06-8471. Medicare Program; Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates: Final Fiscal Year 2007 Wage Indices and Payment Rates After Application of Revised Occupational Mix Adjustment to Wage Index
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Start Preamble
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AGENCY:
Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION:
Notice.
SUMMARY:
This notice contains tables listing the final occupational mix adjusted wage indices, hospital reclassifications, payment rates, impacts, and other related tables as a result of the application of the occupational mix adjustment to 100 percent of the wage index effective for fiscal year (FY) 2007.
DATES:
Effective Date: This notice is effective on October 1, 2006.
Start Further InfoFOR FURTHER INFORMATION CONTACT:
Valerie Miller, (410) 786-4535, Wage Index Issues. Brian Slater, (410) 786-5229, Geographic Reclassification Issues. Marc Hartstein, (410) 786-4548, All Other Issues.
End Further Info End Preamble Start Supplemental InformationSUPPLEMENTARY INFORMATION:
I. Background
In the August 18, 2006 Federal Register (71 FR 47870) (hereinafter referred to as the FY 2007 IPPS final rule), we set forth our final rule for the Medicare inpatient prospective payment system (IPPS). Due to the decision in the case Bellevue Hosp. Center v. Leavitt, 443 F. 3d 163 (2nd Cir. 2006), we stated that we would publish the FY 2007 occupational mix adjusted wage index tables, rates, and impacts on our Web site and in a Federal Register document subsequent to the FY 2007 IPPS final rule. (See the FY 2007 IPPS final rule for a full explanation of the reasons for such subsequent publication.) This notice includes such wage index tables, rates, and impacts.
II. Final FY 2007 Occupational Mix Adjusted Wage Indices, Rates, and Impacts
A. Wage Index and Occupational Mix Adjustment
1. Implementation of the New Occupational Mix Adjustment for the FY 2007 Wage Index
The final wage index values for FY 2007 (except those for hospitals receiving wage index adjustments under section 505 of Pub. L. 108-173) are included in Tables 4A-1, 4A-2, 4B, 4C-1, 4C-2, and 4F of the Addendum to this notice and are posted on our Web site at http://www.cms.hhs.gov/AcuteInpatientPPS/. For hospitals that are receiving a wage index adjustment under section 505 of Pub. L. 108-173, the hospital's final wage index will reflect the adjustment shown in Table 4J of the Addendum to this notice. Tables 3A and 3B of the Addendum to this notice and on our Web site reflect the 3-year average of the average hourly wage for each labor market area before the redesignation of hospitals, used for FYs 2005, 2006, and 2007. Table 3A lists average hourly wages for urban areas and Table 3B lists these data for rural areas. In addition, Table 2 in the Addendum to this notice includes the occupational mix adjusted average hourly wage for each hospital from the FYs 2001, 2002, and 2003 cost reporting periods. The average hourly wages for FYs 2001 and 2002 reflect a 10 percent occupational mix adjustment using the survey data used to develop the FYs 2005 and 2006 wage indices, respectively. The FY 2003 average hourly wages reflect a 100 percent occupational mix adjustment using the recently collected survey data and were used to calculate the FY 2007 wage index.
2. Proxy Occupational Mix Adjustment for Hospitals With No Survey Data
As stated in the FY 2007 IPPS final rule (71 FR 48014), we have applied the average occupational mix adjustment for a hospital's labor market area to the wage data of hospitals that did not submit occupational mix survey data or that submitted survey data that could not be used because we determined it to be aberrant. For example, a hospital's individual nurse category average hourly wages were out of range (that is, unusually high or low), and the hospital did not provide sufficient documentation to explain the aberrancy, or the hospital did not submit any registered nurse staff salaries or hours data.
In calculating the average occupational mix adjustment factor for an area, we replicated Steps 1 through 6 of the calculation for the occupational mix adjustment (see 71 FR 48009). However, instead of performing these steps at the hospital level, we aggregated the data at the labor market area level. In following these steps, for example, for Core-Based Statistical Areas (CBSAs) that contain providers that did not submit occupational mix survey data, the occupational mix adjustment factor ranged from a low of 0.8944 (CBSA 39820, Redding, CA), to a high of 1.0924 (CBSA 38220, Pine Bluff, AR). Also, in computing a hospital's occupational mix adjusted salaries and wage-related costs for nursing employees (Step 7 of the calculation (see 71 FR 48010)) in the absence of occupational mix survey data, we multiplied the hospital's total salaries and wage-related costs by the percentage of the area's total workers attributable to the area's total nursing category. There were also two CBSAs in which none of the providers submitted the occupational mix survey (CBSA 49740, Yuma, AZ, and CBSA 25020, Guayama, P.R.). In the absence of any data in these labor market areas, we applied an occupational mix adjustment factor of 1.0 to all providers.
3. Analysis of the Final FY 2007 Wage Index
Using the new occupational mix survey data and applying the occupational mix adjustment to 100 percent of the FY 2007 wage index results in a national average hourly wage of $29.6529 and a Puerto-Rico specific average hourly wage of $13.0943. We calculated the FY 2007 wage index using the Worksheet S-3 cost report data of 3,570 hospitals and occupational mix survey data from 3,239 hospitals (90.7 percent response rate). Although more than 3,239 hospitals submitted occupational mix survey data for the January through March 2006 collection period, we excluded the data for 37 hospitals that did not have FY 2003 Worksheet S-3 cost report data for use in calculating the FY 2007 wage index. Also, we excluded the occupational mix survey data of another 30 hospitals because their data was incomplete or aberrant. Using the occupational mix data of 3,239 hospitals, the FY 2007 national average hourly wages for each occupational mix nursing subcategory as calculated in Step 2 of the occupational mix calculation are as follows: Start Printed Page 59887
Occupational mix nursing subcategory Average hourly wage National RN Management $38.5908 National RN Staff 33.3739 National LPN 19.2721 National Nurse Aides, Orderlies, and Attendants 13.6906 National Medical Assistants 15.6304 National Nurse Category 28.7431 The national average hourly wage for the entire nurse category as computed in Step 5 of the occupational mix calculation is $28.7431. Hospitals with a nurse category average hourly wage (as calculated in Step 4) of greater than national nurse category average hourly wage receive an occupational mix adjustment factor (as calculated in Step 6) of less than 1.0. Hospitals with a nurse category average hourly wage (as calculated in Step 4) of less than national nurse category average hourly wage receive an occupational mix adjustment factor (as calculated in Step 6) of greater than 1.0.
Based on the January through March 2006 occupational mix survey data, we determined (in Step 7 of the occupational mix calculation) that the national percentage of hospital employees in the Nurse category is 42.9 percent, and the national percentage of hospital employees in the All Other Occupations category is 57.1 percent. At the CBSA level, the percentage of hospital employees in the Nurse category ranged from a low of 23.0 percent in one CBSA, to a high of 85.5 percent in another CBSA.
After adjusting the FY 2007 wage indices by 100 percent for occupational mix, the wage index values for a total of 250 hospitals in 73 labor market areas are assigned a statewide rural wage index value (“the rural floor”) according to section 4410 of Pub. L. 105-33, or an imputed floor, for hospitals located in all-urban States, according to § 412.64(h).
a. Effect of the 2006 Occupational Data on the FY 2007 Wage Index (Unadjusted Relative to Adjusted Wage Index). We compared the FY 2007 unadjusted wage indices for each CBSA to the FY 2007 wage indices adjusted for occupational mix. In implementing an occupational mix adjusted wage index based on the above calculation, the final wage index values for 14 rural areas (29.8 percent) and 201 urban areas (52.1 percent) would decrease as a result of the adjustment. Six rural areas (12.8 percent) and 108 urban areas (28.0 percent) would experience a decrease of 1 percent or greater in their wage index values. The largest negative impacts would be 2.7 percent and 6.0 percent. In addition, 33 rural areas (70.2 percent) and 181 urban areas (46.9 percent) would experience an increase in their wage index values. The largest increase for a rural area would be 3.16 percent and the largest increase for an urban area would be 8.39 percent. Four urban areas would be unaffected. These results indicate that a larger percentage of rural areas benefit from an occupational mix adjustment than do urban areas. However, as was the case with the previous occupational mix data, close to a third of rural CBSAs (29.8 percent) continue to experience a decrease in their wage indices as a result of the occupational mix adjustment.
b. Effect of the 2006 Occupational Mix Survey Data Relative to the 2003 Survey Data. We also analyzed the effect on the FY 2007 wage index of applying the January through March 2006 occupational mix survey data, relative to applying the 2003 occupational mix survey data. In this analysis, we compared the FY 2007 wage index adjusted 100 percent using 2003 and 2006 survey data. By controlling for changes in hospitals' wage data and geographic reclassification, we determined that the wage index values for 27 rural areas (57.4 percent) and 183 urban areas (47.4 percent) would decrease as a result of applying the 2006 survey data instead of the 2003 survey data. Ten rural areas (21.3 percent) and 96 urban areas (24.9 percent) would experience a decrease of 1 percent or greater in their wage index values. The largest negative impact for a rural area would be 3.6 percent. Six urban areas (1.2 percent) would be decreasing by greater than 5 percent; the largest urban decrease would be 20.9 percent, and the second largest decrease for an urban area would be 7.7 percent. One rural and one urban area would be unaffected by the change in the occupational mix data. In addition, 19 rural areas (40.4 percent) and 202 urban areas (52.3 percent) would experience an increase in their wage index values. The largest increase for a rural area would be 2.6 percent and the largest increase for an urban area would be 7.15 percent.
B. Final FY 2007 Hospital Reclassifications/Redesignations
1. Withdrawals and Terminations
As we stated in the FY 2007 IPPS final rule (71 FR 48020), for FY 2007, rather than hospitals withdrawing or terminating their 3-year reclassifications within 45 days of the publication of the IPPS proposed rule, hospitals would be subject to special procedures unique to FY 2007.
These procedures are as follows:
- Hospitals had 15 days from the display date of the FY 2007 IPPS final rule to notify us of whether, in the absence of viewing the final 100 percent occupational mix-adjusted wage index data, they wish to choose a particular wage index for which they are eligible (such as to definitively maintain, terminate, or withdraw from a reclassification that they received ).
- If we did not receive notice from the hospital within the 15-day timeframe, we made our best efforts to give the hospital the highest wage index among its available options. We made reclassification withdrawal and termination decisions based on what we perceived would be most advantageous to the hospital. (See 71 FR 48020 for an explanation of the reclassifications and adjustment we chose among.) Please note that in some cases we terminated a hospital's Lugar reclassification under section 1886(d)(8)(B) of the Act in order to receive the out-migration adjustment. Because this termination would result in the hospital losing urban status, we published a separate table (Table 9D) identifying these hospitals that move from Lugar/urban status to rural status with the out-migration adjustment. Also, in some cases, we may have made half-year terminations/withdrawals on behalf of section 508 hospitals (or groups containing section 508 hospitals) using the procedures identified in the FY 2007 IPPS final rule. (See 71 FR 48021 for an explanation of the half-year reclassifications that could occur for section 508 hospitals and groups containing section 508 hospitals.
- We have posted the final occupational mix-adjusted wage indices, out-migration adjustments, and our decisions on hospital reclassification on the CMS Web site at http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp. We have posted the same table on the CMS Web site that appeared in the Federal Register final notice of the occupational mix-adjusted wage indices.
- In the FY 2007 IPPS final rule, we acknowledged that hospitals may base termination/withdrawal decisions on factors other than simply what results in the highest wage index for the upcoming fiscal year. For this reason, we allowed a hospital to change a decision that is made by CMS on its behalf. Hospitals now have a 30-day period from the date these final data and our final decisions appear on the CMS Web site to notify CMS in writing, with a copy to the MGCRB, of whether they wish to reverse the reclassification decision made by CMS or to choose another reclassification for which they are eligible. Hospitals are able to Start Printed Page 59888determine the reclassification decision applied on their behalf by reviewing Tables 9A through 9C for hospitals that are reclassified under section 1886(d)(8)(B) of the Act, section 508 of Pub. L. 108-173, or section 1886(d)(10) of the Act. The applicable wage index for these hospitals will be found on Table 2. If a hospital is not listed in Tables 9A through 9C, CMS has made a decision not to reclassify the hospital and its home wage index will apply, including the effect of any out-migration adjustment (if applicable). Again, the wage index that will apply to the hospital is found in Table 2. Any applicable out-migration adjustment for the hospital is found in Table 4J. As indicated above in this section, we are publishing a separate table identifying hospitals that we move from Lugar/urban status to rural status with the out-migration adjustment in Table 9D.
- Requests to reverse a decision made on behalf of a hospital by CMS and to choose another reclassification or adjustment for which the hospital is otherwise eligible must be received by CMS no later than 5 p.m., e.s.t., with a copy sent to the MGCRB by October 30, 2006 (or within 30 days from the date the information appears on the CMS Web site at http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp at the following addresses: Division of Acute Care, C4-08-06, 7500 Security Boulevard, Baltimore, MD 21244, Attn: Marianne Myers; and a copy to Medicare Geographic Classification Review Board, 2520 Lord Baltimore Drive, Suite L, Baltimore, MD 21244-2670.
As required under § 412.273(c), requests by groups of hospitals must be made by all hospitals that are a party to the application or reclassification. The reclassification or adjustment chosen by the hospital must be one for which the hospital would otherwise be eligible had CMS not made the withdrawal or termination decision on the hospital's behalf.
- If a hospital (or group of hospitals) fails to notify CMS that it is revising a determination made on its behalf within 30 days from the date the information appears on the CMS Web site, the decision made by CMS on the hospital's behalf will be final for FY 2007. Therefore, if CMS made a decision on a hospital's (or group of hospitals) behalf to terminate or withdraw a reclassification and the hospital does not reverse or modify CMS's decision within 30 days of posting the decision on the CMS Web site, we will deem the hospital's reclassification is withdrawn or terminated. If the hospital does not reverse or modify CMS's decision within 30 days of posting of the decision on the CMS Web site, once CMS's decision on the hospital's behalf is in effect, it will be treated in the same manner as if the hospital(s) had made the reclassification decision on its own. Thus, for example, because a hospital cannot have overlapping reclassifications, if we decide a hospital should accept a FY 2007 through 2009 reclassification and the hospital does not modify or reverse CMS's decision within 30 days of posting the decision on the CMS Web site, any reclassification the hospital previously had for FY 2006 through 2008 would be permanently terminated.
Hospitals should note that we will not recalculate the wage indices or budget neutrality factors now that CMS has made their decisions regarding what is most advantageous to each hospital using the 100 percent occupational mix-adjusted wage data. That is, we will not further recalculate the wage indices (including any rural floors or imputed rural floors) or standardized amounts based on hospital decisions that further revise decisions made by CMS on the hospitals' behalf.
In addition, we note that rural areas that include a section 508 hospital (specifically a hospital with wages relatively higher than the wages of other hospitals) may experience a decrease in their wage index for the second half of FY 2007. This is because section 508 hospitals are not considered reclassified under section 1886(d)(10) of the Act, and therefore, are not subject to the rule in section 1886(d)(8)(C)(ii) of the Act requiring rural area wage indices to be calculated exclusive of hospitals reclassified under section 1886(d)(10) of the Act, if doing so would increase the rural wage index. Thus, for the first half of the year, a section 508 hospital may be included in the home wage index of a rural area, while the hospitals reclassified under section 1886(d)(10) of the Act are excluded, since such exclusion increases the wage index of the rural area. However, for the second half of the year, the hospital is no longer a section 508 hospital. If the former section 508 hospital is reclassified under section 1886(d)(10) of the Act, it is grouped with other hospitals so reclassified. The high wages of the section 508 hospital may operate such that, for the second half of the year, it is more advantageous for all of the reclassified hospitals to be included in the wage index of the rural area (rather than excluded as they were in the first half of the year). However, because the other reclassified hospitals are now included in the wage index, and not just the sole section 508 hospital with high wages, the area may see a decline in the wage index. We view this scenario as arising due to the rural area's higher than expected wage index during the first half of the year from including only the section 508 hospital and not any reclassified hospitals. If we did not establish special rules that allowed for one-half year reclassifications, the section 508 hospital likely would have reclassified for the entire year under section 1886(d)(10) of the Act. In that case, the wage index for the second-half of FY 2007 would have applied for the entire year.
2. MGCRB Applications for FY 2008
Section 1886(d)(10)(C)(ii) of the Act indicates that a hospital requesting a change in geographic classification for a fiscal year must submit its application to the MGCRB no later than the first day of the 13-month period ending on September 30 of the preceding fiscal year. Thus, the statute requires that FY 2008 reclassification applications be submitted to the MGCRB no later than September 1, 2006. For this reason, hospitals must have filed a FY 2008 reclassification application by the September 1, 2006 deadline even though the average hourly wage data used to develop the final FY 2007 wage indices was not available.
The MGCRB, in evaluating a hospital's request for reclassification for FY 2008 for the wage index, must utilize the official data used to develop the FY 2007 wage index. The wage data used to support the hospital's wage comparisons must be from the CMS hospital wage survey. Generally, the source for these data is the IPPS final rule. However, the wage tables identifying the 3-year average hourly wages of hospitals were not available in time to include them in the FY 2007 IPPS final rule and by the September 1, 2006 deadline for submitting FY 2008 geographic reclassification applications.
As outlined in § 412.256(c)(2), hospitals with incomplete applications have the opportunity to request that the MGCRB grant a hospital that has submitted an application by September 1, 2006, an extension beyond September 1, 2006, to complete its application. Thus, while hospitals must file an application for reclassification to the MGCRB by September 1, 2006, they are able to supplement the reclassification application with official data used to develop the FY 2007 wage index after filing their initial application.
Therefore, as we stated in the FY 2007 IPPS final rule (71 FR 48022 through 48023), we are allowing hospitals 30 days after the final wage data is posted on the CMS Web site or by October 30, Start Printed Page 598892006 to file a supplement to the reclassification application they filed by September 1, 2006. The supplement would include the official data (Attachment H in the MGCRB Application) used to develop the FY 2007 wage index. Supplements must be received within 30 days this final data is posted on the CMS Web site or by October 30, 2006. The 3-year average hourly wage information necessary for FY 2008 reclassification applications appears in Tables 2, 3A, and 3B of the Addendum to this notice. The information also is available on the CMS Web site at: http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp and then by accessing the page titled “MGCRB Reclassification Data for FY 2008 Applications.” Applications and other information about MGCRB reclassifications may be obtained via the CMS Internet Web site at: http://www.cms.hhs.gov/mgcrb/,, or by calling the MGCRB at (410) 786-1174. The mailing address of the MGCRB is: 2520 Lord Baltimore Drive, Suite L, Baltimore, MD 21244-2670.
3. Cancellations of Previous Withdrawals or Terminations for FY 2008 and Subsequent Fiscal Years
We are also allowing a 30-day period from the date the final wage data is posted on the CMS Web site to cancel a previous withdrawal or termination in order for a hospital to reinstate its reclassification for FY 2008 (for a FY 2006-2008 reclassification) or FY 2008 and FY 2009 (for a FY 2007-2009 reclassification). Because we have made termination or withdrawal decisions on behalf of hospitals, hospitals should look carefully at these decisions and determine whether they want to cancel such withdrawals or terminations for FY 2008 or FY 2009 if the reclassification time period includes these years. Hospitals must request to reinstate a reclassification that includes FY 2008 within 30 days of posting the Web site data for the reclassification to continue in that year even if they agree with the decision we made on their behalf for FY 2007.
Hospitals must request to reinstate a reclassification that includes FY 2008 within 30 days of when the data are posted to the CMS Web site or by October 30, 2006.
Requests to cancel a withdrawal or termination in order to reinstate a hospital's reclassification for FY 2008 or FY 2009, or both fiscal years, should be forwarded to the following addresses: Medicare Geographic Classification Review Board, 2520 Lord Baltimore Drive, Suite L, Baltimore, MD 21244-2670; and a copy to Division of Acute Care, C4-08-06, 7500 Security Boulevard, Baltimore, MD 21244, Attn: Marianne Myers.
All requests must be received within 30 days of this posting of CMS final wage data and final reclassification decisions on the CMS Web site or by October 30, 2006.
C. Final FY 2007 Prospective Payment Systems Payment Rates for Hospital Operating and Capital Related Costs
As discussed in the FY 2007 IPPS final rule, due to the unusual circumstances imposed by the order of the Court of Appeals for the Second Circuit in the decision in Bellevue Hospital Center v. Leavitt, we did not publish the final FY 2007 budget neutrality factors, standardized amounts, fixed-loss cost threshold, outlier offset factor, DRG weights, or wage indices in the FY 2007 IPPS final rule. Because the occupational mix adjustment affects the calculation of the outlier threshold as well as the outlier offset and budget neutrality factors that are applied to the standardized amounts, we were only able to provide tentative figures in that final rule. As discussed above in this notice, we are publishing final occupation mix-adjusted wage indices. Accordingly, in this section of this notice, we are discussing the final FY 2007 prospective payment rates for Medicare hospital inpatient operating costs and Medicare hospital inpatient capital-related costs. We calculated these final rates using the methodology we adopted in the FY 2007 IPPS final rule.
We note that, because hospitals excluded from the IPPS are paid on a cost basis (and not by the IPPS), these hospitals were not affected by the tentative figures for standardized amounts, offsets, and budget neutrality factors. Therefore, the rate-of-increase percentages for updating the target amounts for hospitals and hospital units excluded from the IPPS that are effective October 1, 2006 were finalized in the FY 2007 IPPS final rule (71 FR 48164) and are not included in this notice.
1. Final FY 2007 Prospective Payment Rates for Hospital Inpatient Operating Costs
a. Final FY 2007 Standardized Amount. We calculated the final FY 2007 standardized amounts using the methodology we adopted in the FY 2007 IPPS final rule. For a complete description of this methodology, please see the FY 2007 IPPS final rule (71 FR 48145 through 48155). Tables 1A and 1B in the Addendum to this notice contain the final national standardized amount that we are applying to all hospitals, except hospitals in Puerto Rico. The final Puerto Rico-specific amounts are shown in Table 1C. The final amounts shown in Tables 1A and 1B differ only in that the labor-related share applied to the final standardized amounts in Table 1A is 69.7 percent, and the labor-related share applied to the final standardized amounts in Table 1B is 62 percent. (The labor-related share is 62 percent for all hospitals (other than those in Puerto Rico) whose wage indices are less than or equal to 1.0000.)
In addition, Tables 1A and 1B include final standardized amounts reflecting the full 3.4 percent update for FY 2007, and final standardized amounts reflecting the 2.0 percentage point reduction to the update (a 1.4 percent update) applicable for hospitals that fail to submit quality data consistent with section 1886(b)(3)(B)(viii) of the Act.
In the FY 2007 IPPS final rule, we did not supply a table that illustrated the changes from the FY 2006 national average standardized amount because we were only setting the standardized amounts tentatively, but we stated that we would provide the table in the subsequent Federal Register notice. Therefore, in this notice, we include below a table that details the calculation of the final standardized amounts.
Comparison of FY 2006 Standardized Amounts to Final FY 2007 Single Standardized Amount With Full Update and Reduced Update
Full update (3.4 percent) Reduced update (1.4 percent) FY 2006 Base Rate, after removing reclassification budget neutrality, demonstration budget neutrality, wage index transition budget neutrality factors and outlier offset (based on the proposed labor and nonlabor market share percentage for FY 2007) Labor: $3,505.76 Nonlabor: $1,524.03 Labor: $3,505.76. Nonlabor: $1,524.03. Final FY 2007 Update Factor 1.034. 1.014. Start Printed Page 59890 Final FY 2007 DRG Recalibrations and Wage Index Budget Neutrality Factor 0.995662. 0.995662. Final FY 2007 Reclassification Budget Neutrality Factor 0.992355. 0.992355. Adjusted for Blend of FY 2006 DRG Recalibration and Wage Index Budget Neutrality Factors Labor: $3,581.64 Nonlabor: $1,557.01 Labor: $3,512.37. Nonlabor: $1,526.90. Final FY 2007 Outlier Factor 0.948968. 0.948968. Final FY 2007 Labor Market Wage Index Transition Budget Neutrality Factor 0.999700. 0.999700. Final Rural Demonstration Budget Neutrality Factor 0.999905. 0.999905. Final Rate for FY 2007 (after multiplying FY 2006 base rate by above factors) where the wage index is less than or equal to 1.0000 Labor: $3,022.18 Nonlabor: $1,852.31 Labor: $2,963.73. Nonlabor: $1,816.48. Final Rate for FY 2007 (after multiplying FY 2006 base rate by above factors) where the wage index is greater than 1.0000 Labor: $3,397.52 Nonlabor: $1,476.97 Labor: $3,331.80. Nonlabor: $1,448.40. The final labor-related and nonlabor-related portions of the national average standardized amounts for Puerto Rico hospitals for FY 2007 are set forth in Table 1C in the Addendum to this notice. (The labor-related share applied to the Puerto Rico-specific standardized amount is 58.7 percent, or 62 percent, depending on which is more advantageous to the hospital.
b. Final Adjustments for Area Wage Levels. The final occupational mix adjusted wage indices by geographic area are listed in Tables 4A-1, 4A-2, 4B, 4C-1, 4C-2, and 4F in the Addendum to this notice. (These tables are also available on the CMS Web site.)
c. FY 2007 Final Outlier Fixed-Loss Cost Threshold. Using the methodology we adopted in the FY 2007 IPPS final rule, we are establishing a final outlier fixed-loss cost threshold for FY 2007 equal to the prospective payment rate for the DRG, plus any IME and DSH payments, and any add-on payments for new technology, plus $24,485.
d. DRG Weights. Because we rely on the wage index data as one of the standardizing factors that we use in calculating both the charge-based and the cost-based relative weights that we are blending to set the FY 2007 transitional relative weights, we have recalculated the FY 2007 relative weights. We list the final DRG weights in Table 5 of the Addendum to this notice.
2. Final FY 2007 Prospective Payment Rates for Acute Care Hospital Inpatient Capital-Related Costs
We have calculated the final FY 2007 capital Federal rates, offsets, and budget neutrality factors using the methodology we adopted in the FY 2007 IPPS final rule. For a complete description of this methodology, please see the FY 2007 IPPS final rule (71 FR 48155 through 48156).
a. Inpatient Hospital Capital-Related Prospective Payment Rate Update. The factors used in the update framework are not affected by the occupational mix information used to adjust the wage index. Therefore, the update factor for FY 2007 was not revised from the capital PPS standard Federal rate update factor published in the FY 2007 IPPS final rule and remains at 1.10 percent for FY 2007. A full discussion of the update framework is provided in the FY 2007 IPPS final rule (71 FR 48156 through 48158).
b. Outlier Payment Adjustment Factor. Based on the final thresholds as set forth in section II.C. of this notice, we estimate that final outlier payments for capital-related costs will equal 4.32 percent for inpatient capital-related payments based on the final Federal rate in FY 2007. Therefore, we are applying a final outlier adjustment factor of 0.9568 to the final capital Federal rate. Thus, we estimate that the percentage of capital outlier payments to total capital standard payments for FY 2007 will be slightly lower than the percentages for FY 2006.
The outlier thresholds for FY 2007 are in section II.C.1. of this notice. For FY 2007, a case qualifies as a cost outlier if the cost for the case plus the IME and DSH payments are greater than the prospective payment rate for the DRG plus $24,485.
c. Budget Neutrality Adjustment Factor for Changes in DRG Classifications and Weights and the GAF. Using the methodology discussed in the FY 2007 IPPS final rule (71 FR 48158 through 48161), for FY 2007, we are establishing a final GAF/DRG budget neutrality factor of 0.9986. The GAF/DRG budget neutrality factors are built permanently into the capital rates; that is, they are applied cumulatively in determining the capital Federal rate. This follows from the requirement that estimated aggregate payments each year be no more or less than they would have been in the absence of the annual DRG reclassification and recalibration and changes in the GAF. The final incremental change in the adjustment from FY 2006 to FY 2007 is 0.9986. The final cumulative change in the capital Federal rate due to this adjustment is 0.9906 (the product of the incremental factors for FYs 1993 though 2006 and the final incremental factor of 0.9986 for FY 2007). (We note that averages of the incremental factors that were in effect during FYs 2005 and 2006, respectively, were used in the calculation of the final cumulative adjustment of 0.9986 for FY 2007.)
This factor accounts for DRG reclassifications and recalibration and for changes in the GAF as well as the revised wage index as adjusted by occupational mix data. It also incorporates the effects on the final GAF of FY 2007 geographic reclassification decisions made by the MGCRB compared to FY 2006 decisions. However, it does not account for changes in payments due to changes in the DSH and IME adjustment factors or in the large urban add-on.
d. Exceptions Payment Adjustment Factor. The adjustments made to the wage index as a result of the application of occupational mix data had no effect on capital exceptions payments. Therefore, the special exceptions adjustment factor remains at 0.9997 as discussed in section III.A.4. of FY 2007 IPPS final rule (71 FR 48161). We also explained that the adjustments for regular exception payments are no longer necessary as they were only applicable during the capital transition period (cost reporting periods beginning on or after October 1, 1991 and before October 1, 2001).
e. Capital Standard Federal Rate for FY 2007. We are providing a chart that shows how each of the factors and adjustments for FY 2007 affected the computation of the final FY 2007 capital Federal rate in comparison to the FY Start Printed Page 598912006 capital Federal rate. The FY 2007 update factor has the effect of increasing the final capital Federal rate by 1.1 percent compared to the average FY 2006 Federal rate. The final GAF/DRG budget neutrality factor has the effect of decreasing the final capital Federal rate by 0.14 percent. The final FY 2007 outlier adjustment factor has the effect of increasing the final capital Federal rate by 0.56 percent compared to the average FY 2006 capital Federal rate. The FY 2007 exceptions payment adjustment factor remains unchanged from the FY 2006 exceptions payment adjustment factor, and therefore, has a 0.0 percent net effect on the final FY 2007 capital Federal rate. The combined effect of all the changes is to increase the capital Federal rate by 1.52 percent compared to the average FY 2006 capital Federal rate.
