic format of the DRG calculator and the service line mapping in the DRG Table were copied from similar products created by Xerox State Healthcare and were modified by Navigant Healthcare. For more background on the Florida Medicaid DRG pricing method, please see the Florida provider billing manuals, Florida Medicaid State Plan, specifically attachment 4.19-A, the inpatient reimbursement section of the Florida Medicaid website, http://ahca.myflorida.com/Medicaid/cost_reim/index.shtml, and the Florida Medicaid web portal, http://mymedicaid-florida.com. The handbook named "Hospital Services Coverage and Limitations Handbook" contains the most detailed information about DRG pricing. In addition, AHCA has made available an email address, [email protected], that can be used to submit questions related to DRG reimbursement. 2014-05-30 - New version of DRG Calculator for state fiscal year (SFY) 2014/2015 effective from July 1, 2014 through June 30, 2015. Version 31 DRG relative weights added (in place of version 30). DRG base rate, policy adjustors, and cost outlier parameters updated to the values specified in the General Appropriations Act (GAA) for Medicaid hospital inpatient fee-for-service for SFY 2014/2015. References to self-funded IGT payments were removed in this version because self-funded IGT funds will now be part of the LIP pool and be distributed as LIP 6 payments outside of claim payments in SFY 2014/2015. Calculation of outlier payment changed to be independent of IGT payments. Also, non-covered day adjustment and charge cap adjustment no longer affect IGT payment. Cost-to-charge ratios listed in this version are those calculated from hospital cost reports received by AHCA by April 15, 2013. The cost-to-charge ratios will be updated using cost reports received by AHCA by April 15, 2014 prior to the start of fiscal year 2014/2015. Florida Medicaid DRG Pricing Calculator Calculator Version: May 30, 2014 This spreadsheet is designed to enable interested parties to predict payment under an APR-DRG payment method for inpatient fee-for-service stays covered by Florida Medicaid. This version of the DRG Calculator applies to hospital admissions within Florida state fiscal year 2014/2015 which encompasses dates from July 1, 2014 through June 30, 2015. A separate version of the DRG Calculator exists for admissions within state fiscal year 2013/2014. The spreadsheet allows calculation of payment for a single claim with the input of only a few data elements. One of those data elements is the APR-DRG. The APR-DRG for the hospital stay must be determined outside of this calculator and entered as a data element by the user. For more information on APR-DRGs, contact 3M Health Information Systems, which developed and maintains the software. Cover Page Change History This calculator spreadsheet is intended to be helpful to users, but it cannot capture all the editing and pricing complexity of the Florida Medicaid Management Information System (FMMIS). In cases of difference, the FMMIS claims processing system is correct.

Transcript of Florida Medicaid DRG Pricing...

Page 1: Florida Medicaid DRG Pricing Calculatorsafetynetsflorida.org/wp-content/uploads/FL-Medicaid-DRG-Pricing-Calculator.pdfFlorida Medicaid DRG Pricing Calculator Structure of the Calculator

This spreadsheet includes data obtained through the use of proprietary computer software created, owned and licensed by the 3M Company. All copyrights in and to the 3MTM Software are owned by 3M. All rights reserved.

This DRG pricing calculator spreadsheet was prepared by Navigant Healthcare, a consultant for the Agency for Health Care Administration (AHCA). The basic format of the DRG calculator and the service line mapping in the DRG Table were copied from similar products created by Xerox State Healthcare and were modified by Navigant Healthcare.

For more background on the Florida Medicaid DRG pricing method, please see the Florida provider billing manuals, Florida Medicaid State Plan, specifically attachment 4.19-A, the inpatient reimbursement section of the Florida Medicaid website, http://ahca.myflorida.com/Medicaid/cost_reim/index.shtml, and the Florida Medicaid web portal, http://mymedicaid-florida.com. The handbook named "Hospital Services Coverage and Limitations Handbook" contains the most detailed information about DRG pricing. In addition, AHCA has made available an email address, [email protected], that can be used to submit questions related to DRG reimbursement.

2014-05-30 - New version of DRG Calculator for state fiscal year (SFY) 2014/2015 effective from July 1, 2014 through June 30, 2015. Version 31 DRG relative weights added (in place of version 30). DRG base rate, policy adjustors, and cost outlier parameters updated to the values specified in the General Appropriations Act (GAA) for Medicaid hospital inpatient fee-for-service for SFY 2014/2015. References to self-funded IGT payments were removed in this version because self-funded IGT funds will now be part of the LIP pool and be distributed as LIP 6 payments outside of claim payments in SFY 2014/2015. Calculation of outlier payment changed to be independent of IGT payments. Also, non-covered day adjustment and charge cap adjustment no longer affect IGT payment. Cost-to-charge ratios listed in this version are those calculated from hospital cost reports received by AHCA by April 15, 2013. The cost-to-charge ratios will be updated using cost reports received by AHCA by April 15, 2014 prior to the start of fiscal year 2014/2015.

Florida Medicaid DRG Pricing Calculator

Calculator Version: May 30, 2014

This spreadsheet is designed to enable interested parties to predict payment under an APR-DRG payment method for inpatient fee-for-service stays covered by Florida Medicaid. This version of the DRG Calculator applies to hospital admissions within Florida state fiscal year 2014/2015 which encompasses dates from July 1, 2014 through June 30, 2015. A separate version of the DRG Calculator exists for admissions within state fiscal year 2013/2014.

The spreadsheet allows calculation of payment for a single claim with the input of only a few data elements. One of those data elements is the APR-DRG. The APR-DRG for the hospital stay must be determined outside of this calculator and entered as a data element by the user. For more information on APR-DRGs, contact 3M Health Information Systems, which developed and maintains the software.

Cover Page

Change History

This calculator spreadsheet is intended to be helpful to users, but it cannot capture all the editing and pricing complexity of the Florida Medicaid Management Information System (FMMIS). In cases of difference, the FMMIS claims processing system is correct.

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Non-Participating Provs

The "Non-Participating Provs" worksheet contains the provider-specific values that should be used for providers who have not signed agreements to participate in the Florida Medicaid program. Generally, these are providers who are not located in the state of Florida.

The "Provider Adjustor" worksheet contains a list of the categories of hospitals who receive provider-specific policy adjustors. It also lists the specific adjustor values. Adjustors are multipliers used in the DRG pricing calculation that have the effect of increasing payment (assuming the adjustors are always set greater than 1.0). The adjustor values are expected to be updated annually at the start of each new state fiscal year, July 1. The provider category assigned to each individual hospital can be found on the following worksheet, called "Provider Table."

The "Provider Table" worksheet contains a list of all active hospital providers with signed agreements to participate in the Florida Medicaid program. It also includes each provider's numerical parameters used in the DRG pricing calculation. The cost-to-charge ratio is calculated using hospital cost reports and is used in outlier calculations. The provider casemix is the average DRG relative weight for historical claims from each provider and is used in the casemix adjustment of IGT supplemental payments in the DRG pricing calculation. The provider category is used to determine which provider policy adjustor applies for each provider. The average per discharge IGT payments are used to calculate IGT supplemental payments for each hospital stay. The values in this worksheet are anticipated to be recalculated and made effective at the beginning of each state fiscal year - July 1st.

Calculator Instructions

Interactive Calculator

DRG Table

Provider Adjustor

Provider Table

The "Calculator Instructions" worksheet contains a description of the data that must be entered to estimate the Florida Medicaid payment amount for an inpatient hospital stay. The instructions also describe the calculations being made to determine the payment amount.

The "Interactive Calculator" worksheet is the primary worksheet in the DRG Calculator spreadsheet. All other worksheets exist to support the "Interactive Calculator." The user can enter just a few data elements describing an individual hospital admission at the top of the "Interactive Calculator" and an estimate of the Florida Medicaid payment for that admission will be displayed at the bottom of the Calculator.

The "DRG Table" worksheet contains a list of the APR-DRG codes and parameters used in pricing individual hospital inpatient stays. These parameters will be updated each time Florida Medicaid installs a new version of the DRG Grouper. The current plan is to install a new version of the DRG grouper annually at the beginning of each state fiscal year (July 1). APR-DRG codes, descriptions, average lengths of stay, and national relative weights are determined by 3M Health Information Systems. Florida Medicaid, with direction from the Florida Legislature, determines the re-centered relative weight and the service and age policy adjustors. The service lines are used to identify which specific DRG codes will be assigned service and age policy adjustors.

The "Structure" worksheet contains a synopsis of the information provided in the DRG Calculator spreadsheet.

Florida Medicaid DRG Pricing CalculatorStructure of the Calculator Spreadsheet

Cover

The "Cover" worksheet contains an introduction to the DRG Calculator and offers websites where interested parties can learn more about the Florida Medicaid inpatient DRG pricing method.

Structure

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Col ID Column/Field Name DescriptionE7 Submitted charges Also referred to as "covered charges." Generally this equals hospital billed amount because there are rarely non-covered charges on a claim. But

technically, this field equals Field Locator 47 minus Field Locator 48 on the UB-04 paper claim form.

E8 Length of stayThe length of stay equals discharge date minus admit date, unless discharge date equals admit date, in which case length of stay is 1. A DRG payment is intended as payment for a complete hospital stay. All stays priced through the DRG calculator are assumed to be complete hospital stays. Also, the day of discharge is not a covered day.

This is the number of days payable by Florida Medicaid fee-for-service. In most cases this will equal the full length of stay. The Medicaid eligible days are never more than the length of stay. Some scenarios exist in which the Medicaid eligible days are less than the full length of stay. These scenarios are, 1) Recipient is an undocumented non-citizen (for which only emergency services are reimbursed) 2) Recipient exhausted his/her 45-day benefit limit prior to admission (in which case only emergency services are reimbursed) (If a recipient has at least one day of coverage remaining within his/her 45-day benefit limit at the time of admission, then Medicaid eligible days should be set equal to the full length of stay.) 3) Recipient is under the age of 21 and exhausts his/her managed care benefits during an inpatient admission 4) Recipient is dually eligible for Medicare and Medicaid and exhausts his/her Medicare Part A benefits during an inpatient admission 5) Recipient shifts from Medicaid fee-for-service to Medicaid managed care during an inpatient stay 6) Medical needy recipients who reach their share of cost level during an inpatient hospital stay. 7) Additional scenarios may also exist in which only a portion of the hospital stay is reimbursable by Medicaid fee-for-service

For scenarios 1, 2 and 3, the number of Medicaid eligible days will be determined by the peer review organization (PRO) and recorded in the service authorization. For scenario 4, the number of eligible days is determined by comparing the date in which Medicare Part A eligibility exhausted to the discharge date. The date in which Medicare Part A eligibility exhausted is communicated on the claim with occurrence code A3. For scenarios 5 and 6, Medicaid eligibility data is used to determine the number of fee-for-service eligible days for the stay.

E10 Transfer status This is a "Yes/No" field indicating whether or not the patient was transferred from one acute care hospital to another. Acute-to-acute transfers are identified by patient discharge status values "02", "05", "65", "66", "82", "85", "93", and "94".

E11 Patient age in yearsThis is a numerical value. If the patient is less than one year old, a value of zero should be entered. This field is only used in the determination of whether or not an age adjustor is applicable to the claim. If the age is less than the age cut-off (shown in cell E21) then the age adjustor stored with the DRG code is applicable.

E12 Other health coverage Amount of money paid by another insurance company prior to Medicaid receiving the claim. This does not include payments by Medicare. For recipients dually eligible for Medicare and Medicaid for which Medicare is the primary payer, the claim submitted to Medicaid is called a "crossover" claim and Medicaid only pays the sum of Medicare deductible and coinsurance. Crossover claims do not get paid a DRG payment amount.

E13 Medicaid copayment Amount of payment due from the recipient to the hospital, if applicable.

E14 Provider Medicaid ID Nine-digit Medicaid provider ID. If the provider does not have a signed agreement to participate in the Florida Medicaid program, such as most hospitals located outside the state of Florida, "Non-Par" should be entered instead of the provider number. When "Non-Par" is entered, the calculator retrieves provider parameters from the worksheet called, "Non-Participating Provs" instead of from the worksheet called "Provider Table."

E15 APR-DRG code

Four digit number consisting of a 3-digit base DRG code followed by a 1-digit severity of illness. No hyphen or other separator should be entered between the base DRG and the severity of illness. When determining the applicable APR-DRG code for an admission, users should take care to ensure the version of APR-DRG grouping they employ matches the version used by Florida Medicaid. Florida Medicaid plans to install a new version of APR-DRGs at the beginning of each state fiscal year, July 1. New versions of APR-DRG grouping software are released each year coinciding with the start of the federal fiscal year, October 1. As a result, there will be a nine month delay between new releases of APR-DRG grouping software and installation of these new releases by Florida Medicaid.For newborns, Florida Medicaid intends to use birthweight option 5, "Coded with default" which indicates birthweight of a newborn is communicated through diagnosis codes. If no diagnosis code indicating birthweight is included with the claim, then normal, full birthweight will be assumed (2,500 grams or greater).The HAC version utilized by Florida Medicaid will match the DRG code version. In state fiscal year 2014/2015, both equal version 31.0.

Florida Medicaid DRG Pricing CalculatorInstructions for Interactive Calculator

Information About the Hospital Stay (Entered by the User)

E9 Medicaid payment eligible days

General Comments

Only the fields highlighted in green need to be populated by the user. When that is done, the Calculator will retrieve applicable data elements for the DRG code and for the provider, then calculate the Medicaid allowed amount and reimbursement amount for the hospital stay. Allowed amount and reimbursement amount are shown at the bottom of the Calculator and between these fields and the user entered data all the intermediate calculations used to determine the allowed amount are displayed.

This Calculator is intended to mimick the actual DRG pricing calculations within the Florida Medicaid claims adjudication software application, FMMIS. However, if there is ever a difference in payment amounts calculated through this spreadsheet versus FMMIS, FMMIS is correct.

Hospitals do not need to submit APR-DRG codes on their claims when billing Florida Medicaid. However, users of this DRG Calculator must have a way to identify the appropriate APR-DRG code for a hospital stay and enter the DRG code as one of the data fields needed for calculating a Medicaid payment amount. Many hospitals purchase APR-DRG grouping software from 3M Health Information Systems which allows them to determine the APR-DRG for individual admissions. If a hospital in Florida does not license this software, 3M makes available a website in which information for an individual admisison can be entered and the website will return the APR-DRG. Hospitals may contact AHCA at [email protected] to obtain log on information for this 3M website.

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E22 - E26 APR-DRG Information Values in this section are retrieved from the worksheet called "DRG Table" based on the DRG code entered in cell E15.

E28 - E32 Provider InformationIf the hospital is participating in the Florida Medicaid program, then its Medicaid ID will be in the worksheet called "Provider Table" and values in this section are retrieved from the worksheet PRovider Table" based on the provider ID entered in cell E14. If the hospital does not have a signed agreement to participate in the Florida Medicaid program (such as most out-of-state providers), then "Non-Par" should be entered in cell E14 and the values in cells E28 - E32 will be retrieved from the worksheet called "Non-Participating Provs."

34 Maximum policy adjustor This is the maximum of the service, age and provider policy adjustors applicable to this admission. If the recipient's age at admission is less than the age cutoff included in cell E20, then the age adjustor is assumed to equal 1.0, which means no adjustment.

35 Pre-Transfer DRG base payment This value is used in further calculations unless it gets overridden by the Transfer Base Payment in cell E38.

E37 - E38 Transfer Base PaymentA Transfer Base Payment is only calculated if the value in cell E10 is "Yes". This indicates the discharge status is one included in the transfer policy. The Transfer Base Payment is calculated in a per-diem type of calculation in which the per diem amount is determined using the Pre-Transfer DRG Base Payment and the DRG national average length of stay.

E39 - E40 Full stay DRG base payment If the admission applied to the transfer policy and the Transfer Base Payment is less than the Pre-Transfer DRG Base Payment, then the Transfer Base Payment is used. In all other cases, the Pre-Transfer DRG Base Payment is used.

E42 - E45 Cost outlier paymentOutlier payments are made on admissions in which the estimated cost to the hospital far exceeds the Full Stay DRG Base Payment. Outlier payments are based on estimated hospital cost, not on length of stay. When applicable, an outlier payment is made in addition to DRG base payment and the IGT supplemental payment.

E47 - E48 IGT supplemental paymentFor hospitals that receive automatic IGT payments, the IGT payments are made as supplemental payments in addition to the DRG payment for each inpatient admission. In these cells, the IGT payment is casemix adjusted which increases payment above the hospital's average if the DRG relative weight for the admission is above the hospital's annual average (identified in cell E29) and decreases payment below the hospital's average if the DRG relative weight for the admission is below the hospital's annual average.

E50 - E54 Non-covered day adjustment

The full-stay DRG payment gets reduced if there are any days of the stay not payable by Medicaid fee-for-service. This is determined by comparing Medicaid Eligible Days in cell E9 to the length of stay in cell E8. If the number of Medicaid Eligible Days is less, then the non-covered day adjustment applies. The non-covered day adjustment is applied only to the two parts of the DRG payment - DRG Base Paymenta and Outlier Payment. Reasons why some days of a hospital stay might not be covered by Medicaid fee-for-service are included with the description of cell E9 above.

E56 - E60 Charge cap adjustmentA charge cap adjustment applies only if the DRG payment calculated through cell E54 is greater than the submitted charges. If total payment is greater than the submitted charges, then both parts of the DRG payment - DRG Base Payment and Outlier Payment get reduced so that total DRG payment equals submitted charges.

E62 Allowed amount Allowed amount is also referred to as the "price" or Medicaid benefit amount. It is the Medicaid payment amount before considering copayments and payments made by other insurers (a.k.a. third party liability).

E65 Payment amount Payment amount is the final payment for the claim and equals allowed amount minus copay and other insurer payments.

DRG Pricing Calculation

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45 Information Data Comments or Formula6 INFORMATION FROM THE HOSPITAL7 Submitted charges $860,671.00 UB-04 Field Locator 47 minus FL 488 Length of stay 96 Used for transfer pricing and covered days adjustments9 Medicaid payment eligible days 96 Used for non-covered days adjustment

10 Was patient transferred - discharge status = 02, 05, 65, 66, 82, 85, 93, or 94? No Used for transfer pricing adjustment

11 Patient age (in years) 18 Used for age adjustor12 Other health coverage $0.00 UB-04 Field Locator 54 for payments by third parties13 Medicaid copayment $0.00 Includes spend-down or copayment14 Provider primary Medicaid ID 010020000 Used for look ups to the provider table - 9 digit number, or "Non-Par"15 APR-DRG 2454 From separate APR-DRG grouping software16 PAYMENT POLICY PARAMETERS SET BY MEDICAID17 DRG standardized base rate $3,078.93 Used for DRG base payment18 Cost outlier threshold $60,000 Used for cost outlier adjustments19 Marginal cost percentage 60% Used for cost outlier adjustments20 Age cut-off for age policy adjustor 21 Used for age policy adjustor21 APR-DRG INFORMATION

22 APR-DRG description Inflammatory Bowel Disease Look up from DRG table

23 DRG relative weight--re-centered for FL Medicaid 2.7918 Look up from DRG table24 Service adjustor 1.000 Look up from DRG table25 Age adjustor 1.300 Look up from DRG table26 Average length of stay for this APR-DRG 11.43 Look up from DRG table27 HOSPITAL INFORMATION28 Hospital-specific cost-to-charge ratio 18.739% Used to estimate the hospital's cost of this stay29 Hospital casemix 1.3297 Hospital's annual average FL Medicaid APR-DRG relative weight30 Hospital category All Other Used to determine provider policy adjustor31 Hospital average per discharge automatic IGT add on pymt $2,539.56 Supplemental payment amount before casemix adjustment32 Provider adjustor 1.000 Look up from provider adjustor table33 DRG BASE PAYMENT34 Maximum policy adjustor 1.300 IF E11 < E20 Then maximum of (E24, E25, E32) Else maximum of (E24, E32)35 Pre-Transfer DRG base payment $11,174.48 E17 * E23 * E3436 TRANSFER PAYMENT ADJUSTMENT37 Is a transfer adjustment potentially applicable? No If E10 = "Yes" AND DRG Base Not IN ("580", "581") Then "Yes", Else "No"38 Transfer Base Payment N/A IF E37="Yes", then (E35 / E26) * (E8 + 1), else "N/A"39 Is per diem payment amount < full stay base payment? N/A IF E37 ="Yes" then [if (E38 < E35), then "Yes" else "No"] Else "N/A"40 Full stay DRG base payment $11,174.48 IF E39 = "Yes" Then E38 Else E35 41 COST OUTLIER42 Estimated cost of the stay $161,281.14 E7 * E2843 Does this claim require an outlier payment? Yes IF (E42-E40) > E18 Then "Yes" Else "No"44 Estimated loss on this case $150,106.65 IF E43 = "Yes" Then E42 - E40 Else "N/A"45 DRG cost outlier payment increase $54,063.99 IF E43 = "Yes" Then (E44 - E18) * E19, Else 046 ADD-ON IGT PAYMENT47 IGT casemix adjustor 2.099571 E23 / E2948 Automatic IGT add-on payment $5,331.99 E31 * E4749 NON-COVERED DAYS PAYMENT ADJUSTMENT50 Are covered days less than length of stay No IF E9 < E8 Then "Yes" Else "No"51 Non-covered day reduction factor 1.000000 IF E50 = "Yes" Then (E9 / E8) Else 1.052 NCD Adjusted DRG base payment $11,174.48 E40 * E5153 NCD Adjusted outlier payment $54,063.99 E45 * E5154 Pre-charge cap DRG Payment $65,238.48 E52 + E5355 CHARGE CAP ADJUSTMENT56 Does the charge cap apply? No IF E54 > E7 Then "Yes" Else "No"57 Charge cap reduction factor 1.000000 IF E56 = "Yes" Then E7 / E54 Else 1.058 Final DRG base payment $11,174.48 E52 * E5759 Final outlier payment $54,063.99 E53 * E5760 Final DRG payment $65,238.48 E58 + E5961 CALCULATION OF ALLOWED AMOUNT AND REIMBURSEMENT AMOUNT62 Allowed amount $70,570.46 (E60 + E48) rounded to two decimal places63 Other health coverage $0.00 E1264 Medicaid copayment $0.00 E1365 Payment amount $70,570.46 IF (E62-E63-E64) > 0, then E62-E63-E64, else 0

Florida Medicaid DRG Pricing Calculator

Note: The parameters used in this spreadsheet are those specified in the state fiscal year 2014-15 General Appropriations Act (GAA) for Medicaid hospital inpatient fee-for-service. The per discharge IGT payments included in this spreadsheet were calculated from total per-claim IGT disbursements defined in the GAA. The DRG pricing parameters in this spreadsheet match those planned for implementation in the Medicaid claims processing system on July 1, 2014. The provider cost-to-charge ratios listed in the Provider Table are the values retrieved from cost reports received by AHCA by April 15, 2013. Updates to the cost-to-charge ratios are planned and will include data from cost reports received by AHCA by April 15, 2014. The release date for the updated provider cost-to-charge ratios is not finalized.

Cost outlier calculations are slightly different for SFY 2014/2015 than the formulas used in SFY 2013/2014. Also, non-covered day and charge cap payment reductions no longer affect IGT payment. In addition, self-funded IGT payments have been removed from the DRG calculator as they will be made outside of claim payments in SFY 2014/2015.

CALCULATOR VALUES ARE FOR PURPOSES OF ILLUSTRATION ONLY.

