| Acute Care Episode Demonstration Shared Savings Computation For Discharges through September 30, 2009 |
| MS-DRG |
MS-DRG Description |
Beneficiary Incentive Payment |
| 216 |
Cardiac valve replacement & other major cardiothoracic procedures with cardiac catheterization with major complications or co-morbidities |
$1,157 |
| 217 |
Cardiac valve replacement & other major cardiothoracic procedures with cardiac catheterization with complications or co-morbidities |
$975 |
| 218 |
Cardiac valve replacement & other major cardiothoracic procedures with cardiac catheterization without complications/major complications or co--morbidities |
$732 |
| 219 |
Cardiac valve replacement & other major cardiothoracic procedures without cardiac catheterization with major complications or co-morbidities |
$1,048 |
| 220 |
Cardiac valve replacement & other major cardiothoracic procedures without cardiac catheterization with complications or co-morbidities |
$724 |
| 221 |
Cardiac valve replacement & other major cardiothoracic procedures without cardiac catheterization without complications/major complications or co-morbidities |
$581 |
| 226 |
Cardiac defibrillator implantation without cardiac catheterization with major complications or co-morbidities |
$822 |
| 227 |
Cardiac defibrillator implantation without cardiac catheterization without major complications or co-morbidities |
$593 |
| 231 |
Coronary bypass with percutaneous transluminal coronary angioplasty (balloon angioplasty and stent placement) with major complications or co-morbidities |
$1,000 |
| 232 |
Coronary bypass with percutaneous transluminal coronary angioplasty (balloon angioplasty and stent placement) without major complications or co-morbidities |
$743 |
| 233 |
Coronary artery bypass with cardiac catheterization with major complications or co-morbidities |
$964 |
| 234 |
Coronary artery bypass with cardiac catheterization without major complications or co-morbidities |
$643 |
| 235 |
Coronary artery bypass without cardiac catheterization with major complications or co-morbidities |
$768 |
| 236 |
Coronary artery bypass without cardiac catheterization without major complications or co-morbidities |
$478 |
| 242 |
Permanent cardiac pacemaker implant with major complications or co-morbidities |
$470 |
| 243 |
Permanent cardiac pacemaker implant with complications or co-morbidities |
$317 |
| 244 |
Permanent cardiac pacemaker implant without complications or major complications or co-morbidities |
$248 |
| 246 |
Percutaneous cardiovascular procedure with drug-eluting stent with major complications or co-morbidities OR involving four or more vessels or stent placements |
$392 |
| 247 |
Percutaneous cardiovascular procedure with drug-eluting stent without major complications or co-morbidities |
$247 |
| 248 |
Percutaneous cardiovascular procedure with non-drug-eluting stent with major complications or co-morbidities OR involving four or more vessels or stent placements |
$364 |
| 249 |
Percutaneous cardiovascular procedure with non-drug-eluting stent without major complications or co-morbidities |
$219 |
| 250 |
Percutaneous cardiovascular procedure without coronary artery stent or heart attack with major complications or co-morbidities |
$386 |
| 251 |
Percutaneous cardiovascular procedure without coronary artery stent or heart attack without major complications or co-morbidities |
$224 |
| 258 |
Cardiac pacemaker device replacement with major complications or co-morbidities |
$357 |
| 259 |
Cardiac pacemaker device replacement without major complications or co-morbidities |
$209 |
| 260 |
Cardiac pacemaker revision (not total device replacement) with major complications or co-morbidities |
$460 |
| 261 |
Cardiac pacemaker revision (not total device replacement) with complications or co-morbidities |
$185 |
| 262 |
Cardiac pacemaker revision (not total device replacement) without complications/major complications or co-morbidities |
$135 |
| 461 |
Bilateral or multiple major joint procedures of lower extremity with major complications or co-morbidities (excludes ankle replacement) |
$600 |
| 462 |
Bilateral or multiple major joint procedures of lower extremity without major complications or co-morbidities (excludes ankle replacement) |
$422 |
| 466 |
Revision of hip or knee replacement with major complications or co-morbidities |
$584 |
| 467 |
Revision of hip or knee replacement with complications or co-morbidities |
$391 |
| 468 |
Revision of hip or knee replacement without complications/major complications or co-morbidities |
$318 |
| 469 |
Major joint replacement of lower extremity with major complications or co-morbidities |
$450 |
| 470 |
Major joint replacement of lower extremity without major complications or co-morbidities |
$271 |
| 488 |
Knee procedures not due to infection with complications/major complications or co-morbidities |
$228 |
| 489 |
Knee procedures not due to infection without complications/major complications or co-morbidities |
$162 |
| (*) 2009 Part B premium = $1,156.80 |
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