Comparison of Factors and Adjustments: FY 2006 Capital Federal Rate and FY 2007 Capital Federal Rate
FY 2006 FY 2007 Change Percent change Update Factor 1 1.0080 1.0110 1.0110 1.10 GAF/DRG Adjustment Factor 1 1.0008 3 0.9986 0.9986 −0.14 Outlier Adjustment Factor 2 0.9515 3 0.9568 1.0056 0.56 Exceptions Adjustment Factor 2 0.9997 0.9997 0.0000 0.00 Capital Federal Rate $420.65 3 $427. 03 1.0152 1.52 1 The update factor and the GAF/DRG budget neutrality factors are built permanently into the capital rates. Thus, for example, the incremental change from FY 2006 to FY 2007 resulting from the application of the final GAF/DRG budget neutrality factor for FY 2007 is 0.9986. 2 The outlier reduction factor and the exceptions adjustment factor are not built permanently into the capital rates; that is, these factors are not applied cumulatively in determining the capital rates. Thus, for example, the net change resulting from the application of the final FY 2007 outlier adjustment factor would be 0.9568/0.9515, or 1.0056. 3 Final factors for FY 2007, as discussed in section II.E. of this notice. We provided a chart in the FY 2007 IPPS final rule (71 FR 48162) that compared the tentative FY 2007 capital Federal rate to the proposed FY 2007 capital Federal rate (71 FR 24158 through 24159). We are now providing a chart that shows how the final FY 2007 capital Federal rate differs from the tentative FY 2007 capital Federal rate as presented in the FY 2007 IPPS final rule.
Comparison of Factors and Adjustments: FY 2007 Tentative Capital Federal Rate and FY 2007 Final Capital Federal Rate
Tentative FY 2007 1 Final FY 2007 2 Change Percent change Update Factor 1 1.0110 1.0110 0 0 GAF/DRG Adjustment Factor 1 0.9994 0.9986 0.0008 −0.08 Outlier Adjustment Factor 2 0.9568 0.9568 0 0 Exceptions Adjustment Factor 2 0.9997 0.9997 0.0000 0.00 Capital Federal Rate $427.38 $427.03 0.0008 0.08 1 As published in the FY 2007 IPPS final rule without the application of occupational mix data to the wage index. 2 Final capital inpatient factors and rates after occupational mix adjustment to wage index in accordance with the order of the Second Circuit Court. As a final comparison, we are providing a chart that shows how the final FY 2007 capital Federal rate differs from the proposed FY 2007 capital Federal rate presented in the FY 2007 IPPS proposed rule (71 FR 24158 through 24159).
Start Printed Page 59892Comparison of Factors and Adjustments: Proposed FY 2007 Capital Federal Rate and Final FY 2007 Capital Federal Rate
Proposed FY 2007 Final FY 2007 Change Percent change Update Factor 1.0080 1.0110 1.0030 0.30 GAF/DRG Adjustment Factor 1.0012 * 0.9986 0.9974 −0.26 Outlier Adjustment Factor 0.9513 * 0.9568 1.0058 0.58 Exceptions Adjustment Factor 0.9997 0.9997 0.0000 0.00 Capital Federal Rate $424.42 * $427.03 1.0061 0.61 * Final factors for FY 2007, as discussed in section II.C.2 of this notice. g. Special Capital Rate for Puerto Rico Hospitals. Using the methodology discussed in the FY 2007 IPPS final rule (71 FR 48104), the final FY 2007 special capital rate for Puerto Rico is $203.06. (See the FY 2007 IPPS final rule (71 FR 48163) for additional information on the calculation of FY 2007 capital PPS payments.)
D. Final FY 2007 Inpatient Operating and Capital-Related Impacts
1. Final FY 2007 Inpatient Operating Impacts (Quantitative Effects of the Final Occupational Mix Adjusted Wage Indices)
The impact analysis for policy changes under the IPPS for operating costs was included in the FY 2007 IPPS final rule. As stated in that impact section (71 FR 48332), we were unable to provide final occupational mix adjusted wage indices because of our obligation to collect new occupational mix survey data consistent with the order of the Court of Appeals in the Second Circuit. We were also unable to provide final relative weights, budget neutrality calculations, the outlier threshold and outlier offsets to the standardized amounts because these figures are all dependent on final wage indices. However, we also indicated that when 100 percent occupational mix adjusted wage data were available, we would recalculate the impacts and provide them in a subsequent Federal Register notice prior to October 1, 2006. Now that the new occupational mix survey data are available and the final 100 percent occupational mix adjusted wage data have been prepared, we are providing the final impacts for FY 2007 including the effect of the occupational mix adjusted wage data. Since there are statutory budget neutrality requirements applied to changes in DRGs and recalibration, wage index and geographic reclassifications, our payment estimates for hospitals overall are consistent with our estimate from the FY 2007 IPPS final rule (71 FR 48331). That is, the revisions to these figures do not increase or decrease aggregate total IPPS payments relative to those we earlier calculated. We continue to estimate that the changes in the FY 2007 IPPS final rule, in conjunction with the final IPPS rates included in this notice, will result in an approximate $3.4 billion increase in operating and capital payments. (See the FY 2007 IPPS final rule (71 FR 48331) for a more detailed explanation of how we estimated this $3.4 billion increase).
a. Analysis of Impact Table I. Table I displays the results of our analysis of the payment changes for FY 2007 that are affected by use of the 100 percent occupational-mix adjusted wage data using occupational-mix survey data from January through March. These impacts update the tentative ones that were shown in the FY 2007 IPPS final rule. As explained in the FY 2007 IPPS final rule and this notice, the FY 2006 occupational-mix survey data were unavailable in time for the completion of the IPPS final rule that was made available to the public on August 1. In this notice, we are only displaying the columns that were affected by the change to the 100 percent occupational-mix adjusted wage data and therefore we are not reprinting the impacts to the quality data rate difference or the MDH changes from section 5003 of the Deficit Reduction Act that were published in the FY 2007 IPPS final rule. (See the FY 2007 IPPS final rule (71 FR 48333 through 48341) for a full discussion of the FY 2007 regulatory impact analysis.)
Table I categorizes hospitals by various geographic and special payment consideration groups to illustrate the varying impacts on different types of hospitals. The top row of the table shows the overall impact on the 3,595 hospitals included in the analysis. The next four rows of Table I contain hospitals categorized according to their geographic location: all urban, which is further divided into large urban and other urban; and rural. There are 2,590 hospitals located in urban areas included in our analysis. Among these, there are 1,441 hospitals located in large urban areas (populations over 1 million), and 1,149 hospitals in other urban areas (populations of 1 million or fewer). In addition, there are 1,005 hospitals in rural areas. The next two groupings are by bed-size categories, shown separately for urban and rural hospitals. The final groupings by geographic location are by census divisions, also shown separately for urban and rural hospitals.
The second part of Table I shows hospital groups based on hospitals' FY 2007 payment classifications, including any reclassifications under section 1886(d)(10) of the Act. For example, the rows labeled urban, large urban, other urban, and rural show that the number of hospitals paid based on these categorizations after consideration of geographic reclassifications (including reclassifications under sections 1886(d)(8)(B) and 1886(d)(8)(E) of the Act, which have implications for capital payments) are 2,607, 1,448, 1,159, and 988, respectively.
The next three groupings examine the impacts of the changes on hospitals grouped by whether or not they have GME residency programs (teaching hospitals that receive an IME adjustment) or receive DSH payments, or some combination of these two adjustments. There are 2,511 non-teaching hospitals in our analysis, 843 teaching hospitals with fewer than 100 residents, and 241 teaching hospitals with 100 or more residents.
In the DSH categories, hospitals are grouped according to their DSH payment status, and whether they are considered urban or rural for DSH purposes. The next category groups hospitals considered urban after geographic reclassification, in terms of whether they receive the IME adjustment, the DSH adjustment, both, or neither.
The next five rows examine the impacts of the changes on rural hospitals by special payment groups (sole community hospitals (SCHs), rural referral centers (RRCs), and Medicare dependent hospitals (MDHs)), as well as rural hospitals not receiving a special payment designation. There were 187 RRCs, 376 SCHs, 146 MDHs, 98 hospitals that are both SCHs and RRCs, and 8 hospitals that are both MDHs and RRCs.
The next two groupings are based on type of ownership and the hospital's Medicare utilization expressed as a percent of total patient days. These data are taken primarily from the FY 2004 Medicare cost reports, if available, (otherwise FY 2003 data are used).
The next series of groupings concern the geographic reclassification status of hospitals. The first grouping displays all urban hospitals that were reclassified by the MGCRB for FY 2007. The next grouping shows the MGCRB rural reclassifications. The final three rows in Table I contain hospitals located in urban counties, but deemed to be rural under section 1886(d)(8)(E) of the Act, hospitals located in rural counties but deemed to be urban under section 1886(d)(8)(B) of the Act, and hospitals currently reclassified under section 508 of Pub. L. 108-173, which expires on March 31, 2007. Start Printed Page 59893
Table I.—Impact Analysis of Changes for FY 2007
Number of hospitals 1 (1) FY 2007 Transitional1/3 Cost2/3 charge weights & DRG changes 2 (2) FY 2007 wage data 3 (3) FY 2007 DRG, Rel. Wts. and Wage index changes 4 (4) FY 2007 wage index transition for hospitals moving from urban to rural 5 (5) FY 2007 MGCRB reclassifications 6 (6) FY 2007 out-migration adjustment 7 (7) All FY 2007 changes 8 (8) All Hospitals 3,595 0.3 0.2 0.0 0.0 0.0 0.1 3.5 By Geographic Location: Urban hospitals 2,590 0.2 0.1 0.0 0.0 −0.3 0.1 3.4 Large urban areas (populations over 1 million) 1,441 0.4 0.0 −0.1 0.0 −0.4 0.0 3.5 Other urban areas (populations of 1 million or fewer) 1,149 0.1 0.3 0.0 0.0 −0.1 0.2 3.4 Rural hospitals 1,005 0.3 0.3 0.4 0.3 2.1 0.1 3.9 Bed Size (Urban): 0-99 beds 651 0.4 0.1 0.0 0.0 −0.5 0.1 3.5 100-199 beds 867 0.6 0.2 0.3 0.0 −0.1 0.1 3.8 200-299 beds 492 0.3 0.1 0.0 0.0 −0.3 0.1 3.6 300-499 beds 413 0.1 0.2 −0.2 0.0 −0.3 0.1 3.3 500 or more beds 167 0.0 0.1 −0.3 0.0 −0.3 0.0 3.2 Bed Size (Rural): 0-49 beds 348 0.5 0.2 0.6 0.1 0.8 0.2 4.7 50-99 beds 370 0.5 0.2 0.4 0.2 1.1 0.2 4.9 100-149 beds 174 0.4 0.4 0.5 0.5 2.5 0.1 3.6 150-199 beds 68 0.3 0.4 0.3 0.4 3.4 0.1 3.3 200 or more beds 45 0.0 0.3 −0.1 0.0 3.1 0.0 3.0 Urban by Region: New England 128 0.4 1.1 1.0 0.0 0.3 0.1 3.5 Middle Atlantic 357 0.5 0.6 0.7 0.0 −0.1 0.2 3.9 South Atlantic 388 0.1 −0.2 −0.5 0.0 −0.4 0.0 3.2 East North Central 395 0.2 0.3 0.1 0.0 −0.3 0.0 3.4 East South Central 165 −0.1 −0.6 −1.0 0.0 −0.4 0.1 2.7 West North Central 157 0.0 −0.4 −0.8 0.0 −0.6 0.0 2.8 West South Central 374 0.2 −0.1 −0.3 0.0 −0.5 0.0 3.4 Mountain 149 0.2 0.2 0.0 0.0 −0.2 0.0 3.7 Pacific 424 0.4 0.1 0.1 0.0 −0.3 0.1 3.7 Puerto Rico 53 0.3 −1.4 −1.5 0.0 −0.6 0.0 2.0 Rural by Region: New England 19 0.5 −0.2 0.1 0.0 2.0 0.1 6.0 Middle Atlantic 72 0.5 0.2 0.5 0.1 2.3 0.0 5.2 South Atlantic 176 0.4 0.4 0.5 0.2 2.2 0.2 3.8 East North Central 125 0.2 −0.2 −0.1 0.1 1.6 0.0 3.8 East South Central 180 0.3 0.6 0.5 0.2 2.5 0.1 3.5 West North Central 116 0.2 0.2 0.2 0.0 2.0 0.1 4.3 West South Central 193 0.4 0.9 0.9 0.5 2.8 0.2 4.1 Mountain 81 0.3 −0.2 −0.1 2.1 0.8 0.1 2.7 Pacific 43 0.3 −0.3 −0.2 0.0 1.8 0.1 3.2 By Payment Classification: Urban hospitals 2,607 0.2 0.1 0.0 0.0 −0.3 0.1 3.4 Large urban areas (populations over 1 million) 1,448 0.4 0.0 −0.1 0.0 −0.4 0.0 3.5 Other urban areas (populations of 1 million or fewer) 1,159 0.1 0.3 0.0 0.0 −0.1 0.2 3.4 Rural areas 988 0.3 0.3 0.4 0.3 2.0 0.1 4.0 Teaching Status: Nonteaching 2,511 0.4 0.1 0.1 0.0 0.2 0.1 3.8 Fewer than 100 residents 843 0.2 0.1 −0.1 0.0 −0.2 0.1 3.4 100 or more residents 241 0.1 0.3 −0.1 0.0 −0.3 0.0 3.1 Urban DSH: Non−DSH 906 0.2 0.1 −0.1 0.0 −0.1 0.1 3.6 100 or more beds 1,520 0.2 0.1 0.0 0.0 −0.3 0.1 3.4 Less than 100 beds 346 0.6 0.0 0.2 0.0 −0.3 0.1 3.6 Rural DSH: SCH 386 0.3 0.2 0.4 0.2 0.6 0.1 4.6 Start Printed Page 59894 RRC 199 0.2 0.4 0.3 0.2 3.4 0.0 3.5 Other Rural: 100 or more beds 55 0.6 0.7 0.9 0.9 0.7 0.2 3.5 Less than 100 beds 183 0.6 0.5 0.7 0.4 0.9 0.4 3.8 Urban teaching and DSH: Both teaching and DSH 815 0.2 0.1 −0.1 0.0 −0.3 0.0 3.3 Teaching and no DSH 201 0.1 0.3 0.0 0.0 −0.1 0.2 3.3 No teaching and DSH 1,051 0.5 0.1 0.1 0.0 −0.1 0.1 3.7 No teaching and no DSH 540 0.3 0.0 −0.2 0.0 −0.3 0.0 3.5 Special Hospital Types: RRC 187 0.2 0.5 0.3 0.2 3.1 0.1 3.5 SCH 376 0.3 0.1 0.3 0.2 0.4 0.1 3.6 MDH 146 0.5 0.2 0.5 0.0 0.7 0.1 9.0 SCH and RRC 98 0.1 −0.1 −0.1 0.0 1.9 0.0 3.1 MDH and RRC 8 0.3 −0.1 0.3 0.0 1.0 0.0 14.0 Type of Ownership: Voluntary 2,102 0.2 0.2 0.1 0.0 0.0 0.1 3.5 Proprietary 880 0.4 −0.1 −0.2 0.1 −0.1 0.0 3.5 Government 603 0.3 0.0 −0.2 0.0 0.1 0.1 3.4 Unknown 10 2.2 0.1 1.7 0.0 −0.3 0.2 7.6 Medicare Utilization as a Percent of Inpatient Days: 0-25 243 0.6 −0.1 0.1 0.0 −0.3 0.0 3.6 25-50 1,328 0.2 0.0 −0.2 0.0 −0.4 0.0 3.3 50-65 1,478 0.3 0.3 0.2 0.0 0.4 0.1 3.7 Over 65 462 0.2 0.3 0.1 0.0 0.5 0.1 3.8 Unknown 84 1.0 −0.4 0.1 0.0 −0.5 0.1 4.4 Urban Hospitals Reclassified by the Medicare Geographic Classification Review Board: First Half FY 2007 Reclassifications 281 0.3 0.3 0.1 0.0 2.4 0.0 3.7 Urban Nonreclassified, First Half FY 2007: 2,284 0.2 0.1 −0.1 0.0 −0.6 0.1 3.4 All Urban Hospitals Reclassified Second Half FY 2007: 341 0.3 0.4 0.2 0.0 1.8 0.0 3.5 Urban Nonreclassified Hospitals Second Half FY 2007: 2,224 0.2 0.1 −0.1 0.0 −0.6 0.1 3.4 All Rural Hospitals Reclassified Full Year FY 2007: 369 0.2 0.3 0.2 0.1 3.6 0.0 3.6 Rural Nonreclassified Hospitals Full Year FY 2007: 578 0.5 0.3 0.5 0.6 −0.3 0.3 4.4 All Section 401 Reclassified Hospitals: 30 0.2 0.8 0.8 0.0 −0.1 0.0 5.4 Other Reclassified Hospitals (Section 1886(d)(8)(B)) 57 0.6 0.3 0.6 0.0 3.6 0.0 4.4 Section 508 Hospitals 108 0.2 0.6 0.4 0.0 −0.2 0.0 1.9 Specialty Hospitals Cardiac Specialty Hospitals 21 −2.0 0.0 −2.4 0.0 −0.6 0.0 1.2 1 Because data necessary to classify some hospitals by category were missing, the total number of hospitals in each category may not equal the national total. Discharge data are from FY 2005, and hospital cost report data are from reporting periods beginning in FY 2004 and FY 2003. 2 This column displays the final payment impact of the changes to the V24 GROUPER and the recalibration of the DRG cost weights based on FY 2005 MedPAR data in accordance with section 1886(d)(4)(C)(iii) of the Act. 3 This column displays the final payment impact of updating the wage index data with the 100 percent occupational mix adjustment applied to the FY 2003 cost report data. Start Printed Page 59895 4 This column displays the final payment impact of the 0.995662 budget neutrality factor for DRG and wage index changes (with a 100 percent occupational mix adjustment applied to the wage index) data in accordance with section 1886(d)(4)(C)(iii) of the Act and section 1886(d)(3)(E) of the Act. 5 Shown here are the final effects of providing rural hospitals formerly located in urban areas with urban wage index values in FY 2007. The effects reflected here are budget neutral: this column therefore includes the effect of the 0.999700 adjustment that we have applied to the rates to ensure budget neutrality. 6 Shown here are the final effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB) and CMS decisions made on behalf of the hospital for FY 2007. The effects demonstrate the FY 2007 payment impact of going from no reclassifications to the reclassifications scheduled to be in effect for FY 2007. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflects the geographic budget neutrality factor of 0.992355. 7 This column displays the final impact of the FY 2007 implementation of section 505 of Pub. L. 108-173, which provides for an increase in a hospital's wage index if the hospital qualifies by meeting a threshold percentage of residents of the county where the hospital is located who commute to work at hospitals in counties with higher wage indices. 8 This column shows final changes in payments from FY 2006 to FY 2007. It incorporates all of the changes displayed in Columns 2, 3, 4,5, and 6 (the changes displayed in Columns 2 and 3 are included in Column 4), as well as those displayed in columns 2 and 3 (related to the quality data differential in the IPPS update and implementation of the MDH DRA provisions) of the FY 2007 IPPS final rule. It also reflects the impact of the FY 2007 update, changes in hospitals' reclassification status in FY 2007 compared to FY 2006, and the changes in payments as a result of continuing the reclassifications under section 508 of Pub. L. 108-173. The product of these impacts may be different from the percentage changes shown here due to rounding and interactive effects. (1) Effects of the Changes to the DRG Reclassifications and Relative Cost-Based Weights (Column 2). In Column 2 of Table I, we present the combined effects of the DRG reclassifications and recalibration, as discussed in section II. of the preamble to the FY 2007 IPPS final rule (71 FR 47879 through 47979). Section 1886(d)(4)(C)(i) of the Act requires us annually to make appropriate classification changes in order to reflect changes in treatment patterns, technology, and any other factors that may change the relative use of hospital resources.
As discussed in the preamble of the FY 2007 IPPS final rule (71 FR 47882 through 47898), we are changing the relative weight calculation methodology from a charge-based to a cost-based method. Further, we are implementing the new methodology under a 3-year transition such that weights in FY 2007 are 1/3 cost-based and 2/3 charge-based. As part of the methodology for determining cost weights, we standardize hospital charges by the wage index to remove the effect of area wage differences. Since the wage index data has been updated to reflect a 100 percent occupational mix adjustment based on the latest survey data available, we recalculated the relative weights for the FY 2007 by standardizing charges using the 100 percent occupational mix adjusted wage indices. The use of occupational mix adjusted wage indices to standardize hospital charges resulted in very small changes to the DRG relative weights. No DRG weight changed by greater or less than 1 percent from those shown in Table 5 of the FY 2007 IPPS final rule. The revised and final FY 2007 DRG relative weights are shown in Table 5 of the Addendum to this notice.
In column 2, we compare aggregate payments using the FY 2007 blended relative weights (GROUPER Version 24) to the FY 2006 DRG relative charge weights (GROUPER Version 23.0) so the percentages shown here illustrate the effect of changes to the DRGs and relative weights. The method of calculating the relative weights and the reclassification changes to the GROUPER are described in more detail in section II. of the preamble to the FY 2007 IPPS final rule. The impacts shown in this column are generally very consistent by hospital category with those shown in column 4 of Table I of the FY 2007 IPPS final rule (71 FR 48335). With the exception of using occupational mix adjusted wage indices to standardize hospital charges, the data and methodology that we modeled in this column are identical to the FY 2007 IPPS final rule. Therefore, any differences in the impacts shown in this column from column 6 of Table I of the FY 2007 IPPS final rule and column 4 of the table above are due to the use of occupational mix adjusted wage data. We note that this column reflects the impact of changes to the DRG classifications and relative weights only and is not budget neutral. Consistent with section 1886(d)(4)(C)(iii) of the Act, we apply a single budget neutrality factor to ensure that the combined overall payment impact of changes to the DRG classification, relative weights, and wage index is budget neutral. The budget neutrality factor for the combined changes to the DRGs, relative weights, and wage index are shown in the table above entitled, “Comparison of FY 2006 Standardized Amounts to Final FY 2007 Single Standardized Amount with Full Update and Reduced Update.”
(2) Effects of Wage Index Changes (Column 3). Section 1886(d)(3)(E) of the Act requires that, beginning October 1, 1993, we annually update the wage data used to calculate the wage index. In accordance with this requirement, the wage index for FY 2007 is based on data submitted for hospital cost reporting periods beginning on or after October 1, 2002 and before October 1, 2003. In the IPPS FY 2007 IPPS final rule, due to the decision in Bellevue Hosp. Center v. Leavitt, in which the Court of Appeals for the Second Circuit ordered CMS to apply the occupational mix adjustment to 100 percent of the wage index effective for FY 2007 (see section III.C. of the FY 2007 IPPS final rule for more details of this Court decision (71 FR 48006)), we were unable to show the impact of the 100 percent occupational mix adjustment as the necessary data were unavailable in time for making the final IPPS rule available to the public on August 1. This column now shows the final estimated effect of updating the wage index with wage data from FY 2003 hospital cost reports and moving to a 100 percent occupational mix adjusted wage index using occupational mix survey data for January through March of this year.
The estimated impact on hospital payments of the new wage data with the 100 percent occupational mix adjustment applied using the new survey data is isolated in Column 3 by holding the other payment parameters constant. That is, Column 3 shows the percentage changes in payments when going from a model using the FY 2006 wage index, based on FY 2002 wage data and having a 10-percent occupational mix adjustment applied, to a model using the FY 2007 pre-reclassification wage index, based on FY 2003 wage data with a 100 percent occupational mix adjustment based on the latest occupational mix survey data. The wage data collected on the FY 2003 cost report are the same as the FY 2002 wage data that were used to calculate the FY 2006 wage index.
Hospitals located in urban New England are estimated to receive the greatest benefit from the new wage and occupational mix data. Payments to hospitals in urban New England are estimated to increase 1.1 percent while rural hospitals located in the West South Central region experience an increase of 0.9 percent from these data. Start Printed Page 59896Puerto Rico hospitals see the least benefit from the change to the wage and occupational mix data with a 1.4 percent estimated decrease in payments.
The national average hourly wage increased 5.9 percent compared to FY 2006 from the new wage data. Therefore, the only manner in which to maintain or exceed the previous year's wage index was to match the national 5.9 increase in average hourly wage. Of the 3,491 hospitals with wage data for both FYs 2006 and 2007, 1,706, or 48.9 percent, also experienced an average hourly wage increase of 5.9 percent or more.
The following chart compares the shifts in wage index values for hospitals for FY 2007 relative to FY 2006. Among urban hospitals, 40 will experience an increase of between 5 percent and 10 percent and 15 will experience an increase of more than 10 percent. No rural hospitals will experience an increase greater than 5 percent, but 790 will experience increases between 0 and 5 percent. On the negative side, 79 urban hospitals will experience decreases in their wage index values of at least 5 percent, but less than 10 percent. Eight urban hospitals will experience decreases in their wage index values greater than 10 percent.
The following chart shows the projected impact for urban and rural hospitals:
Percentage change in area wage index values Number of hospitals Urban Rural Increase more than 10 percent 15 0 Increase more than 5 percent and less than 10 percent 40 0 Increase or decrease less than 5 percent 2,354 986 Decrease more than 5 percent and less than 10 percent 79 5 Decrease more than 10 percent 8 4 (3) Combined Effects of DRG and Wage Index Changes, Including Budget Neutrality Adjustment (Column 4). Section 1886(d)(4)(C)(iii) of the Act requires that changes to DRG reclassifications and the relative weights cannot increase or decrease aggregate payments. In addition, section 1886(d)(3)(E) of the Act specifies that any updates or adjustments to the wage index are to be budget neutral. As noted in the Addendum to this final rule, in determining the budget neutrality factor, we equated simulated aggregate payments for FY 2006 and FY 2007 using the FY 2005 Medicare utilization data after applying the changes to the DRG relative weights and the wage index.
We computed a wage and DRG recalibration budget neutrality factor of 0.995662. The 0.0 percent impact for all hospitals demonstrates that these changes, in combination with the budget neutrality factor, are budget neutral. In Table I, the combined overall impacts of the effects of both the DRG reclassifications and the updated wage index are shown in Column 4. The changes in this column are the sum of the changes in Columns 2 and 3, combined with the budget neutrality factor for the wage index, including the wage index floor for urban areas required by section 4410 of Pub. L. 105-33. There also may be some variation of plus or minus 0.1 percentage point due to rounding. As indicated above, the changes in the relative weights are generally consistent with those we showed in Table I of the FY 2007 IPPS final rule while the impacts due to the wage data may be somewhat different than those shown there because of the new occupational mix survey and a 100 percent adjustment to the wage index. Any changes between column 6 of Table I of the FY 2007 IPPS final rule and column 4 of Table I of this notice are due to use of a 100 percent adjustment for occupational mix and the new survey data.
(4) Effects of the 3-Year Provision Allowing Urban Hospitals that Were Converted to Rural as a Result of the FY 2005 Labor Market Area Changes to Maintain the Wage Index of the Urban Labor Market Area in Which They Were Formerly Located (Column 5). To help alleviate the decreased payments for urban hospitals that became rural under the new labor market area definitions, for purposes of the wage index, we adopted a policy in FY 2005 to allow them to maintain the wage index assignment of the MSA where they were located for the 3-year period FY 2005, FY 2006, and FY 2007. Column 5 shows the impact of the remaining labor market area transition, for those hospitals that were urban under the old labor market area designations and are now considered rural hospitals. Section 1886(d)(3)(E) of the Act specifies that any updates or adjustments to the wage index are to be budget neutral. Therefore, we applied a adjustment of 0.999700 to ensure that the effects of reclassification are budget neutral as indicated by the zero effect on payments to hospitals overall. The rural hospital row shows a 0.3 percent benefit from this provision as these hold-harmless hospitals are now classified as geographically rural.
(5) Effects of MGCRB Reclassifications (Column 6). Our impact analysis up to this point has assumed hospitals are paid on the basis of their actual geographic location (with the exception of ongoing policies that provide that certain hospitals receive payments on other bases than where they are geographically located, such as hospitals in rural counties that are deemed urban under section 1886(d)(8)(B) of the Act). The changes in Column 6 reflect the per case payment impact of moving from this baseline to a simulation incorporating the MGCRB decisions for FY 2007 which affect hospitals' wage index area assignments.
By February 28 of each year, the MGCRB makes reclassification determinations that will be effective for the next fiscal year, which begins on October 1. The MGCRB may approve a hospital's reclassification request for the purpose of using another area's wage index value. The FY 2007 wage index values incorporate all of the MGCRB's reclassification decisions for FY 2007 as well as any decisions made by the CMS Administrator through the appeals and review process.
For FY 2007, as stated in the FY 2006 IPPS final rule (70 FR 47382, August 12, 2005), we established procedural rules under section 1886(d)(10)(D)(v) of the Act to address specific circumstances where individual and group reclassifications involve a section 508 hospital. The rules were designed to recognize the special circumstances of section 508 hospital reclassifications ending midyear during FY 2007 and were intended to allow previously approved reclassifications to continue through March 31, 2007, and new section 1886(d)(10) reclassifications to begin April 1, 2007, upon the conclusion of the section 508 reclassifications. Under these procedural rules, some section 1886(d)(10) hospital reclassifications are only in effect for the second half of the fiscal year.
The first and second half fiscal year section 1886(d)(10) reclassifications permitted under these procedural rules have implications for the calculation of the reclassified wage indices and the reclassification budget neutrality factor. Section 1886(d)(8)(c) of the Act provides requirements for determining the wage index values for hospitals that were reclassified as a result of the MGCRB decisions under 1886(d)(10) of the Act. As provided in the statute, we are required to calculate a separate wage index for hospitals reclassified to an area if including the wage data for the reclassified hospitals would reduce the area wage index by more than 1 percent. Start Printed Page 59897
Because of the half-year reclassifications permitted under the procedural rules, in this final rule, we are issuing two separate wage indices for affected areas (one effective from October 1, 2006, through March 31, 2007 and a second reclassified wage index effective April 1, 2007, through September 30, 2007). The FY 2007 wage index values are calculated based on the wage data for hospitals reclassified to the area in the respective half of the fiscal year. The impact of this policy is modeled in Column 6 of Table I of this notice.