Indicates payment policy parameters set by MedicaidIndicates data to be input by the user

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Pediatric Adult0011 Liver &/or Intest Transpl 7.59 6.6674 8.9243 1.00 1.00 Transplant Pediatric Transplant Adult0012 Liver &/or Intest Transpl 8.15 7.2982 9.7686 1.00 1.00 Transplant Pediatric Transplant Adult0013 Liver &/or Intest Transpl 11.88 9.0947 12.1732 1.00 1.30 Transplant Pediatric Transplant Adult0014 Liver &/or Intest Transpl 28.65 17.7526 23.7618 1.00 1.30 Transplant Pediatric Transplant Adult0021 Heart &/or Lung Transpl 9.36 9.0557 12.1210 1.00 1.00 Transplant Pediatric Transplant Adult0022 Heart &/or Lung Transpl 13.05 10.0846 13.4982 1.00 1.00 Transplant Pediatric Transplant Adult0023 Heart &/or Lung Transpl 21.04 13.0086 17.4119 1.00 1.30 Transplant Pediatric Transplant Adult0024 Heart &/or Lung Transpl 35.15 21.2277 28.4132 1.00 1.30 Transplant Pediatric Transplant Adult0031 Bone Marrow Transpl 16.44 4.6121 6.1733 1.00 1.00 Transplant Pediatric Transplant Adult0032 Bone Marrow Transpl 22.39 6.4124 8.5830 1.00 1.00 Transplant Pediatric Transplant Adult0033 Bone Marrow Transpl 32.46 10.5431 14.1119 1.00 1.30 Transplant Pediatric Transplant Adult0034 Bone Marrow Transpl 49.40 20.0119 26.7858 1.00 1.30 Transplant Pediatric Transplant Adult0041 Trach, MV 96+ Hrs, w Ext Proc 19.77 6.5868 8.8164 1.00 1.00 Pediatric Misc Adult0042 Trach, MV 96+ Hrs, w Ext Proc 20.00 7.3188 9.7962 1.00 1.00 Pediatric Misc Adult0043 Trach, MV 96+ Hrs, w Ext Proc 26.00 10.0196 13.4112 1.00 1.30 Pediatric Misc Adult0044 Trach, MV 96+ Hrs, w Ext Proc 37.11 15.1318 20.2538 1.00 1.30 Pediatric Misc Adult0051 Trach, MV 96+ Hrs, w/o Ext Proc 17.85 4.8566 6.5005 1.00 1.00 Pediatric Misc Adult0052 Trach, MV 96+ Hrs, w/o Ext Proc 17.24 5.3963 7.2229 1.00 1.00 Pediatric Misc Adult0053 Trach, MV 96+ Hrs, w/o Ext Proc 23.00 6.9968 9.3652 1.00 1.30 Pediatric Misc Adult0054 Trach, MV 96+ Hrs, w/o Ext Proc 31.20 10.4855 14.0348 1.00 1.30 Pediatric Misc Adult0061 Pancreas Transpl 5.33 6.3379 8.4832 1.00 1.00 Transplant Pediatric Transplant Adult0062 Pancreas Transpl 7.89 8.3020 11.1122 1.00 1.00 Transplant Pediatric Transplant Adult0063 Pancreas Transpl 9.84 8.5569 11.4534 1.00 1.30 Transplant Pediatric Transplant Adult0064 Pancreas Transpl 21.81 13.2661 17.7566 1.00 1.30 Transplant Pediatric Transplant Adult0201 Craniotomy for Trauma 5.13 1.8063 2.4177 1.00 1.00 Pediatric Misc Adult0202 Craniotomy for Trauma 6.00 2.4962 3.3412 1.00 1.00 Pediatric Misc Adult0203 Craniotomy for Trauma 10.03 3.6037 4.8235 1.00 1.30 Pediatric Misc Adult0204 Craniotomy for Trauma 17.35 6.8953 9.2293 1.00 1.30 Pediatric Misc Adult0211 Craniotomy Exc for Trauma 3.73 1.9679 2.6340 1.00 1.00 Pediatric Misc Adult0212 Craniotomy Exc for Trauma 5.49 2.6264 3.5154 1.00 1.00 Pediatric Misc Adult0213 Craniotomy Exc for Trauma 9.94 4.0238 5.3858 1.00 1.30 Pediatric Misc Adult0214 Craniotomy Exc for Trauma 18.65 7.4824 10.0152 1.00 1.30 Pediatric Misc Adult0221 Ventricular Shunt Procs 2.56 1.1849 1.5860 1.00 1.00 Pediatric Misc Adult0222 Ventricular Shunt Procs 4.90 1.7216 2.3044 1.00 1.00 Pediatric Misc Adult0223 Ventricular Shunt Procs 10.50 3.6021 4.8214 1.00 1.30 Pediatric Misc Adult0224 Ventricular Shunt Procs 19.64 7.2016 9.6393 1.00 1.30 Pediatric Misc Adult0231 Spinal Procs 3.05 1.4187 1.8989 1.00 1.00 Pediatric Misc Adult0232 Spinal Procs 5.43 2.0011 2.6785 1.00 1.00 Pediatric Misc Adult0233 Spinal Procs 9.71 4.0854 5.4683 1.00 1.30 Pediatric Misc Adult0234 Spinal Procs 18.82 7.0503 9.4368 1.00 1.30 Pediatric Misc Adult0241 Extracranial Vascular Procs 1.43 1.0407 1.3930 1.00 1.00 Pediatric Misc Adult0242 Extracranial Vascular Procs 2.67 1.4617 1.9565 1.00 1.00 Pediatric Misc Adult0243 Extracranial Vascular Procs 6.97 2.9238 3.9135 1.00 1.30 Pediatric Misc Adult0244 Extracranial Vascular Procs 13.69 6.1041 8.1703 1.00 1.30 Pediatric Misc Adult0261 Oth Nerv Sys & Related Procs 2.36 1.2566 1.6820 1.00 1.00 Pediatric Misc Adult0262 Oth Nerv Sys & Related Procs 4.08 1.6968 2.2712 1.00 1.00 Pediatric Misc Adult0263 Oth Nerv Sys & Related Procs 8.14 2.5116 3.3618 1.00 1.30 Pediatric Misc Adult0264 Oth Nerv Sys & Related Procs 19.39 5.8597 7.8432 1.00 1.30 Pediatric Misc Adult0401 Spinal Dis & Injuries 3.32 0.8893 1.1903 1.00 1.00 Pediatric Misc Adult0402 Spinal Dis & Injuries 4.48 1.1024 1.4756 1.00 1.00 Pediatric Misc Adult0403 Spinal Dis & Injuries 6.46 1.4750 1.9743 1.00 1.30 Pediatric Misc Adult0404 Spinal Dis & Injuries 12.92 3.4382 4.6020 1.00 1.30 Pediatric Misc Adult0411 Nervous Sys Malig 2.73 0.7604 1.0178 1.00 1.00 Pediatric Misc Adult0412 Nervous Sys Malig 3.59 0.8079 1.0814 1.00 1.00 Pediatric Misc Adult

5. This spreadsheet includes data obtained through the use of proprietary computer software created, owned and licensed by the 3M Company. All copyrights in and to the 3MTM Software are owned by 3M. All rights reserved.

4. This DRG pricing calculator file was prepared by Navigant Healthcare. The service line mapping was copied from a similar mapping created by Xerox State Healthcare and modified by Navigant Healthcare.

2. Average length of stay is the trimmed arithmetic value.

1. Average length of stay and casemix relative values were calculated from the Nationwide Inpatient Sample by 3M Health Information Systems for APR-DRG Version 31 which was released on 10/1/2013.

APR-DRG Description Age AdjustorAPR-DRG

Service Line

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

3. The Florida Medicaid relative weight re-centering factor for SFY 2014/2015 is 0.747108.

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

0413 Nervous Sys Malig 5.63 1.1441 1.5314 1.00 1.30 Pediatric Misc Adult0414 Nervous Sys Malig 9.10 2.1664 2.8997 1.00 1.30 Pediatric Misc Adult0421 Degen Nerv Sys Dis Exc Ms 4.18 0.5500 0.7362 1.00 1.00 Pediatric Misc Adult0422 Degen Nerv Sys Dis Exc Ms 7.82 0.6838 0.9153 1.00 1.00 Pediatric Misc Adult0423 Degen Nerv Sys Dis Exc Ms 8.11 1.0128 1.3556 1.00 1.30 Pediatric Misc Adult0424 Degen Nerv Sys Dis Exc Ms 11.96 2.8244 3.7804 1.00 1.30 Pediatric Misc Adult0431 Mult Sclerosis 3.41 0.7760 1.0387 1.00 1.00 Pediatric Misc Adult0432 Mult Sclerosis 4.37 0.9915 1.3271 1.00 1.00 Pediatric Misc Adult0433 Mult Sclerosis 6.99 1.5001 2.0079 1.00 1.30 Pediatric Misc Adult0434 Mult Sclerosis 12.10 3.4288 4.5894 1.00 1.30 Pediatric Misc Adult0441 Intracranial Hemorrhage 3.27 0.7614 1.0191 1.00 1.00 Pediatric Misc Adult0442 Intracranial Hemorrhage 4.38 1.0045 1.3445 1.00 1.00 Pediatric Misc Adult0443 Intracranial Hemorrhage 5.09 1.3742 1.8394 1.00 1.30 Pediatric Misc Adult0444 Intracranial Hemorrhage 8.27 2.5376 3.3966 1.00 1.30 Pediatric Misc Adult0451 CVA & Precereb Occl w Infarct 2.66 0.7120 0.9530 1.00 1.00 Pediatric Misc Adult0452 CVA & Precereb Occl w Infarct 3.67 0.8573 1.1475 1.00 1.00 Pediatric Misc Adult0453 CVA & Precereb Occl w Infarct 5.76 1.2591 1.6853 1.00 1.30 Pediatric Misc Adult0454 CVA & Precereb Occl w Infarct 10.75 2.7542 3.6865 1.00 1.30 Pediatric Misc Adult0461 Nonspec CVA w/o Infarct 2.31 0.6937 0.9285 1.00 1.00 Pediatric Misc Adult0462 Nonspec CVA w/o Infarct 3.09 0.7885 1.0554 1.00 1.00 Pediatric Misc Adult0463 Nonspec CVA w/o Infarct 4.47 1.0758 1.4400 1.00 1.30 Pediatric Misc Adult0464 Nonspec CVA w/o Infarct 8.53 2.3406 3.1329 1.00 1.30 Pediatric Misc Adult0471 Transient Ischemia 1.83 0.5753 0.7700 1.00 1.00 Pediatric Misc Adult0472 Transient Ischemia 2.38 0.6232 0.8341 1.00 1.00 Pediatric Misc Adult0473 Transient Ischemia 3.57 0.8203 1.0980 1.00 1.30 Pediatric Misc Adult0474 Transient Ischemia 7.87 1.8914 2.5316 1.00 1.30 Pediatric Misc Adult0481 Nerve Disorders 2.59 0.5850 0.7830 1.00 1.00 Pediatric Misc Adult0482 Nerve Disorders 3.55 0.6588 0.8818 1.00 1.00 Pediatric Misc Adult0483 Nerve Disorders 4.87 0.9005 1.2053 1.00 1.30 Pediatric Misc Adult0484 Nerve Disorders 12.24 2.6031 3.4842 1.00 1.30 Pediatric Misc Adult0491 Bact & Tub Inf of Nervous Sys 5.13 0.8815 1.1799 1.00 1.00 Pediatric Misc Adult0492 Bact & Tub Inf of Nervous Sys 6.16 1.8288 2.4478 1.00 1.00 Pediatric Misc Adult0493 Bact & Tub Inf of Nervous Sys 10.11 2.4181 3.2366 1.00 1.30 Pediatric Misc Adult0494 Bact & Tub Inf of Nervous Sys 15.95 4.4391 5.9417 1.00 1.30 Pediatric Misc Adult0501 Non-Bact Inf of Nerv Sys 3.72 0.6347 0.8495 1.00 1.00 Pediatric Misc Adult0502 Non-Bact Inf of Nerv Sys 5.16 1.0958 1.4667 1.00 1.00 Pediatric Misc Adult0503 Non-Bact Inf of Nerv Sys 8.42 1.8047 2.4156 1.00 1.30 Pediatric Misc Adult0504 Non-Bact Inf of Nerv Sys 15.67 4.6051 6.1639 1.00 1.30 Pediatric Misc Adult0511 Viral Meningitis 2.53 0.4835 0.6472 1.00 1.00 Pediatric Misc Adult0512 Viral Meningitis 3.59 0.7101 0.9505 1.00 1.00 Pediatric Misc Adult0513 Viral Meningitis 6.17 1.3116 1.7556 1.00 1.30 Pediatric Misc Adult0514 Viral Meningitis 12.43 3.3198 4.4435 1.00 1.30 Pediatric Misc Adult0521 Nontraumatic Stupor & Coma 1.98 0.5392 0.7217 1.00 1.00 Pediatric Misc Adult0522 Nontraumatic Stupor & Coma 2.94 0.6263 0.8383 1.00 1.00 Pediatric Misc Adult0523 Nontraumatic Stupor & Coma 4.67 0.8924 1.1945 1.00 1.30 Pediatric Misc Adult0524 Nontraumatic Stupor & Coma 10.25 2.4657 3.3003 1.00 1.30 Pediatric Misc Adult0531 Seizure 2.20 0.4840 0.6478 1.00 1.00 Pediatric Misc Adult0532 Seizure 2.72 0.5898 0.7894 1.00 1.00 Pediatric Misc Adult0533 Seizure 4.05 0.8779 1.1751 1.00 1.30 Pediatric Misc Adult0534 Seizure 8.76 2.4116 3.2279 1.00 1.30 Pediatric Misc Adult0541 Migraine & Oth Headaches 2.22 0.5049 0.6758 1.00 1.00 Pediatric Misc Adult0542 Migraine & Oth Headaches 2.65 0.5997 0.8027 1.00 1.00 Pediatric Misc Adult0543 Migraine & Oth Headaches 3.61 0.7940 1.0628 1.00 1.30 Pediatric Misc Adult0544 Migraine & Oth Headaches 6.62 1.8286 2.4476 1.00 1.30 Pediatric Misc Adult0551 Head Trauma w Coma >1 Hr 2.10 0.6365 0.8520 1.00 1.00 Pediatric Misc Adult0552 Head Trauma w Coma >1 Hr 3.30 0.8726 1.1680 1.00 1.00 Pediatric Misc Adult0553 Head Trauma w Coma >1 Hr 4.96 1.3717 1.8360 1.00 1.30 Pediatric Misc Adult0554 Head Trauma w Coma >1 Hr 11.37 3.3854 4.5313 1.00 1.30 Pediatric Misc Adult0561 Complic Skull Fx, Coma <1 Hr 2.15 0.6594 0.8826 1.00 1.00 Pediatric Misc Adult0562 Complic Skull Fx, Coma <1 Hr 3.36 0.9378 1.2552 1.00 1.00 Pediatric Misc Adult0563 Complic Skull Fx, Coma <1 Hr 5.56 1.4720 1.9703 1.00 1.30 Pediatric Misc Adult0564 Complic Skull Fx, Coma <1 Hr 12.84 3.7182 4.9768 1.00 1.30 Pediatric Misc Adult0571 Uncomplic Head Trauma 1.43 0.6401 0.8568 1.00 1.00 Pediatric Misc Adult0572 Uncomplic Head Trauma 2.26 0.8432 1.1286 1.00 1.00 Pediatric Misc Adult0573 Uncomplic Head Trauma 4.12 1.2448 1.6662 1.00 1.30 Pediatric Misc Adult0574 Uncomplic Head Trauma 9.89 3.1443 4.2086 1.00 1.30 Pediatric Misc Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

0581 Oth Dis of Nervous Sys 2.51 0.5973 0.7995 1.00 1.00 Pediatric Misc Adult0582 Oth Dis of Nervous Sys 3.55 0.7317 0.9794 1.00 1.00 Pediatric Misc Adult0583 Oth Dis of Nervous Sys 5.22 1.0335 1.3833 1.00 1.30 Pediatric Misc Adult0584 Oth Dis of Nervous Sys 10.53 2.3704 3.1728 1.00 1.30 Pediatric Misc Adult0701 Orbital Procs 2.01 0.8559 1.1456 1.00 1.00 Pediatric Misc Adult0702 Orbital Procs 3.55 1.2263 1.6414 1.00 1.00 Pediatric Misc Adult0703 Orbital Procs 5.80 2.2069 2.9539 1.00 1.30 Pediatric Misc Adult0704 Orbital Procs 12.36 4.2630 5.7060 1.00 1.30 Pediatric Misc Adult0731 Eye Procs Exc Orbit 2.12 0.7246 0.9699 1.00 1.00 Pediatric Misc Adult0732 Eye Procs Exc Orbit 2.80 0.9095 1.2174 1.00 1.00 Pediatric Misc Adult0733 Eye Procs Exc Orbit 5.23 1.4745 1.9736 1.00 1.30 Pediatric Misc Adult0734 Eye Procs Exc Orbit 9.81 3.0607 4.0967 1.00 1.30 Pediatric Misc Adult0801 Acute Maj Eye Inf 2.80 0.3823 0.5117 1.00 1.00 Pediatric Misc Adult0802 Acute Maj Eye Inf 3.66 0.5606 0.7504 1.00 1.00 Pediatric Misc Adult0803 Acute Maj Eye Inf 5.60 0.9514 1.2734 1.00 1.30 Pediatric Misc Adult0804 Acute Maj Eye Inf 10.27 2.5990 3.4787 1.00 1.30 Pediatric Misc Adult0821 Eye Dis Exc Maj Inf 2.18 0.4694 0.6283 1.00 1.00 Pediatric Misc Adult0822 Eye Dis Exc Maj Inf 2.58 0.6046 0.8093 1.00 1.00 Pediatric Misc Adult0823 Eye Dis Exc Maj Inf 3.84 0.8375 1.1210 1.00 1.30 Pediatric Misc Adult0824 Eye Dis Exc Maj Inf 11.19 3.1147 4.1690 1.00 1.30 Pediatric Misc Adult0891 Maj Cranial/Facial Bone Procs 2.18 1.4678 1.9646 1.00 1.00 Pediatric Misc Adult0892 Maj Cranial/Facial Bone Procs 3.61 1.9312 2.5849 1.00 1.00 Pediatric Misc Adult0893 Maj Cranial/Facial Bone Procs 8.17 3.4677 4.6415 1.00 1.30 Pediatric Misc Adult0894 Maj Cranial/Facial Bone Procs 16.12 6.7356 9.0156 1.00 1.30 Pediatric Misc Adult0901 Maj Larynx & Trachea Procs 2.45 0.6794 0.9094 1.00 1.00 Pediatric Misc Adult0902 Maj Larynx & Trachea Procs 7.65 2.2831 3.0559 1.00 1.00 Pediatric Misc Adult0903 Maj Larynx & Trachea Procs 12.66 3.6271 4.8549 1.00 1.30 Pediatric Misc Adult0904 Maj Larynx & Trachea Procs 23.69 7.2240 9.6693 1.00 1.30 Pediatric Misc Adult0911 Oth Maj Head & Neck Procs 2.96 1.3682 1.8313 1.00 1.00 Pediatric Misc Adult0912 Oth Maj Head & Neck Procs 4.34 2.0706 2.7715 1.00 1.00 Pediatric Misc Adult0913 Oth Maj Head & Neck Procs 9.20 3.8502 5.1535 1.00 1.30 Pediatric Misc Adult0914 Oth Maj Head & Neck Procs 16.98 6.2667 8.3879 1.00 1.30 Pediatric Misc Adult0921 Facial Bone Procs Exc Major 1.90 1.0432 1.3963 1.00 1.00 Pediatric Misc Adult0922 Facial Bone Procs Exc Major 2.74 1.4599 1.9541 1.00 1.00 Pediatric Misc Adult0923 Facial Bone Procs Exc Major 5.40 2.4996 3.3457 1.00 1.30 Pediatric Misc Adult0924 Facial Bone Procs Exc Major 13.93 5.4688 7.3200 1.00 1.30 Pediatric Misc Adult0931 Sinus & Mastoid Procs 2.18 1.0289 1.3772 1.00 1.00 Pediatric Misc Adult0932 Sinus & Mastoid Procs 3.48 1.3608 1.8214 1.00 1.00 Pediatric Misc Adult0933 Sinus & Mastoid Procs 6.82 2.0923 2.8005 1.00 1.30 Pediatric Misc Adult0934 Sinus & Mastoid Procs 10.97 3.1170 4.1721 1.00 1.30 Pediatric Misc Adult0951 Cleft Lip & Palate Repair 1.37 0.5968 0.7988 1.00 1.00 Pediatric Misc Adult0952 Cleft Lip & Palate Repair 1.86 0.7159 0.9582 1.00 1.00 Pediatric Misc Adult0953 Cleft Lip & Palate Repair 3.29 1.2238 1.6380 1.00 1.30 Pediatric Misc Adult0954 Cleft Lip & Palate Repair 6.95 2.5795 3.4526 1.00 1.30 Pediatric Misc Adult0971 Tonsil & Adenoid Procs 1.48 0.3823 0.5117 1.00 1.00 Pediatric Misc Adult0972 Tonsil & Adenoid Procs 2.56 0.6393 0.8557 1.00 1.00 Pediatric Misc Adult0973 Tonsil & Adenoid Procs 5.30 1.4120 1.8900 1.00 1.30 Pediatric Misc Adult0974 Tonsil & Adenoid Procs 14.94 4.0469 5.4168 1.00 1.30 Pediatric Misc Adult0981 Oth Ear, Nose Throat Procs 1.98 0.7380 0.9878 1.00 1.00 Pediatric Misc Adult0982 Oth Ear, Nose Throat Procs 2.95 1.0095 1.3512 1.00 1.00 Pediatric Misc Adult0983 Oth Ear, Nose Throat Procs 6.19 1.7195 2.3015 1.00 1.30 Pediatric Misc Adult0984 Oth Ear, Nose Throat Procs 13.40 3.8394 5.1390 1.00 1.30 Pediatric Misc Adult1101 Ear, Nose, Throat, Facial Malig 2.67 0.5973 0.7995 1.00 1.00 Pediatric Misc Adult1102 Ear, Nose, Throat, Facial Malig 3.89 0.8044 1.0767 1.00 1.00 Pediatric Misc Adult1103 Ear, Nose, Throat, Facial Malig 6.20 1.1979 1.6034 1.00 1.30 Pediatric Misc Adult1104 Ear, Nose, Throat, Facial Malig 11.95 2.5823 3.4564 1.00 1.30 Pediatric Misc Adult1111 Vertigo & Oth Labyrinth Dis 1.93 0.4941 0.6614 1.00 1.00 Pediatric Misc Adult1112 Vertigo & Oth Labyrinth Dis 2.38 0.5510 0.7375 1.00 1.00 Pediatric Misc Adult1113 Vertigo & Oth Labyrinth Dis 3.32 0.7091 0.9491 1.00 1.30 Pediatric Misc Adult1114 Vertigo & Oth Labyrinth Dis 6.84 1.3356 1.7877 1.00 1.30 Pediatric Misc Adult1131 Inf of Upper Resp Tract 1.81 0.2701 0.3615 1.00 1.00 Pediatric Resp Adult1132 Inf of Upper Resp Tract 2.37 0.4020 0.5381 1.00 1.00 Pediatric Resp Adult1133 Inf of Upper Resp Tract 3.68 0.6973 0.9333 1.00 1.30 Pediatric Resp Adult1134 Inf of Upper Resp Tract 6.75 1.5787 2.1131 1.00 1.30 Pediatric Resp Adult1141 Dental & Oral Conditions 2.07 0.4145 0.5548 1.00 1.00 Pediatric Misc Adult1142 Dental & Oral Conditions 2.81 0.6110 0.8178 1.00 1.00 Pediatric Misc Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

1143 Dental & Oral Conditions 5.16 1.0184 1.3631 1.00 1.30 Pediatric Misc Adult1144 Dental & Oral Conditions 10.20 2.2968 3.0743 1.00 1.30 Pediatric Misc Adult1151 Oth Ear, Nose, Throat Diags 2.16 0.4368 0.5847 1.00 1.00 Pediatric Misc Adult1152 Oth Ear, Nose, Throat Diags 2.80 0.6284 0.8411 1.00 1.00 Pediatric Misc Adult1153 Oth Ear, Nose, Throat Diags 4.45 0.9000 1.2046 1.00 1.30 Pediatric Misc Adult1154 Oth Ear, Nose, Throat Diags 8.81 2.0355 2.7245 1.00 1.30 Pediatric Misc Adult1201 Maj Resp & Chest Procs 4.67 1.6695 2.2346 1.00 1.00 Pediatric Resp Adult1202 Maj Resp & Chest Procs 6.54 2.0668 2.7664 1.00 1.00 Pediatric Resp Adult1203 Maj Resp & Chest Procs 11.00 3.1559 4.2242 1.00 1.30 Pediatric Resp Adult1204 Maj Resp & Chest Procs 18.91 5.9661 7.9856 1.00 1.30 Pediatric Resp Adult1211 Oth Resp & Chest Procs 3.25 1.1406 1.5267 1.00 1.00 Pediatric Resp Adult1212 Oth Resp & Chest Procs 5.16 1.4818 1.9834 1.00 1.00 Pediatric Resp Adult1213 Oth Resp & Chest Procs 9.74 2.5323 3.3895 1.00 1.30 Pediatric Resp Adult1214 Oth Resp & Chest Procs 18.11 5.5363 7.4103 1.00 1.30 Pediatric Resp Adult1301 Resp Sys Diag w MV 96+ Hrs 10.87 2.9787 3.9870 1.00 1.00 Pediatric Resp Adult1302 Resp Sys Diag w MV 96+ Hrs 11.05 3.3097 4.4300 1.00 1.00 Pediatric Resp Adult1303 Resp Sys Diag w MV 96+ Hrs 13.23 3.6775 4.9223 1.00 1.30 Pediatric Resp Adult1304 Resp Sys Diag w MV 96+ Hrs 17.65 5.2495 7.0264 1.00 1.30 Pediatric Resp Adult1311 Cystic Fibrosis - Pulmon Dis 6.65 1.2642 1.6921 1.00 1.00 Pediatric Resp Adult1312 Cystic Fibrosis - Pulmon Dis 7.93 1.5282 2.0455 1.00 1.00 Pediatric Resp Adult1313 Cystic Fibrosis - Pulmon Dis 10.16 2.0225 2.7071 1.00 1.30 Pediatric Resp Adult1314 Cystic Fibrosis - Pulmon Dis 12.73 2.8454 3.8086 1.00 1.30 Pediatric Resp Adult1321 Chronic Resp Dis Fm Perinatal 2.90 0.4193 0.5612 1.00 1.00 Pediatric Resp Adult1322 Chronic Resp Dis Fm Perinatal 3.62 0.5682 0.7605 1.00 1.00 Pediatric Resp Adult1323 Chronic Resp Dis Fm Perinatal 5.68 0.9013 1.2064 1.00 1.30 Pediatric Resp Adult1324 Chronic Resp Dis Fm Perinatal 7.99 1.7995 2.4086 1.00 1.30 Pediatric Resp Adult1331 Pulmon Edema & Resp Failure 2.37 0.5336 0.7142 1.00 1.00 Pediatric Resp Adult1332 Pulmon Edema & Resp Failure 3.83 0.6953 0.9307 1.00 1.00 Pediatric Resp Adult1333 Pulmon Edema & Resp Failure 5.18 1.0635 1.4235 1.00 1.30 Pediatric Resp Adult1334 Pulmon Edema & Resp Failure 6.55 1.8149 2.4292 1.00 1.30 Pediatric Resp Adult1341 Pulmonary Embolism 3.52 0.6491 0.8688 1.00 1.00 Pediatric Resp Adult1342 Pulmonary Embolism 4.38 0.8436 1.1292 1.00 1.00 Pediatric Resp Adult1343 Pulmonary Embolism 6.04 1.2302 1.6466 1.00 1.30 Pediatric Resp Adult1344 Pulmonary Embolism 8.96 2.1811 2.9194 1.00 1.30 Pediatric Resp Adult1351 Maj Chest & Resp Trauma 2.67 0.6548 0.8764 1.00 1.00 Pediatric Resp Adult1352 Maj Chest & Resp Trauma 3.51 0.8258 1.1053 1.00 1.00 Pediatric Resp Adult1353 Maj Chest & Resp Trauma 5.46 1.2201 1.6331 1.00 1.30 Pediatric Resp Adult1354 Maj Chest & Resp Trauma 7.97 2.2590 3.0237 1.00 1.30 Pediatric Resp Adult1361 Resp Malig 2.87 0.5979 0.8003 1.00 1.00 Pediatric Resp Adult1362 Resp Malig 3.95 0.7818 1.0464 1.00 1.00 Pediatric Resp Adult1363 Resp Malig 6.25 1.2613 1.6882 1.00 1.30 Pediatric Resp Adult1364 Resp Malig 8.93 2.0725 2.7740 1.00 1.30 Pediatric Resp Adult1371 Maj Resp Inf & Inflammations 4.13 0.6561 0.8782 1.00 1.00 Pediatric Resp Adult1372 Maj Resp Inf & Inflammations 4.97 0.7973 1.0672 1.00 1.00 Pediatric Resp Adult1373 Maj Resp Inf & Inflammations 6.98 1.2396 1.6592 1.00 1.30 Pediatric Resp Adult1374 Maj Resp Inf & Inflammations 9.94 2.1438 2.8695 1.00 1.30 Pediatric Resp Adult1381 Bronchiolitis & RSV Pneumonia 2.27 0.2731 0.3655 1.00 1.00 Pediatric Resp Adult1382 Bronchiolitis & RSV Pneumonia 2.98 0.3829 0.5125 1.00 1.00 Pediatric Resp Adult1383 Bronchiolitis & RSV Pneumonia 5.09 0.8200 1.0976 1.00 1.30 Pediatric Resp Adult1384 Bronchiolitis & RSV Pneumonia 8.30 2.0086 2.6885 1.00 1.30 Pediatric Resp Adult1391 Oth Pneumonia 2.58 0.3915 0.5240 1.00 1.00 Pediatric Resp Adult1392 Oth Pneumonia 3.59 0.5640 0.7549 1.00 1.00 Pediatric Resp Adult1393 Oth Pneumonia 5.34 0.9394 1.2574 1.00 1.30 Pediatric Resp Adult1394 Oth Pneumonia 8.58 1.8747 2.5093 1.00 1.30 Pediatric Resp Adult1401 COPD 2.98 0.4753 0.6362 1.00 1.00 Pediatric Resp Adult1402 COPD 3.65 0.6013 0.8048 1.00 1.00 Pediatric Resp Adult1403 COPD 4.90 0.8527 1.1413 1.00 1.30 Pediatric Resp Adult1404 COPD 8.39 1.7791 2.3813 1.00 1.30 Pediatric Resp Adult1411 Asthma 2.10 0.3450 0.4618 1.00 1.00 Pediatric Resp Adult1412 Asthma 2.93 0.5100 0.6826 1.00 1.00 Pediatric Resp Adult1413 Asthma 4.11 0.7777 1.0409 1.00 1.30 Pediatric Resp Adult1414 Asthma 5.21 1.4124 1.8905 1.00 1.30 Pediatric Resp Adult1421 Interstitial & Alveolar Lung Dis 3.10 0.6219 0.8324 1.00 1.00 Pediatric Resp Adult1422 Interstitial & Alveolar Lung Dis 3.98 0.7464 0.9991 1.00 1.00 Pediatric Resp Adult1423 Interstitial & Alveolar Lung Dis 5.89 1.0935 1.4636 1.00 1.30 Pediatric Resp Adult1424 Interstitial & Alveolar Lung Dis 9.97 2.1496 2.8772 1.00 1.30 Pediatric Resp Adult

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Page 10

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

1431 Oth Resp Diags Exc Minor 2.69 0.4348 0.5820 1.00 1.00 Pediatric Resp Adult1432 Oth Resp Diags Exc Minor 3.53 0.6716 0.8989 1.00 1.00 Pediatric Resp Adult1433 Oth Resp Diags Exc Minor 5.24 1.0911 1.4604 1.00 1.30 Pediatric Resp Adult1434 Oth Resp Diags Exc Minor 7.68 1.9072 2.5528 1.00 1.30 Pediatric Resp Adult1441 Resp Symptoms & Minor Diags 2.05 0.4281 0.5730 1.00 1.00 Pediatric Resp Adult1442 Resp Symptoms & Minor Diags 2.80 0.5369 0.7186 1.00 1.00 Pediatric Resp Adult1443 Resp Symptoms & Minor Diags 3.99 0.7831 1.0482 1.00 1.30 Pediatric Resp Adult1444 Resp Symptoms & Minor Diags 6.78 1.4933 1.9988 1.00 1.30 Pediatric Resp Adult1601 Maj Repair of Heart Anomaly 4.63 2.8405 3.8020 1.00 1.00 Pediatric Circulatory Adult1602 Maj Repair of Heart Anomaly 5.98 3.2378 4.3338 1.00 1.00 Pediatric Circulatory Adult1603 Maj Repair of Heart Anomaly 9.38 4.5788 6.1287 1.00 1.30 Pediatric Circulatory Adult1604 Maj Repair of Heart Anomaly 22.69 10.3840 13.8989 1.00 1.30 Pediatric Circulatory Adult1611 Defib & Heart Assist Implant 2.98 3.9742 5.3194 1.00 1.00 Pediatric Circulatory Adult1612 Defib & Heart Assist Implant 7.50 5.2448 7.0201 1.00 1.00 Pediatric Circulatory Adult1613 Defib & Heart Assist Implant 15.55 8.5977 11.5080 1.00 1.30 Pediatric Circulatory Adult1614 Defib & Heart Assist Implant 30.04 21.1733 28.3403 1.00 1.30 Pediatric Circulatory Adult1621 Cardiac Valve Procs w Cath 7.87 4.0948 5.4809 1.00 1.00 Pediatric Circulatory Adult1622 Cardiac Valve Procs w Cath 9.01 4.7410 6.3458 1.00 1.00 Pediatric Circulatory Adult1623 Cardiac Valve Procs w Cath 12.97 6.4396 8.6194 1.00 1.30 Pediatric Circulatory Adult1624 Cardiac Valve Procs w Cath 20.97 10.2515 13.7216 1.00 1.30 Pediatric Circulatory Adult1631 Cardiac Valve Procs w/o Cath 5.50 3.6285 4.8567 1.00 1.00 Pediatric Circulatory Adult1632 Cardiac Valve Procs w/o Cath 6.31 3.9870 5.3366 1.00 1.00 Pediatric Circulatory Adult1633 Cardiac Valve Procs w/o Cath 9.07 5.2947 7.0869 1.00 1.30 Pediatric Circulatory Adult1634 Cardiac Valve Procs w/o Cath 17.94 9.5401 12.7694 1.00 1.30 Pediatric Circulatory Adult1651 Coronary Bypass w Cath 6.63 3.3755 4.5181 1.00 1.00 Pediatric Circulatory Adult1652 Coronary Bypass w Cath 8.04 3.8919 5.2093 1.00 1.00 Pediatric Circulatory Adult1653 Coronary Bypass w Cath 10.27 4.9288 6.5972 1.00 1.30 Pediatric Circulatory Adult1654 Coronary Bypass w Cath 16.91 7.9370 10.6236 1.00 1.30 Pediatric Circulatory Adult1661 Coronary Bypass w/o Cath 4.95 2.6441 3.5391 1.00 1.00 Pediatric Circulatory Adult1662 Coronary Bypass w/o Cath 5.97 3.0517 4.0847 1.00 1.00 Pediatric Circulatory Adult1663 Coronary Bypass w/o Cath 8.40 4.0194 5.3799 1.00 1.30 Pediatric Circulatory Adult1664 Coronary Bypass w/o Cath 15.40 7.0219 9.3988 1.00 1.30 Pediatric Circulatory Adult1671 Oth Cardiothoracic Procs 4.22 2.7237 3.6457 1.00 1.00 Pediatric Circulatory Adult1672 Oth Cardiothoracic Procs 5.54 3.1727 4.2466 1.00 1.00 Pediatric Circulatory Adult1673 Oth Cardiothoracic Procs 8.91 4.2031 5.6258 1.00 1.30 Pediatric Circulatory Adult1674 Oth Cardiothoracic Procs 17.23 7.8847 10.5536 1.00 1.30 Pediatric Circulatory Adult1691 Maj Vascular Procs 4.18 1.6272 2.1780 1.00 1.00 Pediatric Circulatory Adult1692 Maj Vascular Procs 5.43 2.2164 2.9666 1.00 1.00 Pediatric Circulatory Adult1693 Maj Vascular Procs 9.11 3.7066 4.9613 1.00 1.30 Pediatric Circulatory Adult1694 Maj Vascular Procs 16.76 7.1697 9.5966 1.00 1.30 Pediatric Circulatory Adult1701 Pacemaker Impl w AMI or Shock 4.06 2.1844 2.9238 1.00 1.00 Pediatric Circulatory Adult1702 Pacemaker Impl w AMI or Shock 5.03 2.2764 3.0469 1.00 1.00 Pediatric Circulatory Adult1703 Pacemaker Impl w AMI or Shock 8.67 2.8201 3.7747 1.00 1.30 Pediatric Circulatory Adult1704 Pacemaker Impl w AMI or Shock 15.44 4.7353 6.3382 1.00 1.30 Pediatric Circulatory Adult1711 Pacemaker Impl w/o AMI or Shock 2.46 1.5036 2.0126 1.00 1.00 Pediatric Circulatory Adult1712 Pacemaker Impl w/o AMI or Shock 3.74 1.7570 2.3517 1.00 1.00 Pediatric Circulatory Adult1713 Pacemaker Impl w/o AMI or Shock 6.22 2.3204 3.1058 1.00 1.30 Pediatric Circulatory Adult1714 Pacemaker Impl w/o AMI or Shock 12.56 4.3382 5.8067 1.00 1.30 Pediatric Circulatory Adult1731 Oth Vascular Procs 2.31 1.7115 2.2908 1.00 1.00 Pediatric Circulatory Adult1732 Oth Vascular Procs 3.83 2.0744 2.7766 1.00 1.00 Pediatric Circulatory Adult1733 Oth Vascular Procs 7.86 2.9436 3.9400 1.00 1.30 Pediatric Circulatory Adult1734 Oth Vascular Procs 16.66 5.7459 7.6909 1.00 1.30 Pediatric Circulatory Adult1741 Percut CV Procs w AMI 2.36 1.8805 2.5170 1.00 1.00 Pediatric Circulatory Adult1742 Percut CV Procs w AMI 2.98 2.0349 2.7237 1.00 1.00 Pediatric Circulatory Adult1743 Percut CV Procs w AMI 5.05 2.6304 3.5208 1.00 1.30 Pediatric Circulatory Adult1744 Percut CV Procs w AMI 8.77 4.3826 5.8661 1.00 1.30 Pediatric Circulatory Adult1751 Percut CV Procs w/o AMI 1.63 1.7292 2.3145 1.00 1.00 Pediatric Circulatory Adult1752 Percut CV Procs w/o AMI 2.40 1.9648 2.6299 1.00 1.00 Pediatric Circulatory Adult1753 Percut CV Procs w/o AMI 4.86 2.5362 3.3947 1.00 1.30 Pediatric Circulatory Adult1754 Percut CV Procs w/o AMI 9.68 4.4253 5.9232 1.00 1.30 Pediatric Circulatory Adult1761 Pacemaker & Defib Replacement 2.76 1.3448 1.8000 1.00 1.00 Pediatric Circulatory Adult1762 Pacemaker & Defib Replacement 2.32 2.5940 3.4721 1.00 1.00 Pediatric Circulatory Adult1763 Pacemaker & Defib Replacement 4.15 2.8665 3.8368 1.00 1.30 Pediatric Circulatory Adult1764 Pacemaker & Defib Replacement 12.48 5.1041 6.8318 1.00 1.30 Pediatric Circulatory Adult1771 Pacemaker & Defib Revision 2.40 1.1286 1.5106 1.00 1.00 Pediatric Circulatory Adult1772 Pacemaker & Defib Revision 3.85 1.4479 1.9380 1.00 1.00 Pediatric Circulatory Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

1773 Pacemaker & Defib Revision 7.16 2.2745 3.0444 1.00 1.30 Pediatric Circulatory Adult1774 Pacemaker & Defib Revision 15.49 4.6590 6.2360 1.00 1.30 Pediatric Circulatory Adult1801 Oth Circulatory Sys Procs 3.80 1.0951 1.4658 1.00 1.00 Pediatric Circulatory Adult1802 Oth Circulatory Sys Procs 5.51 1.4866 1.9898 1.00 1.00 Pediatric Circulatory Adult1803 Oth Circulatory Sys Procs 9.14 2.3219 3.1079 1.00 1.30 Pediatric Circulatory Adult1804 Oth Circulatory Sys Procs 15.45 4.5752 6.1239 1.00 1.30 Pediatric Circulatory Adult1901 Acute Myocardial Infarction 2.04 0.6724 0.9000 1.00 1.00 Pediatric Circulatory Adult1902 Acute Myocardial Infarction 3.03 0.8005 1.0715 1.00 1.00 Pediatric Circulatory Adult1903 Acute Myocardial Infarction 4.96 1.1342 1.5181 1.00 1.30 Pediatric Circulatory Adult1904 Acute Myocardial Infarction 8.27 2.3036 3.0834 1.00 1.30 Pediatric Circulatory Adult1911 Cardiac Cath Exc Ischem Disease 2.34 0.9803 1.3121 1.00 1.00 Pediatric Circulatory Adult1912 Cardiac Cath Exc Ischem Disease 3.40 1.1679 1.5632 1.00 1.00 Pediatric Circulatory Adult1913 Cardiac Cath Exc Ischem Disease 5.52 1.5372 2.0575 1.00 1.30 Pediatric Circulatory Adult1914 Cardiac Cath Exc Ischem Disease 11.62 3.5277 4.7218 1.00 1.30 Pediatric Circulatory Adult1921 Cardiac Cath for Ischem Disease 1.82 0.8346 1.1171 1.00 1.00 Pediatric Circulatory Adult1922 Cardiac Cath for Ischem Disease 2.46 0.9643 1.2907 1.00 1.00 Pediatric Circulatory Adult1923 Cardiac Cath for Ischem Disease 4.19 1.3276 1.7770 1.00 1.30 Pediatric Circulatory Adult1924 Cardiac Cath for Ischem Disease 8.62 2.6781 3.5846 1.00 1.30 Pediatric Circulatory Adult1931 Acute & Subacute Endocarditis 4.92 0.8680 1.1618 1.00 1.00 Pediatric Circulatory Adult1932 Acute & Subacute Endocarditis 6.52 1.0880 1.4563 1.00 1.00 Pediatric Circulatory Adult1933 Acute & Subacute Endocarditis 9.55 1.7821 2.3853 1.00 1.30 Pediatric Circulatory Adult1934 Acute & Subacute Endocarditis 14.42 3.1016 4.1515 1.00 1.30 Pediatric Circulatory Adult1941 Heart Failure 2.75 0.4868 0.6516 1.00 1.00 Pediatric Circulatory Adult1942 Heart Failure 3.57 0.6127 0.8201 1.00 1.00 Pediatric Circulatory Adult1943 Heart Failure 5.36 0.9591 1.2838 1.00 1.30 Pediatric Circulatory Adult1944 Heart Failure 9.22 2.0096 2.6898 1.00 1.30 Pediatric Circulatory Adult1961 Cardiac Arrest 1.55 0.3736 0.5001 1.00 1.00 Pediatric Circulatory Adult1962 Cardiac Arrest 2.16 0.4921 0.6587 1.00 1.00 Pediatric Circulatory Adult1963 Cardiac Arrest 2.24 0.7585 1.0152 1.00 1.30 Pediatric Circulatory Adult1964 Cardiac Arrest 4.46 1.7617 2.3580 1.00 1.30 Pediatric Circulatory Adult1971 Peripheral & Oth Vascular Dis 3.07 0.4686 0.6272 1.00 1.00 Pediatric Circulatory Adult1972 Peripheral & Oth Vascular Dis 3.84 0.6456 0.8641 1.00 1.00 Pediatric Circulatory Adult1973 Peripheral & Oth Vascular Dis 5.13 0.9773 1.3081 1.00 1.30 Pediatric Circulatory Adult1974 Peripheral & Oth Vascular Dis 9.74 2.3003 3.0789 1.00 1.30 Pediatric Circulatory Adult1981 Angina Pect & Atherosclerosis 1.58 0.4166 0.5576 1.00 1.00 Pediatric Circulatory Adult1982 Angina Pect & Atherosclerosis 2.03 0.4889 0.6544 1.00 1.00 Pediatric Circulatory Adult1983 Angina Pect & Atherosclerosis 3.19 0.6950 0.9303 1.00 1.30 Pediatric Circulatory Adult1984 Angina Pect & Atherosclerosis 6.93 1.6460 2.2032 1.00 1.30 Pediatric Circulatory Adult1991 Hypertension 1.89 0.4473 0.5987 1.00 1.00 Pediatric Circulatory Adult1992 Hypertension 2.46 0.5298 0.7091 1.00 1.00 Pediatric Circulatory Adult1993 Hypertension 3.74 0.7689 1.0292 1.00 1.30 Pediatric Circulatory Adult1994 Hypertension 7.44 1.7671 2.3653 1.00 1.30 Pediatric Circulatory Adult2001 Cardiac Structural Dis 2.23 0.5222 0.6990 1.00 1.00 Pediatric Circulatory Adult2002 Cardiac Structural Dis 2.95 0.6050 0.8098 1.00 1.00 Pediatric Circulatory Adult2003 Cardiac Structural Dis 4.75 0.8963 1.1997 1.00 1.30 Pediatric Circulatory Adult2004 Cardiac Structural Dis 9.43 2.2777 3.0487 1.00 1.30 Pediatric Circulatory Adult2011 Cardiac Arrhythmias 1.90 0.4137 0.5537 1.00 1.00 Pediatric Circulatory Adult2012 Cardiac Arrhythmias 2.77 0.5364 0.7180 1.00 1.00 Pediatric Circulatory Adult2013 Cardiac Arrhythmias 4.40 0.8355 1.1183 1.00 1.30 Pediatric Circulatory Adult2014 Cardiac Arrhythmias 8.69 1.9734 2.6414 1.00 1.30 Pediatric Circulatory Adult2031 Chest Pain 1.41 0.4365 0.5843 1.00 1.00 Pediatric Circulatory Adult2032 Chest Pain 1.85 0.5142 0.6883 1.00 1.00 Pediatric Circulatory Adult2033 Chest Pain 2.87 0.6966 0.9324 1.00 1.30 Pediatric Circulatory Adult2034 Chest Pain 6.82 1.5573 2.0844 1.00 1.30 Pediatric Circulatory Adult2041 Syncope & Collapse 1.91 0.4997 0.6688 1.00 1.00 Pediatric Circulatory Adult2042 Syncope & Collapse 2.51 0.5749 0.7695 1.00 1.00 Pediatric Circulatory Adult2043 Syncope & Collapse 3.64 0.7482 1.0015 1.00 1.30 Pediatric Circulatory Adult2044 Syncope & Collapse 8.12 1.6806 2.2495 1.00 1.30 Pediatric Circulatory Adult2051 Cardiomyopathy 2.13 0.4461 0.5971 1.00 1.00 Pediatric Circulatory Adult2052 Cardiomyopathy 2.82 0.5884 0.7876 1.00 1.00 Pediatric Circulatory Adult2053 Cardiomyopathy 4.56 0.9025 1.2080 1.00 1.30 Pediatric Circulatory Adult2054 Cardiomyopathy 9.70 2.5460 3.4078 1.00 1.30 Pediatric Circulatory Adult2061 Complic of CV Device or Proc 2.06 0.5186 0.6941 1.00 1.00 Pediatric Circulatory Adult2062 Complic of CV Device or Proc 3.17 0.6498 0.8698 1.00 1.00 Pediatric Circulatory Adult2063 Complic of CV Device or Proc 5.15 1.0777 1.4425 1.00 1.30 Pediatric Circulatory Adult2064 Complic of CV Device or Proc 10.67 2.4957 3.3405 1.00 1.30 Pediatric Circulatory Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

2071 Oth Circulatory Sys Diags 2.22 0.4849 0.6490 1.00 1.00 Pediatric Circulatory Adult2072 Oth Circulatory Sys Diags 3.10 0.6498 0.8698 1.00 1.00 Pediatric Circulatory Adult2073 Oth Circulatory Sys Diags 4.51 0.9485 1.2696 1.00 1.30 Pediatric Circulatory Adult2074 Oth Circulatory Sys Diags 7.84 1.9499 2.6099 1.00 1.30 Pediatric Circulatory Adult2201 Maj Stomach & Esophag Procs 3.53 1.2475 1.6698 1.00 1.00 Pediatric Gastroent Adult2202 Maj Stomach & Esophag Procs 6.88 1.9689 2.6354 1.00 1.00 Pediatric Gastroent Adult2203 Maj Stomach & Esophag Procs 11.61 3.3262 4.4521 1.00 1.30 Pediatric Gastroent Adult2204 Maj Stomach & Esophag Procs 20.52 6.6379 8.8848 1.00 1.30 Pediatric Gastroent Adult2211 Maj Small & Large Bowel Procs 4.78 1.2786 1.7114 1.00 1.00 Pediatric Gastroent Adult2212 Maj Small & Large Bowel Procs 6.87 1.6875 2.2587 1.00 1.00 Pediatric Gastroent Adult2213 Maj Small & Large Bowel Procs 11.79 2.8353 3.7950 1.00 1.30 Pediatric Gastroent Adult2214 Maj Small & Large Bowel Procs 19.86 5.9885 8.0156 1.00 1.30 Pediatric Gastroent Adult2221 Oth Stomach & Esophag Procs 2.14 0.7874 1.0539 1.00 1.00 Pediatric Gastroent Adult2222 Oth Stomach & Esophag Procs 3.32 1.1721 1.5688 1.00 1.00 Pediatric Gastroent Adult2223 Oth Stomach & Esophag Procs 7.79 2.0783 2.7818 1.00 1.30 Pediatric Gastroent Adult2224 Oth Stomach & Esophag Procs 16.90 5.0112 6.7075 1.00 1.30 Pediatric Gastroent Adult2231 Oth Small & Large Bowel Procs 4.24 1.0189 1.3638 1.00 1.00 Pediatric Gastroent Adult2232 Oth Small & Large Bowel Procs 6.13 1.3881 1.8580 1.00 1.00 Pediatric Gastroent Adult2233 Oth Small & Large Bowel Procs 10.53 2.4131 3.2299 1.00 1.30 Pediatric Gastroent Adult2234 Oth Small & Large Bowel Procs 18.61 5.2460 7.0217 1.00 1.30 Pediatric Gastroent Adult2241 Peritoneal Adhesiolysis 5.12 1.1032 1.4766 1.00 1.00 Pediatric Gastroent Adult2242 Peritoneal Adhesiolysis 7.57 1.5243 2.0403 1.00 1.00 Pediatric Gastroent Adult2243 Peritoneal Adhesiolysis 11.15 2.3829 3.1895 1.00 1.30 Pediatric Gastroent Adult2244 Peritoneal Adhesiolysis 17.29 4.5490 6.0888 1.00 1.30 Pediatric Gastroent Adult2251 Appendectomy 1.49 0.7515 1.0059 1.00 1.00 Pediatric Gastroent Adult2252 Appendectomy 3.57 1.0240 1.3706 1.00 1.00 Pediatric Gastroent Adult2253 Appendectomy 6.94 1.8176 2.4328 1.00 1.30 Pediatric Gastroent Adult2254 Appendectomy 12.90 3.7288 4.9910 1.00 1.30 Pediatric Gastroent Adult2261 Anal Procs 2.39 0.6123 0.8196 1.00 1.00 Pediatric Gastroent Adult2262 Anal Procs 3.83 0.8581 1.1486 1.00 1.00 Pediatric Gastroent Adult2263 Anal Procs 6.86 1.4698 1.9673 1.00 1.30 Pediatric Gastroent Adult2264 Anal Procs 12.62 2.9913 4.0038 1.00 1.30 Pediatric Gastroent Adult2271 Oth Hernia Procs 2.78 0.9519 1.2741 1.00 1.00 Pediatric Gastroent Adult2272 Oth Hernia Procs 4.20 1.2364 1.6549 1.00 1.00 Pediatric Gastroent Adult2273 Oth Hernia Procs 7.70 2.1375 2.8610 1.00 1.30 Pediatric Gastroent Adult2274 Oth Hernia Procs 14.59 4.5062 6.0315 1.00 1.30 Pediatric Gastroent Adult2281 Inguin, Fem & Umbil Hernia Procs 1.88 0.7130 0.9543 1.00 1.00 Pediatric Gastroent Adult2282 Inguin, Fem & Umbil Hernia Procs 3.24 0.9429 1.2621 1.00 1.00 Pediatric Gastroent Adult2283 Inguin, Fem & Umbil Hernia Procs 5.90 1.5104 2.0217 1.00 1.30 Pediatric Gastroent Adult2284 Inguin, Fem & Umbil Hernia Procs 12.55 3.5338 4.7300 1.00 1.30 Pediatric Gastroent Adult2291 Oth Digestive & Abdo Procs 3.63 1.0497 1.4050 1.00 1.00 Pediatric Gastroent Adult2292 Oth Digestive & Abdo Procs 5.22 1.4386 1.9256 1.00 1.00 Pediatric Gastroent Adult2293 Oth Digestive & Abdo Procs 9.27 2.3975 3.2090 1.00 1.30 Pediatric Gastroent Adult2294 Oth Digestive & Abdo Procs 17.92 5.1659 6.9145 1.00 1.30 Pediatric Gastroent Adult2401 Digestive Malig 3.20 0.6679 0.8940 1.00 1.00 Pediatric Gastroent Adult2402 Digestive Malig 3.97 0.7865 1.0527 1.00 1.00 Pediatric Gastroent Adult2403 Digestive Malig 6.30 1.2182 1.6306 1.00 1.30 Pediatric Gastroent Adult2404 Digestive Malig 11.51 2.5436 3.4046 1.00 1.30 Pediatric Gastroent Adult2411 Peptic Ulcer & Gastritis 2.41 0.5377 0.7197 1.00 1.00 Pediatric Gastroent Adult2412 Peptic Ulcer & Gastritis 3.11 0.6767 0.9058 1.00 1.00 Pediatric Gastroent Adult2413 Peptic Ulcer & Gastritis 4.60 1.0170 1.3612 1.00 1.30 Pediatric Gastroent Adult2414 Peptic Ulcer & Gastritis 9.83 2.5521 3.4160 1.00 1.30 Pediatric Gastroent Adult2421 Maj Esophageal Dis 2.18 0.5052 0.6762 1.00 1.00 Pediatric Gastroent Adult2422 Maj Esophageal Dis 3.02 0.6692 0.8957 1.00 1.00 Pediatric Gastroent Adult2423 Maj Esophageal Dis 4.32 1.0032 1.3428 1.00 1.30 Pediatric Gastroent Adult2424 Maj Esophageal Dis 9.71 2.6264 3.5154 1.00 1.30 Pediatric Gastroent Adult2431 Oth Esophageal Dis 1.80 0.4555 0.6097 1.00 1.00 Pediatric Gastroent Adult2432 Oth Esophageal Dis 2.63 0.5912 0.7913 1.00 1.00 Pediatric Gastroent Adult2433 Oth Esophageal Dis 4.44 0.8942 1.1969 1.00 1.30 Pediatric Gastroent Adult2434 Oth Esophageal Dis 9.66 2.1630 2.8952 1.00 1.30 Pediatric Gastroent Adult2441 Diverticulitis & Diverticulosis 2.82 0.4862 0.6508 1.00 1.00 Pediatric Gastroent Adult2442 Diverticulitis & Diverticulosis 3.48 0.6176 0.8267 1.00 1.00 Pediatric Gastroent Adult2443 Diverticulitis & Diverticulosis 5.17 0.9682 1.2959 1.00 1.30 Pediatric Gastroent Adult2444 Diverticulitis & Diverticulosis 10.10 2.2481 3.0091 1.00 1.30 Pediatric Gastroent Adult2451 Inflammatory Bowel Disease 3.22 0.5668 0.7587 1.00 1.00 Pediatric Gastroent Adult2452 Inflammatory Bowel Disease 3.90 0.6826 0.9137 1.00 1.00 Pediatric Gastroent Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