The overall effect of geographic reclassification is required by section 1886(d)(8)(D) of the Act to be budget neutral. In this final rule, we are calculating one budget neutrality adjustment that reflects the average of the adjustments required for first and second half fiscal year reclassifications, respectively. Therefore, we applied an adjustment of 0.992355 to ensure that the effects of the section 1886(d)(10) reclassifications are budget neutral. (See section II.A. of the Addendum to FY 2007 IPPS final rule (71 48146).) As noted in section II.B. of this notice, CMS applied reclassification decisions for FY 2007 on behalf of hospitals to give them the highest wage index. Hospitals have 30 days from the date of the posting of these data on the CMS Web site to revise the decision that CMS made on their behalf.
The impacts shown in Column 6 of Table 1 above reflect the CMS reclassification decisions on behalf of hospitals, which reflect the area that would give the hospital the highest wage index using a 100 percent occupational-mix adjustment and the most recent survey data. As a group, rural hospitals benefit most from reclassification. We estimate that their payments will rise 2.1 percent in FY 2007. Payments to urban hospitals will decline by 0.3 percent. Hospitals in other urban areas will experience an overall decrease in payments of 0.1 percent, while hospitals in large urban areas will lose 0.4 percent. Among urban hospital groups (that is, bed size, census division and IME/DSH status), payments generally would decline.
A positive impact is evident among all of the rural hospital groups. The smallest increase among rural census divisions is 0.8 percent for the Mountain region. The largest increases are in the rural West South Central and rural East South Central regions with 2.8 and 2.5 percent, respectively. Urban hospitals reclassified for FY 2007 are expected to receive an increase of 2.4 percent, while rural reclassified hospitals are expected to benefit from the MGCRB changes with a 3.6 percent increase in payments. Payments to urban and rural hospitals that did not reclassify are expected to decrease slightly due to the MGCRB changes, decreasing by 0.6 percent for urban hospitals and 0.3 percent for rural hospitals.
(6) Effects of the Wage Index Adjustment for Out-Migration (Column 7). Section 1886(d)(13) of the Act, as added by section 505 of Pub. L. 108-173, provides for an increase in the wage index for hospitals located in certain counties that have a relatively high percentage of hospital employees who reside in the county, but work in a different area with a higher wage index. Hospitals located in counties that qualify for the payment adjustment are to receive an increase in the wage index that is equal to a weighted average of the difference between the wage index of the resident county and the higher wage index work area(s), weighted by the overall percentage of workers who are employed in an area with a higher wage index.
Using our established criteria, 583 providers in 282 counties are eligible for this adjustment. Due to the statutory formula to calculate the adjustment and the small number of counties that qualify, the impact on hospitals is minimal, with an overall impact on all hospitals of 0.1 percent.
(7) Effects of All Changes (Column 8). Column 8 compares our estimate of payments per case between FY 2006 and FY 2007, incorporating all changes reflected in the FY 2007 IPPS final rule and in this notice (including statutory changes). This column reflects the impact of all FY 2007 changes relative to FY 2006, including the impact of the quality data changes and the MDH changes from section 5003 of the DRA (see 70 FR 48335) and the impacts shown in Columns 2 through 8 as well as other factors that are not applied until the final rates are calculated. The average increase for all hospitals is approximately 3.5 percent. This increase includes the effects of the 3.4 percent market basket update. It also reflects the 0.5 percentage point difference between the projected outlier payments in FY 2006 (5.1 percent of total DRG payments) and the current estimate of the percentage of actual outlier payments in FY 2006 (4.6 percent), as described in the introduction to this Appendix and the Addendum to this final rule. As a result, payments are projected to be 0.5 percentage points lower in FY 2006 than originally estimated, resulting in a 0.5 percentage point greater increase for FY 2007 than would otherwise occur. In addition, the impact of section 505 adjustments accounted for a 0.1 percent increase. Indirect medical education formula changes for teaching hospitals under section 502 of Pub. L. 108-173, changes in payments due to the difference between the FY 2006 and FY 2007 wage index values assigned to providers reclassified under section 508 of Pub. L. 108-173, and changes in the incremental increase in payments from section 505 of Pub. L. 108-173 out-migration adjustments account for the remaining −0.6 percent.
There might also be interactive effects among the various factors comprising the payment system that we are not able to isolate. For these reasons, the values in Column 8 may not equal the product of the percentage changes described above. We estimate that payments will increase across all hospitals in each category shown in column 8.
We estimate that the average payment per case will increase in FY 2007 by 3.5 percent across all hospitals, 3.4 percent for hospitals in urban areas, 3.5 percent for hospitals in large urban areas, 3.4 percent for hospitals in other urban areas and 3.9 percent for hospitals in rural areas.
Among urban census divisions, we estimate the largest payment increases would be 3.9 percent in the Mid Atlantic region and 3.7 percent in the Pacific and Mountain regions. We estimate that the smallest urban increase will be 2.0 percent in Puerto Rico.
Among rural areas, the New England and Middle Atlantic regions would benefit the most from changes in the FY 2007 IPPS final rule, with 6.0 and 5.2 percent increases, respectively. The smallest increase would occur in the Mountain region, with a 2.7 percent increase in payments.
Among special categories of rural hospitals in Column 8, MDH/RRC providers receive an increase in payments of 14.0 percent and MDH providers receive an increase of 9.0 percent, primarily due to the changes to MDH payments set forth in section 5003 of Pub. L. 109-171 (see 70 FR 48062).
Urban hospitals reclassified for the first half of FY 2007 are anticipated to receive an increase of 3.7 percent, while urban hospitals that reclassified for the second half of FY 2007 are expected to receive an increase of 3.5 percent. The same set of rural hospitals is reclassified for the first and second half of FY 2007. Rural hospitals reclassifying for the entire year of FY 2007 are anticipated to receive a 3.6 percent payment increase. Those hospitals located in rural counties, but deemed to be urban under section 1886(d)(8)(B) of the Act are expected to receive an increase in Start Printed Page 59898payments of 4.4 percent. Hospitals that were reclassified under section 508 of Pub. L. 108-173, which is only effective through March 31, 2007, are expected to receive an increase of 1.9 percent. This lower estimated increase in payment than the average for all hospitals is due to the expiration of the higher section 508 wage indices in effect for 6 months of FY 2007.
b. Analysis of Impact Table II. Table II presents the projected impact of the changes for FY 2007 for urban and rural hospitals and for the different categories of hospitals shown in Table I. It compares the estimated payments per case for FY 2006 with the average estimated per case payments for FY 2007, as calculated under our models. Thus, this table presents, in terms of the average dollar amounts paid per discharge, the combined effects of the changes presented in Table I. The percentage changes shown in the last column of Table II equal the percentage changes in average payments from Column 8 of Table I.
TABLE II.—Impact Analysis of Changes for FY 2007 Operating Prospective Payment System
[Payments per case]
Number of hospitals (1) Average FY 2006 payment per case 1 (2) Average FY 2007 payment per case 1 (3) All FY 2007 changes (4) All hospitals 3,595 8,540 8,838 3.5 By Geographic Location: Urban hospitals 2,590 8,951 9,258 3.4 Large urban areas (populations over 1 million) 1,441 9,368 9,692 3.5 Other urban areas (populations of 1 million or fewer) 1,149 8,446 8,731 3.4 Rural hospitals 1,005 6,228 6,474 3.9 Bed Size (Urban): 0-99 beds 651 6,730 6,964 3.5 100-199 beds 867 7,490 7,772 3.8 200-299 beds 492 8,403 8,702 3.6 300-499 beds 413 9,405 9,719 3.3 500 or more beds 167 11,388 11,748 3.2 Bed Size (Rural): 0-49 beds 348 5,222 5,466 4.7 50-99 beds 370 5,622 5,897 4.9 100-149 beds 174 6,199 6,425 3.6 150-199 beds 68 6,933 7,163 3.3 200 or more beds 45 7,898 8,134 3.0 Urban by Region: New England 128 9,391 9,717 3.5 Middle Atlantic 357 9,833 10,217 3.9 South Atlantic 388 8,476 8,747 3.2 East North Central 395 8,561 8,854 3.4 East South Central 165 8,209 8,433 2.7 West North Central 157 8,689 8,929 2.8 West South Central 374 8,447 8,737 3.4 Mountain 149 8,812 9,140 3.7 Pacific 424 10,742 11,144 3.7 Puerto Rico 53 4,190 4,272 2.0 Rural by Region: New England 19 8,137 8,627 6.0 Middle Atlantic 72 6,291 6,616 5.2 South Atlantic 176 6,033 6,264 3.8 East North Central 125 6,457 6,700 3.8 East South Central 180 5,973 6,181 3.5 West North Central 116 6,422 6,696 4.3 West South Central 193 5,669 5,902 4.1 Mountain 81 6,589 6,768 2.7 Pacific 43 7,608 7,850 3.2 By Payment Classification: Urban hospitals 2,607 8,939 9,245 3.4 Large urban areas (populations over 1 million) 1,448 9,357 9,682 3.5 Other urban areas (populations of 1 million or fewer) 1,159 8,431 8,714 3.4 Rural areas 988 6,278 6,530 4.0 Teaching Status: Non-teaching 2,511 7,124 7,393 3.8 Fewer than 100 Residents 843 8,640 8,932 3.4 100 or more Residents 241 12,605 13,001 3.1 Urban DSH: Non-DSH 906 7,725 8,001 3.6 100 or more beds 1,520 9,424 9,746 3.4 Less than 100 beds 346 6,159 6,383 3.6 Rural DSH: SCH 386 5,816 6,080 4.6 RRC 199 6,946 7,186 3.5 Start Printed Page 59899 Other Rural: 100 or more beds 55 5,737 5,936 3.5 Less than 100 beds 183 5,104 5,301 3.8 Urban teaching and DSH: Both teaching and DSH 815 10,367 10,707 3.3 Teaching and no DSH 201 8,601 8,889 3.3 No teaching and DSH 1,051 7,617 7,899 3.7 No teaching and no DSH 540 7,283 7,539 3.5 Rural Hospital Types: RRC 187 7,277 7,529 3.5 SCH 376 6,216 6,439 3.6 MDH 146 5,190 5,657 9.0 SCH and RRC 98 7,408 7,637 3.1 MDH and RRC 8 6,439 7,341 14.0 Unknown Type of Ownership: Voluntary 2,102 8,680 8,984 3.5 Proprietary 880 7,714 7,984 3.5 Government 603 8,779 9,078 3.4 Unknown 10 13,196 14,194 7.6 Medicare Utilization as a Percent of Inpatient Days: 0-25 243 12,182 12,620 3.6 25-50 1,328 9,739 10,057 3.3 50-65 1,478 7,438 7,714 3.7 Over 65 462 6,662 6,915 3.8 Unknown 84 9,920 10,354 4.4 Hospitals Reclassified by the Medicare Geographic Classification Review Board: FY 2005 Reclassifications: Urban Hospitals Reclassified by the Medicare Geographic Classification Review Board: First Half FY 2007 Reclassifications: 281 8,778 9,099 3.7 Urban Nonreclassified, First Half FY 2007: 2,284 8,983 9,288 3.4 All Urban Hospitals Reclassified Second Half FY 2007: 341 9,038 9,351 3.5 Urban Nonreclassified Hospitals Second Half FY 2007: 2,224 8,947 9,253 3.4 All Rural Hospitals Reclassified Second Half FY 2007: 369 6,759 7,004 3.6 Rural Nonreclassified Hospitals Second Half FY 2007: 578 5,559 5,806 4.4 All Section 401 Reclassified Hospitals: 30 7,030 7,408 5.4 Other Reclassified Hospitals (Section 1886(d)(8)(B)) 57 5,839 6,097 4.4 Section 508 Hospitals 108 9,268 9,446 1.9 Specialty Hospitals Cardiac Specialty Hospitals 21 11,363 11,497 1.2 1 These payment amounts per case do not reflect any estimates of annual case-mix increase. 2. Final FY 2007 Capital-Related Impacts (Quantitative Effects of the Final Occupational Mix Adjusted Wage Indices)
(a) General Considerations. In accordance with § 412.312, the basic methodology for determining a capital PPS payment is:
(Standard Federal Rate) × (DRG weight) × (Geographic Adjustment Factor (GAF)) × (Large Urban Add-on, if applicable) × (COLA for hospitals located in Alaska and Hawaii) × (1 + Disproportionate Share (DSH) Adjustment Factor + Indirect Medical Education (IME) Adjustment Factor, if applicable).
In addition, hospitals may also receive outlier payments for those cases that qualify under the threshold established for each fiscal year.
The data used in developing the impact analysis presented below are taken from the March 2006 update of the FY 2005 MedPAR file and the March 2006 update of the Provider-Specific File that is used for payment purposes. Although the analyses of the changes to the capital prospective payment system do not incorporate cost data, we used the March 2006 update of the most recently available hospital cost report data (FYs 2003 and 2004) to categorize hospitals. Our analysis has several qualifications. First, we do not make adjustments for behavioral changes that hospitals may adopt in response to policy changes. Second, due to the interdependent nature of the IPPS, it is very difficult to precisely quantify the impact associated with each change. Third, we draw upon various sources for the data used to categorize hospitals in the tables. In some cases (for instance, the number of beds), there is a fair degree of variation in the data from different sources. We have attempted to construct these variables with the best available sources overall. However, for individual hospitals, some miscategorizations are possible.
Using cases from the March 2006 update of the FY 2005 MedPAR file, we simulated payments under the capital PPS for FY 2006 and FY 2007 for a comparison of total payments per case. Any short-term, acute care hospitals not paid under the general IPPS (Indian Health Service hospitals and hospitals in Maryland) are excluded from the simulations. Start Printed Page 59900
We modeled payments for each hospital by multiplying the capital Federal rate by the GAF and the hospital's case-mix. We then added estimated payments for indirect medical education, disproportionate share, large urban add-on, and outliers, if applicable. For purposes of this impact analysis, the model includes the following assumptions:
- We estimate that the Medicare case-mix index will increase by 1.0 percent in both FYs 2006 and 2007.
- We estimate that the Medicare discharges will be 13.5 million in FY 2006 and 13.1 million in FY 2007 for a 3.0 percent decrease from FY 2006 to FY 2007.
- The capital Federal rate was updated beginning in FY 1996 by an analytical framework that considers changes in the prices associated with capital-related costs and adjustments to account for forecast error, changes in the case-mix index, allowable changes in intensity, and other factors. The FY 2007 update is 1.1 percent (see section II.E.2. of this notice).
- In addition to the FY 2007 update factor, the FY 2007 capital Federal rate was calculated based on a GAF/DRG budget neutrality factor of 0.9986, an outlier adjustment factor of 0.9568, and an exceptions adjustment factor of 0.9997.
(b) Results. We used the actuarial model described above to estimate the potential impact of our changes for FY 2007 on total capital payments per case, using a universe of 3,595 hospitals. As described above, the individual hospital payment parameters are taken from the best available data, including the March 2006 update of the FY 2005 MedPAR file, the March 2006 update to the Provider-Specific File, and the most recent cost report data from the March 2006 update of HCRIS. In Table III, we present a comparison of total payments per case for FY 2006 compared to FY 2007 based on the FY 2007 payment policies. Column 2 shows estimates of payments per case under our model for FY 2006. Column 3 shows estimates of payments per case under our model for FY 2007. Column 4 shows the total percentage change in payments from FY 2006 to FY 2007. The change represented in Column 4 includes the 1.1 percent update to the capital Federal rate, a 0.0 percent increase in case-mix, changes in the adjustments to the capital Federal rate (for example, the effect of the hospital wage index on the GAF), and reclassifications by the MGCRB. The comparisons are provided by: (1) Geographic location; (2) region; and (3) payment classification.
The simulation results show that, on average, capital payments per case can be expected to increase 2.4 percent in FY 2007. In addition to the 1.1 percent increase due to the capital market basket update, this projected increase in capital payments per case is largely attributable to the change in the DRG recalibration process methodology for FY 2007 as discussed in section II.C. of the preamble of the FY 2007 IPPS final rule (71 FR 48006). To a lesser extent, the final outlier factor also contributes to the increase in capital payments per case, while the final GAF has the opposite effect on capital payments (0.2 percent and −0.1 percent, respectively).
The results of our comparisons by geographic location and by region are consistent with the results we expected after applying the changes to the DRG recalibration methodology. The geographic comparison shows that urban hospitals are expected to experience a 2.3 percent increase in IPPS capital payments per case, while rural hospitals are expected to experience a 2.4 percent increase in capital payments per case. This difference is mostly due to the changes to the methodology used to recalibrate DRGs discussed in the FY 2007 IPPS final rule (71 FR 47882). The capital impact is largely consistent with the impacts in the FY 2007 IPPS final rule (71 FR 48348). However the capital GAF is somewhat affected by the wage index changes resulting from using the revised occupational mix survey data and applying a 100 percent occupational mix adjustment. Any changes from the impact presented in the FY 2007 IPPS final rule would be due to the revised wage indices and the new occupational mix adjustment. Due to circumstances described in the FY 2007 IPPS final rule (71 FR 48005), the wage index used in these calculations is final.
All regions are estimated to receive an increase in total capital payments per case from FY 2006 to FY 2007. Changes vary by region from a minimum increase of 0.14 percent in Puerto Rico for (urban) to a maximum increase of 3.1 percent in the West South Central rural region and the Middle Atlantic rural region. The change in payments per case for all hospitals is 2.4 percent and is the same as indicated in the FY 2007 IPPS final rule.
Section 1886(d)(10) of the Act established the MGCRB. Before FY 2005, hospitals could apply to the MGCRB for reclassification for purposes of the standardized amount, wage index, or both. Section 401(c) of Pub. L. 108-173 equalized the standardized amounts under the operating IPPS. Therefore, beginning in FY 2005, there is no longer reclassification for the purposes of the standardized amounts; however, hospitals still may apply for reclassification for purposes of the wage index for FY 2007. Reclassification for wage index purposes also affects the GAF because that factor is constructed from the hospital wage index.
As discussed in the FY 2007 IPPS final rule (71 FR 48067), procedural rules were established in the FY 2006 IPPS final rule (70 FR 47382) to recognize the special circumstances of section 508 hospital reclassifications ending midyear during FY 2007. Under these procedural rules, some section 1886(d)(10) hospital reclassifications are only in effect for the second half of the fiscal year. These half fiscal year reclassifications have implications for the calculation of reclassified wage indices and therefore, affect capital payments because GAF values are calculated from the hospital wage index.
To present the effects of the hospitals being reclassified for FY 2007, we show the average payments per case for reclassified hospitals for each half of FY 2007 compared to the average payments per case for the same time period in FY 2006. The reclassified groups are compared to all other nonreclassified hospitals for the same time period. These categories are further identified by urban and rural designation. In general, the average payments per case in the first half of FY 2007 is the same or 0.1 percent less as the average payments per case in the second half of FY 2007 for each category of reclassified hospitals shown in Table III . The exception to that generalization is rural nonreclassified hospitals, which are expected to have the largest increases in payments, as well as the largest increase from the first half to the second half of FY 2007, that is, 2.7 percent in the first half of FY 2007, and 3.0 percent in the second half of FY 2007. Urban reclassified hospitals are expected to increase 2.6 percent and 2.5 percent in the first and second halves of FY 2007, respectively. Reclassified rural hospitals and nonreclassified urban hospitals are projected to have the same increase of 2.3 percent in the first half, while in the second half, the increase in payments per discharge to urban nonreclassified hospitals will remain at 2.3 percent but payments per discharge to rural reclassified hospitals are expected to decrease by 0.1 percent to 2.2 percent from the first half of FY 2007 to the second half of FY 2007. Start Printed Page 59901
Table III.—Comparison of Total Payments Per Case
[FY 2006 payments compared to FY 2007 payments]
Number of hospitals Average FY 2006 payments/ case Average FY 2007 payments/ case Change By Geographic Location: All hospitals 3,595 753 771 2.4 Large urban areas (populations over 1 million) 1,441 849 869 2.4 Other urban areas (populations of 1 million or fewer) 1,149 731 747 2.3 Rural areas 1,005 513 526 2.4 Urban hospitals 2,590 796 814 2.3 0-99 beds 651 617 631 2.3 100-199 beds 867 673 690 2.6 200-299 beds 492 751 769 2.4 300-499 beds 413 827 845 2.2 500 or more beds 167 1,005 1,027 2.2 Rural hospitals 1,005 513 526 2.4 0-49 beds 348 422 435 3.1 50-99 beds 370 469 482 2.8 100-149 beds 174 516 528 2.3 150-199 beds 68 564 576 2.2 200 or more beds 45 642 654 1.9 By Region: Urban by Region 2,590 796 814 2.3 New England 128 853 874 2.5 Middle Atlantic 357 873 898 2.9 South Atlantic 388 755 771 2.0 East North Central 395 782 801 2.5 East South Central 165 720 731 1.6 West North Central 157 783 795 1.6 West South Central 374 740 758 2.4 Mountain 149 787 808 2.6 Pacific 424 920 942 2.4 Puerto Rico 53 347 348 0.1 Rural by Region 1,005 513 526 2.4 New England 19 686 696 1.5 Middle Atlantic 72 518 534 3.1 South Atlantic 176 497 511 2.7 East North Central 125 547 560 2.2 East South Central 180 476 487 2.3 West North Central 116 540 551 2.2 West South Central 193 464 479 3.1 Mountain 81 535 542 1.3 Pacific 43 616 627 1.7 By Payment Classification: All hospitals 3,595 753 771 2.4 Large urban areas (populations over 1 million) 1,448 848 869 2.4 Other urban areas (populations of 1 million or fewer) 1,159 730 746 2.3 Rural areas 988 515 527 2.4 Teaching Status: Non-teaching 2,511 630 645 2.5 Fewer than 100 Residents 843 765 782 2.2 100 or more Residents 241 1,100 1,125 2.3 Urban DSH: 100 or more beds 1,520 821 840 2.4 Less than 100 beds 346 543 557 2.5 Rural DSH: Sole Community (SCH/EACH) 386 464 477 2.7 Referral Center (RRC/EACH) 199 570 582 2.1 Other Rural: 100 or more beds 55 475 486 2.3 Less than 100 beds 183 423 435 3.0 Urban teaching and DSH: Both teaching and DSH 815 902 922 2.3 Teaching and no DSH 201 816 835 2.3 No teaching and DSH 1,051 667 683 2.5 No teaching and no DSH 540 700 716 2.3 Rural Hospital Types: Non special status hospitals 2,490 799 818 2.3 RRC/EACH 44 707 722 2.2 SCH/EACH 39 627 640 2.1 Medicare-dependent hospitals (MDH) 18 421 433 2.8 SCH, RRC and EACH 16 736 756 2.7 Start Printed Page 59902 Hospitals Reclassified by the Medicare Geographic Classification Review Board: FY2007 Reclassifications: All Urban Reclassified 1st Half 281 777 797 2.6 All Urban Non-Reclassified 1st Half 2,284 799 818 2.3 All Rural Reclassified 1st Half 358 555 568 2.3 All Rural Non-Reclassified 1st Half 589 460 473 2.7 All Urban Reclassified 2nd Half 341 807 826 2.5 All Urban Non-Reclassified 2nd Half 2,224 795 814 2.3 ALL Rural Reclassified 2nd Half 369 559 571 2.2 All Rural Non-Reclassified 2nd Half 578 451 464 3.0 All Section 401 Reclassified Hospitals 30 553 565 2.3 Other Reclassified Hospitals (Section 1886(d)(8)(B)) 53 516 528 2.2 Type of Ownership: Voluntary 2,102 771 790 2.4 Proprietary 880 679 695 2.3 Government 603 740 757 2.3 Medicare Utilization as a Percent of Inpatient Days: 0-25 243 999 1,026 2.7 25-50 1,328 855 874 2.2 50-65 1,478 663 680 2.5 Over 65 462 597 611 2.4 III. Collection of Information Requirements
This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995.
Start SignatureDated: September 21, 2006.
Mark B. McClellan,
Administrator, , Centers for Medicare & Medicaid Services.
Approved: September 27, 2006.Michael O. Leavitt,
Secretary.
Addendum
This addendum includes tables referred to throughout the notice which contain data relating to the FY 2007 wage indices and the hospital reclassifications and payment amounts for operating and capital-related costs that are affected by the new occupational mix survey data discussed in section II. of this notice.