2453 Inflammatory Bowel Disease 5.89 1.0444 1.3979 1.00 1.30 Pediatric Gastroent Adult2454 Inflammatory Bowel Disease 11.43 2.0858 2.7918 1.00 1.30 Pediatric Gastroent Adult2461 Gastroint Vasc Insufficiency 3.02 0.6075 0.8131 1.00 1.00 Pediatric Gastroent Adult2462 Gastroint Vasc Insufficiency 3.86 0.7384 0.9883 1.00 1.00 Pediatric Gastroent Adult2463 Gastroint Vasc Insufficiency 5.70 1.1106 1.4865 1.00 1.30 Pediatric Gastroent Adult2464 Gastroint Vasc Insufficiency 10.58 2.4932 3.3371 1.00 1.30 Pediatric Gastroent Adult2471 Intestinal Obstruction 2.74 0.4610 0.6170 1.00 1.00 Pediatric Gastroent Adult2472 Intestinal Obstruction 3.58 0.5848 0.7828 1.00 1.00 Pediatric Gastroent Adult2473 Intestinal Obstruction 5.60 0.9453 1.2653 1.00 1.30 Pediatric Gastroent Adult2474 Intestinal Obstruction 10.68 2.2781 3.0492 1.00 1.30 Pediatric Gastroent Adult2481 Maj Gastroint & Peritoneal Inf 3.18 0.4873 0.6522 1.00 1.00 Pediatric Gastroent Adult2482 Maj Gastroint & Peritoneal Inf 4.52 0.7008 0.9380 1.00 1.00 Pediatric Gastroent Adult2483 Maj Gastroint & Peritoneal Inf 6.81 1.1156 1.4932 1.00 1.30 Pediatric Gastroent Adult2484 Maj Gastroint & Peritoneal Inf 11.71 2.4130 3.2298 1.00 1.30 Pediatric Gastroent Adult2491 Non-Bact Gastroenteritis, N & V 2.09 0.3694 0.4944 1.00 1.00 Pediatric Gastroent Adult2492 Non-Bact Gastroenteritis, N & V 2.72 0.4787 0.6407 1.00 1.00 Pediatric Gastroent Adult2493 Non-Bact Gastroenteritis, N & V 4.04 0.7126 0.9538 1.00 1.30 Pediatric Gastroent Adult2494 Non-Bact Gastroenteritis, N & V 8.84 1.8534 2.4808 1.00 1.30 Pediatric Gastroent Adult2511 Abdominal Pain 2.08 0.4570 0.6117 1.00 1.00 Pediatric Gastroent Adult2512 Abdominal Pain 2.72 0.5648 0.7560 1.00 1.00 Pediatric Gastroent Adult2513 Abdominal Pain 3.90 0.7919 1.0600 1.00 1.30 Pediatric Gastroent Adult2514 Abdominal Pain 7.36 1.7093 2.2879 1.00 1.30 Pediatric Gastroent Adult2521 Complic of Gi Device or Proc 3.07 0.5027 0.6729 1.00 1.00 Pediatric Gastroent Adult2522 Complic of Gi Device or Proc 3.81 0.6718 0.8992 1.00 1.00 Pediatric Gastroent Adult2523 Complic of Gi Device or Proc 5.84 1.1040 1.4777 1.00 1.30 Pediatric Gastroent Adult2524 Complic of Gi Device or Proc 11.09 2.5420 3.4025 1.00 1.30 Pediatric Gastroent Adult2531 Oth & Unspec Gi Hemorrhage 2.40 0.5057 0.6769 1.00 1.00 Pediatric Gastroent Adult2532 Oth & Unspec Gi Hemorrhage 3.21 0.6605 0.8841 1.00 1.00 Pediatric Gastroent Adult2533 Oth & Unspec Gi Hemorrhage 4.77 1.0117 1.3542 1.00 1.30 Pediatric Gastroent Adult2534 Oth & Unspec Gi Hemorrhage 8.92 2.2370 2.9942 1.00 1.30 Pediatric Gastroent Adult2541 Oth Digestive Sys Diags 2.36 0.4623 0.6188 1.00 1.00 Pediatric Gastroent Adult2542 Oth Digestive Sys Diags 3.31 0.6264 0.8384 1.00 1.00 Pediatric Gastroent Adult2543 Oth Digestive Sys Diags 4.91 0.9433 1.2626 1.00 1.30 Pediatric Gastroent Adult2544 Oth Digestive Sys Diags 9.55 2.1937 2.9363 1.00 1.30 Pediatric Gastroent Adult2601 Maj Pancreas & Liver Procs 4.51 1.6323 2.1848 1.00 1.00 Pediatric Gastroent Adult2602 Maj Pancreas & Liver Procs 5.80 2.0526 2.7474 1.00 1.00 Pediatric Gastroent Adult2603 Maj Pancreas & Liver Procs 10.49 3.2997 4.4166 1.00 1.30 Pediatric Gastroent Adult2604 Maj Pancreas & Liver Procs 21.13 7.5962 10.1675 1.00 1.30 Pediatric Gastroent Adult2611 Maj Biliary Tract Procs 4.40 1.2431 1.6639 1.00 1.00 Pediatric Gastroent Adult2612 Maj Biliary Tract Procs 6.73 1.8024 2.4125 1.00 1.00 Pediatric Gastroent Adult2613 Maj Biliary Tract Procs 10.86 2.6799 3.5870 1.00 1.30 Pediatric Gastroent Adult2614 Maj Biliary Tract Procs 18.69 5.4292 7.2670 1.00 1.30 Pediatric Gastroent Adult2621 Cholecystectomy Exc Laparo 3.92 1.0777 1.4425 1.00 1.00 Pediatric Gastroent Adult2622 Cholecystectomy Exc Laparo 5.50 1.4311 1.9155 1.00 1.00 Pediatric Gastroent Adult2623 Cholecystectomy Exc Laparo 8.83 2.2661 3.0332 1.00 1.30 Pediatric Gastroent Adult2624 Cholecystectomy Exc Laparo 16.43 4.8622 6.5080 1.00 1.30 Pediatric Gastroent Adult2631 Laparoscopic Cholecystectomy 2.29 0.8997 1.2042 1.00 1.00 Pediatric Gastroent Adult2632 Laparoscopic Cholecystectomy 3.47 1.1593 1.5517 1.00 1.00 Pediatric Gastroent Adult2633 Laparoscopic Cholecystectomy 6.07 1.6788 2.2471 1.00 1.30 Pediatric Gastroent Adult2634 Laparoscopic Cholecystectomy 13.08 3.7247 4.9855 1.00 1.30 Pediatric Gastroent Adult2641 Oth Hepatobiliary & Abdo Procs 4.13 1.3448 1.8000 1.00 1.00 Pediatric Gastroent Adult2642 Oth Hepatobiliary & Abdo Procs 5.09 1.4772 1.9772 1.00 1.00 Pediatric Gastroent Adult2643 Oth Hepatobiliary & Abdo Procs 9.92 2.5198 3.3727 1.00 1.30 Pediatric Gastroent Adult2644 Oth Hepatobiliary & Abdo Procs 21.01 6.2077 8.3090 1.00 1.30 Pediatric Gastroent Adult2791 Hepatic Coma & Oth Maj Liver Dis 2.63 0.4856 0.6500 1.00 1.00 Pediatric Gastroent Adult2792 Hepatic Coma & Oth Maj Liver Dis 3.40 0.6419 0.8592 1.00 1.00 Pediatric Gastroent Adult2793 Hepatic Coma & Oth Maj Liver Dis 5.34 1.0769 1.4414 1.00 1.30 Pediatric Gastroent Adult2794 Hepatic Coma & Oth Maj Liver Dis 11.32 3.1204 4.1766 1.00 1.30 Pediatric Gastroent Adult2801 Alcoholic Liver Disease 2.67 0.5208 0.6971 1.00 1.00 Pediatric Gastroent Adult2802 Alcoholic Liver Disease 3.22 0.6323 0.8463 1.00 1.00 Pediatric Gastroent Adult2803 Alcoholic Liver Disease 4.98 1.0089 1.3504 1.00 1.30 Pediatric Gastroent Adult2804 Alcoholic Liver Disease 10.27 2.6386 3.5318 1.00 1.30 Pediatric Gastroent Adult2811 Malig of Hepatobiliary Sys 2.96 0.6632 0.8877 1.00 1.00 Pediatric Gastroent Adult2812 Malig of Hepatobiliary Sys 3.96 0.8427 1.1279 1.00 1.00 Pediatric Gastroent Adult2813 Malig of Hepatobiliary Sys 5.75 1.1996 1.6057 1.00 1.30 Pediatric Gastroent Adult2814 Malig of Hepatobiliary Sys 9.15 2.1989 2.9432 1.00 1.30 Pediatric Gastroent Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

2821 Dis of Pancreas Exc Malig 3.02 0.5230 0.7000 1.00 1.00 Pediatric Gastroent Adult2822 Dis of Pancreas Exc Malig 3.80 0.6688 0.8952 1.00 1.00 Pediatric Gastroent Adult2823 Dis of Pancreas Exc Malig 6.10 1.1576 1.5494 1.00 1.30 Pediatric Gastroent Adult2824 Dis of Pancreas Exc Malig 13.48 3.2699 4.3767 1.00 1.30 Pediatric Gastroent Adult2831 Oth Dis of the Liver 2.69 0.5281 0.7069 1.00 1.00 Pediatric Gastroent Adult2832 Oth Dis of the Liver 3.19 0.6591 0.8822 1.00 1.00 Pediatric Gastroent Adult2833 Oth Dis of the Liver 4.72 0.9886 1.3232 1.00 1.30 Pediatric Gastroent Adult2834 Oth Dis of the Liver 8.59 2.3016 3.0807 1.00 1.30 Pediatric Gastroent Adult2841 Dis of Gallbladder 2.31 0.5483 0.7339 1.00 1.00 Pediatric Gastroent Adult2842 Dis of Gallbladder 3.29 0.7370 0.9865 1.00 1.00 Pediatric Gastroent Adult2843 Dis of Gallbladder 5.06 1.1017 1.4746 1.00 1.30 Pediatric Gastroent Adult2844 Dis of Gallbladder 10.17 2.4891 3.3316 1.00 1.30 Pediatric Gastroent Adult3011 Hip Joint Replacement 3.53 1.5344 2.0538 1.00 1.00 Pediatric Misc Adult3012 Hip Joint Replacement 3.81 1.6994 2.2746 1.00 1.00 Pediatric Misc Adult3013 Hip Joint Replacement 5.03 2.3477 3.1424 1.00 1.30 Pediatric Misc Adult3014 Hip Joint Replacement 12.50 3.9622 5.3034 1.00 1.30 Pediatric Misc Adult3021 Knee Joint Replacement 2.89 1.4391 1.9262 1.00 1.00 Pediatric Misc Adult3022 Knee Joint Replacement 3.30 1.6326 2.1852 1.00 1.00 Pediatric Misc Adult3023 Knee Joint Replacement 4.87 2.1427 2.8680 1.00 1.30 Pediatric Misc Adult3024 Knee Joint Replacement 12.35 4.3055 5.7629 1.00 1.30 Pediatric Misc Adult3031 Lumb Fusion for Back Curvature 4.39 4.4766 5.9919 1.00 1.00 Pediatric Misc Adult3032 Lumb Fusion for Back Curvature 5.42 5.3576 7.1711 1.00 1.00 Pediatric Misc Adult3033 Lumb Fusion for Back Curvature 8.03 7.6399 10.2260 1.00 1.30 Pediatric Misc Adult3034 Lumb Fusion for Back Curvature 15.46 10.5504 14.1217 1.00 1.30 Pediatric Misc Adult3041 Lumb Fusion Exc Back Curvature 2.89 2.7723 3.7107 1.00 1.00 Pediatric Misc Adult3042 Lumb Fusion Exc Back Curvature 3.87 3.3279 4.4544 1.00 1.00 Pediatric Misc Adult3043 Lumb Fusion Exc Back Curvature 6.94 4.9545 6.6316 1.00 1.30 Pediatric Misc Adult3044 Lumb Fusion Exc Back Curvature 17.05 8.8245 11.8115 1.00 1.30 Pediatric Misc Adult3051 Amput of Lower Limb Exc Toes 5.08 1.0055 1.3459 1.00 1.00 Pediatric Misc Adult3052 Amput of Lower Limb Exc Toes 7.00 1.3407 1.7945 1.00 1.00 Pediatric Misc Adult3053 Amput of Lower Limb Exc Toes 10.64 2.2265 2.9802 1.00 1.30 Pediatric Misc Adult3054 Amput of Lower Limb Exc Toes 18.88 4.8069 6.4340 1.00 1.30 Pediatric Misc Adult3081 Hip & Femur Procs for Trauma 4.07 1.1528 1.5430 1.00 1.00 Pediatric Misc Adult3082 Hip & Femur Procs for Trauma 4.83 1.4139 1.8925 1.00 1.00 Pediatric Misc Adult3083 Hip & Femur Procs for Trauma 6.66 1.9946 2.6698 1.00 1.30 Pediatric Misc Adult3084 Hip & Femur Procs for Trauma 12.29 3.7591 5.0315 1.00 1.30 Pediatric Misc Adult3091 Hip & Femur Procs Non-Trauma 2.62 1.1190 1.4978 1.00 1.00 Pediatric Misc Adult3092 Hip & Femur Procs Non-Trauma 4.57 1.5661 2.0962 1.00 1.00 Pediatric Misc Adult3093 Hip & Femur Procs Non-Trauma 8.11 2.3877 3.1959 1.00 1.30 Pediatric Misc Adult3094 Hip & Femur Procs Non-Trauma 17.46 4.7150 6.3110 1.00 1.30 Pediatric Misc Adult3101 Disc Excision & Decompress 1.70 0.8864 1.1864 1.00 1.00 Pediatric Misc Adult3102 Disc Excision & Decompress 2.84 1.1825 1.5828 1.00 1.00 Pediatric Misc Adult3103 Disc Excision & Decompress 5.86 1.6972 2.2717 1.00 1.30 Pediatric Misc Adult3104 Disc Excision & Decompress 15.31 4.5640 6.1089 1.00 1.30 Pediatric Misc Adult3121 Skin Graft for Connect Tis Diags 4.92 1.5130 2.0251 1.00 1.00 Pediatric Misc Adult3122 Skin Graft for Connect Tis Diags 8.03 2.1075 2.8209 1.00 1.00 Pediatric Misc Adult3123 Skin Graft for Connect Tis Diags 17.57 4.1211 5.5161 1.00 1.30 Pediatric Misc Adult3124 Skin Graft for Connect Tis Diags 31.77 9.1404 12.2344 1.00 1.30 Pediatric Misc Adult3131 Knee & Lower Leg Procs Exc Foot 2.51 1.0267 1.3742 1.00 1.00 Pediatric Misc Adult3132 Knee & Lower Leg Procs Exc Foot 4.05 1.4643 1.9600 1.00 1.00 Pediatric Misc Adult3133 Knee & Lower Leg Procs Exc Foot 7.13 2.3345 3.1247 1.00 1.30 Pediatric Misc Adult3134 Knee & Lower Leg Procs Exc Foot 16.04 4.8261 6.4597 1.00 1.30 Pediatric Misc Adult3141 Foot & Toe Procs 2.30 0.9044 1.2105 1.00 1.00 Pediatric Misc Adult3142 Foot & Toe Procs 4.78 1.0911 1.4604 1.00 1.00 Pediatric Misc Adult3143 Foot & Toe Procs 7.52 1.5974 2.1381 1.00 1.30 Pediatric Misc Adult3144 Foot & Toe Procs 14.60 3.6775 4.9223 1.00 1.30 Pediatric Misc Adult3151 Shoulder And Arm Procs 1.74 0.8431 1.1285 1.00 1.00 Pediatric Misc Adult3152 Shoulder And Arm Procs 2.52 1.4697 1.9672 1.00 1.00 Pediatric Misc Adult3153 Shoulder And Arm Procs 6.00 2.2149 2.9646 1.00 1.30 Pediatric Misc Adult3154 Shoulder And Arm Procs 13.90 4.7315 6.3331 1.00 1.30 Pediatric Misc Adult3161 Hand & Wrist Procs 2.14 0.7724 1.0339 1.00 1.00 Pediatric Misc Adult3162 Hand & Wrist Procs 3.68 1.1495 1.5386 1.00 1.00 Pediatric Misc Adult3163 Hand & Wrist Procs 6.72 1.8343 2.4552 1.00 1.30 Pediatric Misc Adult3164 Hand & Wrist Procs 13.97 3.8071 5.0958 1.00 1.30 Pediatric Misc Adult3171 Soft Tissue Procs 2.78 0.7903 1.0578 1.00 1.00 Pediatric Misc Adult3172 Soft Tissue Procs 4.99 1.1748 1.5725 1.00 1.00 Pediatric Misc Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

3173 Soft Tissue Procs 8.98 2.1100 2.8242 1.00 1.30 Pediatric Misc Adult3174 Soft Tissue Procs 19.04 5.0673 6.7826 1.00 1.30 Pediatric Misc Adult3201 Oth Muscskl & Connect Tis Procs 2.10 0.9827 1.3153 1.00 1.00 Pediatric Misc Adult3202 Oth Muscskl & Connect Tis Procs 4.35 1.4119 1.8898 1.00 1.00 Pediatric Misc Adult3203 Oth Muscskl & Connect Tis Procs 8.24 2.2274 2.9814 1.00 1.30 Pediatric Misc Adult3204 Oth Muscskl & Connect Tis Procs 16.67 4.5382 6.0744 1.00 1.30 Pediatric Misc Adult3211 Cervical Spinal Fusion 1.61 1.6084 2.1528 1.00 1.00 Pediatric Misc Adult3212 Cervical Spinal Fusion 2.97 2.1314 2.8529 1.00 1.00 Pediatric Misc Adult3213 Cervical Spinal Fusion 8.13 3.7486 5.0175 1.00 1.30 Pediatric Misc Adult3214 Cervical Spinal Fusion 17.29 7.2108 9.6516 1.00 1.30 Pediatric Misc Adult3401 Fracture of Femur 2.66 0.4001 0.5355 1.00 1.00 Pediatric Misc Adult3402 Fracture of Femur 3.17 0.5072 0.6789 1.00 1.00 Pediatric Misc Adult3403 Fracture of Femur 4.70 0.7884 1.0553 1.00 1.30 Pediatric Misc Adult3404 Fracture of Femur 6.61 1.6282 2.1793 1.00 1.30 Pediatric Misc Adult3411 Fx of Pelvis or Dislocation of Hip 2.85 0.4511 0.6038 1.00 1.00 Pediatric Misc Adult3412 Fx of Pelvis or Dislocation of Hip 3.48 0.5367 0.7184 1.00 1.00 Pediatric Misc Adult3413 Fx of Pelvis or Dislocation of Hip 4.53 0.7633 1.0217 1.00 1.30 Pediatric Misc Adult3414 Fx of Pelvis or Dislocation of Hip 9.76 2.2491 3.0104 1.00 1.30 Pediatric Misc Adult3421 Fx & Dislc Exc Femur, Pelvis, Back 2.06 0.4462 0.5972 1.00 1.00 Pediatric Misc Adult3422 Fx & Dislc Exc Femur, Pelvis, Back 3.14 0.5926 0.7932 1.00 1.00 Pediatric Misc Adult3423 Fx & Dislc Exc Femur, Pelvis, Back 4.83 0.8859 1.1858 1.00 1.30 Pediatric Misc Adult3424 Fx & Dislc Exc Femur, Pelvis, Back 10.51 2.3197 3.1049 1.00 1.30 Pediatric Misc Adult3431 Muscskl Malig & Pathol Fx 3.45 0.6900 0.9236 1.00 1.00 Pediatric Misc Adult3432 Muscskl Malig & Pathol Fx 4.33 0.8540 1.1431 1.00 1.00 Pediatric Misc Adult3433 Muscskl Malig & Pathol Fx 7.11 1.3832 1.8514 1.00 1.30 Pediatric Misc Adult3434 Muscskl Malig & Pathol Fx 12.36 2.5984 3.4779 1.00 1.30 Pediatric Misc Adult3441 Musculoskeletal Inf 4.08 0.6481 0.8675 1.00 1.00 Pediatric Misc Adult3442 Musculoskeletal Inf 5.36 0.8477 1.1346 1.00 1.00 Pediatric Misc Adult3443 Musculoskeletal Inf 9.27 1.4545 1.9468 1.00 1.30 Pediatric Misc Adult3444 Musculoskeletal Inf 16.36 2.7915 3.7364 1.00 1.30 Pediatric Misc Adult3461 Connective Tissue Dis 2.94 0.5642 0.7552 1.00 1.00 Pediatric Misc Adult3462 Connective Tissue Dis 3.90 0.7671 1.0268 1.00 1.00 Pediatric Misc Adult3463 Connective Tissue Dis 6.80 1.3788 1.8455 1.00 1.30 Pediatric Misc Adult3464 Connective Tissue Dis 14.96 4.0194 5.3799 1.00 1.30 Pediatric Misc Adult3471 Oth Back & Neck Dis, Fx & Injuries 2.75 0.5427 0.7264 1.00 1.00 Pediatric Misc Adult3472 Oth Back & Neck Dis, Fx & Injuries 3.65 0.6981 0.9344 1.00 1.00 Pediatric Misc Adult3473 Oth Back & Neck Dis, Fx & Injuries 4.97 1.0118 1.3543 1.00 1.30 Pediatric Misc Adult3474 Oth Back & Neck Dis, Fx & Injuries 11.45 2.5795 3.4526 1.00 1.30 Pediatric Misc Adult3491 Complic of Ortho Device or Proc 2.09 0.4430 0.5930 1.00 1.00 Pediatric Misc Adult3492 Complic of Ortho Device or Proc 3.95 0.6753 0.9039 1.00 1.00 Pediatric Misc Adult3493 Complic of Ortho Device or Proc 6.42 1.1348 1.5189 1.00 1.30 Pediatric Misc Adult3494 Complic of Ortho Device or Proc 12.66 2.5088 3.3580 1.00 1.30 Pediatric Misc Adult3511 Oth Muscskl & Connect Tis Diags 2.33 0.4438 0.5940 1.00 1.00 Pediatric Misc Adult3512 Oth Muscskl & Connect Tis Diags 3.27 0.5584 0.7474 1.00 1.00 Pediatric Misc Adult3513 Oth Muscskl & Connect Tis Diags 5.03 0.9173 1.2278 1.00 1.30 Pediatric Misc Adult3514 Oth Muscskl & Connect Tis Diags 10.72 2.2049 2.9512 1.00 1.30 Pediatric Misc Adult3611 Skin Graft for Cutaneous Diags 3.66 1.2044 1.6121 1.00 1.00 Pediatric Misc Adult3612 Skin Graft for Cutaneous Diags 6.74 1.6249 2.1749 1.00 1.00 Pediatric Misc Adult3613 Skin Graft for Cutaneous Diags 12.09 2.5019 3.3488 1.00 1.30 Pediatric Misc Adult3614 Skin Graft for Cutaneous Diags 25.86 5.6734 7.5938 1.00 1.30 Pediatric Misc Adult3621 Mastectomy Procs 1.71 1.0393 1.3911 1.00 1.00 Pediatric Misc Adult3622 Mastectomy Procs 2.17 1.3899 1.8604 1.00 1.00 Pediatric Misc Adult3623 Mastectomy Procs 5.49 1.9466 2.6055 1.00 1.30 Pediatric Misc Adult3624 Mastectomy Procs 12.96 4.8961 6.5534 1.00 1.30 Pediatric Misc Adult3631 Breast Procs Exc Mastectomy 1.88 0.9268 1.2405 1.00 1.00 Pediatric Misc Adult3632 Breast Procs Exc Mastectomy 3.01 1.5952 2.1352 1.00 1.00 Pediatric Misc Adult3633 Breast Procs Exc Mastectomy 4.80 1.9454 2.6039 1.00 1.30 Pediatric Misc Adult3634 Breast Procs Exc Mastectomy 17.06 4.3072 5.7652 1.00 1.30 Pediatric Misc Adult3641 Oth Cutaneous & Related Procs 2.65 0.7745 1.0367 1.00 1.00 Pediatric Misc Adult3642 Oth Cutaneous & Related Procs 4.73 1.0939 1.4642 1.00 1.00 Pediatric Misc Adult3643 Oth Cutaneous & Related Procs 8.42 1.8051 2.4161 1.00 1.30 Pediatric Misc Adult3644 Oth Cutaneous & Related Procs 17.46 3.8855 5.2007 1.00 1.30 Pediatric Misc Adult3801 Skin Ulcers 3.68 0.5305 0.7101 1.00 1.00 Pediatric Misc Adult3802 Skin Ulcers 4.40 0.6373 0.8530 1.00 1.00 Pediatric Misc Adult3803 Skin Ulcers 6.51 0.9823 1.3148 1.00 1.30 Pediatric Misc Adult3804 Skin Ulcers 14.42 2.2675 3.0350 1.00 1.30 Pediatric Misc Adult

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

3811 Maj Skin Dis 2.80 0.4290 0.5742 1.00 1.00 Pediatric Misc Adult3812 Maj Skin Dis 3.94 0.6180 0.8272 1.00 1.00 Pediatric Misc Adult3813 Maj Skin Dis 6.23 1.1214 1.5010 1.00 1.30 Pediatric Misc Adult3814 Maj Skin Dis 13.15 4.0939 5.4797 1.00 1.30 Pediatric Misc Adult3821 Malignant Breast Dis 2.45 0.4763 0.6375 1.00 1.00 Pediatric Misc Adult3822 Malignant Breast Dis 3.87 0.6647 0.8897 1.00 1.00 Pediatric Misc Adult3823 Malignant Breast Dis 5.94 1.1145 1.4918 1.00 1.30 Pediatric Misc Adult3824 Malignant Breast Dis 9.23 2.1109 2.8254 1.00 1.30 Pediatric Misc Adult3831 Cellulitis & Oth Bact Skin Inf 2.81 0.4085 0.5468 1.00 1.00 Pediatric Misc Adult3832 Cellulitis & Oth Bact Skin Inf 3.91 0.5713 0.7647 1.00 1.00 Pediatric Misc Adult3833 Cellulitis & Oth Bact Skin Inf 5.73 0.9202 1.2317 1.00 1.30 Pediatric Misc Adult3834 Cellulitis & Oth Bact Skin Inf 11.28 2.2703 3.0388 1.00 1.30 Pediatric Misc Adult3841 Trauma To Cutaneous Tissue 1.80 0.5357 0.7170 1.00 1.00 Pediatric Misc Adult3842 Trauma To Cutaneous Tissue 2.81 0.6311 0.8447 1.00 1.00 Pediatric Misc Adult3843 Trauma To Cutaneous Tissue 4.50 0.9201 1.2315 1.00 1.30 Pediatric Misc Adult3844 Trauma To Cutaneous Tissue 10.30 2.3406 3.1329 1.00 1.30 Pediatric Misc Adult3851 Oth Cutaneous Tis & Breast Dis 2.32 0.3755 0.5026 1.00 1.00 Pediatric Misc Adult3852 Oth Cutaneous Tis & Breast Dis 3.31 0.5217 0.6983 1.00 1.00 Pediatric Misc Adult3853 Oth Cutaneous Tis & Breast Dis 5.12 0.8649 1.1577 1.00 1.30 Pediatric Misc Adult3854 Oth Cutaneous Tis & Breast Dis 12.29 2.7566 3.6897 1.00 1.30 Pediatric Misc Adult4011 Pituitary & Adrenal Procs 2.87 1.3956 1.8680 1.00 1.00 Pediatric Misc Adult4012 Pituitary & Adrenal Procs 4.00 1.8484 2.4741 1.00 1.00 Pediatric Misc Adult4013 Pituitary & Adrenal Procs 8.04 3.1182 4.1737 1.00 1.30 Pediatric Misc Adult4014 Pituitary & Adrenal Procs 21.52 7.6253 10.2064 1.00 1.30 Pediatric Misc Adult4031 Procs for Obesity 1.78 1.2891 1.7255 1.00 1.00 Pediatric Misc Adult4032 Procs for Obesity 2.12 1.3780 1.8444 1.00 1.00 Pediatric Misc Adult4033 Procs for Obesity 4.45 2.1362 2.8593 1.00 1.30 Pediatric Misc Adult4034 Procs for Obesity 17.34 6.6404 8.8881 1.00 1.30 Pediatric Misc Adult4041 Thyroid Procs 1.23 0.7491 1.0027 1.00 1.00 Pediatric Misc Adult4042 Thyroid Procs 1.97 0.9687 1.2966 1.00 1.00 Pediatric Misc Adult4043 Thyroid Procs 6.24 2.0570 2.7533 1.00 1.30 Pediatric Misc Adult4044 Thyroid Procs 16.08 4.5470 6.0861 1.00 1.30 Pediatric Misc Adult4051 Oth Procs for Metabolic Dis 3.51 1.2630 1.6905 1.00 1.00 Pediatric Misc Adult4052 Oth Procs for Metabolic Dis 5.18 1.4856 1.9885 1.00 1.00 Pediatric Misc Adult4053 Oth Procs for Metabolic Dis 8.89 2.2765 3.0471 1.00 1.30 Pediatric Misc Adult4054 Oth Procs for Metabolic Dis 21.06 5.6640 7.5812 1.00 1.30 Pediatric Misc Adult4201 Diabetes 2.44 0.3878 0.5191 1.00 1.00 Pediatric Misc Adult4202 Diabetes 2.60 0.5046 0.6754 1.00 1.00 Pediatric Misc Adult4203 Diabetes 3.98 0.7890 1.0561 1.00 1.30 Pediatric Misc Adult4204 Diabetes 9.08 2.2166 2.9669 1.00 1.30 Pediatric Misc Adult4211 Nutritional Dis 3.13 0.3411 0.4566 1.00 1.00 Pediatric Misc Adult4212 Nutritional Dis 4.08 0.5263 0.7044 1.00 1.00 Pediatric Misc Adult4213 Nutritional Dis 5.86 0.8545 1.1437 1.00 1.30 Pediatric Misc Adult4214 Nutritional Dis 12.35 2.1860 2.9259 1.00 1.30 Pediatric Misc Adult4221 Hypovolemia 1.89 0.2799 0.3746 1.00 1.00 Pediatric Misc Adult4222 Hypovolemia 2.75 0.4353 0.5826 1.00 1.00 Pediatric Misc Adult4223 Hypovolemia 4.14 0.6672 0.8930 1.00 1.30 Pediatric Misc Adult4224 Hypovolemia 8.36 1.6750 2.2420 1.00 1.30 Pediatric Misc Adult4231 Inborn Errors of Metabolism 2.47 0.5488 0.7346 1.00 1.00 Pediatric Misc Adult4232 Inborn Errors of Metabolism 3.28 0.6839 0.9154 1.00 1.00 Pediatric Misc Adult4233 Inborn Errors of Metabolism 5.29 1.0513 1.4072 1.00 1.30 Pediatric Misc Adult4234 Inborn Errors of Metabolism 14.46 3.7552 5.0263 1.00 1.30 Pediatric Misc Adult4241 Oth Endocrine Dis 2.39 0.4625 0.6191 1.00 1.00 Pediatric Misc Adult4242 Oth Endocrine Dis 3.72 0.6679 0.8940 1.00 1.00 Pediatric Misc Adult4243 Oth Endocrine Dis 5.53 0.9983 1.3362 1.00 1.30 Pediatric Misc Adult4244 Oth Endocrine Dis 10.83 2.3931 3.2032 1.00 1.30 Pediatric Misc Adult4251 Electrolyte Dis Exc Hypovolemia 2.28 0.3909 0.5232 1.00 1.00 Pediatric Misc Adult4252 Electrolyte Dis Exc Hypovolemia 2.83 0.4950 0.6626 1.00 1.00 Pediatric Misc Adult4253 Electrolyte Dis Exc Hypovolemia 4.30 0.7831 1.0482 1.00 1.30 Pediatric Misc Adult4254 Electrolyte Dis Exc Hypovolemia 8.85 1.9206 2.5707 1.00 1.30 Pediatric Misc Adult4401 Kidney Transpl 4.45 4.4669 5.9789 1.00 1.00 Transplant Pediatric Transplant Adult4402 Kidney Transpl 5.43 4.9490 6.6242 1.00 1.00 Transplant Pediatric Transplant Adult4403 Kidney Transpl 8.13 5.8979 7.8943 1.00 1.30 Transplant Pediatric Transplant Adult4404 Kidney Transpl 18.74 10.2326 13.6963 1.00 1.30 Transplant Pediatric Transplant Adult4411 Maj Bladder Procs 4.54 1.3835 1.8518 1.00 1.00 Pediatric Misc Adult4412 Maj Bladder Procs 7.05 2.1535 2.8824 1.00 1.00 Pediatric Misc Adult

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Page 17

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

4413 Maj Bladder Procs 9.42 2.8853 3.8620 1.00 1.30 Pediatric Misc Adult4414 Maj Bladder Procs 20.93 6.2275 8.3355 1.00 1.30 Pediatric Misc Adult4421 Kidney & Urinary Procs for Malig 3.13 1.2368 1.6555 1.00 1.00 Pediatric Misc Adult4422 Kidney & Urinary Procs for Malig 4.04 1.4537 1.9458 1.00 1.00 Pediatric Misc Adult4423 Kidney & Urinary Procs for Malig 7.64 2.3238 3.1104 1.00 1.30 Pediatric Misc Adult4424 Kidney & Urinary Procs for Malig 16.37 5.5703 7.4558 1.00 1.30 Pediatric Misc Adult4431 Kidney & Urinary Procs Nonmalig 2.40 1.0451 1.3989 1.00 1.00 Pediatric Misc Adult4432 Kidney & Urinary Procs Nonmalig 3.33 1.2727 1.7035 1.00 1.00 Pediatric Misc Adult4433 Kidney & Urinary Procs Nonmalig 7.55 1.9614 2.6253 1.00 1.30 Pediatric Misc Adult4434 Kidney & Urinary Procs Nonmalig 16.44 4.6814 6.2660 1.00 1.30 Pediatric Misc Adult4441 Renal Dialysis Access Proc 2.44 1.0607 1.4197 1.00 1.00 Pediatric Misc Adult4442 Renal Dialysis Access Proc 4.13 1.3767 1.8427 1.00 1.00 Pediatric Misc Adult4443 Renal Dialysis Access Proc 8.44 2.2748 3.0448 1.00 1.30 Pediatric Misc Adult4444 Renal Dialysis Access Proc 15.28 4.2183 5.6462 1.00 1.30 Pediatric Misc Adult4451 Oth Bladder Procs 1.76 0.8427 1.1279 1.00 1.00 Pediatric Misc Adult4452 Oth Bladder Procs 3.00 1.1649 1.5592 1.00 1.00 Pediatric Misc Adult4453 Oth Bladder Procs 7.52 1.7045 2.2815 1.00 1.30 Pediatric Misc Adult4454 Oth Bladder Procs 13.48 3.4617 4.6335 1.00 1.30 Pediatric Misc Adult4461 Urethral Procs 1.76 0.6353 0.8503 1.00 1.00 Pediatric Misc Adult4462 Urethral Procs 2.45 0.8297 1.1105 1.00 1.00 Pediatric Misc Adult4463 Urethral Procs 5.78 1.4067 1.8829 1.00 1.30 Pediatric Misc Adult4464 Urethral Procs 12.64 2.9870 3.9981 1.00 1.30 Pediatric Misc Adult4471 Oth Kidney & Urinary Procs 2.07 1.1047 1.4786 1.00 1.00 Pediatric Misc Adult4472 Oth Kidney & Urinary Procs 3.29 1.4130 1.8913 1.00 1.00 Pediatric Misc Adult4473 Oth Kidney & Urinary Procs 6.68 2.1343 2.8567 1.00 1.30 Pediatric Misc Adult4474 Oth Kidney & Urinary Procs 16.90 5.3709 7.1889 1.00 1.30 Pediatric Misc Adult4601 Renal Failure 2.61 0.5282 0.7070 1.00 1.00 Pediatric Misc Adult4602 Renal Failure 3.40 0.6539 0.8752 1.00 1.00 Pediatric Misc Adult4603 Renal Failure 4.65 0.8229 1.1014 1.00 1.30 Pediatric Misc Adult4604 Renal Failure 10.62 2.3691 3.1710 1.00 1.30 Pediatric Misc Adult4611 Kidney & Urinary Tract Malig 2.45 0.5372 0.7190 1.00 1.00 Pediatric Misc Adult4612 Kidney & Urinary Tract Malig 3.37 0.6440 0.8620 1.00 1.00 Pediatric Misc Adult4613 Kidney & Urinary Tract Malig 5.59 1.0132 1.3562 1.00 1.30 Pediatric Misc Adult4614 Kidney & Urinary Tract Malig 10.44 2.1997 2.9443 1.00 1.30 Pediatric Misc Adult4621 Nephritis & Nephrosis 2.47 0.4100 0.5488 1.00 1.00 Pediatric Misc Adult4622 Nephritis & Nephrosis 3.49 0.5627 0.7532 1.00 1.00 Pediatric Misc Adult4623 Nephritis & Nephrosis 6.06 1.0233 1.3697 1.00 1.30 Pediatric Misc Adult4624 Nephritis & Nephrosis 13.11 2.5548 3.4196 1.00 1.30 Pediatric Misc Adult4631 Kidney & Urinary Tract Inf 2.55 0.3999 0.5353 1.00 1.00 Pediatric Misc Adult4632 Kidney & Urinary Tract Inf 3.33 0.5233 0.7004 1.00 1.00 Pediatric Misc Adult4633 Kidney & Urinary Tract Inf 4.74 0.7556 1.0114 1.00 1.30 Pediatric Misc Adult4634 Kidney & Urinary Tract Inf 8.50 1.5742 2.1071 1.00 1.30 Pediatric Misc Adult4651 Urinary Stones & Obstruction 1.59 0.4258 0.5699 1.00 1.00 Pediatric Misc Adult4652 Urinary Stones & Obstruction 1.91 0.5390 0.7214 1.00 1.00 Pediatric Misc Adult4653 Urinary Stones & Obstruction 3.61 0.8707 1.1654 1.00 1.30 Pediatric Misc Adult4654 Urinary Stones & Obstruction 8.12 1.8978 2.5402 1.00 1.30 Pediatric Misc Adult4661 Complic Genitourin Dev or Proc 1.93 0.4066 0.5442 1.00 1.00 Pediatric Misc Adult4662 Complic Genitourin Dev or Proc 3.21 0.6088 0.8149 1.00 1.00 Pediatric Misc Adult4663 Complic Genitourin Dev or Proc 4.99 1.0015 1.3405 1.00 1.30 Pediatric Misc Adult4664 Complic Genitourin Dev or Proc 9.08 2.0320 2.7198 1.00 1.30 Pediatric Misc Adult4681 Oth Kidney & Urinary Diags 2.30 0.4466 0.5978 1.00 1.00 Pediatric Misc Adult4682 Oth Kidney & Urinary Diags 3.10 0.6071 0.8126 1.00 1.00 Pediatric Misc Adult4683 Oth Kidney & Urinary Diags 4.74 0.9024 1.2079 1.00 1.30 Pediatric Misc Adult4684 Oth Kidney & Urinary Diags 9.66 2.0975 2.8075 1.00 1.30 Pediatric Misc Adult4801 Maj Male Pelvic Procs 1.71 1.1347 1.5188 1.00 1.00 Pediatric Misc Adult4802 Maj Male Pelvic Procs 2.28 1.2391 1.6585 1.00 1.00 Pediatric Misc Adult4803 Maj Male Pelvic Procs 5.74 2.0423 2.7336 1.00 1.30 Pediatric Misc Adult4804 Maj Male Pelvic Procs 14.59 4.7195 6.3170 1.00 1.30 Pediatric Misc Adult4811 Penis Procs 2.08 0.7097 0.9499 1.00 1.00 Pediatric Misc Adult4812 Penis Procs 2.29 1.2315 1.6484 1.00 1.00 Pediatric Misc Adult4813 Penis Procs 8.02 1.8989 2.5417 1.00 1.30 Pediatric Misc Adult4814 Penis Procs 18.63 4.7349 6.3376 1.00 1.30 Pediatric Misc Adult4821 Transurethral Prostatectomy 1.62 0.5652 0.7565 1.00 1.00 Pediatric Misc Adult4822 Transurethral Prostatectomy 2.54 0.7366 0.9859 1.00 1.00 Pediatric Misc Adult4823 Transurethral Prostatectomy 6.75 1.4837 1.9859 1.00 1.30 Pediatric Misc Adult4824 Transurethral Prostatectomy 12.54 2.9912 4.0037 1.00 1.30 Pediatric Misc Adult

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Page 18

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

4831 Testes & Scrotal Procs 1.82 0.6293 0.8423 1.00 1.00 Pediatric Misc Adult4832 Testes & Scrotal Procs 4.90 1.1660 1.5607 1.00 1.00 Pediatric Misc Adult4833 Testes & Scrotal Procs 10.02 2.2493 3.0107 1.00 1.30 Pediatric Misc Adult4834 Testes & Scrotal Procs 19.25 5.1267 6.8621 1.00 1.30 Pediatric Misc Adult4841 Oth Male Reproductive Procs 2.43 0.8232 1.1018 1.00 1.00 Pediatric Misc Adult4842 Oth Male Reproductive Procs 1.84 1.1490 1.5379 1.00 1.00 Pediatric Misc Adult4843 Oth Male Reproductive Procs 4.60 1.5155 2.0285 1.00 1.30 Pediatric Misc Adult4844 Oth Male Reproductive Procs 17.00 3.7821 5.0623 1.00 1.30 Pediatric Misc Adult5001 Malig, Male Reproductive Sys 2.38 0.5204 0.6966 1.00 1.00 Pediatric Misc Adult5002 Malig, Male Reproductive Sys 3.96 0.6802 0.9104 1.00 1.00 Pediatric Misc Adult5003 Malig, Male Reproductive Sys 5.66 1.0124 1.3551 1.00 1.30 Pediatric Misc Adult5004 Malig, Male Reproductive Sys 10.10 2.0363 2.7256 1.00 1.30 Pediatric Misc Adult5011 Male Reproduct Diags Exc Malig 2.48 0.4185 0.5602 1.00 1.00 Pediatric Misc Adult5012 Male Reproduct Diags Exc Malig 3.33 0.5593 0.7486 1.00 1.00 Pediatric Misc Adult5013 Male Reproduct Diags Exc Malig 4.97 0.8553 1.1448 1.00 1.30 Pediatric Misc Adult5014 Male Reproduct Diags Exc Malig 10.63 2.0236 2.7086 1.00 1.30 Pediatric Misc Adult5101 Radical Hysterectectomy 2.35 1.1360 1.5205 1.00 1.00 Pediatric Misc Adult5102 Radical Hysterectectomy 3.69 1.4335 1.9187 1.00 1.00 Pediatric Misc Adult5103 Radical Hysterectectomy 8.75 2.8012 3.7494 1.00 1.30 Pediatric Misc Adult5104 Radical Hysterectectomy 17.07 6.3097 8.4455 1.00 1.30 Pediatric Misc Adult5111 Procs for Uterine/Adnexa Malig 3.17 1.1613 1.5544 1.00 1.00 Pediatric Misc Adult5112 Procs for Uterine/Adnexa Malig 4.67 1.4508 1.9419 1.00 1.00 Pediatric Misc Adult5113 Procs for Uterine/Adnexa Malig 8.34 2.2407 2.9992 1.00 1.30 Pediatric Misc Adult5114 Procs for Uterine/Adnexa Malig 17.11 5.0181 6.7167 1.00 1.30 Pediatric Misc Adult5121 Uterine/Adnexa Procs Oth Malig 2.09 1.0656 1.4263 1.00 1.00 Pediatric Misc Adult5122 Uterine/Adnexa Procs Oth Malig 2.91 1.2088 1.6180 1.00 1.00 Pediatric Misc Adult5123 Uterine/Adnexa Procs Oth Malig 6.50 1.9910 2.6649 1.00 1.30 Pediatric Misc Adult5124 Uterine/Adnexa Procs Oth Malig 15.65 4.8909 6.5464 1.00 1.30 Pediatric Misc Adult5131 Uterine/Adnexa Procs Non-Malig 1.79 0.7716 1.0328 1.00 1.00 Pediatric Misc Adult5132 Uterine/Adnexa Procs Non-Malig 2.37 0.9118 1.2204 1.00 1.00 Pediatric Misc Adult5133 Uterine/Adnexa Procs Non-Malig 5.27 1.5798 2.1146 1.00 1.30 Pediatric Misc Adult5134 Uterine/Adnexa Procs Non-Malig 13.92 4.3806 5.8634 1.00 1.30 Pediatric Misc Adult5141 Fem Reproduct Reconstr Procs 1.32 0.6621 0.8862 1.00 1.00 Pediatric Misc Adult5142 Fem Reproduct Reconstr Procs 1.62 0.9203 1.2318 1.00 1.00 Pediatric Misc Adult5143 Fem Reproduct Reconstr Procs 4.69 1.5649 2.0946 1.00 1.30 Pediatric Misc Adult5144 Fem Reproduct Reconstr Procs 14.30 4.9612 6.6405 1.00 1.30 Pediatric Misc Adult5171 D&C for Non-Obstetric Diags 1.79 0.6257 0.8375 1.00 1.00 Pediatric Misc Adult5172 D&C for Non-Obstetric Diags 2.75 0.8002 1.0711 1.00 1.00 Pediatric Misc Adult5173 D&C for Non-Obstetric Diags 6.07 1.4011 1.8754 1.00 1.30 Pediatric Misc Adult5174 D&C for Non-Obstetric Diags 11.85 2.6972 3.6102 1.00 1.30 Pediatric Misc Adult5181 Oth Fem Reproductive Procs 2.13 0.7283 0.9748 1.00 1.00 Pediatric Misc Adult5182 Oth Fem Reproductive Procs 3.57 1.0042 1.3441 1.00 1.00 Pediatric Misc Adult5183 Oth Fem Reproductive Procs 8.00 1.9484 2.6079 1.00 1.30 Pediatric Misc Adult5184 Oth Fem Reproductive Procs 18.13 4.9279 6.5960 1.00 1.30 Pediatric Misc Adult5191 Uterine/Adnexa Procs Leiomyoma 2.00 0.8122 1.0871 1.00 1.00 Pediatric Misc Adult5192 Uterine/Adnexa Procs Leiomyoma 2.64 0.9389 1.2567 1.00 1.00 Pediatric Misc Adult5193 Uterine/Adnexa Procs Leiomyoma 5.72 1.7068 2.2845 1.00 1.30 Pediatric Misc Adult5194 Uterine/Adnexa Procs Leiomyoma 13.78 4.5193 6.0491 1.00 1.30 Pediatric Misc Adult5301 Female Reproductive Sys Malig 2.36 0.4909 0.6571 1.00 1.00 Pediatric Misc Adult5302 Female Reproductive Sys Malig 3.56 0.6538 0.8751 1.00 1.00 Pediatric Misc Adult5303 Female Reproductive Sys Malig 5.87 1.1038 1.4774 1.00 1.30 Pediatric Misc Adult5304 Female Reproductive Sys Malig 10.66 2.3304 3.1192 1.00 1.30 Pediatric Misc Adult5311 Female Reproductive Sys Inf 2.55 0.4478 0.5994 1.00 1.00 Pediatric Misc Adult5312 Female Reproductive Sys Inf 3.57 0.6234 0.8344 1.00 1.00 Pediatric Misc Adult5313 Female Reproductive Sys Inf 6.01 1.0518 1.4078 1.00 1.30 Pediatric Misc Adult5314 Female Reproductive Sys Inf 11.13 2.2864 3.0603 1.00 1.30 Pediatric Misc Adult5321 Menstrual & Oth Fem Reprod Dis 1.66 0.4218 0.5646 1.00 1.00 Pediatric Misc Adult5322 Menstrual & Oth Fem Reprod Dis 2.23 0.5080 0.6800 1.00 1.00 Pediatric Misc Adult5323 Menstrual & Oth Fem Reprod Dis 4.07 0.8303 1.1114 1.00 1.30 Pediatric Misc Adult5324 Menstrual & Oth Fem Reprod Dis 8.43 1.8457 2.4705 1.00 1.30 Pediatric Misc Adult5401 Cesarean Del 2.96 0.5185 0.6940 1.00 1.00 Obstetrics Obstetrics5402 Cesarean Del 3.62 0.6237 0.8348 1.00 1.00 Obstetrics Obstetrics5403 Cesarean Del 5.64 0.9296 1.2443 1.00 1.00 Obstetrics Obstetrics5404 Cesarean Del 10.06 2.8305 3.7886 1.00 1.00 Obstetrics Obstetrics5411 Vag Del w Ster &/or D&C 2.08 0.4895 0.6552 1.00 1.00 Obstetrics Obstetrics5412 Vag Del w Ster &/or D&C 2.33 0.5356 0.7169 1.00 1.00 Obstetrics Obstetrics