Table 1A—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Is Greater Than 1)
Table 1B—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Is Less Than or Equal To 1)
Table 1C—Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor
Table 1D—Capital Standard Federal Payment Rate
Table 2—Hospital Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2005; Hospital Wage Indexes for Federal Fiscal Year 2007; Hospital Average Hourly Wage for Federal Fiscal Years 2005 (2001 Wage Data), 2006 (2002 Wage Data), and 2007 (2003 Wage Data); Wage Indexes and 3-Year Average of Hospital Average Hourly Wages
Table 3A—FY 2007 and 3-Year Average Hourly Wage for Urban Areas by CBSA
Table 3B—FY 2007 and 3-Year Average Hourly Wage for Rural Areas by CBSA
Table 4A—1—Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA—FY 2007
Table 4A—2—Wage Index and Capital Geographic Adjustment Factor (GAF) for Certain Urban Areas by CBSA for the Period April 1 through September 30, 2007
Table 4B—1—Wage Index and Capital Geographic Adjustment Factor (GAF) for Rural Areas by CBSA—FY 2007
Table 4B—2—Wage Index and Capital Geographic Adjustment Factor (GAF) for Certain Rural Areas by CBSA for the Period April 1 through September 30, 2007*
Table 4C—1—Wage Index and Capital Geographic Adjustment Factor (GAF) for Hospitals That Are Reclassified by CBSA—FY 2007
Table 4C—2—Wage Index and Capital Geographic Adjustment Factor (GAF) for Certain Hospitals That Are Reclassified by CBSA for the Period April 1 through September 30, 2007
Table 4F—Puerto Rico Wage Index and Capital Geographic Adjustment Factor (GAF) by CBSA—FY 2007
Table 4J—Out-Migration Adjustment—FY 2007
Table 5—List of Diagnosis-Related Groups (DRGs), Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay (LOS)
Table 9A—Hospital Reclassifications and Redesignations by Individual Hospitals and CBSA for FY 2007
Table 9B—Hospital Reclassifications and Redesignations by Individual Hospital Under Section 508 of Pub. L. 108-173 for FY 2007
Table 9C—Hospitals Redesignated as Rural under Section 1886(d)(8)(E) of the Act for FY 2007
Table 9D—Hospitals who waived Lugar status to receive Out-migration Adjustment
Table 10—Geometric Mean Plus the Lesser of 0.75 of the National Adjusted Operating Standardized Payment Amount (Increased to Reflect the Difference Between Costs and Charges) or 0.75 of One Standard Deviation of Mean Charges by Diagnosis-Related Group (DRG)—September 2006
Start Printed Page 59903Table 1A.—National Adjusted Operating Standardized; Labor/Nonlabor
[69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1]
Full Update (3.4 Percent) Reduced Update (1.4 Percent) Labor-related Nonlabor-related Labor-related Nonlabor-related $3,397.52 $1,476.97 $3,331.80 $1,448.40 Table 1B.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor
[62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than or Equal to 1]
Full Update (3.4 Percent) Reduced Update (1.4 Percent) Labor-related Nonlabor-related Labor-related Nonlabor-related $3,022.18 $1,852.31 $2,963.73 $1,816.48 Table 1C.—Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor
Rates If Wage Index Greater Than 1 Rates If Wage Index Less Than or Equal to 1 Labor Nonlabor Labor Nonlabor National $3,397.52 $1,476.97 $3,022.18 $1,852.31 Puerto Rico 1,436.12 880.20 1,359.68 956.64 Table 1D.—Capital Standard Federal Payment Rate
Rate National $427.03 Puerto Rico 203.03 Table 2.—Hospital Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2005; Hospital Wage Indexes for Federal Fiscal Year 2007; Hospital Average Hourly Wages for Federal Fiscal Years 2005 (2001 Wage Data), 2006 (2002 Wage Data), and 2007 (2003 Wage Data); Wage Indexes and 3-Year Average of Hospital Average Hourly Wages
Provider No. Case-mix index 2 FY 2007 wage index Average hourly wage FY 2005 Average hourly wage FY 2006 Average hourly wage FY 2007 1 Average hourly wage** (3 years) 010001 1.4913 0.7664 20.6563 21.6546 22.1989 21.5314 010004 *** * 22.7585 * * 22.7585 010005 h 1.1262 0.8889 20.4937 22.4906 23.6022 22.2289 010006 1.4596 0.7876 21.0241 23.4823 23.4975 22.6401 010007 1.0707 0.7664 16.8811 18.2430 19.9328 18.3636 010008 0.9820 0.7933 23.8333 20.4591 17.9533 20.5783 010009 0.9668 0.8756 21.6422 23.2229 23.5626 22.8435 010010 h 1.0464 0.9226 22.3021 21.4974 27.0386 23.4333 010011 1.5930 0.8889 24.8166 27.4850 27.6658 26.6785 010012 1.2376 0.8822 21.7622 22.7020 24.4059 22.9524 010015 1.0200 0.7664 20.4732 21.5111 22.3383 21.4818 010016 1.5194 0.8889 23.0414 25.1502 24.6488 24.2708 010018 1.4681 0.8889 20.5888 22.2990 23.7048 22.1788 010019 1.2315 0.7876 20.1336 22.0906 22.8766 21.7323 010021 h 1.2160 0.7664 20.7108 18.6785 19.7367 19.6613 010022 0.9818 0.9699 25.8797 24.5670 25.8403 25.4393 010023 1.9061 0.7933 23.7791 27.6174 25.4272 25.5461 010024 1.6733 0.7933 20.0067 20.7265 22.0819 20.8864 010025 1.2764 0.8371 19.8561 21.2674 22.7635 21.2709 010027 0.7773 0.7664 14.9585 15.3704 16.4681 15.5470 010029 1.5790 0.8371 21.6724 22.6976 23.9007 22.7914 010031 *** * 20.9463 * * 20.9463 010032 0.8962 0.7664 18.5073 19.1555 19.3311 19.0281 010033 2.0668 0.8889 25.5165 26.3784 27.4181 26.4464 010034 0.9985 0.7933 17.1625 16.9686 17.7457 17.3133 010035 1.2645 0.8889 23.1319 22.2870 24.2425 23.2085 010036 1.1237 0.7664 20.5125 22.9747 21.5796 21.7075 Start Printed Page 59904 010038 1.3446 0.8059 20.3935 21.4509 23.7039 21.9034 010039 1.6165 0.8967 23.4151 25.8820 26.9919 25.4654 010040 1.5959 0.8060 21.6708 22.8851 24.3207 22.9524 010043 1.0507 0.8889 19.5422 22.5945 21.9775 21.4194 010044 1.0646 0.8889 23.0220 21.4036 22.5009 22.2925 010045 1.1547 0.8889 20.5658 19.8803 20.4927 20.3026 010046 1.4907 0.8060 20.8935 21.6965 23.4219 21.9636 010047 0.8902 0.7819 19.5937 21.0604 26.4851 22.3753 010049 1.1436 0.7664 17.7801 20.2413 21.7888 19.9912 010050 1.0226 0.8889 21.5625 22.1584 22.9620 22.2007 010051 0.8417 0.8761 14.7053 15.2208 18.7700 16.2601 010052 0.8872 0.7767 21.3673 16.4959 25.9233 21.5543 010053 1.0524 * 17.4160 19.0108 * 18.2193 010054 1.0884 0.8756 23.1894 22.5554 23.3624 23.0327 010055 1.5280 0.7664 19.1847 22.3800 22.5396 21.3292 010056 1.5788 0.8889 22.7183 23.7144 23.7398 23.3988 010058 0.9540 0.8889 20.3182 18.5537 19.5091 19.5962 010059 1.0302 0.8756 23.6963 21.3237 23.0012 22.7246 010061 1.0116 0.8170 20.5683 21.9370 24.1185 22.2906 010062 1.0689 0.7664 18.1323 18.3435 21.4805 19.2652 010064 1.6993 0.8889 25.4345 26.1110 24.8155 25.4466 010065 1.4873 0.7933 20.0108 21.3785 23.0477 21.5043 010066 0.8394 0.7664 17.0935 17.6152 19.8692 18.2085 010068 *** * 17.5690 19.0789 22.7156 19.7871 010069 1.0221 0.7664 19.6317 21.3608 23.1243 21.2883 010072 *** * 21.5419 21.8169 24.4989 22.5892 010073 0.9710 0.7664 16.4043 16.4168 18.3963 17.0851 010078 1.5086 0.8059 21.0633 21.6857 23.5279 22.1019 010079 1.1637 0.8967 20.4254 21.8199 22.7337 21.6778 010083 h 1.1649 0.7871 20.2166 22.3041 22.4279 21.6675 010084 1.5041 0.8889 22.5219 24.7127 26.3238 24.5148 010085 1.3171 0.8756 23.7007 24.4710 24.2609 24.1411 010086 1.0946 0.7664 19.4332 18.6081 22.2096 20.0606 010087 1.9800 0.7847 21.6226 22.5225 22.4318 22.1820 010089 1.2666 0.8889 22.2508 22.8448 25.0811 23.4064 010090 1.7203 0.7847 21.4322 23.6948 26.0494 23.6535 010091 0.9645 0.7664 19.4222 18.6912 23.1309 20.2880 010092 1.6031 0.8761 22.0709 24.4592 26.6796 24.3552 010095 0.8478 0.8761 13.4426 13.9326 16.5250 14.6585 010097 0.7204 0.7933 17.1735 16.7548 19.4511 17.7707 010098 1.0596 * 19.6717 14.3076 * 16.5936 010099 0.9988 0.7664 18.1849 18.7909 20.8383 19.2535 010100 h 1.6823 0.7871 20.0027 21.2915 23.8919 21.8071 010101 1.1315 0.7997 21.0085 21.6593 24.2575 22.2800 010102 0.9487 0.7664 19.9196 21.0903 25.6158 22.2527 010103 1.8923 0.8889 24.2201 26.1163 27.8272 26.0578 010104 1.8099 0.8889 24.1929 24.7394 27.6471 25.5331 010108 1.1555 0.7933 23.7803 28.4624 24.6740 25.5797 010109 0.9897 0.8115 21.7128 21.6194 17.6733 20.3002 010110 0.7990 0.7664 19.2706 17.5957 26.0039 20.5257 010112 1.0377 0.7664 17.2963 16.8902 17.1833 17.1259 010113 1.6543 0.7847 20.4181 21.4121 22.3282 21.3874 010114 1.3860 0.8889 21.5319 22.3752 25.6152 23.1874 010115 0.8661 * 17.5985 21.7478 * 19.2200 010118 1.2128 0.8362 18.8560 19.7673 21.4630 20.1843 010119 *** * 21.8215 * * 21.8215 010120 0.9876 0.7664 20.5855 20.9450 20.9019 20.8146 010121 *** * 17.0329 24.0867 * 19.3686 010125 1.0409 0.7664 16.8419 18.4114 21.5123 18.8320 010126 1.1468 0.7933 23.1856 23.1381 23.9327 23.4131 010128 0.8695 0.7664 17.9354 21.4201 23.6648 21.1327 010129 h 1.0101 0.7968 18.7821 21.3555 22.1574 20.8452 010130 0.9443 0.8889 18.4944 23.2488 23.7528 21.6390 010131 1.3815 0.8967 24.2197 25.7837 26.4297 25.5385 010137 1.2390 0.8889 29.7665 24.7366 27.5782 27.2371 010138 0.6122 0.7664 13.5082 13.8475 16.7601 14.7816 Start Printed Page 59905 010139 1.5771 0.8889 24.9410 25.3014 26.8726 25.7394 010143 1.1687 0.8889 22.1312 22.0215 26.2762 23.4710 010144 1.5743 0.7847 20.6425 20.8209 22.5133 21.3563 010145 1.3832 0.8761 23.1976 24.9531 24.5092 24.2395 010146 1.1039 0.8059 19.9944 20.8917 22.6586 21.2025 010148 0.8960 0.7664 18.5309 20.5589 23.9246 21.0046 010149 1.2672 0.7933 23.1593 26.5854 24.4805 24.6823 010150 1.0581 0.8152 20.6738 21.6377 23.6081 21.9568 010152 1.1825 0.7847 22.1626 22.6202 22.4075 22.4009 010157 1.1543 0.7876 21.3574 24.3560 23.3829 23.0158 010158 1.1398 0.8065 22.4440 24.3531 23.5533 23.4497 010161 *** * 27.5119 * * 27.5119 010162 *** * * * 33.8778 33.8778 010164 1.1726 0.7997 * * * * 010165 1.5088 0.8967 * * * * 010166 1.6844 0.8761 * * * * 020001 1.6874 1.1916 31.6091 32.8120 35.4232 33.3471 020004 1.1410 1.0702 29.9926 32.0966 31.8004 31.3123 020006 1.2700 1.1916 33.4210 36.0540 34.3752 34.6332 020008 1.2785 1.2055 34.5856 35.9236 36.1251 35.5664 020012 1.3355 1.0993 29.3419 31.8995 32.5975 31.2913 020014 1.1955 1.0702 32.1233 32.0893 29.4472 31.1605 020017 1.9901 1.1916 32.9281 33.5852 35.4119 33.9602 020018 0.9378 1.9343 * * * * 020019 0.9085 1.9343 * * * * 020020 0.8722 * * * * * 020024 1.1254 1.0702 27.9799 33.0644 29.5195 30.2029 020026 1.6132 1.9343 * * * * 020027 0.8940 1.9343 * * * * 030001 1.4281 1.0146 27.7572 29.9840 32.4791 30.1381 030002 2.0911 1.0146 27.9628 29.0519 30.2200 29.0083 030006 1.6285 0.9390 24.0169 25.8872 27.0599 25.7641 030007 1.4071 1.1073 26.9442 29.6174 31.1928 29.3442 030009 *** * 21.4065 22.3992 26.5408 22.6580 030010 1.3731 0.9390 22.8647 24.8275 28.5684 25.4056 030011 1.4469 0.9390 22.8422 25.1361 28.1423 25.5193 030012 1.3762 0.9748 25.5205 26.3859 27.3895 26.4764 030013 1.4295 0.9269 23.5229 25.7050 27.0111 25.4677 030014 1.4878 1.0146 25.1189 25.6259 29.6582 26.7569 030016 1.2207 1.0146 27.1583 26.7003 29.1980 27.7047 030017 2.0849 1.0146 24.4055 26.2452 30.6008 27.1050 030018 1.2384 1.0146 24.4308 28.9476 29.4567 27.3566 030019 1.3107 1.0146 28.4917 27.3156 29.5921 28.5143 030022 1.5662 1.0146 25.1461 26.4404 30.5710 27.4209 030023 1.6988 1.1538 28.4112 33.8333 34.2142 32.1557 030024 2.0618 1.0146 28.3470 31.6658 31.9247 30.7056 030027 0.9474 * 21.0527 20.4031 * 20.7264 030030 1.5463 1.0146 24.6005 30.2712 32.0993 28.8311 030033 1.2690 1.1073 26.6009 26.6531 28.7508 27.3705 030036 1.4179 1.0146 26.5708 30.3521 30.9834 29.5043 030037 2.2619 1.0146 30.3907 28.6453 31.2878 30.1945 030038 1.6872 1.0146 26.5178 29.5509 29.9314 28.8772 030040 0.9065 0.9269 22.5130 24.8145 27.5322 24.9809 030043 1.2654 0.9269 26.0825 24.7932 26.5834 25.8015 030044 0.8433 * 19.5714 * * 19.5714 030055 h 1.4168 1.1148 23.1837 24.5202 27.1473 25.0480 030059 *** * 24.7676 * * 24.7676 030060 1.1881 0.9269 22.3551 24.3523 24.8373 23.8179 030061 1.6331 1.0146 23.4722 25.5529 28.0696 25.7847 030062 1.2612 0.9269 21.9849 23.8068 26.6881 24.2112 030064 1.9613 0.9390 24.6732 25.4922 28.3853 26.2854 030065 1.5988 1.0146 25.6738 27.1646 29.5883 27.5688 030067 1.0785 0.9269 19.1332 20.4376 20.7590 20.1031 030068 1.1498 0.9269 19.7030 20.8846 23.1394 21.2604 030069 h 1.3722 1.1148 25.6243 26.3518 30.2224 27.2876 030071 0.9150 1.4448 * * * * Start Printed Page 59906 030073 0.8489 1.4448 * * * * 030074 0.9110 1.4448 * * * * 030077 0.8100 1.4448 * * * * 030078 0.9644 1.4448 * * * * 030080 1.4636 0.9390 24.3573 25.2077 27.1360 25.5290 030083 1.3648 1.0146 24.9269 27.5353 27.4983 26.6771 030084 0.8727 1.4448 * * * * 030085 1.5795 0.9390 23.2070 24.5792 26.8364 24.9731 030087 1.5934 1.0146 26.3878 26.6594 29.5962 27.6820 030088 1.3693 1.0146 23.2478 26.6796 27.8604 25.9831 030089 1.5137 1.0146 26.2166 27.1835 28.9068 27.5504 030092 1.4265 1.0146 25.4127 27.3203 31.7512 28.3500 030093 1.2271 1.0146 23.5623 25.8955 26.4430 25.4779 030094 1.3649 1.0146 26.9985 29.5948 31.5422 29.4037 030099 0.8324 0.9269 26.7996 26.3236 27.1402 26.7623 030100 2.0680 0.9390 * 29.0691 31.5628 30.3333 030101 h 1.4490 1.1148 25.0077 26.1927 27.8302 26.3906 030102 2.6120 1.0146 * 29.0942 31.6285 30.4080 030103 1.6687 1.0146 28.2832 30.1994 31.7322 30.0675 030105 2.3289 1.0146 27.6900 31.3094 31.2970 30.3890 030106 1.6799 1.0146 30.4791 34.7222 32.9840 32.3777 030107 1.9370 1.0146 * * 35.6197 35.6197 030108 2.0799 1.0146 * * * * 030109 2.6500 1.0146 * * 16.5905 16.5905 030110 1.4264 1.0146 * * 31.4852 31.4852 030111 1.0600 0.9390 * * * * 030112 1.9402 1.0146 * * * * 030113 0.9319 1.4448 * * * * 030114 1.3877 0.9390 * * * * 030115 1.3290 1.0146 * * * * 030116 2.1291 * * * * * 040001 1.0908 0.9027 23.1475 23.7718 22.9327 23.2665 040002 1.2196 0.7475 19.3429 20.1384 21.2021 20.2735 040003 1.2374 * 18.5000 * * 18.5000 040004 1.6187 0.9027 23.3504 25.0286 27.1741 25.2030 040007 1.7035 0.9704 23.4565 25.7142 40.1291 29.6908 040010 1.3929 0.9027 22.0984 23.0274 24.2315 23.1437 040011 1.0337 0.7475 19.0319 20.3970 21.0968 20.2388 040014 1.4604 0.9265 24.0846 25.3451 26.4777 25.2922 040015 1.0455 0.7475 18.0793 19.2831 20.4279 19.2708 040016 1.6832 0.9704 22.7219 22.1228 25.8056 23.5485 040017 1.1272 0.8816 19.4365 21.9875 21.9147 21.1493 040018 1.0700 0.7850 23.8515 23.6044 24.0026 23.8116 040019 1.1015 0.8984 21.5316 23.7328 23.8705 23.0548 040020 1.5654 0.8984 20.9136 21.6603 22.6497 21.7619 040021 1.2737 0.9704 24.7771 25.6917 25.4047 25.3035 040022 1.5286 0.9027 23.7462 25.4052 29.5000 26.1298 040024 0.6959 * 20.1101 * * 20.1101 040026 1.5264 0.8829 24.3053 25.4072 27.7931 25.9042 040027 1.4577 0.8412 19.9348 21.1412 21.4252 20.8384 040029 1.5455 0.9704 22.8770 24.0704 24.8409 23.9749 040032 *** * 18.5171 * * 18.5171 040035 *** * 13.4265 * * 13.4265 040036 1.6111 0.9704 24.2851 26.3226 27.6234 26.1793 040039 1.2926 0.8353 17.7976 19.5998 21.2712 19.5845 040041 1.1431 0.9265 22.0188 22.1531 23.7787 22.6793 040042 1.3631 0.9307 18.9550 19.9627 21.1716 20.0582 040045 0.9923 * 18.7952 17.2280 * 17.9500 040047 1.1022 0.8353 21.5334 21.9163 22.4250 21.9377 040050 1.1632 0.7475 15.4782 16.3930 17.6906 16.5483 040051 0.9570 0.7475 18.8943 19.1401 21.3342 19.8090 040053 1.0148 * 20.8153 20.7824 * 20.7984 040054 1.1388 0.7475 16.7370 18.2684 18.0510 17.6860 040055 1.5959 0.7850 22.2237 23.3156 23.0448 22.8516 040062 1.7015 0.7850 21.6403 23.3083 23.8994 22.9604 040066 *** * 23.4616 * * 23.4616 Start Printed Page 59907 040067 1.0263 0.7475 15.1441 16.8799 19.0471 16.9179 040069 1.0365 0.8984 21.7607 24.4662 24.8060 23.6538 040071 1.4687 0.9265 22.9350 24.3824 25.4680 24.2630 040072 1.0609 0.7475 20.8269 19.9009 22.4741 21.0044 040074 1.1734 0.9704 22.6147 25.2423 25.2700 24.2961 040075 0.9763 * 16.2583 18.3254 * 17.2857 040076 1.0169 0.9265 21.0442 20.6272 23.5742 21.7288 040077 0.9627 * 18.3261 18.2082 * 18.2646 040078 1.6285 0.9265 24.4589 24.5378 23.5915 24.1852 040080 1.0358 0.8345 21.3483 22.3392 24.1921 22.7065 040081 0.8428 0.7475 13.7148 15.1081 16.8436 15.2255 040084 1.1782 0.9704 22.6441 24.7225 27.7626 25.1456 040085 1.0419 0.7475 18.0756 29.8444 22.9916 22.7039 040088 1.3247 0.8688 21.2974 22.6183 22.4860 22.1468 040091 1.2014 0.8107 23.0252 23.1320 24.2398 23.4639 040100 1.3467 0.9265 19.3560 20.0460 21.3051 20.2851 040105 1.0208 * 15.8171 18.2182 * 16.9121 040109 1.1303 * 18.8624 22.8801 * 20.7540 040114 1.7605 0.9704 23.5628 24.8992 26.7581 25.1160 040118 1.4309 0.8345 24.2547 24.7363 26.0389 24.9780 040119 1.4108 0.9265 20.1631 21.0103 24.3680 21.8564 040126 0.8957 * 12.5944 14.0701 15.6984 14.0818 040132 *** * 36.5525 28.1390 * 32.3748 040134 2.4378 0.9704 * 27.3412 31.9325 29.6807 040137 1.3158 0.9704 23.4672 25.2907 25.9979 24.8946 040138 1.3474 0.9027 23.3615 25.7513 27.8584 25.9401 040140 *** * 25.1224 * * 25.1224 040141 0.8250 0.9027 * 24.0901 26.1041 25.1761 040142 1.4241 0.8829 * 27.9695 21.4222 24.3073 040143 *** * * * 37.1976 37.1976 040144 *** * * * 21.4007 21.4007 040145 1.7851 0.8345 * * * * 040147 1.7154 0.9704 * * * * 050002 1.3823 1.5617 31.9709 34.1948 35.5184 33.9903 050006 1.6010 1.2203 27.6176 30.5373 33.5751 30.3271 050007 1.4646 1.5419 37.5804 38.7033 43.4440 39.9548 050008 1.3293 1.5445 36.9371 39.1539 49.3166 41.9596 050009 1.7661 1.4095 35.5384 39.6393 43.0584 39.5056 050013 1.9243 1.4095 31.7637 31.9837 35.7592 33.1828 050014 1.1607 1.2986 29.5726 33.0373 36.0305 33.0187 050015 1.2479 1.1202 30.1398 30.7940 32.2188 31.0764 050016 1.3066 1.1305 25.5735 26.2162 24.5768 25.4173 050017 2.0706 1.2986 30.5863 36.6593 39.6653 35.6426 050018 1.1919 1.1686 20.3179 22.3472 23.3204 21.9572 050022 1.5562 1.1202 28.2773 29.8632 31.6467 30.0139 050024 1.1462 1.1202 26.9378 27.5587 29.4062 27.9891 050025 1.9310 1.1202 31.7242 36.1622 33.5466 33.8328 050026 1.5374 1.1202 26.6406 28.3027 31.5250 28.9332 050028 1.2575 1.1202 21.5448 26.6160 27.3826 24.7519 050029 *** * 34.3934 * * 34.3934 050030 1.2476 1.1202 22.9148 24.9707 27.2945 25.0204 050036 1.6440 1.1202 27.4915 32.7929 33.8000 31.4474 050038 1.5531 1.5324 35.0441 38.7527 44.2265 39.3929 050039 1.6651 1.1202 29.8179 31.6734 35.2630 32.1614 050040 1.3176 1.1686 31.8983 34.3279 35.8322 34.0141 050042 1.4741 1.2203 29.8062 33.9415 37.3760 33.6941 050043 1.6384 1.5617 39.6054 43.1589 45.4887 42.6954 050045 1.2887 1.1202 22.7051 23.8408 25.0150 23.8863 050046 1.1821 1.1525 25.2786 25.6875 26.1926 25.7298 050047 1.7523 1.5445 39.3993 40.9874 55.9367 45.8065 050054 1.2126 1.1202 27.1437 24.1262 21.3650 24.0140 050055 1.2484 1.5445 36.9386 37.5879 42.9516 39.0065 050056 1.3357 1.1686 29.4829 27.9330 30.6126 29.3527 050057 1.6734 1.1202 26.2099 29.4351 30.0236 28.5928 050058 1.5474 1.1686 27.3584 33.8215 33.1409 31.4044 050060 1.5254 1.1202 26.5515 27.3282 29.9762 27.9723 Start Printed Page 59908 050061 *** * * 32.2172 * 32.2172 050063 1.3269 1.1686 32.0515 33.3039 34.0906 33.1167 050065 1.8250 1.1525 33.8223 34.0280 34.9110 34.2663 050067 1.1481 1.1735 29.6982 31.9597 38.8070 33.9918 050069 1.6715 1.1525 28.6752 31.2172 34.6353 31.5321 050070 1.2884 1.5419 40.5645 45.3382 47.4099 44.7713 050071 1.2950 1.5617 41.1036 44.9464 50.7602 46.0847 050072 1.2895 1.5617 40.8108 44.2651 49.4344 45.2871 050073 1.2440 1.5617 41.3430 45.9765 49.9730 46.2034 050075 1.1895 1.5617 43.7101 47.2356 54.4089 49.0009 050076 1.7287 1.5617 43.0845 46.4990 52.3788 47.8548 050077 1.5565 1.1202 29.6264 32.0245 34.8660 32.3083 050078 1.2226 1.1686 25.6814 31.1425 32.0133 29.3832 050079 1.4970 1.5617 42.7385 47.8597 47.3448 46.0427 050082 1.6400 1.1439 28.9139 37.7783 38.2878 35.2197 050084 1.5674 1.2029 28.2664 33.0179 35.5196 32.1347 050088 *** * 26.4093 25.7385 * 26.0862 050089 1.3319 1.1525 29.4884 33.5323 33.9593 32.4106 050090 1.2881 1.5260 31.1774 32.9584 33.8953 32.6836 050091 1.1230 1.1686 30.1534 30.8560 32.1301 31.0759 050093 1.5061 1.1202 31.1083 33.4119 36.9481 33.8765 050096 1.2727 1.1686 24.2277 24.6680 34.9236 28.0644 050097 *** * 26.6788 * * 26.6788 050099 1.4964 1.1525 28.7711 31.0437 33.4174 31.1779 050100 1.8441 1.1202 28.0303 29.6949 31.4404 29.7728 050101 1.3366 1.5617 35.4655 40.3195 42.4588 39.5443 050102 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1.3281 * 28.7202 28.3860 * 28.5544 240014 1.0334 1.0782 28.3788 29.8623 29.8905 29.4068 240016 1.2566 * 24.9211 26.7814 * 25.9310 240017 1.2297 0.9238 23.3314 24.4417 24.3596 24.0453 240018 1.2775 1.0782 27.9218 25.6236 28.1432 27.0877 240019 1.0794 1.0285 27.5441 28.6723 33.7546 29.9360 240020 1.0697 1.0782 28.1568 31.2443 31.3874 30.2352 240021 0.9533 * 23.7096 27.1235 * 25.3021 240022 1.1304 0.9238 23.7368 25.2066 26.1920 25.0459 240025 *** * 27.8656 * * 27.8656 240027 0.9029 * 20.2531 18.2481 * 19.1090 240029 1.1322 * 24.3017 25.3568 * 24.8217 240030 1.3341 1.0302 23.3753 24.7154 26.5508 24.8983 240031 0.9625 * 26.7242 26.7778 * 26.7517 240036 1.6508 1.1029 27.0821 28.0812 32.7028 29.2395 240037 1.0388 * 24.3986 * * 24.3986 240038 1.5474 1.0782 29.8465 31.0779 31.9891 30.9872 240040 1.0882 1.0285 26.3177 27.4895 27.5074 27.1265 240043 1.1386 0.9238 20.7155 21.8685 23.3489 22.0037 Start Printed Page 59934 240044 1.1310 1.0106 24.3009 22.0973 25.0988 23.8092 240045 1.0872 * 26.1743 * 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* 23.7898 240141 1.1273 1.0782 26.7173 26.4016 31.4468 28.5886 240143 0.8825 * 21.1180 21.7416 * 21.4375 240152 0.9888 * 27.3445 29.6196 * 28.5127 240154 1.0590 * 23.9643 * * 23.9643 240162 1.1482 * 22.3136 22.2721 * 22.2926 240166 1.1472 0.9238 23.4265 25.7509 27.6987 25.6501 240179 *** * 20.8449 * * 20.8449 240187 1.2453 1.0782 26.5129 27.8811 27.8844 27.4419 240196 0.7779 1.0782 28.9380 30.7719 31.5965 30.4819 240206 0.8207 1.4448 * * * * 240207 1.1876 1.0782 29.2395 31.7665 32.5589 31.2507 240210 1.2705 1.0782 29.7227 32.1564 32.7123 31.5359 240211 0.9908 1.0782 44.4214 18.8503 22.5431 24.6609 240213 1.3702 1.0782 31.3974 32.7532 33.8680 32.7407 250001 1.8583 0.8214 21.9176 22.7827 23.5222 22.7777 250002 0.9020 0.8169 20.1310 23.3845 23.4064 22.1926 250004 1.8948 0.8984 20.6828 24.1065 24.7907 23.1544 250006 1.0666 0.8984 21.4038 24.0191 24.4282 23.2690 250007 1.2504 0.8748 23.6933 25.8710 24.8929 24.8386 250009 1.2767 0.8643 20.4329 22.2323 23.0352 21.9113 250010 1.0365 0.7796 19.4130 19.4403 21.4322 20.0759 250012 0.9304 0.9307 20.0493 20.2921 21.5539 20.6182 Start Printed Page 59935 250015 1.0396 0.7796 20.6931 20.7555 22.0067 21.1413 250017 1.0373 0.7796 18.1013 21.3950 22.7661 20.9402 250018 0.8282 0.7796 17.0689 16.6294 17.1276 16.9471 250019 1.5803 0.8748 22.8358 23.9741 25.7376 24.1729 250020 0.9690 0.7796 19.3390 21.4019 22.1851 20.9799 250021 *** * 15.1242 20.3559 * 16.1481 250023 0.8543 0.8461 16.1820 16.2418 18.0108 16.8283 250025 1.1121 0.7796 20.6892 20.5258 22.5621 21.2882 250027 0.9523 0.7796 17.3313 17.3481 24.4937 19.7107 250031 1.3346 0.8214 22.0850 21.4326 24.8139 22.6468 250034 1.5496 0.8984 20.6752 24.3189 26.1887 23.7216 250035 0.8573 0.7796 14.6149 17.2045 20.1622 17.3598 250036 1.0183 0.8144 17.8313 19.1975 20.3625 19.2231 250037 0.8536 * 17.4463 17.4012 0.0000 17.4232 250038 0.9874 0.8214 18.0209 18.9050 22.2571 19.6992 250039 0.9189 * 15.2939 17.3155 * 16.2540 250040 1.4985 0.8461 21.3451 23.2285 24.5962 23.0919 250042 1.1696 0.8984 21.4117 23.4135 25.6807 23.4660 250043 1.0236 0.7796 18.3322 19.8098 18.8979 19.0278 250044 1.0419 0.7876 21.1198 23.3862 24.0508 22.8288 250045 1.1333 * 25.0863 26.3831 * 25.7497 250048 1.6390 0.8214 21.6547 22.9765 25.2092 23.3037 250049 0.8991 0.7796 17.8154 17.7005 19.1044 18.3112 250050 1.2511 0.7796 18.3170 19.1467 20.8084 19.4590 250051 0.8656 0.7796 10.6908 10.6095 14.3741 11.8797 250057 1.1358 0.7796 19.6789 20.1900 22.7601 20.8814 250058 1.2356 0.7796 17.5160 18.1704 19.2502 18.3263 250059 0.9853 0.7796 17.7270 19.2977 23.8997 20.2473 250060 0.8394 0.7796 20.8115 16.8247 28.1431 21.5713 250061 0.8798 0.7796 15.2515 12.8174 17.8267 15.0890 250065 *** * 16.1984 * * 16.1984 250067 1.0684 0.7796 20.1261 21.6911 23.1193 21.6222 250068 *** * 16.9585 * * 16.9585 250069 1.5324 0.8362 21.6617 22.8162 22.6353 22.4068 250071 *** * 17.7149 * * 17.7149 250072 1.5884 0.8214 22.9316 24.6587 25.8399 24.5004 250077 0.9399 0.7796 14.2271 14.7632 18.3735 15.7279 250078 1.6751 0.8461 18.6563 20.9354 22.1243 20.5542 250079 0.8331 0.8214 27.2549 38.0031 45.5166 38.2904 250081 1.2316 0.8362 21.3830 24.7031 23.9995 23.2075 250082 1.4444 0.8397 20.5212 19.6966 23.0287 21.0512 250083 *** * 19.9484 * * 19.9484 250084 1.1682 0.7796 21.8001 18.5775 19.6492 19.8895 250085 0.9879 0.7796 18.7367 19.7007 22.5512 20.3950 250093 1.1718 0.7796 18.8001 21.3237 23.0984 21.0634 250094 1.5970 0.8461 22.3312 22.7312 24.1422 23.0663 250095 1.0290 0.7796 19.9553 21.3511 21.7488 21.0087 250096 1.1418 0.8214 22.7458 22.6298 24.9187 23.4322 250097 1.5660 0.8085 19.4534 20.1687 21.8139 20.4661 250099 1.2571 0.8214 19.0333 19.5797 21.1269 19.9051 250100 1.4696 0.8362 22.0328 24.2209 25.6846 23.9924 250101 *** * 21.2234 19.3543 * 20.1785 250102 1.5976 0.8214 22.5518 24.2868 24.6652 23.8699 250104 1.4348 0.8214 21.4431 22.6591 23.4303 22.5551 250105 0.9403 * 17.9468 18.1196 * 18.0323 250107 0.9209 * 16.5369 17.8999 * 17.2381 250112 0.9608 0.7796 19.6172 21.2824 24.3067 21.8416 250117 1.0909 0.8461 19.9774 23.3673 22.2450 21.7923 250120 1.0778 0.7796 22.7607 23.4277 24.6370 23.5490 250122 1.0871 0.8129 23.7230 24.5854 27.2795 25.1719 250123 1.2998 0.8748 22.0486 24.5115 26.6221 24.4340 250124 0.8446 0.8214 15.4343 17.2181 20.4395 17.6895 250125 1.3083 0.8748 26.8379 27.7077 27.5158 27.3633 250126 0.9040 0.9307 20.4085 21.7111 24.4126 22.0667 250127 0.8548 1.4448 * * * * 250128 0.8924 0.7796 15.9344 17.6269 17.7624 17.0843 Start Printed Page 59936 250134 0.8120 0.8214 23.5608 25.8368 22.2167 23.8221 250136 1.0356 0.8214 22.5832 23.0637 22.9468 22.8653 250138 1.3041 0.8214 22.7902 23.8861 24.3018 23.6898 250141 1.5949 0.9307 24.5772 27.6158 28.5922 27.0618 250146 0.9048 * 17.2328 18.6486 * 17.9106 250149 0.8797 0.7796 15.0367 15.0641 16.8796 15.6660 250151 0.4842 0.7796 21.8697 17.2205 18.8846 18.4861 250152 0.8955 0.8214 * 25.7837 26.9334 26.3171 250153 *** * * 29.0461 * 29.0461 250155 *** * * * 22.5729 22.5729 250156 1.2778 0.7796 * * * * 250159 0.8769 * * * * * 260001 1.6632 0.8794 25.3084 25.9250 27.9230 26.3723 260002 *** * 27.2329 26.4879 * 26.9807 260003 *** * 17.6339 * * 17.6339 260004 0.9686 0.8353 16.7742 16.9421 20.3217 18.0451 260005 1.4577 0.8998 24.6142 26.5773 27.7855 26.3893 260006 1.4619 0.8353 26.4948 26.7587 30.3440 28.0336 260008 *** * 17.6040 18.9522 * 18.2612 260009 1.2219 0.9345 21.2729 22.1816 24.2360 22.5867 260011 1.4224 0.8620 21.4409 22.7061 25.6387 23.3003 260012 1.1411 * 19.3389 20.3061 * 19.8719 260013 1.0563 * 19.2065 20.5007 * 19.8516 260015 1.0220 0.8353 22.4450 22.5409 24.6139 23.2261 260017 1.3556 0.8889 21.1359 22.7022 23.5713 22.5230 260018 1.0454 * 14.8425 17.0434 * 15.9088 260020 1.7670 0.8998 25.7898 26.0407 27.4730 26.4741 260021 1.3882 0.8998 27.8332 27.6330 29.3646 28.2462 260022 1.2284 0.8658 21.7707 22.8085 23.3393 22.6184 260023 1.2981 0.8998 21.2519 21.2077 24.3192 22.2092 260024 1.1057 0.8353 17.5351 18.4829 19.4952 18.4886 260025 1.3713 0.8889 20.0901 22.4645 22.2451 21.6215 260027 1.6681 0.9345 24.7605 25.3348 26.3590 25.4687 260029 1.1193 * 22.2892 * * 22.2892 260031 *** * 24.2877 * * 24.2877 260032 1.8568 0.8998 23.1125 23.9478 25.6763 24.2466 260034 0.9593 0.9345 23.3034 24.1143 25.0573 24.1894 260035 0.9270 * 16.8502 17.8741 * 17.3672 260036 0.9590 * 20.1324 22.1912 * 21.0403 260039 1.0479 * * * * * 260040 1.6395 0.8570 21.9452 23.3566 24.3938 23.2602 260044 0.9221 * 20.0686 * * 20.0686 260047 1.4927 0.8353 22.6169 24.4185 25.4978 24.2091 260048 1.2143 0.9345 25.8089 24.3906 27.6117 25.9044 260050 1.2087 1.0045 20.6364 23.6849 25.0507 23.2406 260052 1.3323 0.8998 22.5809 24.5165 26.0052 24.3683 260053 1.0942 * 20.0051 21.6607 * 20.8214 260057 1.0951 0.9345 16.4875 19.3335 20.9639 18.8512 260059 1.2013 0.8353 18.6379 19.7243 22.6922 20.4186 260061 1.1161 0.8353 19.6674 21.5264 22.4766 21.1445 260062 1.2300 0.9345 26.0439 26.4539 28.1661 26.8989 260063 *** * 22.0826 * * 22.0826 260064 1.3163 0.8456 19.1587 19.0543 22.2395 20.1462 260065 1.7456 0.8570 23.6969 23.0015 27.1014 24.6097 260067 0.8891 * 16.5364 17.6256 * 17.0827 260068 1.7539 0.8456 23.9340 24.9504 26.0295 24.9978 260070 0.9577 0.8353 14.3881 18.4779 24.6331 19.7034 260073 0.9983 * 19.2744 21.6214 * 20.4508 260074 1.2526 0.8511 23.9301 24.8654 25.6218 24.8258 260077 1.6279 0.8998 23.5466 25.5782 26.7466 25.2766 260078 1.3422 0.8353 18.4017 19.0802 20.1983 19.2331 260080 0.9306 0.8353 11.2817 14.7774 17.9107 14.5610 260081 1.5309 0.8998 23.7447 26.3969 28.1182 26.0827 260085 1.5985 0.9345 24.6046 25.6302 26.6718 25.6383 260086 0.9009 * 17.1202 19.1702 * 18.1866 260091 1.5378 0.8998 26.1149 27.2407 28.0537 27.1569 Start Printed Page 59937 260094 1.5623 0.8412 20.6805 23.2544 24.1473 22.7893 260095 1.3129 0.9345 23.8671 25.5668 24.2698 24.5514 260096 1.4639 0.9345 25.9932 27.5592 29.7312 27.8533 260097 1.1797 0.8778 21.5077 21.3957 25.0624 22.7477 260102 0.9150 0.9345 22.9283 24.2368 27.2145 24.8458 260103 *** * 23.3175 * * 23.3175 260104 1.4937 0.8998 24.0038 26.2867 28.6247 26.3990 260105 1.7783 0.8998 28.4652 28.8849 29.8848 29.0941 260107 1.3517 0.9345 24.2001 26.7782 25.8177 25.5796 260108 1.7976 0.8998 24.0936 24.9880 26.6374 25.2785 260110 1.6936 0.8889 22.2730 23.7978 24.7656 23.6548 260113 1.1163 0.8353 19.2467 20.9644 21.2072 20.4976 260115 1.1806 0.8998 21.7450 21.9859 23.1396 22.3184 260116 1.1089 0.8353 17.2698 18.5076 21.3503 19.0263 260119 1.3445 0.8353 22.1588 24.9937 27.9769 25.0558 260122 1.0843 * 17.3270 20.8015 * 19.0424 260123 *** * 16.1169 * * 16.1169 260127 0.9499 * 22.5328 21.8534 * 22.1664 260134 *** * 18.1531 * * 18.1531 260137 1.6709 0.8794 21.3426 22.7431 24.3273 22.8805 260138 1.9794 0.9345 27.8229 28.5610 30.4410 28.9706 260141 1.8925 0.8456 21.1511 22.4886 24.1555 22.5018 260142 1.0581 0.8353 19.6582 20.3993 21.5923 20.5671 260147 0.9181 0.8353 17.2291 18.5153 21.4235 19.1299 260159 *** * 26.8924 23.7427 22.6277 24.8200 260160 1.0889 0.8353 19.4997 21.0544 23.8256 21.6967 260162 1.3101 0.8998 24.1246 25.1423 27.0236 25.4950 260163 1.1357 0.8353 19.2885 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26.2516 27.6771 31.4284 28.5997 520028 1.2939 1.0621 25.7778 25.4164 26.7260 25.9761 520030 1.7557 0.9947 25.3807 27.0185 29.4678 27.3375 520032 1.0976 * 25.3059 * * 25.3059 520033 1.2339 0.9607 23.9791 25.0854 28.0662 25.8012 520034 1.2025 0.9607 23.6563 23.9850 26.1094 24.6150 520035 1.3238 0.9684 23.2625 24.7767 27.3276 25.1707 520037 1.8307 0.9947 28.6984 29.7234 30.1799 29.5214 520038 1.2393 1.0324 24.6650 26.6470 29.3133 26.9164 520040 1.4779 1.0324 23.8501 27.2325 29.1262 26.6542 520041 1.0893 1.0841 22.8236 22.7596 23.5495 23.0632 520042 1.0028 * 24.0788 * * 24.0788 520044 1.3396 0.9684 24.9387 26.0191 27.3685 26.1391 520045 1.5996 0.9607 24.5844 26.0030 27.3336 25.9816 520047 *** * 25.5346 * * 25.5346 520048 1.6266 0.9607 23.1653 25.1724 26.8080 24.9984 520049 2.1036 0.9607 24.1083 25.9256 26.9851 25.5981 520051 1.6796 1.0324 28.8249 28.4880 31.9949 29.9332 520057 1.2034 0.9725 23.3205 25.3745 27.7528 25.5398 520059 1.2561 1.0651 26.5596 28.0906 29.5801 28.0985 520060 1.2738 0.9607 22.0132 23.8817 24.8638 23.5830 520062 1.2670 1.0324 24.9988 28.2215 28.8510 27.3750 520063 1.1401 1.0324 25.3674 27.4101 29.0993 27.2991 520064 1.5146 1.0324 27.1120 28.6101 30.3225 28.6401 520066 1.4886 1.0621 25.8812 27.1657 29.2088 27.4160 520068 0.9089 * 23.4746 24.8184 * 24.1554 520070 1.7214 0.9613 23.9908 24.8935 27.6771 25.5786 520071 1.1960 1.0209 26.3154 27.6202 30.0263 27.9425 520075 1.4680 0.9607 26.0600 27.1699 29.2920 27.4700 520076 1.2364 1.0621 24.0879 26.1698 27.3335 25.8642 520078 1.5310 1.0324 25.7662 27.5989 29.9837 27.8237 520083 1.7200 1.0841 27.0012 28.8407 30.8826 28.9925 520084 *** * 25.5777 * * 25.5777 520087 1.7229 0.9607 24.5280 27.3374 28.5810 26.7699 520088 1.2892 1.0368 26.0882 26.9936 30.7450 28.0398 520089 1.5179 1.0841 26.6013 30.0448 33.8793 30.2306 520091 1.2839 0.9607 24.8269 24.6320 25.4593 24.9881 520092 *** * 23.4043 * * 23.4043 520094 *** * 25.3166 25.7567 * 25.5399 520095 1.2343 1.0621 28.6376 26.7863 30.4216 28.6080 520096 1.3522 1.0209 22.9929 24.5758 27.8896 25.3901 520097 1.3944 0.9607 25.1135 26.3321 29.1479 26.8851 520098 1.9786 1.0841 28.0730 30.6150 32.5785 30.4882 520100 1.2755 0.9868 24.5914 26.2161 29.3243 26.7266 520102 1.1172 1.0209 25.6146 26.8234 29.1680 27.2579 520103 1.5632 1.0324 25.5361 27.9147 30.3165 28.0905 520107 1.2485 0.9607 27.7413 28.3431 28.9878 28.3702 520109 1.0573 0.9607 22.4048 23.3271 24.7228 23.4867 520111 *** * 26.3095 * * 26.3095 520112 *** * 20.4034 * * 20.4034 520113 1.2842 0.9607 26.7926 27.4135 31.4707 28.5985 520114 *** * 22.0536 * * 22.0536 520116 1.2796 1.0209 26.3057 26.9902 27.9688 27.1297 520117 *** * 22.0023 * * 22.0023 520123 *** * 22.2430 * * 22.2430 520132 0.9607 0.9684 21.6025 23.1941 25.0006 23.2907 520135 *** * 18.5618 * * 18.5618 520136 1.6673 1.0324 25.5145 27.7703 30.6522 27.9536 520138 1.8679 1.0324 26.9047 28.4394 30.8016 28.7391 520139 1.2807 1.0324 25.4424 26.5110 28.8870 27.0173 520140 1.6530 1.0324 26.1616 28.4433 31.0043 28.5899 520148 1.3198 * 26.2258 * * 26.2258 520151 *** * 22.9592 * * 22.9592 520152 1.0804 0.9607 23.2493 24.9392 29.7308 26.1195 Start Printed Page 59968 520154 *** * 23.7160 * * 23.7160 520156 *** * 24.9258 * * 24.9258 520160 1.8219 0.9607 24.3528 25.7588 27.9548 26.0586 520161 *** * 24.0673 * * 24.0673 520170 1.4053 1.0324 25.6124 27.2221 30.4309 27.8135 520173 1.1245 1.0285 26.2224 28.0995 29.2429 27.8645 520177 1.6430 1.0324 28.4663 30.7317 31.4555 30.2920 520178 0.9946 * 23.0419 20.2666 * 21.6760 520189 1.1608 1.0651 26.3172 28.4720 28.0014 27.7043 520193 1.6504 0.9607 * 26.0885 27.8113 27.0087 520194 1.3272 1.0324 * 24.9408 30.1668 27.5109 520195 *** * * 36.6973 36.3116 36.5038 520196 1.6500 0.9613 * 35.1043 36.9266 35.9808 520197 2.6190 1.0324 * * * * 520198 1.3546 0.9607 * * * * 520199 2.3592 1.0324 * * * * 520200 1.3175 * * * * * 530002 1.0817 0.9124 25.2983 26.8356 28.3063 26.8117 530006 1.1609 0.9124 22.8344 24.9318 27.2422 24.9156 530007 *** * 19.3476 20.4391 * 19.9218 530008 1.1112 0.9145 23.8271 23.8589 24.0090 23.8983 530009 0.9348 0.9124 24.2426 26.8316 24.6719 25.2403 530010 1.2278 0.9145 23.9255 25.8482 25.9852 25.2473 530011 1.1081 0.9124 24.1396 24.8245 27.8772 25.6665 530012 1.6961 0.9145 24.3454 25.2526 26.9582 25.5096 530014 1.5337 0.9124 23.6907 24.5947 26.7156 25.0071 530015 1.2055 0.9639 26.3107 27.6876 29.8310 27.9484 530016 *** * 21.6575 * * 21.6575 530017 0.9935 0.9124 23.5415 25.3362 29.8504 26.3807 530023 *** * 24.1493 21.3813 * 22.6795 530025 1.2393 0.9233 27.7988 28.6938 24.4392 26.8843 530031 *** * 16.3472 * * 16.3472 530032 1.0643 0.9124 22.6584 25.7728 23.9005 24.0558 1 Based on salaries adjusted for occupational mix, according to the calculation specified in FY 2007 IPPS final rule (71 FR 48006). 2 The transfer-adjusted case-mix index is based on the billed DRG on the FY 2005 MedPAR. h These hospitals are assigned a wage index value according to the FY 2007 final rule (71 FR 48005). * Denotes wage data not available for the provider for that year. ** Based on the sum of the salaries and hours computed for Federal FYs 2005, 2006, and 2007. *** Denotes MedPAR data not available for the provider for FY 2005. Table 3A.—FY 2007 and 3-Year Average Hourly Wage For Urban Areas By CBSA
[*Based on the salaries and hours computed for Federal FYs 2005, 2006, and 2007.]
CBSA code Urban area FY 2007 average hourly wage 3-year average hourly wage 10180 Abilene, TX 24.7354 22.5497 10380 Aguadilla-Isabela-San Sebastian, PR 11.3127 11.8798 10420 Akron, OH 25.4747 24.8266 10500 Albany, GA 26.8537 26.6477 10580 Albany-Schenectady-Troy, NY 26.2389 24.4301 10740 Albuquerque, NM 28.3608 27.7551 10780 Alexandria, LA 23.4795 22.5264 10900 Allentown-Bethlehem-Easton, PA-NJ 29.9286 27.6856 11020 Altoona, PA 25.3167 24.1524 11100 Amarillo, TX 27.4217 25.7741 11180 Ames, IA 28.7786 26.8184 11260 Anchorage, AK 35.2999 33.6081 11300 Anderson, IN 26.1553 24.4794 11340 Anderson, SC 26.4473 24.8695 11460 Ann Arbor, MI 31.6639 30.4582 11500 Anniston-Oxford, AL 23.4777 21.9712 11540 Appleton, WI 27.7424 25.9029 11700 Asheville, NC 27.4697 25.9704 Start Printed Page 59969 12020 Athens-Clarke County, GA 28.0394 27.4814 12060 Atlanta-Sandy Springs-Marietta, GA 29.0398 27.5973 12100 Atlantic City, NJ 34.6691 32.0567 12220 Auburn-Opelika, AL 23.9007 22.7914 12260 Augusta-Richmond County, GA-SC 28.5862 26.6851 12420 Austin-Round Rock, TX 27.6592 26.5039 12540 Bakersfield, CA 32.3762 29.5765 12580 Baltimore-Towson, MD 29.4225 27.7580 12620 Bangor, ME 28.5032 27.5520 12700 Barnstable Town, MA 37.3300 35.1183 12940 Baton Rouge, LA 23.9749 23.3468 12980 Battle Creek, MI 28.6610 26.6466 13020 Bay City, MI 27.8853 26.4751 13140 Beaumont-Port Arthur, TX 25.8266 24.0155 13380 Bellingham, WA 32.4426 31.9484 13460 Bend, OR 31.0837 29.7964 13644 Bethesda-Gaithersburg-Frederick, MD 32.1685 31.0437 13740 Billings, MT 26.5564 25.0079 13780 Binghamton, NY 26.5773 24.3089 13820 Birmingham-Hoover, AL 26.3579 25.2037 13900 Bismarck, ND 21.6654 20.9327 13980 Blacksburg-Christiansburg-Radford, VA 24.3556 22.6230 14020 Bloomington, IN 26.5655 24.3118 14060 Bloomington-Normal, IL 27.1016 25.5125 14260 Boise City-Nampa, ID 28.0081 26.0160 14484 Boston-Quincy, MA 34.8871 32.7850 14500 Boulder, CO 29.8919 27.9634 14540 Bowling Green, KY 23.9663 22.8146 14740 Bremerton-Silverdale, WA 32.2245 30.0885 14860 Bridgeport-Stamford-Norwalk, CT 37.7967 35.6899 15180 Harlingen, TX 28.8551 27.7588 15260 Brunswick, GA 31.0703 29.3670 15380 Buffalo-Niagara Falls, NY 28.0965 26.4178 15500 Burlington, NC 25.3226 24.6210 15540 Burlington-South Burlington, VT 27.9794 26.2852 15764 Cambridge-Newton-Framingham, MA 32.6270 31.1502 15804 Camden, NJ 31.1549 29.6108 15940 Canton-Massillon, OH 26.8311 25.1139 15980 Cape Coral-Fort Myers, FL 28.0527 26.3302 16180 Carson City, NV 29.3650 28.4400 16220 Casper, WY 26.9582 25.5096 16300 Cedar Rapids, IA 25.8224 24.7388 16580 Champaign-Urbana, IL 28.4141 26.7812 16620 Charleston, WV 25.7589 24.2660 16700 Charleston-North Charleston, SC 27.1568 25.9700 16740 Charlotte-Gastonia-Concord, NC-SC 27.9122 26.9168 16820 Charlottesville, VA 29.7688 28.4674 16860 Chattanooga, TN-GA 26.5327 25.4481 16940 Cheyenne, WY 26.7156 25.0071 16974 Chicago-Naperville-Joliet, IL 31.6404 30.1812 17020 Chico, CA 32.7875 29.9713 17140 Cincinnati-Middletown, OH-KY-IN 28.2340 26.7214 17300 Clarksville, TN-KY 24.9690 23.0942 17420 Cleveland, TN 24.3808 22.6533 17460 Cleveland-Elyria-Mentor, OH 27.8617 26.3788 17660 Coeur d'Alene, ID 27.3597 26.3413 17780 College Station-Bryan, TX 26.4006 25.2360 17820 Colorado Springs, CO 28.0973 26.7757 17860 Columbia, MO 25.0579 23.4777 17900 Columbia, SC 26.5160 25.5945 17980 Columbus, GA-AL 25.2948 24.0613 18020 Columbus, IN 28.0068 26.5764 18140 Columbus, OH 29.8780 27.7524 18580 Corpus Christi, TX 25.0205 23.9295 18700 Corvallis, OR 33.6078 30.4640 19060 Cumberland, MD-WV 24.1695 24.2795 19124 Dallas-Plano-Irving, TX 29.5841 28.2768 19140 Dalton, GA 26.5548 25.7096 19180 Danville, IL 28.3299 24.9634 Start Printed Page 59970 19260 Danville, VA 25.2022 23.9494 19340 Davenport-Moline-Rock Island, IA-IL 26.2005 24.5540 19380 Dayton, OH 27.2364 25.7362 19460 Decatur, AL 23.9150 23.6883 19500 Decatur, IL 24.3550 22.8257 19660 Deltona-Daytona Beach-Ormond Beach, FL 27.2901 25.6532 19740 Denver-Aurora, CO 31.7836 30.1612 19780 Des Moines-West Des Moines, IA 27.1922 26.2387 19804 Detroit-Livonia-Dearborn, MI 30.7812 29.0851 20020 Dothan, AL 22.2783 21.3349 20100 Dover, DE 30.1094 27.9303 20220 Dubuque, IA 26.6704 24.9867 20260 Duluth, MN-WI 30.2214 28.6977 20500 Durham, NC 28.6941 28.1744 20740 Eau Claire, WI 28.5056 26.1726 20764 Edison, NJ 33.0199 31.3235 20940 El Centro, CA 26.6950 25.1556 21060 Elizabethtown, KY 25.6000 24.4113 21140 Elkhart-Goshen, IN 27.8012 26.4097 21300 Elmira, NY 24.7620 23.3890 21340 El Paso, TX 27.3947 25.6383 21500 Erie, PA 26.1902 24.4869 21604 Essex County, MA 30.8811 29.5200 21660 Eugene-Springfield, OR 32.5163 30.5454 21780 Evansville, IN-KY 26.3862 24.2557 21820 Fairbanks, AK 32.5975 31.2913 21940 Fajardo, PR 11.9787 11.2316 22020 Fargo, ND-MN 24.1964 23.9807 22140 Farmington, NM 24.7543 23.2955 22180 Fayetteville, NC 28.0323 26.3806 22220 Fayetteville-Springdale-Rogers, AR-MO 26.7687 24.6433 22380 Flagstaff, AZ 34.2142 32.1557 22420 Flint, MI 32.0203 30.4255 22500 Florence, SC 25.8070 24.8022 22520 Florence-Muscle Shoals, AL 23.3021 22.4484 22540 Fond du Lac, WI 30.7450 28.0398 22660 Fort Collins-Loveland, CO 27.3774 27.5172 22744 Fort Lauderdale-Pompano Beach-Deerfield Beach, FL 29.6372 28.5403 22900 Fort Smith, AR-OK 23.2765 22.7417 23020 Fort Walton Beach-Crestview-Destin, FL 25.4368 24.4697 23060 Fort Wayne, IN 27.5263 26.9363 23104 Fort Worth-Arlington, TX 28.3363 26.7137 23420 Fresno, CA 32.7702 30.1663 23460 Gadsden, AL 23.9000 22.4775 23540 Gainesville, FL 27.9339 26.4188 23580 Gainesville, GA 27.3618 25.9487 23844 Gary, IN 27.8634 26.2470 24020 Glens Falls, NY 25.5656 24.0003 24140 Goldsboro, NC 27.2105 24.9866 24220 Grand Forks, ND-MN 23.2018 23.1061 24300 Grand Junction, CO 28.6313 27.2192 24340 Grand Rapids-Wyoming, MI 28.3292 26.5178 24500 Great Falls, MT 25.1796 24.5500 24540 Greeley, CO 29.6191 27.1542 24580 Green Bay, WI 28.3855 26.7916 24660 Greensboro-High Point, NC 26.6351 25.4930 24780 Greenville, NC 27.6626 26.0809 24860 Greenville, SC 28.3669 27.1599 25020 Guayama, PR 09.5930 09.6934 25060 Gulfport-Biloxi, MS 25.9410 24.7777 25180 Hagerstown-Martinsburg, MD-WV 27.6180 26.6584 25260 Hanford-Corcoran, CA 31.0985 28.1098 25420 Harrisburg-Carlisle, PA 27.7934 26.1846 25500 Harrisonburg, VA 27.1676 25.7382 25540 Hartford-West Hartford-East Hartford, CT 32.5306 30.9139 25620 Hattiesburg, MS 22.5641 21.0861 25860 Hickory-Lenoir-Morganton, NC 26.6596 25.5863 25980 1 Hinesville-Fort Stewart, GA 26100 Holland-Grand Haven, MI 27.3299 25.9201 Start Printed Page 59971 26180 Honolulu, HI 32.3512 30.9292 26300 Hot Springs, AR 26.1802 25.3280 26380 Houma-Bayou Cane-Thibodaux, A 24.2699 22.1607 26420 Houston-Sugar Land-Baytown, TX 29.9311 28.1062 26580 Huntington-Ashland, WV-KY-OH 26.1762 25.9741 26620 Huntsville, AL 26.5886 25.1724 26820 Idaho Falls, ID 26.7936 25.7310 26900 Indianapolis-Carmel, IN 28.9678 27.7854 26980 Iowa City, IA 28.4615 27.0882 27060 Ithaca, NY 29.2529 27.4683 27100 Jackson, MI 28.8148 26.2508 27140 Jackson, MS 24.3583 23.1899 27180 Jackson, TN 26.0828 24.8971 27260 Jacksonville, FL 27.5221 26.2665 27340 Jacksonville, NC 25.0110 23.3845 27500 Janesville, WI 29.2614 27.1061 27620 Jefferson City, MO 25.5406 23.6903 27740 Johnson City, TN 23.9569 22.6132 27780 Johnstown, PA 25.3896 23.5735 27860 Jonesboro, AR 23.2669 22.3980 27900 Joplin, MO 26.0767 24.3379 28020 Kalamazoo-Portage, MI 32.0173 29.7247 28100 Kankakee-Bradley, IL 29.7142 29.3063 28140 Kansas City, MO-KS 27.7105 26.5218 28420 Kennewick-Richland-Pasco, WA 29.9252 29.0588 28660 Killeen-Temple-Fort Hood, TX 26.6669 24.9921 28700 Kingsport-Bristol-Bristol, TN-VA 24.0550 22.7725 28740 Kingston, NY 27.9971 25.8916 28940 Knoxville, TN 24.3875 23.5673 29020 Kokomo, IN 28.6352 26.4213 29100 La Crosse, WI-MN 28.2928 26.4773 29140 Lafayette, IN 26.0274 24.7635 29180 Lafayette, LA 24.8595 23.4330 29340 Lake Charles, LA 23.4919 22.1092 29404 Lake County-Kenosha County, IL-WI 31.5831 29.4832 29460 Lakeland, FL 26.8539 25.1966 29540 Lancaster, PA 29.3703 27.6048 29620 Lansing-East Lansing, MI 29.8547 27.5157 29700 Laredo, TX 24.3950 23.4077 29740 Las Cruces, NM 27.0271 24.5756 29820 Las Vegas-Paradise, NV 33.0567 31.6630 29940 Lawrence, KS 24.7096 23.8060 30020 Lawton, OK 25.1598 23.0756 30140 Lebanon, PA 25.9645 24.4260 30300 Lewiston, ID-WA 28.6158 26.7504 30340 Lewiston-Auburn, ME 27.3831 26.2777 30460 Lexington-Fayette, KY 26.5828 25.5280 30620 Lima, OH 26.3736 25.5860 30700 Lincoln, NE 29.5529 28.3730 30780 Little Rock-North Little Rock, AR 28.7760 25.6122 30860 Logan, UT-ID 26.8219 25.5447 30980 Longview, TX 26.2133 24.6592 31020 Longview, WA 30.3627 27.9557 31084 Los Angeles-Long Beach-Glendale, CA 34.6534 32.9160 31140 Louisville-Jefferson County, KY-IN 27.1468 25.7437 31180 Lubbock, TX 25.3114 24.3391 31340 Lynchburg, VA 25.5005 24.5752 31420 Macon, GA 29.0544 27.2917 31460 Madera, CA 25.2337 24.0664 31540 Madison, WI 32.1479 29.7320 31700 Manchester-Nashua, NH 30.3021 29.0984 31900 Mansfield, OH 27.3884 26.5027 32420 Mayaguez, PR 11.2889 11.4438 32580 McAllen-Edinburg-Mission, TX 26.0769 24.4574 32780 Medford, OR 31.8958 29.4566 32820 Memphis, TN-MS-AR 27.5968 26.0783 32900 Merced, CA 33.8352 30.8333 33124 Miami-Miami Beach-Kendall, FL 29.1208 27.5124 33140 Michigan City-La Porte, IN 26.7983 25.9329 Start Printed Page 59972 33260 Midland, TX 28.2837 26.5950 33340 Milwaukee-Waukesha-West Allis, WI 30.6139 28.5884 33460 Minneapolis-St. Paul-Bloomington, MN-WI 31.9723 30.6935 33540 Missoula, MT 25.7182 25.7998 33660 Mobile, AL 23.2681 22.1095 33700 Modesto, CA 34.7979 33.3338 33740 Monroe, LA 23.9412 22.3954 33780 Monroe, MI 29.0221 26.8789 33860 Montgomery, AL 23.5234 23.1670 34060 Morgantown, WV 25.3671 24.0418 34100 Morristown, TN 23.6707 22.2354 34580 Mount Vernon-Anacortes, WA 30.3080 29.1509 34620 Muncie, IN 24.7233 24.0903 34740 Muskegon-Norton Shores, MI 29.9638 27.6896 34820 Myrtle Beach-Conway-North Myrtle Beach, SC 26.3388 25.0344 34900 Napa, CA 38.3501 35.6146 34940 Naples-Marco Island, FL 29.9690 28.7171 34980 Nashville-Davidson—Murfreesboro, TN 29.0906 27.7029 35004 Nassau-Suffolk, NY 38.4620 36.1106 35084 Newark-Union, NJ-PA 34.8610 32.9825 35300 New Haven-Milford, CT 35.7841 33.4729 35380 New Orleans-Metairie-Kenner, LA 25.6466 24.9412 35644 New York-White Plains-Wayne, NY-NJ 39.5688 37.2163 35660 Niles-Benton Harbor, MI 26.4739 24.9201 35980 Norwich-New London, CT 35.6505 32.7603 36084 Oakland-Fremont-Hayward, CA 45.7373 43.0139 36100 Ocala, FL 25.5292 24.9445 36140 Ocean City, NJ 31.2907 30.2391 36220 Odessa, TX 29.7647 27.8892 36260 Ogden-Clearfield, UT 26.8970 25.5070 36420 Oklahoma City, OK 26.1146 25.0678 36500 Olympia, WA 32.5051 30.7166 36540 Omaha-Council Bluffs, NE-IA 27.8702 26.7732 36740 Orlando-Kissimmee, FL 28.3934 26.8763 36780 Oshkosh-Neenah, WI 27.0950 25.5269 36980 Owensboro, KY 26.0440 24.2668 37100 Oxnard-Thousand Oaks-Ventura, CA 32.9949 31.6529 37340 Palm Bay-Melbourne-Titusville, FL 28.3087 27.1499 37460 Panama City-Lynn Haven, FL 24.2006 22.7018 37620 Parkersburg-Marietta-Vienna, WV-OH 24.0592 23.0883 37700 Pascagoula, MS 24.1489 22.7120 37860 Pensacola-Ferry Pass-Brent, FL 23.3305 22.6237 37900 Peoria, IL 27.0600 25.0857 37964 Philadelphia, PA 32.6068 30.7383 38060 Phoenix-Mesa-Scottsdale, AZ 30.0869 28.3131 38220 Pine Bluff, AR 25.8491 24.4087 38300 Pittsburgh, PA 25.4077 24.3788 38340 Pittsfield, MA 30.4071 28.8423 38540 Pocatello, ID 27.2195 26.2270 38660 Ponce, PR 13.9714 13.6681 38860 Portland-South Portland-Biddeford, ME 29.2449 28.2990 38900 Portland-Vancouver-Beaverton, OR-WA 33.2416 31.5854 38940 Port St. Lucie-Fort Pierce, FL 29.2554 28.0826 39100 Poughkeepsie-Newburgh-Middletown, NY 32.5172 31.0301 39140 Prescott, AZ 28.9051 27.6147 39300 Providence-New Bedford-Fall River, RI-MA 31.8595 30.4800 39340 Provo-Orem, UT 28.1069 26.6360 39380 Pueblo, CO 25.7454 24.3382 39460 Punta Gorda, FL 28.8128 26.5824 39540 Racine, WI 28.1129 25.7619 39580 Raleigh-Cary, NC 28.8272 27.4767 39660 Rapid City, SD 25.8230 24.8711 39740 Reading, PA 28.7892 26.7877 39820 Redding, CA 36.9179 33.9636 39900 Reno-Sparks, NV 35.9585 31.3496 40060 Richmond, VA 26.6797 25.8302 40140 Riverside-San Bernardino-Ontario, CA 31.7977 30.5874 40220 Roanoke, VA 26.1048 23.9632 40340 Rochester, MN 33.3258 31.5976 Start Printed Page 59973 40380 Rochester, NY 26.9944 25.6945 40420 Rockford, IL 29.7962 27.7018 40484 Rockingham County-Strafford County, NH 30.0121 28.7106 40580 Rocky Mount, NC 26.3907 25.0513 40660 Rome, GA 28.7614 26.1851 40900 Sacramento—Arden-Arcade—Roseville, CA 38.5069 35.3185 40980 Saginaw-Saginaw Township North, MI 27.3125 26.3003 41060 St. Cloud, MN 32.7028 29.2101 41100 St. George, UT 28.0291 26.5758 41140 St. Joseph, MO-KS 30.3440 28.0336 41180 St. Louis, MO-IL 26.6812 25.2397 41420 Salem, OR 30.4906 29.2331 41500 Salinas, CA 42.1655 39.2218 41540 Salisbury, MD 26.2842 25.2167 41620 Salt Lake City, UT 28.0986 26.6060 41660 San Angelo, TX 25.1540 23.3032 41700 San Antonio, TX 26.5240 25.1675 41740 San Diego-Carlsbad-San Marcos, CA 32.9130 31.5806 41780 Sandusky, OH 27.4533 25.4522 41884 San Francisco-San Mateo-Redwood City, CA 45.7224 42.2326 41900 San German-Cabo Rojo, PR 14.3995 13.6919 41940 San Jose-Sunnyvale-Santa Clara, CA 45.4409 42.2101 41980 San Juan-Caguas-Guaynabo, PR 13.1933 12.8054 42020 San Luis Obispo-Paso Robles, CA 33.0896 31.3414 42044 Santa Ana-Anaheim-Irvine, CA 33.6565 32.2329 42060 Santa Barbara-Santa Maria, CA 32.1995 31.1050 42100 Santa Cruz-Watsonville, CA 44.6455 42.0789 42140 Santa Fe, NM 32.0477 30.4670 42220 Santa Rosa-Petaluma, CA 42.4689 38.0360 42260 Sarasota-Bradenton-Venice, FL 28.8918 27.0657 42340 Savannah, GA 27.1003 26.2037 42540 Scranton—Wilkes-Barre, PA 24.5216 23.6058 42644 Seattle-Bellevue-Everett, WA 33.3915 32.0468 42680 Sebastian-Vero Beach, FL 29.3162 26.9491 43100 Sheboygan, WI 27.0944 25.2780 43300 Sherman-Denison, TX 25.6518 25.8894 43340 Shreveport-Bossier City, LA 26.2370 24.9393 43580 Sioux City, IA-NE-SD 26.8716 25.6458 43620 Sioux Falls, SD 27.7271 26.5164 43780 South Bend-Mishawaka, IN-MI 29.3973 27.1692 43900 Spartanburg, SC 26.7923 25.8987 44060 Spokane, WA 30.9034 29.8263 44100 Springfield, IL 26.5425 24.6316 44140 Springfield, MA 30.1291 28.5979 44180 Springfield, MO 25.4111 23.7305 44220 Springfield, OH 25.1686 23.9321 44300 State College, PA 25.6643 23.7164 44700 Stockton, CA 34.0233 31.2391 44940 Sumter, SC 24.7899 23.6087 45060 Syracuse, NY 28.9876 26.9574 45104 Tacoma, WA 31.7596 30.3791 45220 Tallahassee, FL 26.5663 24.5843 45300 Tampa-St. Petersburg-Clearwater, FL 27.2772 25.7846 45460 Terre Haute, IN 26.1137 23.7180 45500 Texarkana, TX-Texarkana, AR 24.0237 23.1611 45780 Toledo, OH 28.0359 26.6301 45820 Topeka, KS 25.9836 24.8278 45940 Trenton-Ewing, NJ 32.3220 29.9814 46060 Tucson, AZ 27.8441 25.6497 46140 Tulsa, OK 24.6404 23.8913 46220 Tuscaloosa, AL 25.9777 24.0371 46340 Tyler, TX 26.4318 25.7626 46540 Utica-Rome, NY 25.9564 23.7574 46660 Valdosta, GA 25.1934 24.0205 46700 Vallejo-Fairfield, CA 43.8674 41.4044 47020 Victoria, TX 24.9845 23.3071 47220 Vineland-Millville-Bridgeton, NJ 30.7865 28.7657 47260 Virginia Beach-Norfolk-Newport News, VA-NC 26.0160 24.7890 47300 Visalia-Porterville, CA 29.9158 28.2959 Start Printed Page 59974 47380 Waco, TX 25.9394 23.7524 47580 Warner Robins, GA 26.1288 24.3113 47644 Warren-Troy-Farmington Hills, MI 29.9724 28.0999 47894 Washington-Arlington-Alexandria, DC-VA-MD-WV 32.5489 30.7238 47940 Waterloo-Cedar Falls, IA 25.4836 24.1398 48140 Wausau, WI 29.4678 27.3375 48260 Weirton-Steubenville, WV-OH 23.8928 22.5021 48300 Wenatchee, WA 30.1956 27.5727 48424 West Palm Beach-Boca Raton-Boynton Beach, FL 28.2754 27.8801 48540 Wheeling, WV-OH 21.0012 20.2153 48620 Wichita, KS 26.7361 25.7825 48660 Wichita Falls, TX 25.3878 23.5588 48700 Williamsport, PA 23.9343 23.1797 48864 Wilmington, DE-MD-NJ 31.3445 30.0596 48900 Wilmington, NC 28.9725 26.7451 49020 Winchester, VA-WV 29.8215 28.6809 49180 Winston-Salem, NC 27.4181 25.7927 49340 Worcester, MA 32.0147 30.6187 49420 Yakima, WA 29.1309 28.2366 49500 Yauco, PR 11.1812 11.8242 49620 York-Hanover, PA 28.1586 26.1713 49660 Youngstown-Warren-Boardman, OH-PA 26.0913 24.8348 49700 Yuba City, CA 31.2174 29.7427 49740 Yuma, AZ 27.0111 25.4677 1 This area has no average hourly wage because there are no short-term, acute care hospitals in the area. Table 3B.—FY 2007 and 3-Year* Average Hourly Wage for Rural Areas by CBSA
[*Based on the sum of the salaries and hours computed for federal FYs 2005, 2006, and 2007.]