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

5413 Vag Del w Ster &/or D&C 4.21 0.8539 1.1429 1.00 1.00 Obstetrics Obstetrics5414 Vag Del w Ster &/or D&C 7.96 2.3987 3.2106 1.00 1.00 Obstetrics Obstetrics5421 Vag Del w Proc Exc Ster &/or D&C 2.15 0.3354 0.4489 1.00 1.00 Obstetrics Obstetrics5422 Vag Del w Proc Exc Ster &/or D&C 2.47 0.4327 0.5792 1.00 1.00 Obstetrics Obstetrics5423 Vag Del w Proc Exc Ster &/or D&C 4.62 0.9245 1.2374 1.00 1.00 Obstetrics Obstetrics5424 Vag Del w Proc Exc Ster &/or D&C 10.85 4.2739 5.7206 1.00 1.00 Obstetrics Obstetrics5441 D&C for Obstetric Diags 1.30 0.4962 0.6642 1.00 1.00 Obstetrics Obstetrics5442 D&C for Obstetric Diags 1.77 0.5895 0.7890 1.00 1.00 Obstetrics Obstetrics5443 D&C for Obstetric Diags 3.61 1.1220 1.5018 1.00 1.00 Obstetrics Obstetrics5444 D&C for Obstetric Diags 7.38 2.7655 3.7016 1.00 1.00 Obstetrics Obstetrics5451 Ectopic Pregnancy Proc 1.57 0.7019 0.9395 1.00 1.00 Obstetrics Obstetrics5452 Ectopic Pregnancy Proc 1.85 0.8031 1.0749 1.00 1.00 Obstetrics Obstetrics5453 Ectopic Pregnancy Proc 2.55 1.0009 1.3397 1.00 1.00 Obstetrics Obstetrics5454 Ectopic Pregnancy Proc 4.49 1.5198 2.0342 1.00 1.00 Obstetrics Obstetrics5461 Oth O.R. Proc for Ob Diag Exc Del 2.30 0.5427 0.7264 1.00 1.00 Obstetrics Obstetrics5462 Oth O.R. Proc for Ob Diag Exc Del 3.40 0.7729 1.0345 1.00 1.00 Obstetrics Obstetrics5463 Oth O.R. Proc for Ob Diag Exc Del 6.71 1.5332 2.0522 1.00 1.00 Obstetrics Obstetrics5464 Oth O.R. Proc for Ob Diag Exc Del 13.46 4.4475 5.9530 1.00 1.00 Obstetrics Obstetrics5601 Vaginal Del 2.00 0.3027 0.4052 1.00 1.00 Obstetrics Obstetrics5602 Vaginal Del 2.28 0.3445 0.4611 1.00 1.00 Obstetrics Obstetrics5603 Vaginal Del 3.35 0.5115 0.6846 1.00 1.00 Obstetrics Obstetrics5604 Vaginal Del 7.61 1.7983 2.4070 1.00 1.00 Obstetrics Obstetrics5611 Postpartum Diags w/o Proc 2.01 0.2705 0.3621 1.00 1.00 Obstetrics Obstetrics5612 Postpartum Diags w/o Proc 2.42 0.4048 0.5418 1.00 1.00 Obstetrics Obstetrics5613 Postpartum Diags w/o Proc 3.60 0.6470 0.8660 1.00 1.00 Obstetrics Obstetrics5614 Postpartum Diags w/o Proc 6.38 1.7208 2.3033 1.00 1.00 Obstetrics Obstetrics5631 Threatened Abortion 2.30 0.2796 0.3742 1.00 1.00 Obstetrics Obstetrics5632 Threatened Abortion 3.38 0.3752 0.5022 1.00 1.00 Obstetrics Obstetrics5633 Threatened Abortion 6.53 0.6952 0.9305 1.00 1.00 Obstetrics Obstetrics5634 Threatened Abortion 8.50 1.0550 1.4121 1.00 1.00 Obstetrics Obstetrics5641 Abortion w/o D&C 1.32 0.2882 0.3858 1.00 1.00 Obstetrics Obstetrics5642 Abortion w/o D&C 1.58 0.3370 0.4511 1.00 1.00 Obstetrics Obstetrics5643 Abortion w/o D&C 2.55 0.4880 0.6532 1.00 1.00 Obstetrics Obstetrics5644 Abortion w/o D&C 5.05 2.4470 3.2753 1.00 1.00 Obstetrics Obstetrics5651 False Labor 1.13 0.1321 0.1768 1.00 1.00 Obstetrics Obstetrics5652 False Labor 1.63 0.1982 0.2653 1.00 1.00 Obstetrics Obstetrics5653 False Labor 4.59 0.3151 0.4218 1.00 1.00 Obstetrics Obstetrics5654 False Labor 5.05 0.3467 0.4641 1.00 1.00 Obstetrics Obstetrics5661 Oth Antepartum Diags 1.94 0.2644 0.3539 1.00 1.00 Obstetrics Obstetrics5662 Oth Antepartum Diags 2.57 0.3533 0.4729 1.00 1.00 Obstetrics Obstetrics5663 Oth Antepartum Diags 4.67 0.5578 0.7466 1.00 1.00 Obstetrics Obstetrics5664 Oth Antepartum Diags 8.06 1.7503 2.3428 1.00 1.00 Obstetrics Obstetrics5801 Neo, Tsf<5 Days, Not Born Here 1.44 0.2429 0.3251 1.00 1.00 Neonate Neonate5802 Neo, Tsf<5 Days, Not Born Here 1.59 0.3632 0.4861 1.00 1.00 Neonate Neonate5803 Neo, Tsf<5 Days, Not Born Here 1.82 0.6077 0.8134 1.30 1.00 Neonate Neonate5804 Neo, Tsf<5 Days, Not Born Here 1.65 1.0674 1.4287 1.30 1.00 Neonate Neonate5811 Neo, Tsf<5 Days Old, Born Here 1.24 0.1029 0.1377 1.00 1.00 Neonate Neonate5812 Neo, Tsf<5 Days Old, Born Here 1.28 0.1570 0.2101 1.00 1.00 Neonate Neonate5813 Neo, Tsf<5 Days Old, Born Here 1.26 0.2807 0.3757 1.30 1.00 Neonate Neonate5814 Neo, Tsf<5 Days Old, Born Here 1.35 0.5616 0.7517 1.30 1.00 Neonate Neonate5831 Neo w Ecmo 16.65 12.5910 16.8530 1.00 1.00 Neonate Neonate5832 Neo w Ecmo 18.50 13.9900 18.7255 1.00 1.00 Neonate Neonate5833 Neo w Ecmo 34.49 16.4323 21.9945 1.30 1.00 Neonate Neonate5834 Neo w Ecmo 55.52 26.6993 35.7369 1.30 1.00 Neonate Neonate5881 Neo Bwt <1500G w Maj Proc 45.87 6.7361 9.0162 1.00 1.00 Neonate Neonate5882 Neo Bwt <1500G w Maj Proc 50.97 7.4846 10.0181 1.00 1.00 Neonate Neonate5883 Neo Bwt <1500G w Maj Proc 78.17 16.6068 22.2281 1.30 1.00 Neonate Neonate5884 Neo Bwt <1500G w Maj Proc 111.18 25.2569 33.8062 1.30 1.00 Neonate Neonate5891 Neo Bwt <500G or <24 Wks 58.43 14.1953 19.0003 1.00 1.00 Neonate Neonate5892 Neo Bwt <500G or <24 Wks 48.45 9.9573 13.3278 1.00 1.00 Neonate Neonate5893 Neo Bwt <500G or <24 Wks 28.22 7.1228 9.5338 1.30 1.00 Neonate Neonate5894 Neo Bwt <500G or <24 Wks 1.14 0.2421 0.3240 1.30 1.00 Neonate Neonate5911 Neo Bwt 500-749G w/o Maj Proc 1.00 5.4241 7.2601 1.00 1.00 Neonate Neonate5912 Neo Bwt 500-749G w/o Maj Proc 34.73 8.8862 11.8941 1.00 1.00 Neonate Neonate5913 Neo Bwt 500-749G w/o Maj Proc 71.84 11.1980 14.9885 1.30 1.00 Neonate Neonate5914 Neo Bwt 500-749G w/o Maj Proc 80.93 17.4986 23.4218 1.30 1.00 Neonate Neonate

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Page 20

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

5931 Neo Bwt 750-999G w/o Maj Proc 19.28 3.9034 5.2247 1.00 1.00 Neonate Neonate5932 Neo Bwt 750-999G w/o Maj Proc 52.51 8.2690 11.0680 1.00 1.00 Neonate Neonate5933 Neo Bwt 750-999G w/o Maj Proc 63.26 10.7087 14.3335 1.30 1.00 Neonate Neonate5934 Neo Bwt 750-999G w/o Maj Proc 80.85 15.8429 21.2056 1.30 1.00 Neonate Neonate6021 Neo Bwt 1000-1249G w Maj Problem 32.05 4.5127 6.0402 1.00 1.00 Neonate Neonate6022 Neo Bwt 1000-1249G w Maj Problem 44.50 6.6524 8.9042 1.00 1.00 Neonate Neonate6023 Neo Bwt 1000-1249G w Maj Problem 55.62 8.7849 11.7585 1.30 1.00 Neonate Neonate6024 Neo Bwt 1000-1249G w Maj Problem 70.02 12.7652 17.0862 1.30 1.00 Neonate Neonate6031 Neo Bwt 1000-1249G 21.88 2.8320 3.7906 1.00 1.00 Neonate Neonate6032 Neo Bwt 1000-1249G 36.32 5.0703 6.7866 1.00 1.00 Neonate Neonate6033 Neo Bwt 1000-1249G 49.64 7.8571 10.5167 1.30 1.00 Neonate Neonate6034 Neo Bwt 1000-1249G 59.71 11.4075 15.2689 1.30 1.00 Neonate Neonate6071 Neo Bwt 1250-1499G w Maj Problem 26.15 3.4720 4.6473 1.00 1.00 Neonate Neonate6072 Neo Bwt 1250-1499G w Maj Problem 35.92 5.1990 6.9588 1.00 1.00 Neonate Neonate6073 Neo Bwt 1250-1499G w Maj Problem 44.31 6.7296 9.0075 1.30 1.00 Neonate Neonate6074 Neo Bwt 1250-1499G w Maj Problem 54.70 9.8459 13.1787 1.30 1.00 Neonate Neonate6081 Neo Bwt 1250-1499G 20.03 2.6344 3.5261 1.00 1.00 Neonate Neonate6082 Neo Bwt 1250-1499G 30.12 3.9938 5.3457 1.00 1.00 Neonate Neonate6083 Neo Bwt 1250-1499G 38.72 5.8701 7.8571 1.30 1.00 Neonate Neonate6084 Neo Bwt 1250-1499G 52.06 9.0896 12.1664 1.30 1.00 Neonate Neonate6091 Neo Bwt 1500-2499G w Maj Proc 19.33 3.3299 4.4571 1.00 1.00 Neonate Neonate6092 Neo Bwt 1500-2499G w Maj Proc 19.09 3.8462 5.1481 1.00 1.00 Neonate Neonate6093 Neo Bwt 1500-2499G w Maj Proc 35.44 6.7681 9.0591 1.30 1.00 Neonate Neonate6094 Neo Bwt 1500-2499G w Maj Proc 62.02 14.0684 18.8305 1.30 1.00 Neonate Neonate6111 Neo Bwt 1500-1999G w Maj Anomaly 13.70 1.8141 2.4282 1.00 1.00 Neonate Neonate6112 Neo Bwt 1500-1999G w Maj Anomaly 21.24 2.9476 3.9453 1.00 1.00 Neonate Neonate6113 Neo Bwt 1500-1999G w Maj Anomaly 32.26 4.7871 6.4075 1.30 1.00 Neonate Neonate6114 Neo Bwt 1500-1999G w Maj Anomaly 41.75 8.3931 11.2341 1.30 1.00 Neonate Neonate6121 Neo Bwt 1500-1999G Maj Resp Cond 17.34 2.3035 3.0832 1.00 1.00 Neonate Neonate6122 Neo Bwt 1500-1999G Maj Resp Cond 24.07 3.3732 4.5150 1.00 1.00 Neonate Neonate6123 Neo Bwt 1500-1999G Maj Resp Cond 32.41 4.8599 6.5049 1.30 1.00 Neonate Neonate6124 Neo Bwt 1500-1999G Maj Resp Cond 40.07 6.8091 9.1139 1.30 1.00 Neonate Neonate6131 Neo Bwt 1500-1999G w Inf 14.05 1.8689 2.5015 1.00 1.00 Neonate Neonate6132 Neo Bwt 1500-1999G w Inf 21.15 2.9304 3.9223 1.00 1.00 Neonate Neonate6133 Neo Bwt 1500-1999G w Inf 27.91 3.7013 4.9542 1.30 1.00 Neonate Neonate6134 Neo Bwt 1500-1999G w Inf 42.73 6.7760 9.0696 1.30 1.00 Neonate Neonate6141 Neo Bwt 1500-1999G 10.81 1.2654 1.6937 1.00 1.00 Neonate Neonate6142 Neo Bwt 1500-1999G 19.73 2.6309 3.5214 1.00 1.00 Neonate Neonate6143 Neo Bwt 1500-1999G 28.08 3.9812 5.3288 1.30 1.00 Neonate Neonate6144 Neo Bwt 1500-1999G 35.20 5.4435 7.2861 1.30 1.00 Neonate Neonate6211 Neo Bwt 2000-2499G w Maj Anomaly 7.73 0.9787 1.3100 1.00 1.00 Neonate Neonate6212 Neo Bwt 2000-2499G w Maj Anomaly 13.51 1.9173 2.5663 1.00 1.00 Neonate Neonate6213 Neo Bwt 2000-2499G w Maj Anomaly 20.97 3.2213 4.3117 1.30 1.00 Neonate Neonate6214 Neo Bwt 2000-2499G w Maj Anomaly 27.87 6.1130 8.1822 1.30 1.00 Neonate Neonate6221 Neo Bwt 2000-2499G Maj Resp Cond 10.99 1.5080 2.0184 1.00 1.00 Neonate Neonate6222 Neo Bwt 2000-2499G Maj Resp Cond 14.60 2.1543 2.8835 1.00 1.00 Neonate Neonate6223 Neo Bwt 2000-2499G Maj Resp Cond 19.15 3.0186 4.0404 1.30 1.00 Neonate Neonate6224 Neo Bwt 2000-2499G Maj Resp Cond 23.46 5.4393 7.2805 1.30 1.00 Neonate Neonate6231 Neo Bwt 2000-2499G w Inf 8.85 1.1600 1.5527 1.00 1.00 Neonate Neonate6232 Neo Bwt 2000-2499G w Inf 13.39 1.8661 2.4978 1.00 1.00 Neonate Neonate6233 Neo Bwt 2000-2499G w Inf 18.26 2.6909 3.6018 1.30 1.00 Neonate Neonate6234 Neo Bwt 2000-2499G w Inf 26.96 4.1118 5.5036 1.30 1.00 Neonate Neonate6251 Neo Bwt 2000-2499G w Oth Sig Cond 11.07 1.4107 1.8882 1.00 1.00 Neonate Neonate6252 Neo Bwt 2000-2499G w Oth Sig Cond 15.66 2.0857 2.7917 1.00 1.00 Neonate Neonate6253 Neo Bwt 2000-2499G w Oth Sig Cond 18.95 2.5433 3.4042 1.30 1.00 Neonate Neonate6254 Neo Bwt 2000-2499G w Oth Sig Cond 20.13 3.7878 5.0699 1.30 1.00 Neonate Neonate6261 Norm Newborn, Bwt 2000-2499G 2.63 0.1389 0.1859 1.00 1.00 Normal newborn Normal newborn6262 Norm Newborn, Bwt 2000-2499G 4.30 0.3664 0.4904 1.00 1.00 Normal newborn Normal newborn6263 Norm Newborn, Bwt 2000-2499G 8.30 0.9868 1.3208 1.00 1.00 Normal newborn Normal newborn6264 Norm Newborn, Bwt 2000-2499G 19.17 1.8282 2.4470 1.00 1.00 Normal newborn Normal newborn6301 Neo Bwt >2499G w Maj CV Proc 4.66 1.9767 2.6458 1.00 1.00 Neonate Neonate6302 Neo Bwt >2499G w Maj CV Proc 7.61 3.2029 4.2871 1.00 1.00 Neonate Neonate6303 Neo Bwt >2499G w Maj CV Proc 13.05 5.3723 7.1908 1.30 1.00 Neonate Neonate6304 Neo Bwt >2499G w Maj CV Proc 36.48 12.2738 16.4284 1.30 1.00 Neonate Neonate6311 Neo Bwt >2499G w Oth Maj Proc 3.22 1.0583 1.4165 1.00 1.00 Neonate Neonate6312 Neo Bwt >2499G w Oth Maj Proc 7.94 1.9440 2.6020 1.00 1.00 Neonate Neonate

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Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

6313 Neo Bwt >2499G w Oth Maj Proc 19.84 4.1582 5.5657 1.30 1.00 Neonate Neonate6314 Neo Bwt >2499G w Oth Maj Proc 48.38 11.7078 15.6708 1.30 1.00 Neonate Neonate6331 Neo Bwt >2499G w Maj Anomaly 2.71 0.2448 0.3277 1.00 1.00 Neonate Neonate6332 Neo Bwt >2499G w Maj Anomaly 5.59 0.8164 1.0927 1.00 1.00 Neonate Neonate6333 Neo Bwt >2499G w Maj Anomaly 10.93 1.8717 2.5053 1.30 1.00 Neonate Neonate6334 Neo Bwt >2499G w Maj Anomaly 23.53 5.7609 7.7109 1.30 1.00 Neonate Neonate6341 Neo, Bwt >2499G w Maj Resp Cond 4.43 0.5761 0.7711 1.00 1.00 Neonate Neonate6342 Neo, Bwt >2499G w Maj Resp Cond 6.98 1.1003 1.4727 1.00 1.00 Neonate Neonate6343 Neo, Bwt >2499G w Maj Resp Cond 11.83 2.2439 3.0034 1.30 1.00 Neonate Neonate6344 Neo, Bwt >2499G w Maj Resp Cond 21.79 5.5233 7.3929 1.30 1.00 Neonate Neonate6361 Neo Bwt >2499G w Inf 5.47 0.6953 0.9307 1.00 1.00 Neonate Neonate6362 Neo Bwt >2499G w Inf 7.26 1.0492 1.4043 1.00 1.00 Neonate Neonate6363 Neo Bwt >2499G w Inf 11.04 1.7488 2.3408 1.30 1.00 Neonate Neonate6364 Neo Bwt >2499G w Inf 18.17 4.1018 5.4902 1.30 1.00 Neonate Neonate6391 Neo Bwt >2499G w Oth Sig Cond 3.64 0.4109 0.5500 1.00 1.00 Neonate Neonate6392 Neo Bwt >2499G w Oth Sig Cond 6.21 0.8305 1.1116 1.00 1.00 Neonate Neonate6393 Neo Bwt >2499G w Oth Sig Cond 8.95 1.4629 1.9581 1.30 1.00 Neonate Neonate6394 Neo Bwt >2499G w Oth Sig Cond 15.03 3.7647 5.0390 1.30 1.00 Neonate Neonate6401 Normal Newborn, Bwt >2499G 2.07 0.0969 0.1297 1.00 1.00 Normal newborn Normal newborn6402 Normal Newborn, Bwt >2499G 2.35 0.1371 0.1835 1.00 1.00 Normal newborn Normal newborn6403 Normal Newborn, Bwt >2499G 3.51 0.3651 0.4887 1.00 1.00 Normal newborn Normal newborn6404 Normal Newborn, Bwt >2499G 11.10 1.7726 2.3726 1.00 1.00 Normal newborn Normal newborn6501 Splenectomy 3.37 1.2199 1.6328 1.00 1.00 Pediatric Misc Adult6502 Splenectomy 5.08 1.6938 2.2671 1.00 1.00 Pediatric Misc Adult6503 Splenectomy 8.26 2.5458 3.4075 1.00 1.30 Pediatric Misc Adult6504 Splenectomy 15.14 5.5041 7.3672 1.00 1.30 Pediatric Misc Adult6511 Oth Procs of Blood & Rel Organs 3.08 0.9708 1.2994 1.00 1.00 Pediatric Misc Adult6512 Oth Procs of Blood & Rel Organs 4.54 1.3725 1.8371 1.00 1.00 Pediatric Misc Adult6513 Oth Procs of Blood & Rel Organs 8.63 2.2133 2.9625 1.00 1.30 Pediatric Misc Adult6514 Oth Procs of Blood & Rel Organs 22.85 6.0410 8.0858 1.00 1.30 Pediatric Misc Adult6601 Maj Hem/Immun Diag 2.86 0.6168 0.8256 1.00 1.00 Pediatric Misc Adult6602 Maj Hem/Immun Diag 3.87 0.7575 1.0139 1.00 1.00 Pediatric Misc Adult6603 Maj Hem/Immun Diag 6.02 1.2455 1.6671 1.00 1.30 Pediatric Misc Adult6604 Maj Hem/Immun Diag 13.32 3.8332 5.1307 1.00 1.30 Pediatric Misc Adult6611 Coagulation & Platelet Dis 2.58 0.8301 1.1111 1.00 1.00 Pediatric Misc Adult6612 Coagulation & Platelet Dis 3.49 1.0167 1.3608 1.00 1.00 Pediatric Misc Adult6613 Coagulation & Platelet Dis 5.11 1.8607 2.4905 1.00 1.30 Pediatric Misc Adult6614 Coagulation & Platelet Dis 11.63 3.8366 5.1353 1.00 1.30 Pediatric Misc Adult6621 Sickle Cell Anemia Crisis 3.91 0.5304 0.7099 1.00 1.00 Pediatric Misc Adult6622 Sickle Cell Anemia Crisis 5.01 0.7176 0.9605 1.00 1.00 Pediatric Misc Adult6623 Sickle Cell Anemia Crisis 7.26 1.1378 1.5229 1.00 1.30 Pediatric Misc Adult6624 Sickle Cell Anemia Crisis 12.73 2.9110 3.8964 1.00 1.30 Pediatric Misc Adult6631 Oth Dis of Blood & Rel Organs 2.19 0.4457 0.5966 1.00 1.00 Pediatric Misc Adult6632 Oth Dis of Blood & Rel Organs 2.82 0.5775 0.7730 1.00 1.00 Pediatric Misc Adult6633 Oth Dis of Blood & Rel Organs 4.25 0.8565 1.1464 1.00 1.30 Pediatric Misc Adult6634 Oth Dis of Blood & Rel Organs 8.12 1.8759 2.5109 1.00 1.30 Pediatric Misc Adult6801 Maj O.R. Proc Lymphatic Neoplasm 3.86 1.3997 1.8735 1.00 1.00 Pediatric Misc Adult6802 Maj O.R. Proc Lymphatic Neoplasm 5.91 1.9478 2.6071 1.00 1.00 Pediatric Misc Adult6803 Maj O.R. Proc Lymphatic Neoplasm 11.35 3.4180 4.5750 1.00 1.30 Pediatric Misc Adult6804 Maj O.R. Proc Lymphatic Neoplasm 23.49 7.7209 10.3344 1.00 1.30 Pediatric Misc Adult6811 Oth O.R. Proc Lymphatic Neoplasm 2.49 1.0283 1.3764 1.00 1.00 Pediatric Misc Adult6812 Oth O.R. Proc Lymphatic Neoplasm 4.69 1.4431 1.9316 1.00 1.00 Pediatric Misc Adult6813 Oth O.R. Proc Lymphatic Neoplasm 10.54 2.6159 3.5014 1.00 1.30 Pediatric Misc Adult6814 Oth O.R. Proc Lymphatic Neoplasm 23.90 6.9939 9.3613 1.00 1.30 Pediatric Misc Adult6901 Acute Leukemia 4.31 1.0311 1.3801 1.00 1.00 Pediatric Misc Adult6902 Acute Leukemia 6.73 1.5882 2.1258 1.00 1.00 Pediatric Misc Adult6903 Acute Leukemia 14.03 3.2764 4.3854 1.00 1.30 Pediatric Misc Adult6904 Acute Leukemia 25.36 7.2884 9.7555 1.00 1.30 Pediatric Misc Adult6911 Lymphoma, Myeloma & Non-Ac Leuk 3.47 0.8750 1.1712 1.00 1.00 Pediatric Misc Adult6912 Lymphoma, Myeloma & Non-Ac Leuk 5.09 1.1430 1.5299 1.00 1.00 Pediatric Misc Adult6913 Lymphoma, Myeloma & Non-Ac Leuk 8.05 1.7760 2.3772 1.00 1.30 Pediatric Misc Adult6914 Lymphoma, Myeloma & Non-Ac Leuk 15.27 4.0810 5.4624 1.00 1.30 Pediatric Misc Adult6921 Radiothapy 3.29 0.8390 1.1230 1.00 1.00 Pediatric Misc Adult6922 Radiothapy 4.42 1.5899 2.1281 1.00 1.00 Pediatric Misc Adult6923 Radiothapy 8.16 2.2641 3.0305 1.00 1.30 Pediatric Misc Adult6924 Radiothapy 13.29 4.0490 5.4196 1.00 1.30 Pediatric Misc Adult

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Page 22

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

6931 Chemothapy 2.74 0.7372 0.9867 1.00 1.00 Pediatric Misc Adult6932 Chemothapy 3.49 0.8645 1.1571 1.00 1.00 Pediatric Misc Adult6933 Chemothapy 7.21 1.6893 2.2611 1.00 1.30 Pediatric Misc Adult6934 Chemothapy 23.39 5.9148 7.9169 1.00 1.30 Pediatric Misc Adult6941 Lymphatic & Oth Malig & Neoplasms 2.71 0.5750 0.7696 1.00 1.00 Pediatric Misc Adult6942 Lymphatic & Oth Malig & Neoplasms 3.73 0.7459 0.9984 1.00 1.00 Pediatric Misc Adult6943 Lymphatic & Oth Malig & Neoplasms 6.19 1.2261 1.6411 1.00 1.30 Pediatric Misc Adult6944 Lymphatic & Oth Malig & Neoplasms 11.14 2.6541 3.5525 1.00 1.30 Pediatric Misc Adult7101 Inf & Parasit Dis Incl HIV w O.R. Proc 4.26 1.0636 1.4236 1.00 1.00 Pediatric Misc Adult7102 Inf & Parasit Dis Incl HIV w O.R. Proc 6.44 1.5697 2.1010 1.00 1.00 Pediatric Misc Adult7103 Inf & Parasit Dis Incl HIV w O.R. Proc 10.63 2.5838 3.4584 1.00 1.30 Pediatric Misc Adult7104 Inf & Parasit Dis Incl HIV w O.R. Proc 18.14 5.8067 7.7722 1.00 1.30 Pediatric Misc Adult7111 Post-Op, Device Inf w O.R. Proc 4.37 1.0078 1.3489 1.00 1.00 Pediatric Misc Adult7112 Post-Op, Device Inf w O.R. Proc 6.24 1.4474 1.9373 1.00 1.00 Pediatric Misc Adult7113 Post-Op, Device Inf w O.R. Proc 10.51 2.5455 3.4071 1.00 1.30 Pediatric Misc Adult7114 Post-Op, Device Inf w O.R. Proc 20.18 6.0615 8.1133 1.00 1.30 Pediatric Misc Adult7201 Septicemia & Disseminated Inf 3.21 0.5296 0.7089 1.00 1.00 Pediatric Misc Adult7202 Septicemia & Disseminated Inf 4.20 0.7147 0.9566 1.00 1.00 Pediatric Misc Adult7203 Septicemia & Disseminated Inf 6.32 1.2250 1.6397 1.00 1.30 Pediatric Misc Adult7204 Septicemia & Disseminated Inf 10.19 2.8127 3.7648 1.00 1.30 Pediatric Misc Adult7211 Post-Op, Post-Trauma, Device Inf 3.40 0.5534 0.7407 1.00 1.00 Pediatric Misc Adult7212 Post-Op, Post-Trauma, Device Inf 4.34 0.7394 0.9897 1.00 1.00 Pediatric Misc Adult7213 Post-Op, Post-Trauma, Device Inf 6.45 1.2421 1.6625 1.00 1.30 Pediatric Misc Adult7214 Post-Op, Post-Trauma, Device Inf 10.70 2.5390 3.3984 1.00 1.30 Pediatric Misc Adult7221 Fever 2.20 0.3436 0.4599 1.00 1.00 Pediatric Misc Adult7222 Fever 2.85 0.5288 0.7078 1.00 1.00 Pediatric Misc Adult7223 Fever 4.05 0.7897 1.0570 1.00 1.30 Pediatric Misc Adult7224 Fever 6.72 1.5018 2.0102 1.00 1.30 Pediatric Misc Adult7231 Viral Illness 2.06 0.3265 0.4370 1.00 1.00 Pediatric Misc Adult7232 Viral Illness 2.66 0.4778 0.6395 1.00 1.00 Pediatric Misc Adult7233 Viral Illness 4.30 0.8030 1.0748 1.00 1.30 Pediatric Misc Adult7234 Viral Illness 11.96 2.9290 3.9205 1.00 1.30 Pediatric Misc Adult7241 Oth Inf & Parasit Diseases 3.72 0.5869 0.7856 1.00 1.00 Pediatric Misc Adult7242 Oth Inf & Parasit Diseases 4.37 0.7139 0.9556 1.00 1.00 Pediatric Misc Adult7243 Oth Inf & Parasit Diseases 6.30 1.1693 1.5651 1.00 1.30 Pediatric Misc Adult7244 Oth Inf & Parasit Diseases 12.51 3.0055 4.0228 1.00 1.30 Pediatric Misc Adult7401 Mental Illness Diag w O.R. Proc 4.92 1.3513 1.8087 1.00 1.00 Mental Health Mental Health7402 Mental Illness Diag w O.R. Proc 11.08 1.3783 1.8448 1.00 1.00 Mental Health Mental Health7403 Mental Illness Diag w O.R. Proc 16.87 2.5914 3.4686 1.00 1.30 Mental Health Mental Health7404 Mental Illness Diag w O.R. Proc 20.58 3.7820 5.0622 1.00 1.30 Mental Health Mental Health7501 Schizophrenia 9.08 0.6485 0.8680 1.00 1.00 Mental Health Mental Health7502 Schizophrenia 9.97 0.7178 0.9608 1.00 1.00 Mental Health Mental Health7503 Schizophrenia 13.07 1.0375 1.3887 1.00 1.30 Mental Health Mental Health7504 Schizophrenia 23.33 1.9129 2.5604 1.00 1.30 Mental Health Mental Health7511 Maj Depression 4.73 0.3568 0.4776 1.00 1.00 Mental Health Mental Health7512 Maj Depression 6.52 0.5036 0.6741 1.00 1.00 Mental Health Mental Health7513 Maj Depression 9.39 0.8179 1.0948 1.00 1.30 Mental Health Mental Health7514 Maj Depression 18.69 1.6058 2.1494 1.00 1.30 Mental Health Mental Health7521 Dis of Personality 4.47 0.3245 0.4343 1.00 1.00 Mental Health Mental Health7522 Dis of Personality 5.39 0.4341 0.5810 1.00 1.00 Mental Health Mental Health7523 Dis of Personality 10.16 0.9302 1.2451 1.00 1.30 Mental Health Mental Health7524 Dis of Personality 5.00 0.9981 1.3360 1.00 1.30 Mental Health Mental Health7531 Bipolar Dis 5.34 0.3960 0.5300 1.00 1.00 Mental Health Mental Health7532 Bipolar Dis 7.14 0.5323 0.7125 1.00 1.00 Mental Health Mental Health7533 Bipolar Dis 10.41 0.8615 1.1531 1.00 1.30 Mental Health Mental Health7534 Bipolar Dis 17.35 1.4630 1.9582 1.00 1.30 Mental Health Mental Health7541 Depression Exc Maj Dep 3.70 0.2857 0.3824 1.00 1.00 Mental Health Mental Health7542 Depression Exc Maj Dep 4.85 0.3806 0.5094 1.00 1.00 Mental Health Mental Health7543 Depression Exc Maj Dep 6.42 0.5687 0.7612 1.00 1.30 Mental Health Mental Health7544 Depression Exc Maj Dep 13.92 1.2559 1.6810 1.00 1.30 Mental Health Mental Health7551 Adjust Dis & Neuroses Exc Dep 3.43 0.2559 0.3425 1.00 1.00 Mental Health Mental Health7552 Adjust Dis & Neuroses Exc Dep 5.39 0.4067 0.5444 1.00 1.00 Mental Health Mental Health7553 Adjust Dis & Neuroses Exc Dep 7.99 0.6233 0.8343 1.00 1.30 Mental Health Mental Health7554 Adjust Dis & Neuroses Exc Dep 9.00 0.9405 1.2589 1.00 1.30 Mental Health Mental Health7561 Acute Anxiety & Delirium States 2.89 0.4043 0.5412 1.00 1.00 Mental Health Mental Health7562 Acute Anxiety & Delirium States 3.38 0.5115 0.6846 1.00 1.00 Mental Health Mental Health

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Page 23

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

7563 Acute Anxiety & Delirium States 4.00 0.6403 0.8570 1.00 1.30 Mental Health Mental Health7564 Acute Anxiety & Delirium States 6.90 1.4755 1.9749 1.00 1.30 Mental Health Mental Health7571 Organic Mental Health Disturb 7.25 0.5744 0.7688 1.00 1.00 Mental Health Mental Health7572 Organic Mental Health Disturb 7.95 0.6440 0.8620 1.00 1.00 Mental Health Mental Health7573 Organic Mental Health Disturb 8.88 0.8370 1.1203 1.00 1.30 Mental Health Mental Health7574 Organic Mental Health Disturb 12.86 1.5749 2.1080 1.00 1.30 Mental Health Mental Health7581 Childhood Behavioral Dis 5.92 0.4309 0.5768 1.00 1.00 Mental Health Mental Health7582 Childhood Behavioral Dis 7.93 0.5525 0.7395 1.00 1.00 Mental Health Mental Health7583 Childhood Behavioral Dis 11.01 0.7967 1.0664 1.00 1.30 Mental Health Mental Health7584 Childhood Behavioral Dis 11.00 1.0529 1.4093 1.00 1.30 Mental Health Mental Health7591 Eating Dis 12.43 0.8248 1.1040 1.00 1.00 Mental Health Mental Health7592 Eating Dis 10.90 0.8749 1.1710 1.00 1.00 Mental Health Mental Health7593 Eating Dis 12.44 1.2330 1.6504 1.00 1.30 Mental Health Mental Health7594 Eating Dis 18.42 2.1021 2.8136 1.00 1.30 Mental Health Mental Health7601 Oth Mental Health Dis 6.04 0.5433 0.7272 1.00 1.00 Mental Health Mental Health7602 Oth Mental Health Dis 6.56 0.6410 0.8580 1.00 1.00 Mental Health Mental Health7603 Oth Mental Health Dis 7.45 0.8356 1.1184 1.00 1.30 Mental Health Mental Health7604 Oth Mental Health Dis 9.33 1.4312 1.9157 1.00 1.30 Mental Health Mental Health7701 Drug & Alcohol Abuse, AMA 2.10 0.2154 0.2883 1.00 1.00 Pediatric Misc Adult7702 Drug & Alcohol Abuse, AMA 2.21 0.2594 0.3472 1.00 1.00 Pediatric Misc Adult7703 Drug & Alcohol Abuse, AMA 3.00 0.5909 0.7909 1.00 1.30 Pediatric Misc Adult7704 Drug & Alcohol Abuse, AMA 7.30 2.1709 2.9057 1.00 1.30 Pediatric Misc Adult7721 Alc & Drug Dep w Rehab or Detox 13.51 0.6045 0.8091 1.00 1.00 Pediatric Misc Adult7722 Alc & Drug Dep w Rehab or Detox 14.48 0.7014 0.9388 1.00 1.00 Pediatric Misc Adult7723 Alc & Drug Dep w Rehab or Detox 11.72 0.7319 0.9796 1.00 1.30 Pediatric Misc Adult7724 Alc & Drug Dep w Rehab or Detox 21.08 2.5201 3.3731 1.00 1.30 Pediatric Misc Adult7731 Opioid Abuse & Dependence 3.18 0.2454 0.3285 1.00 1.00 Pediatric Misc Adult7732 Opioid Abuse & Dependence 3.89 0.3141 0.4204 1.00 1.00 Pediatric Misc Adult7733 Opioid Abuse & Dependence 4.65 0.6256 0.8374 1.00 1.30 Pediatric Misc Adult7734 Opioid Abuse & Dependence 8.94 1.8412 2.4644 1.00 1.30 Pediatric Misc Adult7741 Cocaine Abuse & Dependence 3.15 0.3198 0.4281 1.00 1.00 Pediatric Misc Adult7742 Cocaine Abuse & Dependence 3.82 0.3350 0.4484 1.00 1.00 Pediatric Misc Adult7743 Cocaine Abuse & Dependence 4.32 0.6663 0.8918 1.00 1.30 Pediatric Misc Adult7744 Cocaine Abuse & Dependence 10.01 2.2839 3.0570 1.00 1.30 Pediatric Misc Adult7751 Alcohol Abuse & Dependence 2.97 0.3052 0.4085 1.00 1.00 Pediatric Misc Adult7752 Alcohol Abuse & Dependence 3.51 0.4561 0.6105 1.00 1.00 Pediatric Misc Adult7753 Alcohol Abuse & Dependence 5.21 0.8784 1.1757 1.00 1.30 Pediatric Misc Adult7754 Alcohol Abuse & Dependence 11.58 2.6084 3.4913 1.00 1.30 Pediatric Misc Adult7761 Oth Drug Abuse & Dependence 3.45 0.3239 0.4335 1.00 1.00 Pediatric Misc Adult7762 Oth Drug Abuse & Dependence 3.61 0.4293 0.5746 1.00 1.00 Pediatric Misc Adult7763 Oth Drug Abuse & Dependence 4.59 0.7480 1.0012 1.00 1.30 Pediatric Misc Adult7764 Oth Drug Abuse & Dependence 8.31 1.7356 2.3231 1.00 1.30 Pediatric Misc Adult7911 O.R. Proc for Complic of Care 2.90 0.9059 1.2125 1.00 1.00 Pediatric Misc Adult7912 O.R. Proc for Complic of Care 4.68 1.3514 1.8088 1.00 1.00 Pediatric Misc Adult7913 O.R. Proc for Complic of Care 8.86 2.3872 3.1953 1.00 1.30 Pediatric Misc Adult7914 O.R. Proc for Complic of Care 18.81 5.6566 7.5713 1.00 1.30 Pediatric Misc Adult8111 Allergic Reactions 1.47 0.2829 0.3787 1.00 1.00 Pediatric Misc Adult8112 Allergic Reactions 1.91 0.3943 0.5278 1.00 1.00 Pediatric Misc Adult8113 Allergic Reactions 3.69 0.8739 1.1697 1.00 1.30 Pediatric Misc Adult8114 Allergic Reactions 8.72 2.4773 3.3159 1.00 1.30 Pediatric Misc Adult8121 Poisoning of Medicinal Agents 1.54 0.3280 0.4390 1.00 1.00 Pediatric Misc Adult8122 Poisoning of Medicinal Agents 2.09 0.4126 0.5523 1.00 1.00 Pediatric Misc Adult8123 Poisoning of Medicinal Agents 3.22 0.7583 1.0150 1.00 1.30 Pediatric Misc Adult8124 Poisoning of Medicinal Agents 6.45 1.8936 2.5346 1.00 1.30 Pediatric Misc Adult8131 Oth Complics of Treatment 2.37 0.4688 0.6275 1.00 1.00 Pediatric Misc Adult8132 Oth Complics of Treatment 3.12 0.6308 0.8443 1.00 1.00 Pediatric Misc Adult8133 Oth Complics of Treatment 5.05 1.0576 1.4156 1.00 1.30 Pediatric Misc Adult8134 Oth Complics of Treatment 10.71 2.4600 3.2927 1.00 1.30 Pediatric Misc Adult8151 Oth Inj And Poisoning Diags 1.52 0.4610 0.6170 1.00 1.00 Pediatric Misc Adult8152 Oth Inj And Poisoning Diags 2.47 0.5044 0.6751 1.00 1.00 Pediatric Misc Adult8153 Oth Inj And Poisoning Diags 3.88 0.8712 1.1661 1.00 1.30 Pediatric Misc Adult8154 Oth Inj And Poisoning Diags 7.86 2.5646 3.4327 1.00 1.30 Pediatric Misc Adult8161 Toxic Eff of Non-Medicinal Subst 1.59 0.5394 0.7220 1.00 1.00 Pediatric Misc Adult8162 Toxic Eff of Non-Medicinal Subst 2.23 0.5933 0.7941 1.00 1.00 Pediatric Misc Adult8163 Toxic Eff of Non-Medicinal Subst 3.19 0.8201 1.0977 1.00 1.30 Pediatric Misc Adult8164 Toxic Eff of Non-Medicinal Subst 6.68 2.0335 2.7218 1.00 1.30 Pediatric Misc Adult

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Page 24

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

8411 Ext 3Rd Deg Burns w Skin Graft 22.00 4.3866 5.8714 1.00 1.00 Pediatric Misc Adult8412 Ext 3Rd Deg Burns w Skin Graft 9.67 4.4611 5.9712 1.00 1.00 Pediatric Misc Adult8413 Ext 3Rd Deg Burns w Skin Graft 22.44 6.0232 8.0620 1.00 1.30 Pediatric Misc Adult8414 Ext 3Rd Deg Burns w Skin Graft 41.36 17.8643 23.9113 1.00 1.30 Pediatric Misc Adult8421 Full Thick Burns w Graft 7.05 1.4507 1.9418 1.00 1.00 Pediatric Misc Adult8422 Full Thick Burns w Graft 10.10 2.1388 2.8628 1.00 1.00 Pediatric Misc Adult8423 Full Thick Burns w Graft 16.37 3.9838 5.3323 1.00 1.30 Pediatric Misc Adult8424 Full Thick Burns w Graft 28.12 9.8600 13.1976 1.00 1.30 Pediatric Misc Adult8431 Ext Burns w/o Skin Graft 3.10 0.5511 0.7376 1.00 1.00 Pediatric Misc Adult8432 Ext Burns w/o Skin Graft 4.33 0.7603 1.0177 1.00 1.00 Pediatric Misc Adult8433 Ext Burns w/o Skin Graft 6.50 1.3885 1.8585 1.00 1.30 Pediatric Misc Adult8434 Ext Burns w/o Skin Graft 9.00 3.7459 5.0139 1.00 1.30 Pediatric Misc Adult8441 Part Thick Burns w or w/o Graft 2.81 0.5106 0.6834 1.00 1.00 Pediatric Misc Adult8442 Part Thick Burns w or w/o Graft 4.55 0.8354 1.1182 1.00 1.00 Pediatric Misc Adult8443 Part Thick Burns w or w/o Graft 7.04 1.4715 1.9696 1.00 1.30 Pediatric Misc Adult8444 Part Thick Burns w or w/o Graft 18.61 5.9469 7.9599 1.00 1.30 Pediatric Misc Adult8501 Proc w Diag of Rehab or Other 2.38 1.3284 1.7781 1.00 1.00 Rehab Rehab8502 Proc w Diag of Rehab or Other 4.57 1.5061 2.0159 1.00 1.00 Rehab Rehab8503 Proc w Diag of Rehab or Other 14.89 2.8543 3.8205 1.00 1.30 Rehab Rehab8504 Proc w Diag of Rehab or Other 29.86 6.0703 8.1251 1.00 1.30 Rehab Rehab8601 Rehabilitation 8.74 0.7594 1.0165 1.00 1.00 Rehab Rehab8602 Rehabilitation 11.09 1.0475 1.4021 1.00 1.00 Rehab Rehab8603 Rehabilitation 14.23 1.5524 2.0779 1.00 1.30 Rehab Rehab8604 Rehabilitation 17.44 2.2072 2.9543 1.00 1.30 Rehab Rehab8611 Signs, Symptoms & Oth Factors 2.22 0.3815 0.5106 1.00 1.00 Pediatric Misc Adult8612 Signs, Symptoms & Oth Factors 3.07 0.5153 0.6897 1.00 1.00 Pediatric Misc Adult8613 Signs, Symptoms & Oth Factors 4.50 0.7715 1.0326 1.00 1.30 Pediatric Misc Adult8614 Signs, Symptoms & Oth Factors 8.66 1.7744 2.3750 1.00 1.30 Pediatric Misc Adult8621 Oth Aftercare & Convalescence 5.69 0.3560 0.4765 1.00 1.00 Pediatric Misc Adult8622 Oth Aftercare & Convalescence 9.06 0.6244 0.8358 1.00 1.00 Pediatric Misc Adult8623 Oth Aftercare & Convalescence 11.16 0.9804 1.3123 1.00 1.30 Pediatric Misc Adult8624 Oth Aftercare & Convalescence 14.95 1.7535 2.3471 1.00 1.30 Pediatric Misc Adult8631 Neonatal Aftercare 8.14 0.7687 1.0289 1.00 1.00 Neonate Neonate8632 Neonatal Aftercare 17.56 2.1728 2.9083 1.00 1.00 Neonate Neonate8633 Neonatal Aftercare 26.98 3.8897 5.2063 1.30 1.00 Neonate Neonate8634 Neonatal Aftercare 46.57 9.2929 12.4385 1.30 1.00 Neonate Neonate8901 HIV w Mult Maj Related Cond 1.67 1.0816 1.4477 1.00 1.00 Pediatric Misc Adult8902 HIV w Mult Maj Related Cond 6.23 1.2534 1.6777 1.00 1.00 Pediatric Misc Adult8903 HIV w Mult Maj Related Cond 8.48 1.7852 2.3895 1.00 1.30 Pediatric Misc Adult8904 HIV w Mult Maj Related Cond 14.48 4.0088 5.3658 1.00 1.30 Pediatric Misc Adult8921 HIV w Maj Related Cond 5.25 0.6449 0.8632 1.00 1.00 Pediatric Misc Adult8922 HIV w Maj Related Cond 4.65 0.9141 1.2235 1.00 1.00 Pediatric Misc Adult8923 HIV w Maj Related Cond 6.19 1.2370 1.6557 1.00 1.30 Pediatric Misc Adult8924 HIV w Maj Related Cond 10.47 2.3951 3.2058 1.00 1.30 Pediatric Misc Adult8931 HIV w Mult Sig Related Cond 4.24 0.8757 1.1721 1.00 1.00 Pediatric Misc Adult8932 HIV w Mult Sig Related Cond 4.69 0.9376 1.2550 1.00 1.00 Pediatric Misc Adult8933 HIV w Mult Sig Related Cond 6.98 1.4405 1.9281 1.00 1.30 Pediatric Misc Adult8934 HIV w Mult Sig Related Cond 12.45 2.5068 3.3553 1.00 1.30 Pediatric Misc Adult8941 HIV 3.02 0.5862 0.7846 1.00 1.00 Pediatric Misc Adult8942 HIV 3.59 0.7208 0.9648 1.00 1.00 Pediatric Misc Adult8943 HIV 5.29 1.0359 1.3865 1.00 1.30 Pediatric Misc Adult8944 HIV 8.69 2.0605 2.7580 1.00 1.30 Pediatric Misc Adult9101 Craniotomy for Mult Sig Trauma 11.00 2.9358 3.9296 1.00 1.00 Pediatric Misc Adult9102 Craniotomy for Mult Sig Trauma 7.87 3.2546 4.3563 1.00 1.00 Pediatric Misc Adult9103 Craniotomy for Mult Sig Trauma 10.71 4.6015 6.1591 1.00 1.30 Pediatric Misc Adult9104 Craniotomy for Mult Sig Trauma 21.23 9.4321 12.6248 1.00 1.30 Pediatric Misc Adult9111 Ext Trunk Procs Mult Sig Trauma 5.11 1.3037 1.7450 1.00 1.00 Pediatric Misc Adult9112 Ext Trunk Procs Mult Sig Trauma 6.26 2.0504 2.7444 1.00 1.00 Pediatric Misc Adult9113 Ext Trunk Procs Mult Sig Trauma 8.21 2.9684 3.9732 1.00 1.30 Pediatric Misc Adult9114 Ext Trunk Procs Mult Sig Trauma 18.19 7.8869 10.5566 1.00 1.30 Pediatric Misc Adult9121 Muscskl Procs Mult Sig Trauma 5.58 2.0602 2.7576 1.00 1.00 Pediatric Misc Adult9122 Muscskl Procs Mult Sig Trauma 5.85 2.2891 3.0639 1.00 1.00 Pediatric Misc Adult9123 Muscskl Procs Mult Sig Trauma 9.29 3.8503 5.1536 1.00 1.30 Pediatric Misc Adult9124 Muscskl Procs Mult Sig Trauma 17.74 7.6868 10.2887 1.00 1.30 Pediatric Misc Adult9301 Mult Sig Trauma w/o O.R. Proc 2.87 0.8320 1.1136 1.00 1.00 Pediatric Misc Adult9302 Mult Sig Trauma w/o O.R. Proc 3.62 1.0262 1.3736 1.00 1.00 Pediatric Misc Adult

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Page 25

Pediatric AdultAPR-DRG Description Age AdjustorAPR-DRG

National Relative Weight

Service Adjustor

Average Length of

Stay

Relative Weight

Re-centered for Florida Medicaid

9303 Mult Sig Trauma w/o O.R. Proc 5.60 1.6549 2.2151 1.00 1.30 Pediatric Misc Adult9304 Mult Sig Trauma w/o O.R. Proc 13.17 4.4282 5.9271 1.00 1.30 Pediatric Misc Adult9501 Ext Proc Unrel To Diag 3.18 1.4208 1.9017 1.00 1.00 Pediatric Misc Adult9502 Ext Proc Unrel To Diag 5.85 2.1435 2.8691 1.00 1.00 Pediatric Misc Adult9503 Ext Proc Unrel To Diag 11.18 3.3988 4.5493 1.00 1.30 Pediatric Misc Adult9504 Ext Proc Unrel To Diag 21.60 6.8235 9.1332 1.00 1.30 Pediatric Misc Adult9511 Mod Ext Proc Unrel To Diag 2.81 1.0065 1.3472 1.00 1.00 Pediatric Misc Adult9512 Mod Ext Proc Unrel To Diag 4.80 1.4943 2.0001 1.00 1.00 Pediatric Misc Adult9513 Mod Ext Proc Unrel To Diag 9.45 2.5286 3.3845 1.00 1.30 Pediatric Misc Adult9514 Mod Ext Proc Unrel To Diag 18.12 5.2395 7.0130 1.00 1.30 Pediatric Misc Adult9521 Nonext Proc Unrel To Diag 2.49 0.7724 1.0339 1.00 1.00 Pediatric Misc Adult9522 Nonext Proc Unrel To Diag 4.65 1.1821 1.5822 1.00 1.00 Pediatric Misc Adult9523 Nonext Proc Unrel To Diag 8.93 2.0915 2.7995 1.00 1.30 Pediatric Misc Adult9524 Nonext Proc Unrel To Diag 16.98 4.4847 6.0027 1.00 1.30 Pediatric Misc Adult9550 Principal Diag Invalid - - - 1.00 1.00 Error DRG Error DRG9560 Ungroupable - - - 1.00 1.00 Error DRG Error DRG

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All Other 1.000Free-Standing Rehab 2.701Rural 2.119Long Term Acute Care 2.125Hi Mcaid Hi Outlier 2.526

Provider CategoryPolicy

Adjustor

Page 27: Florida Medicaid DRG Pricing Calculatorsafetynetsflorida.org/wp-content/uploads/FL-Medicaid-DRG-Pricing-Calculator.pdfFlorida Medicaid DRG Pricing Calculator Structure of the Calculator