CBSA code Nonurban area FY 2007 average hourly wage 3-Year average hourly wage 01 Alabama 22.7266 21.2362 02 Alaska 31.7349 32.0692 03 Arizona 26.8924 25.0201 04 Arkansas 22.1322 20.8590 05 California 33.2165 30.4210 06 Colorado 26.9566 25.9101 07 Connecticut 35.5471 33.2841 08 Delaware 29.2141 27.0822 10 Florida 25.8957 24.2399 11 Georgia 23.2040 21.7117 12 Hawaii 31.5122 29.7080 13 Idaho 23.7761 22.5379 14 Illinois 24.7833 23.2471 15 Indiana 25.3962 24.0538 16 Iowa 25.5462 23.7246 17 Kansas 23.7576 22.4610 18 Kentucky 23.1433 21.7879 19 Louisiana 22.7152 20.9287 20 Maine 24.8875 24.4422 21 Maryland 26.3358 25.6324 22 Massachusetts 1 23 Michigan 26.7707 24.8965 24 Minnesota 27.2664 25.6919 25 Mississippi 23.1173 21.5916 26 Missouri 24.0814 22.2178 27 Montana 25.6649 24.3121 28 Nebraska 25.6086 24.5327 29 Nevada 27.2229 25.6122 30 New Hampshire 32.3754 29.3617 31 New Jersey 1 32 New Mexico 24.8330 24.0136 33 New York 24.7417 23.0382 34 North Carolina 25.5870 24.0377 35 North Dakota 21.8478 20.8336 36 Ohio 25.7486 24.4334 Start Printed Page 59975 37 Oklahoma 23.2698 21.6211 38 Oregon 28.8316 27.3621 39 Pennsylvania 24.6146 23.2486 40 Puerto Rico 1 41 Rhode Island 1 42 South Carolina 25.7744 24.3480 43 South Dakota 24.6052 23.4919 44 Tennessee 23.8699 22.2751 45 Texas 24.3889 22.6173 46 Utah 24.4689 22.9744 47 Vermont 28.5315 26.6381 49 Virginia 24.0216 22.5475 50 Washington 30.2634 28.7978 51 West Virginia 22.9916 21.8032 52 Wisconsin 28.4880 26.5687 53 Wyoming 26.8294 25.5743 1 All counties in the State or Territory are classified as urban, with the exception of Massachusetts. Massachusetts has area(s) designated as rural. However, no short-term, acute care hospitals are located in the area(s) for FY 2007. Table 4A-1.—Wage Index And Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA
CBSA code Urban area (constituent counties) Wage index GAF 10180 Abilene, TX 0.8380 0.8860 Callahan County, TX Jones County, TX Taylor County, TX 10380 Aguadilla-Isabela-San Sebastián, PR 0.3815 0.5169 Aguada Municipio, PR Aguadilla Municipio, PR Añasco Municipio, PR Isabela Municipio, PR Lares Municipio, PR Moca Municipio, PR Rinc≤n Municipio, PR San Sebastián Municipio 10420 2 Akron, OH 0.8683 0.9078 Portage County, OH Summit County, OH 10500 Albany, GA 0.9056 0.9344 Baker County, GA Dougherty County, GA Lee County, GA Terrell County, GA Worth County, GA 10580 Albany-Schenectady-Troy, NY 0.8849 0.9197 Albany County, NY Rensselaer County, NY Saratoga County, NY Schenectady County, NY Schoharie County, NY 10740 Albuquerque, NM 0.9564 0.9699 Bernalillo County, NM Sandoval County, NM Torrance County, NM Valencia County, NM 10780 Alexandria, LA 0.7961 0.8554 Grant Parish, LA Rapides Parish, LA 10900 Allentown-Bethlehem-Easton, PA-NJ (PA Hospitals) 1.0093 1.0064 Warren County, NJ Carbon County, PA Lehigh County, PA Northampton County, PA 10900 2 Allentown-Bethlehem-Easton, PA-NJ (NJ Hospitals) 1.1402 1.0940 Warren County, NJ Carbon County, PA Start Printed Page 59976 Lehigh County, PA Northampton County, PA 11020 Altoona, PA 0.8538 0.8974 Blair County, PA 11100 Amarillo, TX 0.9248 0.9479 Armstrong County, TX Carson County, TX Potter County, TX Randall County, TX 11180 Ames, IA 0.9705 0.9797 Story County, IA 11260 3 Anchorage, AK 1.1904 1.1268 Anchorage Municipality, AK Matanuska-Susitna Borough, AK 11300 Anderson, IN 0.8820 0.9176 Madison County, IN 11340 Anderson, SC 0.8919 0.9246 Anderson County, SC 11460 3 Ann Arbor, MI 1.0678 1.0459 Washtenaw County, MI 11500 Anniston-Oxford, AL 0.7997 0.8581 Calhoun County, AL 11540 2 Appleton, WI 0.9607 0.9729 Calumet County, WI Outagamie County, WI 11700 Asheville, NC 0.9264 0.9490 Buncombe County, NC Haywood County, NC Henderson County, NC Madison County, NC 12020 Athens-Clarke County, GA 0.9456 0.9624 Clarke County, GA Madison County, GA Oconee County, GA Oglethorpe County, GA 12060 1 Atlanta-Sandy Springs-Marietta, GA 0.9793 0.9858 Barrow County, GA Bartow County, GA Butts County, GA Carroll County, GA Cherokee County, GA Clayton County, GA Cobb County, GA Coweta County, GA Dawson County, GA DeKalb County, GA Douglas County, GA Fayette County, GA Forsyth County, GA Fulton County, GA Gwinnett County, GA Haralson County, GA Heard County, GA Henry County, GA Jasper County, GA Lamar County, GA Meriwether County, GA Newton County, GA Paulding County, GA Pickens County, GA Pike County, GA Rockdale County, GA Spalding County, GA Walton County, GA 12100 Atlantic City, NJ 1.1692 1.1130 Atlantic County, NJ 12220 Auburn-Opelika, AL 0.8060 0.8627 Lee County, AL 12260 Augusta-Richmond County, GA-SC 0.9640 0.9752 Burke County, GA Start Printed Page 59977 Columbia County, GA McDuffie County, GA Richmond County, GA Aiken County, SC Edgefield County, SC 12420 1 Austin-Round Rock, TX 0.9328 0.9535 Bastrop County, TX Caldwell County, TX Hays County, TX Travis County, TX Williamson County, TX 12540 2 Bakersfield, CA 1.1202 1.0808 Kern County, CA 12580 1 Baltimore-Towson, MD 0.9922 0.9947 Anne Arundel County, MD Baltimore County, MD Carroll County, MD Harford County, MD Howard County, MD Queen Anne's County, MD Baltimore City, MD 12620 Bangor, ME 0.9612 0.9733 Penobscot County, ME 12700 Barnstable Town, MA 1.2589 1.1708 Barnstable County, MA 12940 Baton Rouge, LA 0.8085 0.8645 Ascension Parish, LA East Baton Rouge Parish, LA East Feliciana Parish, LA Iberville Parish, LA Livingston Parish, LA Pointe Coupee Parish, LA St. Helena Parish, LA West Baton Rouge Parish, LA West Feliciana Parish, LA 12980 Battle Creek, MI 0.9666 0.9770 Calhoun County, MI 13020 3 Bay City, MI 1.0080 1.0055 Bay County, MI 13140 Beaumont-Port Arthur, TX 0.8710 0.9098 Hardin County, TX Jefferson County, TX Orange County, TX 13380 Bellingham, WA 1.0941 1.0635 Whatcom County, WA 13460 Bend, OR 1.0483 1.0328 Deschutes County, OR 13644 1 Bethesda-Gaithersburg-Frederick, MD 1.0848 1.0573 Frederick County, MD Montgomery County, MD 13740 Billings, MT 0.8956 0.9273 Carbon County, MT Yellowstone County, MT 13780 Binghamton, NY 0.8963 0.9278 Broome County, NY Tioga County, NY 13820 1 Birmingham-Hoover, AL 0.8889 0.9225 Bibb County, AL Blount County, AL Chilton County, AL Jefferson County, AL St. Clair County, AL Shelby County, AL Walker County, AL 13900 2,3 Bismarck, ND 0.7368 0.8113 Burleigh County, ND Morton County, ND 13980 Blacksburg-Christiansburg-Radford, VA 0.8214 0.8740 Giles County, VA Montgomery County, VA Start Printed Page 59978 Pulaski County, VA Radford City, VA 14020 Bloomington, IN 0.8959 0.9275 Greene County, IN Monroe County, IN Owen County, IN 14060 Bloomington-Normal, IL 0.9140 0.9403 McLean County, IL 14260 Boise City-Nampa, ID 0.9445 0.9617 Ada County, ID Boise County, ID Canyon County, ID Gem County, ID Owyhee County, ID 14484 1 Boston-Quincy, MA 1.1765 1.1177 Norfolk County, MA Plymouth County, MA Suffolk County, MA 14500 Boulder, CO 1.0081 1.0055 Boulder County, CO 14540 Bowling Green, KY 0.8082 0.8643 Edmonson County, KY Warren County, KY 14740 Bremerton-Silverdale, WA 1.0867 1.0586 Kitsap County, WA 14860 Bridgeport-Stamford-Norwalk, CT 1.2746 1.1808 Fairfield County, CT 15180 Brownsville-Harlingen, TX 0.9731 0.9815 Cameron County, TX 15260 Brunswick, GA 1.0478 1.0325 Brantley County, GA Glynn County, GA McIntosh County, GA 15380 1 Buffalo-Niagara Falls, NY 0.9475 0.9637 Erie County, NY Niagara County, NY 15500 2 Burlington, NC 0.8629 0.9040 Alamance County, NC 15540 2 Burlington-South Burlington, VT 0.9622 0.9740 Chittenden County, VT Franklin County, VT Grand Isle County, VT 15764 1 Cambridge-Newton-Framingham, MA 1.1003 1.0676 Middlesex County, MA 15804 1,2 Camden, NJ 1.1402 1.0940 Burlington County, NJ Camden County, NJ Gloucester County, NJ 15940 Canton-Massillon, OH 0.9048 0.9338 Carroll County, OH Stark County, OH 15980 Cape Coral-Fort Myers, FL 0.9460 0.9627 Lee County, FL 16180 Carson City, NV 0.9903 0.9933 Carson City, NV 16220 2,3 Casper, WY 0.9199 0.9444 Natrona County, WY 16300 2,3 Cedar Rapids, IA 0.8803 0.9164 Benton County, IA Jones County, IA Linn County, IA 16580 Champaign-Urbana, IL 0.9582 0.9712 Champaign County, IL Ford County, IL Piatt County, IL 16620 Charleston, WV 0.8687 0.9081 Boone County, WV Clay County, WV Kanawha County, WV Lincoln County, WV Start Printed Page 59979 Putnam County, WV 16700 Charleston-North Charleston, SC 0.9197 0.9443 Berkeley County, SC Charleston County, SC Dorchester County, SC 16740 1 Charlotte-Gastonia-Concord, NC-SC 0.9413 0.9594 Anson County, NC Cabarrus County, NC Gaston County, NC Mecklenburg County, NC Union County, NC York County, SC 16820 Charlottesville, VA 1.0039 1.0027 Albemarle County, VA Fluvanna County, VA Greene County, VA Nelson County, VA Charlottesville City, VA 16860 Chattanooga, TN-GA 0.8948 0.9267 Catoosa County, GA Dade County, GA Walker County, GA Hamilton County, TN Marion County, TN Sequatchie County, TN 16940 2,3 Cheyenne, WY 0.9199 0.9444 Laramie County, WY 16974 1 Chicago-Naperville-Joliet, IL 1.0670 1.0454 Cook County, IL DeKalb County, IL DuPage County, IL Grundy County, IL Kane County, IL Kendall County, IL McHenry County, IL Will County, IL 17020 2 Chico, CA 1.1202 1.0808 Butte County, CA 17140 1 Cincinnati-Middletown, OH-KY-IN 0.9522 0.9670 Dearborn County, IN Franklin County, IN Ohio County, IN Boone County, KY Bracken County, KY Campbell County, KY Gallatin County, KY Grant County, KY Kenton County, KY Pendleton County, KY Brown County, OH Butler County, OH Clermont County, OH Hamilton County, OH Warren County, OH 17300 Clarksville, TN-KY 0.8420 0.8889 Christian County, KY Trigg County, KY Montgomery County, TN Stewart County, TN 17420 Cleveland, TN 0.8222 0.8745 Bradley County, TN Polk County, TN 17460 1 Cleveland-Elyria-Mentor, OH 0.9396 0.9582 Cuyahoga County, OH Geauga County, OH Lake County, OH Lorain County, OH Medina County, OH 17660 Coeur d'Alene, ID 0.9227 0.9464 Kootenai County, ID Start Printed Page 59980 17780 College Station-Bryan, TX 0.8903 0.9235 Brazos County, TX Burleson County, TX Robertson County, TX 17820 Colorado Springs, CO 0.9475 0.9637 El Paso County, CO Teller County, CO 17860 Columbia, MO 0.8456 0.8915 Boone County, MO Howard County, MO 17900 Columbia, SC 0.8942 0.9263 Calhoun County, SC Fairfield County, SC Kershaw County, SC Lexington County, SC Richland County, SC Saluda County, SC 17980 Columbus, GA-AL 0.8530 0.8968 Russell County, AL Chattahoochee County, GA Harris County, GA Marion County, GA Muscogee County, GA 18020 Columbus, IN 0.9445 0.9617 Bartholomew County, IN 18140 1 Columbus, OH 1.0076 1.0052 Delaware County, OH Fairfield County, OH Franklin County, OH Licking County, OH Madison County, OH Morrow County, OH Pickaway County, OH Union County, OH 18580 Corpus Christi, TX 0.8438 0.8902 Aransas County, TX Nueces County, TX San Patricio County, TX 18700 Corvallis, OR 1.1334 1.0895 Benton County, OR 19060 2 Cumberland, MD-WV (MD Hospitals) 0.8881 0.9219 Allegany County, MD Mineral County, WV 19060 Cumberland, MD-WV (WV Hospitals) 0.8151 0.8694 Allegany County, MD Mineral County, WV 19124 1 Dallas-Plano-Irving, TX 0.9977 0.9984 Collin County, TX Dallas County, TX Delta County, TX Denton County, TX Ellis County, TX Hunt County, TX Kaufman County, TX Rockwall County, TX 19140 Dalton, GA 0.8955 0.9272 Murray County, GA Whitfield County, GA 19180 Danville, IL 0.9554 0.9692 Vermilion County, IL 19260 Danville, VA 0.8499 0.8946 Pittsylvania County, VA Danville City, VA 19340 Davenport-Moline-Rock Island, IA-IL 0.8836 0.9187 Henry County, IL Mercer County, IL Rock Island County, IL Scott County, IA 19380 Dayton, OH 0.9185 0.9434 Greene County, OH Start Printed Page 59981 Miami County, OH Montgomery County, OH Preble County, OH 19460 Decatur, AL 0.8065 0.8631 Lawrence County, AL Morgan County, AL 19500 2 Decatur, IL 0.8358 0.8844 Macon County, IL 19660 Deltona-Daytona Beach-Ormond Beach, FL 0.9203 0.9447 Volusia County, FL 19740 1 Denver-Aurora, CO 1.0719 1.0487 Adams County, CO Arapahoe County, CO Broomfield County, CO Clear Creek County, CO Denver County, CO Douglas County, CO Elbert County, CO Gilpin County, CO Jefferson County, CO Park County, CO 19780 Des Moines-West Des Moines, IA 0.9170 0.9424 Dallas County, IA Guthrie County, IA Madison County, IA Polk County, IA Warren County, IA 19804 1,3 Detroit-Livonia-Dearborn, MI 1.0381 1.0259 Wayne County, MI 20020 Dothan, AL 0.7664 0.8334 Geneva County, AL Henry County, AL Houston County, AL 20100 Dover, DE 1.0154 1.0105 Kent County, DE 20220 Dubuque, IA 0.8994 0.9300 Dubuque County, IA 20260 Duluth, MN-WI 1.0285 1.0194 Carlton County, MN St. Louis County, MN Douglas County, WI 20500 Durham, NC 0.9677 0.9778 Chatham County, NC Durham County, NC Orange County, NC Person County, NC 20740 Eau Claire, WI 0.9613 0.9733 Chippewa County, WI Eau Claire County, WI 20764 1,2 Edison, NJ 1.1402 1.0940 Middlesex County, NJ Monmouth County, NJ Ocean County, NJ Somerset County, NJ 20940 2 El Centro, CA 1.1202 1.0808 Imperial County, CA 21060 Elizabethtown, KY 0.8633 0.9042 Hardin County, KY Larue County, KY 21140 Elkhart-Goshen, IN 0.9376 0.9568 Elkhart County, IN 21300 2 Elmira, NY 0.8430 0.8896 Chemung County, NY 21340 El Paso, TX 0.9238 0.9472 El Paso County, TX 21500 Erie, PA 0.8832 0.9185 Erie County, PA 21604 2 Essex County, MA 1.0757 1.0512 Essex County, MA 21660 3 Eugene-Springfield, OR 1.0966 1.0652 Start Printed Page 59982 Lane County, OR 21780 Evansville, IN-KY 0.8898 0.9232 Gibson County, IN Posey County, IN Vanderburgh County, IN Warrick County, IN Henderson County, KY Webster County, KY 21820 Fairbanks, AK 1.0993 1.0670 Fairbanks North Star Borough, AK 21940 Fajardo, PR 0.4040 0.5376 Ceiba Municipio, PR Fajardo Municipio, PR Luquillo Municipio, PR 22020 3 Fargo, ND-MN (ND Hospitals) 0.8367 0.8851 Clay County, MN Cass County, ND 22020 2,3 Fargo, ND-MN (MN Hospitals) 0.9195 0.9441 Clay County, MN Cass County, ND 22140 2 Farmington, NM 0.8375 0.8856 San Juan County, NM 22180 Fayetteville, NC 0.9453 0.9622 Cumberland County, NC Hoke County, NC 22220 Fayetteville-Springdale-Rogers, AR-MO 0.9027 0.9323 Benton County, AR Madison County, AR Washington County, AR McDonald County, MO 22380 Flagstaff, AZ 1.1538 1.1029 Coconino County, AZ 22420 Flint, MI 1.0798 1.0540 Genesee County, MI 22500 Florence, SC 0.8703 0.9093 Darlington County, SC Florence County, SC 22520 Florence-Muscle Shoals, AL 0.7876 0.8492 Colbert County, AL Lauderdale County, AL 22540 Fond du Lac, WI 1.0368 1.0251 Fond du Lac County, WI 22660 Fort Collins-Loveland, CO 0.9233 0.9468 Larimer County, CO 22744 1 Fort Lauderdale-Pompano Beach-Deerfield Beach, FL 1.0320 1.0218 Broward County, FL 22900 Fort Smith, AR-OK 0.7850 0.8472 Crawford County, AR Franklin County, AR Sebastian County, AR Le Flore County, OK Sequoyah County, OK 23020 2 Fort Walton Beach-Crestview-Destin, FL 0.8733 0.9114 Okaloosa County, FL 23060 Fort Wayne, IN 0.9283 0.9503 Allen County, IN Wells County, IN Whitley County, IN 23104 1 Fort Worth-Arlington, TX 0.9556 0.9694 Johnson County, TX Parker County, TX Tarrant County, TX Wise County, TX 23420 2 Fresno, CA 1.1202 1.0808 Fresno County, CA 23460 Gadsden, AL 0.8060 0.8627 Etowah County, AL 23540 Gainesville, FL 0.9420 0.9599 Alachua County, FL Gilchrist County, FL Start Printed Page 59983 23580 Gainesville, GA 0.9227 0.9464 Hall County, GA 23844 Gary, IN 0.9397 0.9583 Jasper County, IN Lake County, IN Newton County, IN Porter County, IN 24020 Glens Falls, NY 0.8622 0.9035 Warren County, NY Washington County, NY 24140 Goldsboro, NC 0.9176 0.9428 Wayne County, NC 24220 3 Grand Forks, ND-MN (ND Hospitals) 0.7824 0.8453 Polk County, MN Grand Forks County, ND 24220 2,3 Grand Forks, ND-MN (MN Hospitals) 0.9195 0.9441 Polk County, MN Grand Forks County, ND 24300 3 Grand Junction, CO 0.9655 0.9762 Mesa County, CO 24340 Grand Rapids-Wyoming, MI 0.9554 0.9692 Barry County, MI Ionia County, MI Kent County, MI Newaygo County, MI 24500 Great Falls, MT 0.8747 0.9124 Cascade County, MT 24540 Greeley, CO 0.9989 0.9992 Weld County, CO 24580 2 Green Bay, WI 0.9607 0.9729 Brown County, WI Kewaunee County, WI Oconto County, WI 24660 Greensboro-High Point, NC 0.8982 0.9291 Guilford County, NC Randolph County, NC Rockingham County, NC 24780 Greenville, NC 0.9329 0.9535 Greene County, NC Pitt County, NC 24860 Greenville, SC 0.9566 0.9701 Greenville County, SC Laurens County, SC Pickens County, SC 25020 Guayama, PR 0.3235 0.4617 Arroyo Municipio, PR Guayama Municipio, PR Patillas Municipio, PR 25060 Gulfport-Biloxi, MS 0.8748 0.9125 Hancock County, MS Harrison County, MS Stone County, MS 25180 Hagerstown-Martinsburg, MD-WV 0.9314 0.9525 Washington County, MD Berkeley County, WV Morgan County, WV 25260 2 Hanford-Corcoran, CA 1.1202 1.0808 Kings County, CA 25420 Harrisburg-Carlisle, PA 0.9373 0.9566 Cumberland County, PA Dauphin County, PA Perry County, PA 25500 Harrisonburg, VA 0.9162 0.9418 Rockingham County, VA Harrisonburg City, VA 25540 1,2 Hartford-West Hartford-East Hartford, CT 1.1988 1.1322 Hartford County, CT Litchfield County, CT Middlesex County, CT Tolland County, CT Start Printed Page 59984 25620 2 Hattiesburg, MS 0.7796 0.8432 Forrest County, MS Lamar County, MS Perry County, MS 25860 Hickory-Lenoir-Morganton, NC 0.8991 0.9298 Alexander County, NC Burke County, NC Caldwell County, NC Catawba County, NC 25980 Hinesville-Fort Stewart, GA 0.7825 0.8454 Liberty County, GA Long County, GA 26100 Holland-Grand Haven, MI 0.9217 0.9457 Ottawa County, MI 26180 Honolulu, HI 1.0911 1.0615 Honolulu County, HI 26300 Hot Springs, AR 0.8829 0.9182 Garland County, AR 26380 Houma-Bayou Cane-Thibodaux, LA 0.8185 0.8718 Lafourche Parish, LA Terrebonne Parish, LA 26420 1 Houston-Sugar Land-Baytown, TX 1.0094 1.0064 Austin County, TX Brazoria County, TX Chambers County, TX Fort Bend County, TX Galveston County, TX Harris County, TX Liberty County, TX Montgomery County, TX San Jacinto County, TX Waller County, TX 26580 Huntington-Ashland, WV-KY-OH 0.8828 0.9182 Boyd County, KY Greenup County, KY Lawrence County, OH Cabell County, WV Wayne County, WV 26620 Huntsville, AL 0.8967 0.9281 Limestone County, AL Madison County, AL 26820 3 Idaho Falls, ID 0.9036 0.9329 Bonneville County, ID Jefferson County, ID 26900 1 Indianapolis-Carmel, IN 0.9769 0.9841 Boone County, IN Brown County, IN Hamilton County, IN Hancock County, IN Hendricks County, IN Johnson County, IN Marion County, IN Morgan County, IN Putnam County, IN Shelby County, IN 26980 Iowa City, IA 0.9598 0.9723 Johnson County, IA Washington County, IA 27060 Ithaca, NY 0.9865 0.9907 Tompkins County, NY 27100 Jackson, MI 0.9717 0.9805 Jackson County, MI 27140 Jackson, MS 0.8214 0.8740 Copiah County, MS Hinds County, MS Madison County, MS Rankin County, MS Simpson County, MS 27180 Jackson, TN 0.8796 0.9159 Chester County, TN Start Printed Page 59985 Madison County, TN 27260 1 Jacksonville, FL 0.9281 0.9502 Baker County, FL Clay County, FL Duval County, FL Nassau County, FL St. Johns County, FL 27340 2 Jacksonville, NC 0.8629 0.9040 Onslow County, NC 27500 Janesville, WI 0.9868 0.9909 Rock County, WI 27620 Jefferson City, MO 0.8613 0.9028 Callaway County, MO Cole County, MO Moniteau County, MO Osage County, MO 27740 2 Johnson City, TN 0.8122 0.8672 Carter County, TN Unicoi County, TN Washington County, TN 27780 Johnstown, PA 0.8562 0.8991 Cambria County, PA 27860 Jonesboro, AR 0.8345 0.8835 Craighead County, AR Poinsett County, AR 27900 Joplin, MO 0.8794 0.9158 Jasper County, MO Newton County, MO 28020 Kalamazoo-Portage, MI 1.0797 1.0539 Kalamazoo County, MI Van Buren County, MI 28100 Kankakee-Bradley, IL 1.0021 1.0014 Kankakee County, IL 28140 1 Kansas City, MO-KS 0.9345 0.9547 Franklin County, KS Johnson County, KS Leavenworth County, KS Linn County, KS Miami County, KS Wyandotte County, KS Bates County, MO Caldwell County, MO Cass County, MO Clay County, MO Clinton County, MO Jackson County, MO Lafayette County, MO Platte County, MO Ray County, MO 28420 2 Kennewick-Richland-Pasco, WA 1.0206 1.0141 Benton County, WA Franklin County, WA 28660 Killeen-Temple-Fort Hood, TX 0.8993 0.9299 Bell County, TX Coryell County, TX Lampasas County, TX 28700 Kingsport-Bristol-Bristol, TN-VA 0.8215 0.8740 Hawkins County, TN Sullivan County, TN Bristol City, VA Scott County, VA Washington County, VA 28740 Kingston, NY 0.9442 0.9614 Ulster County, NY 28940 Knoxville, TN 0.8227 0.8749 Anderson County, TN Blount County, TN Knox County, TN Loudon County, TN Union County, TN Start Printed Page 59986 29020 Kokomo, IN 0.9657 0.9764 Howard County, IN Tipton County, IN 29100 2 La Crosse, WI-MN (WI Hospitals) 0.9607 0.9683 Houston County, MN La Crosse County, WI 29100 La Crosse, WI-MN (MN Hospitals) 0.9541 0.9729 Houston County, MN La Crosse County, WI 29140 Lafayette, IN 0.8777 0.9145 Benton County, IN Carroll County, IN Tippecanoe County, IN 29180 Lafayette, LA 0.8408 0.8880 Lafayette Parish, LA St. Martin Parish, LA 29340 Lake Charles, LA 0.7922 0.8526 Calcasieu Parish, LA Cameron Parish, LA 29404 Lake County-Kenosha County, IL-WI 1.0651 1.0441 Lake County, IL Kenosha County, WI 29460 Lakeland, FL 0.9056 0.9344 Polk County, FL 29540 Lancaster, PA 0.9942 0.9960 Lancaster County, PA 29620 Lansing-East Lansing, MI 1.0068 1.0047 Clinton County, MI Eaton County, MI Ingham County, MI 29700 Laredo, TX 0.8227 0.8749 Webb County, TX 29740 Las Cruces, NM 0.9124 0.9391 Dona Ana County, NM 29820 1 Las Vegas-Paradise, NV 1.1148 1.0773 Clark County, NV 29940 Lawrence, KS 0.8333 0.8826 Douglas County, KS 30020 Lawton, OK 8485 0.8936 Comanche County, OK 0. 