Provider Medicaid ID Provider Name

Provider Cost-to-Charge Ratio

Provider Casemix Adjusted to 2014/2015 Provider Category

Provider Average Per-Discharge Automatic IGT Payment

010151600 All Children's Hospital 0.27222 2.1105 Hi Mcaid Hi Outlier 6,999.72$ 011648300 Anne Bates Leach Eye Hospital 1.36121 1.7295 All Other 634.45$ 010204100 Archbold Memorial Hospital 0.34936 0.7540 All Other -$ 010233400 Atmore Community Hospital 0.22807 0.8045 All Other -$ 012037500 Aventura Hospital & Medical Center 0.14256 1.2987 All Other -$ 010074900 Baptist Hospital (Pensacola) 0.31159 0.9933 All Other 1,696.60$ 010074902 Baptist Hospital (Pensacola) 0.31159 0.9933 All Other 1,696.60$ 010074903 Baptist Hospital (Pensacola) 0.31159 0.9933 All Other 1,696.60$ 010232600 Baptist Hospital of Beaches 0.28361 0.6147 All Other -$ 010064100 Baptist Medical Center 0.25799 1.3777 All Other 2,090.14$ 010064102 Baptist Medical Center 0.25799 1.3777 All Other 2,090.14$ 010064103 Baptist Medical Center 0.25799 1.3777 All Other 2,090.14$ 010123100 Baptist Medical Center - Nassau 0.35989 0.5478 Rural 518.44$ 010035800 Baptist of Miami 0.25998 1.0763 All Other 2,493.53$ 012041300 Bartow Memorial Hospital 0.15850 1.3772 All Other 904.39$ 010006400 Bay Medical Center 0.29672 1.4939 All Other 915.60$ 010372100 BayCare Alliant Hospital 0.28974 4.9553 Long Term Acute Care -$ 010156700 Bayfront Medical Center 0.19027 0.8187 All Other 1,079.60$ 010156707 Bayfront Medical Center 0.19027 0.8187 All Other 1,079.60$ 011988100 Bayonet Point/Hudson 0.12607 1.7036 All Other -$ 010183400 Bert Fish Memorial Hospital 0.31553 2.1192 All Other -$ 010140100 Bethesda Mem. Hosp. 0.20487 0.7399 All Other 598.42$ 010140107 Bethesda Mem. Hosp. 0.20487 0.7399 All Other 598.42$ 010141900 Boca Raton Community Hospital 0.29107 1.0322 All Other -$ 011807900 Brandon Regional Medical Center 0.16830 0.8362 All Other 924.12$ 010087100 Brooksville Regional Hospital 0.10256 0.7123 All Other 631.03$ 010087101 Brooksville Regional Hospital 0.10256 0.7123 All Other 631.03$ 010012900 Broward General Hospital 0.29822 1.1240 All Other 2,496.06$ 010012901 Broward General Hospital 0.29822 1.1240 All Other 2,496.06$ 010012905 Broward General Hospital 0.29822 1.1240 All Other 2,496.06$ 010026900 Calhoun Liberty Hospital 0.39090 0.8399 Rural 1,024.75$ 010194000 Campbellton-Graceville Hospital 0.44121 1.0037 Rural 3,701.02$ 010009900 Cape Canaveral Hospital 0.32281 0.8962 All Other -$ 011971700 Cape Coral Hospital 0.28963 0.6937 All Other -$ 011980600 Capital Regional Medical Center 0.19569 0.8245 All Other -$ 010036600 Cedars Medical Center, Inc. 0.17823 1.6470 All Other 2,424.61$ 010036603 Cedars Medical Center, Inc. 0.17823 1.6470 All Other 2,424.61$ 010178800 Central Florida Regional Hospital 0.22189 0.9210 All Other -$ 010027700 Charlotte Regional Medical Center 0.19429 1.5272 All Other -$ 010027702 Charlotte Regional Medical Center 0.19429 1.5272 All Other -$ 010341100 Charlton Memorial Hospital 0.88729 1.1206 All Other -$ 010219900 Citrus Memorial Hospital 0.23688 0.7736 All Other -$ 010314400 Cleveland Clinic FL Hospital - Naples 0.19210 1.2423 All Other -$ 010314401 Cleveland Clinic FL Hospital - Naples 0.19210 1.2423 All Other -$ 010220200 Cleveland Clinic Hospital 0.26321 1.8797 All Other -$ 010253900 Columbia Englewood Community Hosp 0.17784 1.1980 All Other -$ 012030800 Columbia Hospital 0.15104 0.8751 All Other 908.98$ 010146000 Columbia JFK Medical Center 0.12977 1.6094 All Other 1,912.71$ 012013800 Columbia Kendall Medical Center 0.17427 1.0168 All Other 1,066.76$ 010138900 Columbia Medical Center-Osceola 0.16026 0.7689 All Other 1,045.05$ 010552000 Columbia New Port Richey Hospital 0.18940 0.7071 All Other -$ 012026000 Columbia Palms West Hospital 0.16430 0.8300 All Other 877.95$ 012000600 Columbia Plantation General Hosp 0.15662 0.9015 All Other 627.95$ 012000601 Columbia Plantation General Hosp 0.15662 0.9015 All Other 627.95$ 010125700 Columbia Twin Cities Hospital 0.13035 1.1858 All Other -$ 010960600 Coral Gables Hospital 0.13722 1.1118 All Other 1,242.74$ 012040500 Coral Springs Medical Center 0.28354 0.6301 All Other 880.50$ 010202400 D.W.Mcmillan Memorial 0.46516 0.4896 All Other -$ 012009000 Delray Comm. Hospital 0.13905 1.9278 All Other 178.17$ 010192300 Desoto Memorial Hospital 0.44019 0.5125 Rural 678.84$ 010354300 Doctors Hospital 0.23517 1.4156 All Other -$ 011995400 Doctors Hospital of Sarasota 0.15909 1.5855 All Other -$ 010103600 Doctors Memorial Hospital 0.51509 0.7818 Rural 571.98$ 010180000 Doctor's Memorial Hospital 0.37560 0.7456 Rural 792.87$ 010277600 Douglas Gardens Hospital 0.54878 1.0500 All Other -$ 010004800 Ed Fraser Memorial Hospital 6.09027 0.7047 Rural 97.85$

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010259800 Edward White Hospital 0.16605 1.5572 All Other -$ 011746300 Fawcett Memorial Hospital 0.10820 1.4872 All Other -$ 010120600 Fishermen's Hospital 0.51083 0.9370 Rural 1,826.57$ 010171100 Flagler Hospital 0.23283 0.7210 Rural -$ 010201600 Florala Memorial Hospital 0.69164 1.0500 All Other -$ 010129000 Florida Hospital 0.22538 1.0098 All Other 2,193.80$ 010129001 Florida Hospital 0.22538 1.0098 All Other 2,193.80$ 010129004 Florida Hospital 0.22538 1.0098 All Other 2,193.80$ 010189300 Florida Hospital - Flagler 0.23409 1.3100 Rural 1,018.55$ 010090100 Florida Hospital Heartland Med Cntr 0.24892 0.7149 All Other -$ 010090102 Florida Hospital Heartland Med Cntr 0.24892 0.7149 All Other -$ 010109500 Florida Hospital Waterman 0.29255 0.8339 All Other -$ 010260100 Florida Hospital Wauchula 0.13746 0.8676 Rural 972.53$ 010260101 Florida Hospital Wauchula 0.13746 0.8676 Rural 972.53$ 005456800 Florida Hospital Wesley Chapel 0.31076 0.7360 All Other -$ 010149400 Florida Hospital Zephyrhills 0.19087 0.9558 All Other -$ 010149401 Florida Hospital Zephyrhills 0.19087 0.9558 All Other -$ 010209100 Flowers Hospital 0.15326 1.1338 All Other -$ 011132500 Ft. Walton Beach Medical Center 0.12552 0.9457 All Other -$ 010271700 Genesis Rehabilitation Hospital 0.39202 2.1871 Free-Standing Rehab -$ 010271701 Genesis Rehabilitation Hospital 0.39202 2.1871 Free-Standing Rehab -$ 010080300 George E. Weems Memorial Hosp 0.90733 0.7774 Rural 705.01$ 010144300 Glades General Hospital 0.39618 0.6344 Rural 508.42$ 010152400 Good Samaritan Hospital 0.19861 0.8825 All Other -$ 010212100 Grady General Hospital 0.47164 1.0500 All Other -$ 011761700 Gulf Coast Community Hospital 0.15257 0.6797 All Other 850.72$ 012032400 H L Moffitt Cancer Center 0.37989 2.7012 All Other 1,439.65$ 012032402 H L Moffitt Cancer Center 0.37989 2.7012 All Other 1,439.65$ 011975000 H.H. Raulerson 0.17534 1.1474 Rural 1,089.39$ 010184200 Halifax Medical Center 0.36357 0.9759 All Other 1,482.21$ 010135400 Health Central 0.31473 0.8582 All Other 583.17$ 010188500 Healthmark Regional Medical Center 0.30864 0.7975 Rural 563.26$ 010275000 Healthsouth Emerald Coast Hospital 0.49308 1.8569 Free-Standing Rehab -$ 010355100 Healthsouth Hospital of Spring Hill 0.48876 1.9078 Free-Standing Rehab -$ 012005700 Healthsouth Larkin Hospital-Miami 0.29462 1.2607 All Other 2,240.22$ 010268700 HealthSouth Rehab - Dothan 0.51816 1.0500 All Other -$ 010270900 HealthSouth Rehab Hosp - Miami 0.62605 1.9014 Free-Standing Rehab -$ 012038300 HealthSouth Rehab Hosp Sarasota 0.51035 2.5269 Free-Standing Rehab -$ 010175300 HealthSouth Rehab Hosp-Largo 0.64963 2.0475 Free-Standing Rehab -$ 012042100 HealthSouth Rehab Hosp-Sea Pines 0.45758 1.9466 Free-Standing Rehab -$ 012027800 HealthSouth Rehab Hosp-Sunrise 0.52141 1.9453 Free-Standing Rehab -$ 012033200 HealthSouth Rehab Hosp-Tallahassee 0.59136 2.4645 Free-Standing Rehab -$ 012034100 HealthSouth Rehab Hosp-Treasure Coast 0.53474 2.0074 Free-Standing Rehab -$ 010356000 Healthsouth Ridgelake Hospital 0.44981 2.6904 Long Term Acute Care -$ 010228800 Heart of Florida Hospital 0.11325 0.6678 All Other 1,271.48$ 010161300 Helen Ellis Memorial Hospital 0.34795 0.9205 All Other -$ 010161303 Helen Ellis Memorial Hospital 0.34795 0.9205 All Other -$ 010086200 Hendry Regional Medical Center 0.44165 0.9708 Rural 689.32$ 010041200 Hialeah Hospital 0.16539 0.7388 All Other 1,448.86$ 010089700 Highlands Regional Medical Center 0.21686 0.5812 All Other -$ 010008100 Holmes Regional Medical Center 0.29483 0.9810 All Other 1,746.25$ 010018800 Holy Cross Hospital, Inc. 0.28755 0.9938 All Other -$ 010226100 Homestead Hospital 0.35264 0.7189 All Other 2,189.43$ 010821900 Imperial Point Hospital 0.30201 1.2566 All Other 2,484.87$ 010821905 Imperial Point Hospital 0.30201 1.2566 All Other 2,484.87$ 010104400 Indian River Memorial Hospital 0.40995 0.8021 All Other -$ 010106100 Jackson Hospital 0.49316 0.5366 Rural 644.05$ 010042100 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042101 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042102 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042107 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042117 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042118 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042119 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042127 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042134 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042135 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042136 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042142 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010042146 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$

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014042200 Jackson Memorial Hospital 0.37018 1.2802 All Other 4,088.06$ 010173700 Jay Hospital 0.42450 0.7996 Rural 1,569.45$ 012029400 Jupiter Hospital 0.23884 0.7422 All Other -$ 011993800 Kindred Hospital - Coral Gables 0.20771 1.0500 Long Term Acute Care -$ 010019600 Kindred Hospital - Ft. Lauderdale 0.22048 3.0181 Long Term Acute Care -$ 010267900 Kindred Hospital - North Florida 0.23139 3.9530 Long Term Acute Care -$ 000417000 Kindred Hospital - Palm Beaches 0.27476 2.7937 Long Term Acute Care -$ 010234200 Kindred Hospital (Tampa) 0.24154 5.4607 Long Term Acute Care -$ 010230000 Kindred Hospital Central Tampa 0.28444 2.0191 Long Term Acute Care -$ 010353500 Kindred Hospital Ocala 0.25774 2.7692 Long Term Acute Care -$ 010191500 Kindred Hospital-Hollywood 0.21820 1.3163 Long Term Acute Care -$ 001681500 Kindred Hospital-Melbourne 0.29857 1.1299 Long Term Acute Care -$ 010276800 Kindred Hospital-St. Petersburg 0.20214 3.2857 Long Term Acute Care -$ 011021300 L.W. Blake Memorial Hospital 0.14947 1.8037 All Other -$ 010822700 Lake Butler Hospital 0.32954 0.7920 Rural 1,517.06$ 011976800 Lake City Medical Center 0.16913 1.0320 All Other -$ 010166400 Lake Wales Hospital Association 0.15999 1.0550 All Other -$ 010164800 Lakeland Regional Medical Center 0.22193 0.9290 All Other 1,131.77$ 010342000 Lakewood Ranch Medical Center 0.27092 1.1011 All Other -$ 011974100 Largo Medical Center 0.13357 1.4314 All Other 1,006.48$ 011969500 Lawnwood Regional Medical Center 0.12181 0.9376 All Other 1,252.64$ 010110900 Lee Memorial Hospital 0.27720 1.1717 All Other 2,280.95$ 010110911 Lee Memorial Hospital 0.27720 1.1717 All Other 2,280.95$ 010110918 Lee Memorial Hospital 0.27720 1.1717 All Other 2,280.95$ 010107900 Leesburg Regional Medical Center 0.33882 0.7559 All Other -$ 010111700 Lehigh Regional Medical Center 0.17087 1.1902 All Other -$ 010119200 Lower Florida Keys Hospital 0.21721 0.6735 Rural 1,613.14$ 010119201 Lower Florida Keys Hospital 0.21721 0.6735 Rural 1,613.14$ 010115000 Madison County Memorial Hospital 0.25903 0.7566 Rural 343.91$ 010116800 Manatee Memorial Hospital 0.28097 0.8005 All Other 1,069.98$ 010121400 Mariners Hospital 0.64896 0.8148 Rural 2,302.62$ 010118400 Martin Memorial Hospital 0.22205 0.6921 All Other -$ 010072200 Mayo Clinic Florida 0.32975 2.8642 All Other 1,450.02$ 010154100 Mease Hospital Clinic 0.19341 1.6544 All Other -$ 012008100 Mease Hospital Countryside 0.26328 0.8533 All Other -$ 010020000 Memorial Hospital 0.18739 1.3297 All Other 2,539.56$ 010176100 Memorial Hospital 0.31068 0.9778 All Other -$ 010252100 Memorial Hospital - West 0.18953 0.8118 All Other 286.80$ 010187700 Memorial Hospital - West Volusia 0.28603 0.6973 All Other -$ 010345400 Memorial Hospital Miramar 0.26373 0.6296 All Other 700.37$ 011279800 Memorial Hospital of Tampa 0.19607 0.8887 All Other -$ 010193100 Memorial Medical Center 0.16405 0.9333 All Other -$ 010054400 Metropolitan Hospital Miami 0.20989 1.0565 All Other -$ 010060900 Miami Childrens Hospital 0.24813 1.5371 Hi Mcaid Hi Outlier 6,983.26$ 010216400 Mizell Memorial Hospital 0.54230 1.0500 All Other -$ 010158300 Morton F. Plant Hospital 0.27311 0.9024 All Other 1,848.78$ 010158301 Morton F. Plant Hospital 0.27311 0.9024 All Other 1,848.78$ 010046300 Mt. Sinai Medical Center 0.24579 0.9380 All Other 1,381.95$ 010046322 Mt. Sinai Medical Center 0.24579 0.9380 All Other 1,381.95$ 010117600 Munroe Regional Medical Center 0.22199 0.7508 All Other -$ 010031500 Naples Community Hospital 0.29873 0.7049 All Other 783.02$ 004087600 Nemours Children's Hospital 0.64373 1.8159 Hi Mcaid Hi Outlier 6,085.79$ 010150800 North Bay Medical Center 0.31018 1.0655 All Other -$ 010150801 North Bay Medical Center 0.31018 1.0655 All Other -$ 010021800 North Broward Medical Center 0.28171 1.6325 All Other 3,718.99$ 010021803 North Broward Medical Center 0.28171 1.6325 All Other 3,718.99$ 010862600 North Florida Regional Hospital 0.12372 0.8397 All Other -$ 010126500 North Okaloosa Medical Center 0.13941 0.7711 All Other -$ 010049800 Northshore Medical Center 0.17778 1.0230 All Other 1,358.05$ 010049807 Northshore Medical Center 0.17778 1.0230 All Other 1,358.05$ 011519300 Northside Hospital 0.13684 2.2222 All Other 3,070.05$ 010190700 Northwest Community Hospital 0.33633 1.0097 Rural 629.63$ 010459100 Northwest Regional Hospital 0.16689 0.7681 All Other -$ 012007300 Oak Hill Community Hospital 0.10329 1.3200 All Other -$ 010988600 Ocala Regional Medical Center 0.12997 1.5149 All Other -$ 011174100 Orange Park Medical Center 0.13119 0.7587 All Other -$ 010133800 Orlando Regional Medical Center 0.24037 1.1789 All Other 1,775.96$ 010186900 Ormond Beach Memorial Hospital 0.32178 0.7868 All Other -$ 003297500 Palm Bay Hospital 0.31002 1.4657 All Other -$ 010210500 Palm Beach Gardens Medical Center 0.17432 2.0297 All Other -$

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010053600 Palm Springs General Hospital 0.27024 1.1409 All Other -$ 010460400 Palmetto General Hospital 0.15849 0.9257 All Other 1,348.44$ 012011100 Palms of Pasadena Hospital 0.18992 2.0032 All Other -$ 006344700 Park Royal Hospital 0.88174 1.0500 All Other -$ 010010200 Parrish Medical Center 0.45185 0.7446 All Other -$ 010959200 Pasco Community Hospital 0.15394 0.7127 All Other -$ 010028500 Peace River Regional Medical Center 0.17174 0.6839 All Other -$ 010222900 Pembroke Pines Hospital 0.19117 1.4176 All Other 2,593.93$ 011351400 Putnam Community Hospital 0.28192 0.7565 Rural 691.27$ 010323300 Sacred Heart Hosp - Emerald Coast 0.38895 0.5341 Rural 510.97$ 002012700 Sacred Heart Hosp. - Gulf 0.96898 0.7583 Rural 777.45$ 010076500 Sacred Heart Hospital 0.34301 1.2027 All Other 1,744.57$ 010174500 Santa Rosa Hospital 0.20898 0.6850 All Other -$ 012001400 Sebastian Hospital 0.13311 1.0996 All Other -$ 010339000 Select Specialty Hospital - Orlando 0.32537 1.5607 Long Term Acute Care -$ 010337300 Select Specialty Hospital Miami 0.30198 1.7456 Long Term Acute Care -$ 010343800 Select Specialty Hospital Panama City 0.30360 1.8011 Long Term Acute Care -$ 011998900 Seven Rivers Community Hospital 0.16062 0.9028 All Other -$ 010033100 Shands At Lake Shore 0.26428 0.6009 Rural 431.93$ 010179600 Shands at Live Oak 0.23605 0.7845 Rural 204.43$ 010007200 Shands at Starke 0.25677 0.8672 Rural 430.12$ 010067600 Shands Jacksonville Med Cntr 0.30040 1.2577 All Other 2,055.61$ 010003000 Shands Teaching Hospital 0.39492 1.6292 All Other 3,780.07$ 010003001 Shands Teaching Hospital 0.39492 1.6292 All Other 3,780.07$ 010003002 Shands Teaching Hospital 0.39492 1.6292 All Other 3,780.07$ 010003003 Shands Teaching Hospital 0.39492 1.6292 All Other 3,780.07$ 010003004 Shands Teaching Hospital 0.39492 1.6292 All Other 3,780.07$ 002576600 Shriners Hospital for Children 0.49426 1.7958 All Other 8,113.36$ 010328400 Sister Emmanuel Hospital 0.15132 4.6351 Long Term Acute Care -$ 010247400 South Baldwin Hospital 0.58645 0.6903 All Other -$ 011994600 South Bay Hospital 0.12555 1.3283 All Other -$ 010098600 South Florida Baptist 0.25099 0.8906 All Other 1,820.13$ 010207500 South Georgia Medical Center 0.54798 0.8254 All Other -$ 010108700 South Lake Memorial Hospital 0.26437 0.7231 All Other -$ 010058700 South Miami Hospital 0.31579 1.1696 All Other -$ 010206700 Southeast Alabama General 0.19348 1.5828 All Other -$ 010255500 Southeast Georgia Medical Center 0.35500 1.2384 All Other -$ 011134100 Southwest Florida Regional Medical 0.29343 0.6988 All Other -$ 010377200 Specialty Hospital - Gainesville 0.57029 1.7684 Long Term Acute Care -$ 010647000 Specialty Hospital - Jacksonville 0.22745 1.0500 Long Term Acute Care -$ 010376400 Specialty Hospital - Palm Beach 0.41081 3.8085 Long Term Acute Care -$ 010368300 Specialty Hospital - Pensacola 0.33711 2.6289 Long Term Acute Care -$ 010374800 Specialty Hospital - Tallahassee 0.51543 2.0699 Long Term Acute Care -$ 012022700 St Anthonys Hospital 0.24000 1.6090 All Other 2,453.52$ 010346200 St. Cloud Regional Center 0.18318 1.1971 All Other -$ 010240700 St. John's Rehabilitation Hospital 1.35424 2.0345 Free-Standing Rehab -$ 010097800 St. Joseph's Hospital 0.26176 1.1678 All Other 1,975.62$ 010097802 St. Joseph's Hospital 0.26176 1.1678 All Other 1,975.62$ 010097803 St. Joseph's Hospital 0.26176 1.1678 All Other 1,975.62$ 010097805 St. Joseph's Hospital 0.26176 1.1678 All Other 1,975.62$ 010097806 St. Joseph's Hospital 0.26176 1.1678 All Other 1,975.62$ 010373000 St. Lukes- St. Vincent's Healthcare 0.26315 0.7471 All Other -$ 010148600 St. Mary's Hospital 0.19175 1.0687 All Other 1,395.71$ 012010300 St. Petersburg General Hospital 0.15274 0.7652 All Other 1,149.79$ 010073100 St. Vincent's Hospital 0.26197 1.0544 All Other 918.36$ 010073102 St. Vincent's Hospital 0.26197 1.0544 All Other 918.36$ 012002200 St.Catherine's Rehab Hosp 0.45491 1.7714 Free-Standing Rehab -$ 011997100 St.Lucie Medical Center 0.16014 0.7307 All Other 1,276.55$ 010113300 Tallahassee Memorial Rgnl Med Cntr 0.31582 1.0613 All Other 1,516.24$ 010099400 Tampa General Hospital 0.25147 1.3349 All Other 3,721.35$ 010099412 Tampa General Hospital 0.25147 1.3349 All Other 3,721.35$ 010099413 Tampa General Hospital 0.25147 1.3349 All Other 3,721.35$ 010099414 Tampa General Hospital 0.25147 1.3349 All Other 3,721.35$ 010317900 The Villages Regional Hospital 0.22322 1.4855 All Other -$ 011984900 Town and Country Hospital 0.17462 0.9568 All Other -$ 010114100 Tri-County Hospital Williston 0.48243 0.6280 Rural 472.93$ 010281401 U.S.A Children's & Women's Hospital 0.51205 0.7899 All Other -$ 000949600 UCHLTACH at Connerton 0.27011 1.8275 Long Term Acute Care -$ 010094300 Univ Community Hosp Carrollwood 0.24452 1.3742 All Other -$ 010102800 Univ Community Hosp-Tampa 0.23192 1.2180 All Other -$

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010102809 Univ Community Hosp-Tampa 0.23192 1.2180 All Other -$ 010281402 Univ of South Alabama Hospitals 0.61132 1.0500 All Other -$ 011280100 University Hospital & Medical Center 0.14923 0.8411 All Other -$ 010047100 University of Miami Hospital 0.30358 2.6477 All Other -$ 010281400 University of South AL Med Cntr 0.41007 2.9128 All Other -$ 011973300 Venice Hospital 0.20730 1.5990 All Other -$ 003158800 Viera Hospital 0.39606 1.3952 All Other -$ 010182600 Volusia Medical Center 0.25150 1.4744 All Other -$ 010213000 Wellington Regional Medical Center 0.23476 0.8198 All Other 491.78$ 012024300 West Boca Medical Center 0.28063 0.8074 All Other -$ 011321200 West Florida Regional Med Cntr 0.15043 1.1809 All Other -$ 010170200 West Gables Rehabilitation 0.48771 0.8913 Free-Standing Rehab -$ 003226500 West Kendall 0.56555 0.7599 All Other -$ 010062500 Westchester General Hospital 0.33850 0.9188 All Other 1,417.22$ 011230500 Westside Regional Medical Center 0.14476 1.8096 All Other -$ 010169900 Winter Haven Hospital 0.22745 0.7379 All Other 1,277.78$ 010199100 Wiregrass Hospital 0.60049 0.8976 All Other -$ 010320900 Wuesthoff Medical Center Melbourne 0.15511 0.7923 All Other -$ 010011100 Wuesthoff Memorial Hospital 0.18103 0.8567 All Other -$ 010011103 Wuesthoff Memorial Hospital 0.18103 0.8567 All Other -$

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Cost-to-charge ratio 0.32790Hospital casemix 1.050Hospital category All OtherAverage per discharge automatic IGT add on pymt $0.00Provider policy adjustor 1.000

Parameter Value