30140 Lebanon, PA 0.8756 0.9130 Lebanon County, PA 30300 Lewiston, ID-WA (ID Hospitals) 0.9650 0.9759 Nez Perce County, ID Asotin County, WA 30300 2 Lewiston, ID-WA (WA Hospitals) 1.0206 1.0141 Nez Perce County, ID Asotin County, WA 30340 Lewiston-Auburn, ME 0.9235 0.9470 Androscoggin County, ME 30460 Lexington-Fayette, KY 0.8965 0.9279 Bourbon County, KY Clark County, KY Fayette County, KY Jessamine County, KY Scott County, KY Woodford County, KY 30620 Lima, OH 0.8925 0.9251 Allen County, OH 30700 Lincoln, NE 0.9966 0.9977 Lancaster County, NE Seward County, NE 30780 Little Rock-North Little Rock, AR 0.9704 0.9796 Faulkner County, AR Grant County, AR Lonoke County, AR Perry County, AR Pulaski County, AR Saline County, AR 30860 Logan, UT-ID 0.9045 0.9336 Start Printed Page 59987 Franklin County, ID Cache County, UT 30980 Longview, TX 0.8946 0.9266 Gregg County, TX Rusk County, TX Upshur County, TX 31020 Longview, WA 1.0239 1.0163 Cowlitz County, WA 31084 1,3 Los Angeles-Long Beach-Glendale, CA 1.1686 1.1126 Los Angeles County, CA 31140 1 Louisville-Jefferson County, KY-IN 0.9155 0.9413 Clark County, IN Floyd County, IN Harrison County, IN Washington County, IN Bullitt County, KY Henry County, KY Jefferson County, KY Meade County, KY Nelson County, KY Oldham County, KY Shelby County, KY Spencer County, KY Trimble County, KY 31180 Lubbock, TX 0.8536 0.8973 Crosby County, TX Lubbock County, TX 31340 Lynchburg, VA 0.8600 0.9019 Amherst County, VA Appomattox County, VA Bedford County, VA Campbell County, VA Bedford City, VA Lynchburg City, VA 31420 Macon, GA 0.9798 0.9861 Bibb County, GA Crawford County, GA Jones County, GA Monroe County, GA Twiggs County, GA 31460 2 Madera, CA 1.1202 1.0808 Madera County, CA 31540 Madison, WI 1.0841 1.0569 Columbia County, WI Dane County, WI Iowa County, WI 31700 2 Manchester-Nashua, NH 1.1732 1.1156 Hillsborough County, NH Merrimack County, NH 31900 Mansfield, OH 0.9236 0.9470 Richland County, OH 32420 Mayagüez, PR 0.3807 0.5162 Hormigueros Municipio, PR Mayagüez Municipio, PR 32580 McAllen-Edinburg-Mission, TX 0.8794 0.9158 Hidalgo County, TX 32780 Medford, OR 1.0756 1.0512 Jackson County, OR 32820 1 Memphis, TN-MS-AR 0.9307 0.9520 Crittenden County, AR DeSoto County, MS Marshall County, MS Tate County, MS Tunica County, MS Fayette County, TN Shelby County, TN Tipton County, TN 32900 Merced, CA 1.1410 1.0945 Merced County, CA 33124 1 Miami-Miami Beach-Kendall, FL 0.9821 0.9877 Start Printed Page 59988 Miami-Dade County, FL 33140 Michigan City-La Porte, IN 0.9037 0.9330 LaPorte County, IN 33260 Midland, TX 0.9538 0.9681 Midland County, TX 33340 1 Milwaukee-Waukesha-West Allis, WI 1.0324 1.0221 Milwaukee County, WI Ozaukee County, WI Washington County, WI Waukesha County, WI 33460 1 Minneapolis-St. Paul-Bloomington, MN-WI 1.0782 1.0529 Anoka County, MN Carver County, MN Chisago County, MN Dakota County, MN Hennepin County, MN Isanti County, MN Ramsey County, MN Scott County, MN Sherburne County, MN Washington County, MN Wright County, MN Pierce County, WI St. Croix County, WI 33540 Missoula, MT 0.8783 0.9150 Missoula County, MT 33660 Mobile, AL 0.7847 0.8470 Mobile County, AL 33700 Modesto, CA 1.1735 1.1158 Stanislaus County, CA 33740 Monroe, LA 0.8074 0.8637 Ouachita Parish, LA Union Parish, LA 33780 Monroe, MI 0.9787 0.9854 Monroe County, MI 33860 Montgomery, AL 0.7933 0.8534 Autauga County, AL Elmore County, AL Lowndes County, AL Montgomery County, AL 34060 Morgantown, WV 0.8555 0.8986 Monongalia County, WV Preston County, WV 34100 2 Morristown, TN 0.8122 0.8672 Grainger County, TN Hamblen County, TN Jefferson County, TN 34580 Mount Vernon-Anacortes, WA 1.0221 1.0151 Skagit County, WA 34620 2 Muncie, IN 0.8564 0.8993 Delaware County, IN 34740 3 Muskegon-Norton Shores, MI 1.0105 1.0072 Muskegon County, MI 34820 Myrtle Beach-Conway-North Myrtle Beach, SC 0.8882 0.9220 Horry County, SC 34900 Napa, CA 1.2933 1.1926 Napa County, CA 34940 Naples-Marco Island, FL 1.0107 1.0073 Collier County, FL 34980 1 Nashville-Davidson—Murfreesboro, TN 0.9810 0.9869 Cannon County, TN Cheatham County, TN Davidson County, TN Dickson County, TN Hickman County, TN Macon County, TN Robertson County, TN Rutherford County, TN Smith County, TN Sumner County, TN Start Printed Page 59989 Trousdale County, TN Williamson County, TN Wilson County, TN 35004 1,3 Nassau-Suffolk, NY 1.2971 1.1950 Nassau County, NY Suffolk County, NY 35084 1 Newark-Union, NJ-PA 1.1756 1.1172 Essex County, NJ Hunterdon County, NJ Morris County, NJ Sussex County, NJ Union County, NJ Pike County, PA 35300 3 New Haven-Milford, CT 1.2068 1.1374 New Haven County, CT 35380 1 New Orleans-Metairie-Kenner, LA 0.8649 0.9054 Jefferson Parish, LA Orleans Parish, LA Plaquemines Parish, LA St. Bernard Parish, LA St. Charles Parish, LA St. John the Baptist Parish, LA St. Tammany Parish, LA 35644 1,3 New York-White Plains-Wayne, NY-NJ 1.3344 1.2184 Bergen County, NJ Hudson County, NJ Passaic County, NJ Bronx County, NY Kings County, NY New York County, NY Putnam County, NY Queens County, NY Richmond County, NY Rockland County, NY Westchester County, NY 35660 2 Niles-Benton Harbor, MI 0.9028 0.9324 Berrien County, MI 35980 Norwich-New London, CT 1.2031 1.1350 New London County, CT 36084 1 Oakland-Fremont-Hayward, CA 1.5617 1.3570 Alameda County, CA Contra Costa County, CA 36100 2 Ocala, FL 0.8733 0.9114 Marion County, FL 36140 2 Ocean City, NJ 1.1402 1.0940 Cape May County, NJ 36220 Odessa, TX 1.0038 1.0026 Ector County, TX 36260 Ogden-Clearfield, UT 0.9080 0.9360 Davis County, UT Morgan County, UT Weber County, UT 36420 1 Oklahoma City, OK 0.8807 0.9167 Canadian County, OK Cleveland County, OK Grady County, OK Lincoln County, OK Logan County, OK McClain County, OK Oklahoma County, OK 36500 Olympia, WA 1.0962 1.0649 Thurston County, WA 36540 Omaha-Council Bluffs, NE-IA 0.9399 0.9584 Harrison County, IA Mills County, IA Pottawattamie County, IA Cass County, NE Douglas County, NE Sarpy County, NE Saunders County, NE Start Printed Page 59990 Washington County, NE 36740 1 Orlando-Kissimmee, FL 0.9575 0.9707 Lake County, FL Orange County, FL Osceola County, FL Seminole County, FL 36780 2 Oshkosh-Neenah, WI 0.9607 0.9729 Winnebago County, WI 36980 Owensboro, KY 0.8783 0.9150 Daviess County, KY Hancock County, KY McLean County, KY 37100 2 Oxnard-Thousand Oaks-Ventura, CA 1.1202 1.0808 Ventura County, CA 37340 Palm Bay-Melbourne-Titusville, FL 0.9547 0.9688 Brevard County, FL 37460 2 Panama City-Lynn Haven, FL 0.8733 0.9114 Bay County, FL 37620 Parkersburg-Marietta-Vienna, WV-OH (WV Hospitals) 0.8114 0.8667 Washington County, OH Pleasants County, WV Wirt County, WV Wood County, WV 37620 2 Parkersburg-Marietta-Vienna, WV-OH (OH Hospitals) 0.8683 0.9078 Washington County, OH Pleasants County, WV Wirt County, WV Wood County, WV 37700 Pascagoula, MS 0.8144 0.8688 George County, MS Jackson County, MS 37860 2 Pensacola-Ferry Pass-Brent, FL 0.8733 0.9114 Escambia County, FL Santa Rosa County, FL 37900 Peoria, IL 0.9126 0.9393 Marshall County, IL Peoria County, IL Stark County, IL Tazewell County, IL Woodford County, IL 37964 1 Philadelphia, PA 1.0996 1.0672 Bucks County, PA Chester County, PA Delaware County, PA Montgomery County, PA Philadelphia County, PA 38060 1 Phoenix-Mesa-Scottsdale, AZ 1.0146 1.0100 Maricopa County, AZ Pinal County, AZ 38220 Pine Bluff, AR 0.8717 0.9103 Cleveland County, AR Jefferson County, AR Lincoln County, AR 38300 1 Pittsburgh, PA 0.8568 0.8996 Allegheny County, PA Armstrong County, PA Beaver County, PA Butler County, PA Fayette County, PA Washington County, PA Westmoreland County, PA 38340 2 Pittsfield, MA 1.0757 1.0512 Berkshire County, MA 38540 Pocatello, ID 0.9204 0.9448 Bannock County, ID Power County, ID 38660 Ponce, PR 0.4712 0.5973 Juana Díaz Municipio, PR Ponce Municipio, PR Villalba Municipio, PR Start Printed Page 59991 38860 Portland-South Portland-Biddeford, ME 0.9862 0.9905 Cumberland County, ME Sagadahoc County, ME York County, ME 38900 1 Portland-Vancouver-Beaverton, OR-WA 1.1210 1.0814 Clackamas County, OR Columbia County, OR Multnomah County, OR Washington County, OR Yamhill County, OR Clark County, WA Skamania County, WA 38940 Port St. Lucie-Fort Pierce, FL 0.9906 0.9936 Martin County, FL St. Lucie County, FL 39100 Poughkeepsie-Newburgh-Middletown, NY 1.0966 1.0652 Dutchess County, NY Orange County, NY 39140 Prescott, AZ 0.9748 0.9827 Yavapai County, AZ 39300 1,2 Providence-New Bedford-Fall River, RI-MA (RI Hospitals) 1.0744 1.0504 Bristol County, MA Bristol County, RI Kent County, RI Newport County, RI Providence County, RI Washington County, RI 39300 1,2 Providence-New Bedford-Fall River, RI-MA (MA Hospitals) 1.0757 1.0512 Bristol County, MA Bristol County, RI Kent County, RI Newport County, RI Providence County, RI Washington County, RI 39340 Provo-Orem, UT 0.9479 0.9640 Juab County, UT Utah County, UT 39380 2 Pueblo, CO 0.9091 0.9368 Pueblo County, CO 39460 Punta Gorda, FL 0.9717 0.9805 Charlotte County, FL 39540 2 Racine, WI 0.9607 0.9729 Racine County, WI 39580 Raleigh-Cary, NC 0.9722 0.9809 Franklin County, NC Johnston County, NC Wake County, NC 39660 Rapid City, SD 0.8708 0.9096 Meade County, SD Pennington County, SD 39740 Reading, PA 0.9709 0.9800 Berks County, PA 39820 Redding, CA 1.2450 1.1619 Shasta County, CA 39900 Reno-Sparks, NV 1.2126 1.1411 Storey County, NV Washoe County, NV 40060 1 Richmond, VA 0.8997 0.9302 Amelia County, VA Caroline County, VA Charles City County, VA Chesterfield County, VA Cumberland County, VA Dinwiddie County, VA Goochland County, VA Hanover County, VA Henrico County, VA King and Queen County, VA King William County, VA Louisa County, VA Start Printed Page 59992 New Kent County, VA Powhatan County, VA Prince George County, VA Sussex County, VA Colonial Heights City, VA Hopewell City, VA Petersburg City, VA Richmond City, VA 40140 1,2 Riverside-San Bernardino-Ontario, CA 1.1202 1.0808 Riverside County, CA San Bernardino County, CA 40220 Roanoke, VA 0.8803 0.9164 Botetourt County, VA Craig County, VA Franklin County, VA Roanoke County, VA Roanoke City, VA Salem City, VA 40340 Rochester, MN 1.1239 1.0833 Dodge County, MN Olmsted County, MN Wabasha County, MN 40380 1 Rochester, NY 0.9103 0.9377 Livingston County, NY Monroe County, NY Ontario County, NY Orleans County, NY Wayne County, NY 40420 Rockford, IL 1.0048 1.0033 Boone County, IL Winnebago County, IL 40484 2 Rockingham County-Strafford County, NH 1.1732 1.1156 Rockingham County, NH Strafford County, NH 40580 Rocky Mount, NC 0.8900 0.9233 Edgecombe County, NC Nash County, NC 40660 Rome, GA 0.9699 0.9793 Floyd County, GA 40900 1 Sacramento—Arden-Arcade—Roseville, CA 1.2986 1.1959 El Dorado County, CA Placer County, CA Sacramento County, CA Yolo County, CA 40980 Saginaw-Saginaw Township North, MI 0.9211 0.9453 Saginaw County, MI 41060 St. Cloud, MN 1.1029 1.0694 Benton County, MN Stearns County, MN 41100 St. George, UT 0.9452 0.9621 Washington County, UT 41140 St. Joseph, MO-KS 1.0233 1.0159 Doniphan County, KS Andrew County, MO Buchanan County, MO DeKalb County, MO 41180 St. Louis, MO-IL 0.8998 0.9302 Bond County, IL Calhoun County, IL Clinton County, IL Jersey County, IL Macoupin County, IL Madison County, IL Monroe County, IL St. Clair County, IL Crawford County, MO Franklin County, MO Jefferson County, MO Lincoln County, MO St. Charles County, MO Start Printed Page 59993 St. Louis County, MO Warren County, MO Washington County, MO St. Louis City, MO 41420 Salem, OR 1.0283 1.0193 Marion County, OR Polk County, OR 41500 Salinas, CA 1.4220 1.2726 Monterey County, CA 41540 2 Salisbury, MD 0.8881 0.9219 Somerset County, MD Wicomico County, MD 41620 Salt Lake City, UT 0.9476 0.9638 Salt Lake County, UT Summit County, UT Tooele County, UT 41660 San Angelo, TX 0.8483 0.8935 Irion County, TX Tom Green County, TX 41700 1 San Antonio, TX 0.8945 0.9265 Atascosa County, TX Bandera County, TX Bexar County, TX Comal County, TX Guadalupe County, TX Kendall County, TX Medina County, TX Wilson County, TX 41740 1,2 San Diego-Carlsbad-San Marcos, CA 1.1202 1.0808 San Diego County, CA 41780 Sandusky, OH 0.9258 0.9486 Erie County, OH 41884 1 San Francisco-San Mateo-Redwood City, CA 1.5419 1.3452 Marin County, CA San Francisco County, CA San Mateo County, CA 41900 San Germán-Cabo Rojo, PR 0.4856 0.6098 Cabo Rojo Municipio, PR Lajas Municipio, PR Sabana Grande Municipio, PR San Germán Municipio, PR 41940 1 San Jose-Sunnyvale-Santa Clara, CA 1.5324 1.3395 San Benito County, CA Santa Clara County, CA 41980 1 San Juan-Caguas-Guaynabo, PR 0.4449 0.5743 Aguas Buenas Municipio, PR Aibonito Municipio, PR Arecibo Municipio, PR Barceloneta Municipio, PR Barranquitas Municipio, PR Bayamón Municipio, PR Caguas Municipio, PR Camuy Municipio, PR Canóvanas Municipio, PR Carolina Municipio, PR Cataño Municipio, PR Cayey Municipio, PR Ciales Municipio, PR Cidra Municipio, PR Comerío Municipio, PR Corozal Municipio, PR Dorado Municipio, PR Florida Municipio, PR Guaynabo Municipio, PR Gurabo Municipio, PR Hatillo Municipio, PR Humacao Municipio, PR Juncos Municipio, PR Las Piedras Municipio, PR Loíza Municipio, PR Start Printed Page 59994 Manatí Municipio, PR Maunabo Municipio, PR Morovis Municipio, PR Naguabo Municipio, PR Naranjito Municipio, PR Orocovis Municipio, PR Quebradillas Municipio, PR Río Grande Municipio, PR San Juan Municipio, PR San Lorenzo Municipio, PR Toa Alta Municipio, PR Toa Baja Municipio, PR Trujillo Alto Municipio, PR Vega Alta Municipio, PR Vega Baja Municipio, PR Yabucoa Municipio, PR 42020 2 San Luis Obispo-Paso Robles, CA 1.1202 1.0808 San Luis Obispo County, CA 42044 1 Santa Ana-Anaheim-Irvine, CA 1.1350 1.0906 Orange County, CA 42060 2 Santa Barbara-Santa Maria, CA 1.1202 1.0808 Santa Barbara County, CA 42100 Santa Cruz-Watsonville, CA 1.5056 1.3234 Santa Cruz County, CA 42140 Santa Fe, NM 1.0808 1.0547 Santa Fe County, NM 42220 Santa Rosa-Petaluma, CA 1.4322 1.2789 Sonoma County, CA 42260 Sarasota-Bradenton-Venice, FL 0.9743 0.9823 Manatee County, FL Sarasota County, FL 42340 Savannah, GA 0.9139 0.9402 Bryan County, GA Chatham County, GA Effingham County, GA 42540 2 Scranton—Wilkes-Barre, PA 0.8301 0.8803 Lackawanna County, PA Luzerne County, PA Wyoming County, PA 42644 1 Seattle-Bellevue-Everett, WA 1.1261 1.0847 King County, WA Snohomish County, WA 42680 Sebastian-Vero Beach, FL 0.9886 0.9922 Indian River County, FL 43100 2 Sheboygan, WI 0.9607 0.9729 Sheboygan County, WI 43300 Sherman-Denison, TX 0.8651 0.9055 Grayson County, TX 43340 Shreveport-Bossier City, LA 0.8848 0.9196 Bossier Parish, LA Caddo Parish, LA De Soto Parish, LA 43580 Sioux City, IA-NE-SD 0.9062 0.9348 Woodbury County, IA Dakota County, NE Dixon County, NE Union County, SD 43620 Sioux Falls, SD 0.9351 0.9551 Lincoln County, SD McCook County, SD Minnehaha County, SD Turner County, SD 43780 South Bend-Mishawaka, IN-MI 0.9914 0.9941 St. Joseph County, IN Cass County, MI 43900 Spartanburg, SC 0.9072 0.9355 Spartanburg County, SC 44060 Spokane, WA 1.0422 1.0287 Spokane County, WA 44100 Springfield, IL 0.8951 0.9269 Start Printed Page 59995 Menard County, IL Sangamon County, IL 44140 2 Springfield, MA 1.0757 1.0512 Franklin County, MA Hampden County, MA Hampshire County, MA 44180 Springfield, MO 0.8570 0.8997 Christian County, MO Dallas County, MO Greene County, MO Polk County, MO Webster County, MO 44220 2 Springfield, OH 0.8683 0.9078 Clark County, OH 44300 State College, PA 0.8655 0.9058 Centre County, PA 44700 Stockton, CA 1.1474 1.0987 San Joaquin County, CA 44940 2 Sumter, SC 0.8692 0.9085 Sumter County, SC 45060 Syracuse, NY 0.9776 0.9846 Madison County, NY Onondaga County, NY Oswego County, NY 45104 Tacoma, WA 1.0710 1.0481 Pierce County, WA 45220 Tallahassee, FL 0.8959 0.9275 Gadsden County, FL Jefferson County, FL Leon County, FL Wakulla County, FL 45300 1 Tampa-St. Petersburg-Clearwater, FL 0.9265 0.9491 Hernando County, FL Hillsborough County, FL Pasco County, FL Pinellas County, FL 45460 Terre Haute, IN 0.8806 0.9166 Clay County, IN Sullivan County, IN Vermillion County, IN Vigo County, IN 45500 2 Texarkana, TX-Texarkana, AR (TX Hospitals) 0.8225 0.8748 Miller County, AR Bowie County, TX 45500 Texarkana, TX-Texarkana, AR (AR Hospitals) 0.8107 0.8661 Miller County, AR Bowie County, TX 45780 Toledo, OH 0.9455 0.9623 Fulton County, OH Lucas County, OH Ottawa County, OH Wood County, OH 45820 Topeka, KS 0.8763 0.9135 Jackson County, KS Jefferson County, KS Osage County, KS Shawnee County, KS Wabaunsee County, KS 45940 2 Trenton-Ewing, NJ 1.1402 1.0940 Mercer County, NJ 46060 Tucson, AZ 0.9390 0.9578 Pima County, AZ 46140 Tulsa, OK 0.8310 0.8809 Creek County, OK Okmulgee County, OK Osage County, OK Pawnee County, OK Rogers County, OK Tulsa County, OK Wagoner County, OK Start Printed Page 59996 46220 Tuscaloosa, AL 0.8761 0.9134 Greene County, AL Hale County, AL Tuscaloosa County, AL 46340 Tyler, TX 0.8963 0.9278 Smith County, TX 46540 Utica-Rome, NY 0.8753 0.9128 Herkimer County, NY Oneida County, NY 46660 Valdosta, GA 0.8632 0.9042 Brooks County, GA Echols County, GA Lanier County, GA Lowndes County, GA 46700 Vallejo-Fairfield, CA 1.4794 1.3076 Solano County, CA 47020 Victoria, TX 0.8426 0.8893 Calhoun County, TX Goliad County, TX Victoria County, TX 47220 2 Vineland-Millville-Bridgeton, NJ 1.1402 1.0940 Cumberland County, NJ 47260 1 Virginia Beach-Norfolk-Newport News, VA-NC 0.8774 0.9143 Currituck County, NC Gloucester County, VA Isle of Wight County, VA James City County, VA Mathews County, VA Surry County, VA York County, VA Chesapeake City, VA Hampton City, VA Newport News City, VA Norfolk City, VA Poquoson City, VA Portsmouth City, VA Suffolk City, VA Virginia Beach City, VA Williamsburg City, VA 47300 2 Visalia-Porterville, CA 1.1202 1.0808 Tulare County, CA 47380 Waco, TX 0.8748 0.9125 McLennan County, TX 47580 Warner Robins, GA 0.8812 0.9170 Houston County, GA 47644 1 Warren-Troy-Farmington Hills, MI 1.0108 1.0074 Lapeer County, MI Livingston County, MI Macomb County, MI Oakland County, MI St. Clair County, MI 47894 1 Washington-Arlington-Alexandria, DC-VA-MD-WV 1.0977 1.0659 District of Columbia, DC Calvert County, MD Charles County, MD Prince George's County, MD Arlington County, VA Clarke County, VA Fairfax County, VA Fauquier County, VA Loudoun County, VA Prince William County, VA Spotsylvania County, VA Stafford County, VA Warren County, VA Alexandria City, VA Fairfax City, VA Falls Church City, VA Fredericksburg City, VA Manassas City, VA Start Printed Page 59997 Manassas Park City, VA Jefferson County, WV 47940 2,3 Waterloo-Cedar Falls, IA 0.8803 0.9164 Black Hawk County, IA Bremer County, IA Grundy County, IA 48140 Wausau, WI 0.9947 0.9964 Marathon County, WI 48260 Weirton-Steubenville, WV-OH (WV Hospitals) 0.8057 0.8625 Jefferson County, OH Brooke County, WV Hancock County, WV 48260 2 Weirton-Steubenville, WV-OH (OH Hospitals) 0.8683 0.9078 Jefferson County, OH Brooke County, WV Hancock County, WV 48300 2 Wenatchee, WA 1.0206 1.0141 Chelan County, WA Douglas County, WA 48424 1 West Palm Beach-Boca Raton-Boynton Beach, FL 0.9535 0.9679 Palm Beach County, FL 48540 2 Wheeling, WV-OH (WV Hospitals) 0.7754 0.8401 Belmont County, OH Marshall County, WV Ohio County, WV 48540 2 Wheeling, WV-OH (OH Hospitals) 0.8683 0.9078 Belmont County, OH Marshall County, WV Ohio County, WV 48620 Wichita, KS 0.9016 0.9315 Butler County, KS Harvey County, KS Sedgwick County, KS Sumner County, KS 48660 Wichita Falls, TX 0.8562 0.8991 Archer County, TX Clay County, TX Wichita County, TX 48700 2 Williamsport, PA 0.8301 0.8803 Lycoming County, PA 48864 Wilmington, DE-MD-NJ (DE, MD Hospitals) 1.0570 1.0387 New Castle County, DE Cecil County, MD Salem County, NJ 48864 2 Wilmington, DE-MD-NJ (NJ Hospitals) 1.1402 1.0940 New Castle County, DE Cecil County, MD Salem County, NJ 48900 Wilmington, NC 0.9771 0.9843 Brunswick County, NC New Hanover County, NC Pender County, NC 49020 Winchester, VA-WV 1.0057 1.0039 Frederick County, VA Winchester City, VA Hampshire County, WV 49180 Winston-Salem, NC 0.9246 0.9477 Davie County, NC Forsyth County, NC Stokes County, NC Yadkin County, NC 49340 Worcester, MA 1.0796 1.0538 Worcester County, MA 49420 2 Yakima, WA 1.0206 1.0141 Yakima County, WA 49500 Yauco, PR 0.3771 0.5128 Guánica Municipio, PR Guayanilla Municipio, PR Peñuelas Municipio, PR Yauco Municipio, PR Start Printed Page 59998 49620 York-Hanover, PA 0.9496 0.9652 York County, PA 49660 Youngstown-Warren-Boardman, OH-PA 0.8799 0.9161 Mahoning County, OH Trumbull County, OH Mercer County, PA 49700 2 Yuba City, CA 1.1202 1.0808 Sutter County, CA Yuba County, CA 49740 2 Yuma, AZ 0.9269 0.9493 Yuma County, AZ 1 Large urban area. 2 Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2007. 3 For this area, the wage index and GAF on this table are only effective from October 1, 2006 through March 31, 2007. See Table 4A-2 for the values that are effective from April 1 through September 30, 2007. Table 4A-2.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Certain Urban Areas by CBSA for the Period April 1 Through September 30, 2007 *
CBSA code Urban area (constituent counties) Wage index GAF 11260 Anchorage, AK 1.1927 1.1283 11460 Ann Arbor, MI 1.0678 1.0459 13020 Bay City, MI 1.0044 1.0030 13900 Bismarck, ND 0.7368 0.8113 16220 Casper, WY 0.9091 0.9368 16300 Cedar Rapids, IA 0.8708 0.9096 16940 Cheyenne, WY 0.9048 0.9338 19804 Detroit-Livonia-Dearborn, MI 1.0381 1.0259 21660 Eugene-Springfield, OR 1.0966 1.0652 22020 Fargo, ND-MN (ND Hospitals) 0.8367 0.8851 22020 Fargo, ND-MN (MN Hospitals) 0.9280 0.9501 24220 Grand Forks, ND-MN (ND Hospitals) 0.7824 0.8453 24220 Grand Forks, ND-MN (MN Hospitals) 0.9280 0.9501 24300 Grand Junction, CO 0.9879 0.9917 26820 Idaho Falls, ID 0.9217 0.9457 31084 Los Angeles-Long Beach-Santa Ana, CA 1.1686 1.1126 34740 Muskegon-Norton Shores, MI 1.0105 1.0072 35004 Nassau-Suffolk, NY 1.2971 1.1950 35300 New Haven-Milford, CT 1.2142 1.1421 35644 New York-White Plains-Wayne, NY-NJ 1.3344 1.2184 47940 Waterloo-Cedar Falls, IA 0.8615 0.9029 * See Table 4A-1 for the wage index and GAF that are effective from October 1, 2006 through March 31, 2007. For areas that are not listed on this table, the wage index and GAF on Table 4A-1 are effective for the entire FY 2007. Table 4B-1.—Wage Index and Capital Geographic Adjustment (GAF) for Rural Areas by CBSA—FY 2007
CBSA code Nonurban area Wage index GAF 01 Alabama 0.7664 0.8334 02 Alaska 1.0702 1.0476 03 Arizona 0.9269 0.9493 04 Arkansas 0.7475 0.8193 05 California 1.1202 1.0808 06 Colorado 0.9091 0.9368 07 Connecticut 1.1988 1.1322 08 Delaware 1.0009 1.0006 10 Florida 0.8733 0.9114 11 Georgia 0.7825 0.8454 12 Hawaii 1.0627 1.0425 13 Idaho 0.8568 0.8996 14 Illinois 0.8358 0.8844 15 Indiana 0.8564 0.8993 16 Iowa2 0.8803 0.9164 17 Kansas 0.8018 0.8596 18 Kentucky 0.7805 0.8439 Start Printed Page 59999 19 Louisiana 0.7660 0.8331 20 Maine 0.8393 0.8869 21 Maryland 0.8881 0.9219 22 Massachusetts1 1.0757 1.0512 23 Michigan 0.9028 0.9324 24 Minnesota2 0.9195 0.9441 25 Mississippi 0.7796 0.8432 26 Missouri 0.8353 0.8841 27 Montana 0.8655 0.9058 28 Nebraska 0.8636 0.9045 29 Nevada 0.9181 0.9432 30 New Hampshire 1.1732 1.1156 31 New Jersey1 1.1402 1.0940 32 New Mexico 0.8375 0.8856 33 New York 0.8430 0.8896 34 North Carolina 0.8629 0.9040 35 North Dakota 0.7368 0.8113 36 Ohio 0.8683 0.9078 37 Oklahoma 0.7847 0.8470 38 Oregon2 1.0194 1.0132 39 Pennsylvania 0.8301 0.8803 40 Puerto Rico1 41 Rhode Island1 1.0744 1.0504 42 South Carolina 0.8692 0.9085 43 South Dakota 0.8298 0.8801 44 Tennessee 0.8122 0.8672 45 Texas 0.8225 0.8748 46 Utah 0.8252 0.8767 47 Vermont 0.9622 0.9740 49 Virginia 0.8101 0.8657 50 Washington 1.0206 1.0141 51 West Virginia 0.7754 0.8401 52 Wisconsin 0.9607 0.9729 53 Wyoming2 0.9199 0.9444 1 All counties in the State or Territory are classified as urban, with the exception of Massachusetts. Massachusetts has area(s) designated as rural. However, no short-term, acute care hospitals are located in the area(s) for FY 2007. Massachusetts, New Jersey, and Rhode Island rural floors are imputed as discussed in the FY 2005 IPPS final rule, (69 FR 49109). 2 For this area, the wage index and GAF on this table are only effective from October 1, 2006 through March 31, 2007. See Table 4C-2 for the values that are effective from April 1 through September 30, 2007. Table 4B-2.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Certain Rural Areas by CBSA for the Period April 1 Through September 30, 2007 *
CBSA code Nonurban area Wage index GAF 16 Iowa 0.8615 0.9029 24 Minnesota 0.9280 0.9501 38 Oregon 0.9764 0.9838 53 Wyoming 0.9048 0.9338 * See Table 4B-1 for the wage index and GAF that are effective from October 1, 2006 through March 31, 2007. For areas that are not listed on this table, the wage index and GAF on Table 4B-1 are effective for the entire FY 2007. Table 4C-1.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Hospitals that are Reclassified by CBSA
CBSA code Area Wage index GAF 10180 Abilene, TX 0.8380 0.8860 10420 Akron, OH 0.8683 0.9078 10580 Albany-Schenectady-Troy, NY 0.8849 0.9197 10740 Albuquerque, NM 0.9444 0.9616 10780 Alexandria, LA 0.7961 0.8554 10900 Allentown-Bethlehem-Easton, PA-NJ 0.9990 0.9993 11020 Altoona, PA 0.8538 0.8974 11100 Amarillo, TX 0.9248 0.9479 11180 Ames, IA 0.9219 0.9458 Start Printed Page 60000 11460 1 Ann Arbor, MI 1.0563 1.0382 11500 Anniston-Oxford, AL 0.7997 0.8581 11700 Asheville, NC 0.9264 0.9490 12020 Athens-Clarke County, GA 0.9456 0.9624 12060 Atlanta-Sandy Springs-Marietta, GA 0.9793 0.9858 12260 Augusta-Richmond County, GA-SC 0.9531 0.9676 12420 Austin-Round Rock, TX 0.9328 0.9535 12620 Bangor, ME 0.9612 0.9733 12700 Barnstable Town, MA 1.2156 1.1430 12940 Baton Rouge, LA 0.8085 0.8645 13020 1 Bay City, MI 1.0080 1.0055 13644 Bethesda-Gaithersburg-Frederick, MD 1.0848 1.0573 13780 Binghamton, NY 0.8626 0.9037 13820 Birmingham-Hoover, AL 0.8889 0.9225 14260 Boise City-Nampa, ID 0.9313 0.9524 14484 Boston-Quincy, MA 1.1343 1.0901 14540 Bowling Green, KY 0.8082 0.8643 15380 Buffalo-Niagara Falls, NY 0.9475 0.9637 15540 Burlington-South Burlington, VT 0.9436 0.9610 15764 Cambridge-Newton-Framingham, MA 1.1003 1.0676 16180 Carson City, NV 0.9468 0.9633 16580 Champaign-Urbana, IL 0.9096 0.9372 16620 Charleston, WV 0.8415 0.8885 16700 Charleston-North Charleston, SC 0.9197 0.9443 16740 Charlotte-Gastonia-Concord, NC-SC 0.9413 0.9594 16820 Charlottesville, VA 0.9709 0.9800 16860 Chattanooga, TN-GA 0.8822 0.9177 16974 Chicago-Naperville-Joliet, IL 1.0564 1.0383 17140 Cincinnati-Middletown, OH-KY-IN 0.9522 0.9670 17300 Clarksville, TN-KY 0.8014 0.8593 17460 Cleveland-Elyria-Mentor, OH 0.9229 0.9465 17780 College Station-Bryan, TX 0.8903 0.9235 17860 Columbia, MO 0.8456 0.8915 17900 Columbia, SC 0.8942 0.9263 17980 Columbus, GA-AL 0.8371 0.8854 18140 Columbus, OH 0.9891 0.9925 18700 Corvallis, OR 1.0956 1.0645 19124 Dallas-Plano-Irving, TX 0.9743 0.9823 19340 Davenport-Moline-Rock Island, IA-IL 0.8836 0.9187 19380 Dayton, OH 0.9185 0.9434 19460 Decatur, AL 0.8065 0.8631 19740 Denver-Aurora, CO 1.0555 1.0377 19780 Des Moines-West Des Moines,IA 0.9009 0.9310 19804 1 Detroit-Livonia-Dearborn, MI 1.0381 1.0259 20100 Dover, DE 1.0009 1.0006 20260 Duluth, MN-WI 1.0285 1.0194 20500 Durham, NC 0.9677 0.9778 20764 Edison, NJ 1.1402 1.0940 21060 Elizabethtown, KY 0.8144 0.8688 21500 Erie, PA 0.8451 0.8911 21660 1 Eugene-Springfield, OR 1.0494 1.0336 21780 Evansville, IN-KY 0.8553 0.8985 22020 1 Fargo, ND-MN 0.8367 0.8851 22180 Fayetteville, NC 0.9245 0.9477 22220 Fayetteville-Springdale-Rogers, AR-MO 0.8816 0.9173 22380 Flagstaff, AZ 1.1073 1.0723 22420 Flint, MI 1.0602 1.0408 22520 Florence-Muscle Shoals, AL 0.7876 0.8492 22660 Fort Collins-Loveland, CO 0.9233 0.9468 22744 Fort Lauderdale-Pompano Beach-Deerfield Beach, FL 1.0320 1.0218 22900 Fort Smith, AR-OK 0.7847 0.8470 23020 Fort Walton Beach-Crestview-Destin, FL 0.8733 0.9114 23060 Fort Wayne, IN 0.9283 0.9503 23104 Fort Worth-Arlington, TX 0.9556 0.9694 23540 Gainesville, FL 0.9420 0.9599 23844 Gary, IN 0.9397 0.9583 24340 Grand Rapids-Wyoming, MI 0.9554 0.9692 24500 Great Falls, MT 0.8747 0.9124 24540 Greeley, CO 0.9857 0.9902 24580 Green Bay, WI (WI Hospitals) 0.9607 0.9729 Start Printed Page 60001 24580 Green Bay, WI (MI Hospitals) 0.9573 0.9706 24780 Greenville, NC 0.9223 0.9461 24860 Greenville, SC 0.9208 0.9451 25060 Gulfport-Biloxi, MS 0.8461 0.8919 25420 Harrisburg-Carlisle, PA 0.9230 0.9466 25540 Hartford-West Hartford-East Hartford, CT (CT Hospitals) 1.1988 1.1322 25540 Hartford-West Hartford-East Hartford, CT (MA Hospitals) 1.0970 1.0655 25860 Hickory-Lenoir-Morganton, NC 0.8860 0.9205 26100 Holland-Grand Haven, MI 0.9217 0.9457 26180 Honolulu, HI 1.0911 1.0615 26420 Houston-Sugar Land-Baytown, TX 1.0094 1.0064 26580 Huntington-Ashland, WV-KY-OH (WV, KY Hospitals) 0.8681 0.9077 26580 Huntington-Ashland, WV-KY-OH (OH Hospitals) 0.8683 0.9078 26620 Huntsville, AL 0.8756 0.9130 26820 1 Idaho Falls, ID 0.9036 0.9329 26900 Indianapolis-Carmel, IN 0.9619 0.9737 26980 Iowa City, IA 0.9454 0.9623 27060 Ithaca, NY 0.9407 0.9590 27140 Jackson, MS 0.8214 0.8740 27180 Jackson, TN 0.8643 0.9050 27260 Jacksonville, FL 0.9281 0.9502 27860 Jonesboro, AR (AR Hospitals) 0.8345 0.8835 27860 Jonesboro, AR (MO Hospitals) 0.8353 0.8841 27900 Joplin, MO 0.8626 0.9037 28020 Kalamazoo-Portage, MI 1.0797 1.0539 28100 Kankakee-Bradley, IL 1.0021 1.0014 28140 Kansas City, MO-KS 0.9345 0.9547 28420 Kennewick-Richland-Pasco, WA 1.0206 1.0141 28700 Kingsport-Bristol-Bristol, TN-VA 0.8215 0.8740 28740 Kingston, NY 0.9195 0.9441 28940 Knoxville, TN 0.8227 0.8749 29180 Lafayette, LA 0.8408 0.8880 29404 Lake County-Kenosha County, IL-WI 1.0651 1.0441 29460 Lakeland, FL 0.9056 0.9344 29540 Lancaster, PA 0.9942 0.9960 29620 Lansing-East Lansing, MI 0.9896 0.9929 29740 Las Cruces, NM 0.9124 0.9391 29820 Las Vegas-Paradise, NV 1.1006 1.0678 30020 Lawton, OK 0.8485 0.8936 30460 Lexington-Fayette, KY 0.8643 0.9050 30620 Lima, OH 0.8925 0.9251 30700 Lincoln, NE 0.9617 0.9736 30780 Little Rock-North Little Rock, AR 0.9265 0.9491 30980 Longview, TX 0.8946 0.9266 31084 1 Los Angeles-Long Beach-Santa Ana, CA 1.1530 1.1024 31140 Louisville-Jefferson County, KY-IN 0.9155 0.9413 31340 Lynchburg, VA 0.8600 0.9019 31420 Macon, GA 0.9443 0.9615 31540 Madison, WI 1.0621 1.0421 31700 Manchester-Nashua, NH 1.1732 1.1156 32780 Medford, OR 1.0404 1.0275 32820 Memphis, TN-MS-AR 0.8984 0.9293 33124 Miami-Miami Beach-Kendall, FL 0.9821 0.9877 33260 Midland, TX 0.9387 0.9576 33340 Milwaukee-Waukesha-West Allis, WI 1.0209 1.0143 33460 Minneapolis-St. Paul-Bloomington, MN-WI 1.0782 1.0529 33540 Missoula, MT 0.8783 0.9150 33740 Monroe, LA 0.8074 0.8637 33860 Montgomery, AL 0.7933 0.8534 34060 Morgantown, WV 0.8555 0.8986 34980 Nashville-Davidson—Murfreesboro, TN 0.9550 0.9690 35084 Newark-Union, NJ-PA 1.1756 1.1172 35380 New Orleans-Metairie-Kenner, LA 0.8649 0.9054 35644 1 New York-White Plains-Wayne, NY-NJ 1.3134 1.2053 35980 Norwich-New London, CT 1.2031 1.1350 36084 Oakland-Fremont-Hayward, CA 1.5617 1.3570 36140 Ocean City, NJ 1.0336 1.0229 36220 Odessa, TX 0.9714 0.9803 36260 Ogden-Clearfield, UT 0.9080 0.9360 36420 Oklahoma City, OK 0.8807 0.9167 Start Printed Page 60002 36540 Omaha-Council Bluffs, NE-IA 0.9399 0.9584 36740 Orlando-Kissimmee, FL 0.9575 0.9707 37860 Pensacola-Ferry Pass-Brent, FL 0.7871 0.8488 37900 Peoria, IL 0.8966 0.9280 37964 Philadelphia, PA (PA Hospitals) 1.0996 1.0672 37964 Philadelphia, PA (NJ Hospitals) 1.1402 1.0940 38220 Pine Bluff, AR 0.8397 0.8872 38300 Pittsburgh, PA (PA, WV Hospitals) 0.8568 0.8996 38300 Pittsburgh, PA (OH Hospitals) 0.8683 0.9078 38340 Pittsfield, MA 0.9887 0.9922 38540 Pocatello, ID 0.9204 0.9448 38860 Portland-South Portland-Biddeford, ME 0.9472 0.9635 38900 Portland-Vancouver-Beaverton, OR-WA 1.1210 1.0814 38940 Port St. Lucie-Fort Pierce, FL 0.9906 0.9936 39100 Poughkeepsie-Newburgh-Middletown, NY 1.0660 1.0447 39340 Provo-Orem, UT 0.9479 0.9640 39580 Raleigh-Cary, NC 0.9492 0.9649 39740 Reading, PA 0.9709 0.9800 39820 Redding, CA 1.2203 1.1461 39900 Reno-Sparks, NV 1.1713 1.1144 40060 Richmond, VA 0.8997 0.9302 40220 Roanoke, VA 0.8700 0.9090 40340 Rochester, MN 1.1239 1.0833 40380 Rochester, NY 0.9103 0.9377 40420 Rockford, IL 0.9828 0.9882 40484 Rockingham County, NH 1.0237 1.0162 40660 Rome, GA 0.9699 0.9793 40900 Sacramento—Arden-Arcade—Roseville, CA 1.2986 1.1959 40980 Saginaw-Saginaw Township North, MI 0.9028 0.9324 41060 St. Cloud, MN 1.0302 1.0206 41100 St. George, UT 0.9452 0.9621 41140 St. Joseph, MO-KS 1.0045 1.0031 41180 St. Louis, MO-IL 0.8889 0.9225 41620 Salt Lake City, UT 0.9476 0.9638 41700 San Antonio, TX 0.8945 0.9265 41884 San Francisco-San Mateo-Redwood City, CA 1.5260 1.3357 41980 San Juan-Caguas-Guaynabo, PR 0.4449 0.5743 42044 Santa Ana-Anaheim-Irvine, CA 1.1202 1.0808 42140 Santa Fe, NM 0.9808 0.9868 42220 Santa Rosa-Petaluma, CA 1.4116 1.2663 42260 Sarasota-Bradenton-Venice, FL 0.9743 0.9823 42340 Savannah, GA 0.9023 0.9320 42644 Seattle-Bellevue-Everett, WA 1.1096 1.0738 43300 Sherman-Denison, TX 0.8526 0.8965 43340 Shreveport-Bossier City, LA 0.8688 0.9082 43580 Sioux City, IA-NE-SD 0.8693 0.9085 43620 Sioux Falls, SD 0.9238 0.9472 43780 South Bend-Mishawaka, IN-MI 0.9721 0.9808 43900 Spartanburg, SC 0.9072 0.9355 44060 Spokane, WA 1.0244 1.0166 44180 Springfield, MO 0.8412 0.8883 44300 State College, PA 0.8301 0.8803 44940 Sumter, SC 0.8692 0.9085 45060 Syracuse, NY 0.9498 0.9653 45220 Tallahassee, FL 0.8802 0.9163 45300 Tampa-St. Petersburg-Clearwater, FL 0.9265 0.9491 45500 Texarkana, TX-Texarkana, AR 0.8107 0.8661 45780 Toledo, OH 0.9455 0.9623 45820 Topeka, KS 0.8639 0.9047 46140 Tulsa, OK 0.8310 0.8809 46220 Tuscaloosa, AL 0.8362 0.8847 46340 Tyler, TX 0.8963 0.9278 46660 Valdosta, GA 0.8632 0.9042 46700 Vallejo-Fairfield, CA 1.4095 1.2650 47260 Virginia Beach-Norfolk-Newport News, VA 0.8774 0.9143 47380 Waco, TX 0.8748 0.9125 47894 Washington-Arlington-Alexandria, DC-VA-MD-WV 1.0877 1.0593 48140 Wausau, WI 0.9947 0.9964 48620 Wichita, KS 0.8776 0.9145 48700 Williamsport, PA 0.8301 0.8803 Start Printed Page 60003 48864 Wilmington, DE-MD-NJ 1.0570 1.0387 48900 Wilmington, NC 0.9473 0.9636 49180 Winston-Salem, NC 0.9246 0.9477 49340 Worcester, MA 1.1732 1.1156 49660 Youngstown-Warren-Boardman, OH-PA 0.8690 0.9083 04 Arkansas 0.7660 0.8331 05 California 1.1202 1.0808 07 Connecticut 1.1988 1.1322 10 Florida (FL Hospitals) 0.8733 0.9114 10 Florida (GA Hospitals) 0.8489 0.8939 14 Illinois (IL Hospitals) 0.8358 0.8844 14 Illinois (KY Hospitals) 0.8248 0.8764 14 Illinois (MO Hospitals) 0.8353 0.8841 16 1 Iowa 0.8700 0.9090 17 Kansas 0.8018 0.8596 23 Michigan 0.9028 0.9324 26 Missouri 0.8353 0.8841 30 New Hampshire 1.1394 1.0935 33 New York 0.8430 0.8896 34 North Carolina 0.8629 0.9040 36 Ohio 0.8683 0.9078 37 Oklahoma 0.7847 0.8470 38 1 Oregon 1.0194 1.0132 39 Pennsylvania 0.8430 0.8896 44 Tennessee 0.8122 0.8672 45 Texas 0.8225 0.8748 47 Vermont 0.9380 0.9571 50 Washington (WA Hospitals) 1.0206 1.0141 50 Washington (ID Hospitals) 0.9978 0.9985 52 Wisconsin 0.9607 0.9729 53 1 Wyoming 0.9066 0.9351 1 For this area, the wage index and GAF on this table are only effective from October 1, 2006 through March 31, 2007. See Table 4C-2 for the values that are effective from April 1 through September 30, 2007. Table 4C2.—Wage Index and capital Geographic Adjustment Factor (GAF) for Certain Hospitals That Are Reclassified by CBSA for the Period April 1 Trhough September 30, 2007*
CBSA code Area Wage index GAF 11260 Anchorage, AK 1.1927 1.1283 11460 Ann Arbor, MI 1.0440 1.0299 13020 Bay City, MI 1.0044 1.0030 13900 Bismarck, ND 0.73680 0.8113 19804 Detroit-Livonia-Dearborn, MI 1.0281 1.0192 21660 Eugene-Springfield, OR 1.0598 1.0406 22020 Fargo, ND-MN 0.8367 0.8851 24300 Grand Junction, CO 0.9879 0.9917 26820 Idaho Falls, ID 0.9217 0.9457 31084 Los Angeles-Long Beach-Santa Ana, CA 1.1520 1.1017 34740 Muskegon-Norton Shores, MI 0.9762 0.9836 35004 Nassau-Suffolk, NY 1.2730 1.1797 35300 New Haven-Milford, CT 1.2142 1.1421 35644 New York-White Plains-Wayne, NY-NJ 1.3113 1.2039 16 Iowa 0.8615 0.9029 24 Minnesota 0.9280 0.9501 38 Oregon 0.97640 0.9838 53 Wyoming 0.9048 0.9338 ** See Table 4C-1 for the wage index and GAF that are effective from October 1, 2006 through March 31, 2007. For areas that are not listed on this table, the wage index and GAF on Table 4C-1 are effective for the entire FY 2007. Table 4F.—Puerto Rico Wage Index and Capital Geographic Adjustment Factor (GAF) by CBSA
CBSA code Area Wage Index GAF Wage Index—reclassified rospitals GAF— Reclassified hospitals 10380 Aguadilla-Isabela-San Sebastián, PR 0.8736 0.9116 Start Printed Page 60004 21940 Fajardo, PR 0.9168 0.9422 25020 Guayama, PR 0.7326 0.8081; 32420 Mayagüez, PR 0.8739 0.9118; 38660 Ponce, PR 1.0781 1.0528 41900 San Germán-Cabo Rojo, PR 1.1052 1.0709 41980 San Juan-Caguas-Guaynabo, PR 1.0119 1.0081 1.0119 1.0081 49500 Yauco, PR 0.8668 0.9067 The following list represents all hospitals located in counties that became newly eligible in FY 2005, FY 2006 or FY 2007 to have their wage index increased by the out-migration adjustment listed in this table. This table now reflects any additional hospitals located in counties that may newly qualify for the adjustment in FY 2007 based on the 100 percent occupational mix adjusted wage index data. Hospitals cannot receive the out-migration adjustment if they are reclassified under section 1886(d)(10) of the Act, reclassified under section 508 of Pub. L. 108-173, or redesignated under section 1886(d)(8) of the Act. If a hospital has a half fiscal year reclassification, the hospital will be eligible for the out-migration adjustment for the portion of the fiscal year that it is not reclassified. Hospitals that have been reclassified under section 1886(d)(10) of the Act, reclassified under section 508 of Pub. L. 108-173, or redesignated under section 1886(d)(8) of the Act for any portion of the fiscal year are designated with an asterisk. It is important to note that the asterisked information in Table 4J may reflect withdrawal/termination decisions CMS has made on behalf of hospitals. For example, in some cases, CMS may have withdrawn or terminated a reclassification under section 1886(d)(10) of the Act in order for a hospital to receive its home wage index plus an out-migration adjustment. Hospitals have 30 days from this publication of the final occupation mix-adjusted data and other tables on the CMS Web site to reverse a decision CMS has made on its behalf and choose a wage index, adjustment, or reclassification for which they are otherwise eligible.
Start Printed Page 60013Table 4J.—Out-Migration Adjustment —FY 2007
Provider No. Reclassified between 10/1/06 and 3/31/07 Reclassified between 4/1/07 and 9/30/07 Out-migration adjustment Qualifying county name 010005 * * 0.0259 MARSHALL 010008 * * 0.0212 CRENSHAW 010009 * * 0.0259 MARSHALL 010012 * * 0.0205 DE KALB 010022 * * 0.0714 CHEROKEE 010025 * * 0.0235 CHAMBERS 010029 * * 0.0107 LEE 010035 * * 0.0375 CULLMAN 010038 0.0062 CALHOUN 010045 * * 0.0160 FAYETTE 010047 0.0155 BUTLER 010052 0.0103 TALLAPOOSA 010054 * * 0.0092 MORGAN 010061 0.0506 JACKSON 010065 * * 0.0103 TALLAPOOSA 010078 0.0062 CALHOUN 010083 * * 0.0121 BALDWIN 010085 * * 0.0092 MORGAN 010100 * * 0.0121 BALDWIN 010101 * * 0.0310 TALLADEGA 010109 0.0451 PICKENS 010129 0.0121 BALDWIN 010143 * * 0.0375 CULLMAN 010146 0.0062 CALHOUN 010150 * * 0.0155 BUTLER 010158 * * 0.0093 FRANKLIN 010164 * * 0.0310 TALLADEGA 040014 * * 0.0159 WHITE 040019 * * 0.0697 ST. FRANCIS 040047 * * 0.0090 RANDOLPH 040069 * * 0.0140 MISSISSIPPI 040071 * * 0.0026 JEFFERSON 040076 * * 0.1075 HOT SPRING 040100 * * 0.0159 WHITE 050008 0.0026 SAN FRANCISCO Start Printed Page 60005 050009 * * 0.0478 NAPA 050013 * * 0.0478 NAPA 050014 * * 0.0131 AMADOR 050016 0.0103 SAN LUIS OBISPO 050042 * * 0.0219 TEHAMA 050046 * * 0.0156 VENTURA 050047 0.0026 SAN FRANCISCO 050055 0.0026 SAN FRANCISCO 050065 * * 0.0029 ORANGE 050069 * * 0.0029 ORANGE 050073 * * 0.0269 SOLANO 050076 * * 0.0026 SAN FRANCISCO 050082 * 0.0156 VENTURA 050084 0.0555 SAN JOAQUIN 050089 * * 0.0152 SAN BERNARDINO 050090 * * 0.0308 SONOMA 050099 * * 0.0152 SAN BERNARDINO 050101 * * 0.0269 SOLANO 050117 0.0463 MERCED 050118 0.0555 SAN JOAQUIN 050122 0.0555 SAN JOAQUIN 050129 * * 0.0152 SAN BERNARDINO 050133 0.0170 YUBA 050136 * * 0.0308 SONOMA 050140 * * 0.0152 SAN BERNARDINO 050150 * * 0.0316 NEVADA 050152 0.0026 SAN FRANCISCO 050159 * 0.0156 VENTURA 050167 0.0555 SAN JOAQUIN 050168 * * 0.0029 ORANGE 050173 * * 0.0029 ORANGE 050174 * * 0.0308 SONOMA 050193 * * 0.0029 ORANGE 050194 0.0052 SANTA CRUZ 050224 * * 0.0029 ORANGE 050226 * * 0.0029 ORANGE 050228 * * 0.0026 SAN FRANCISCO 050230 * * 0.0029 ORANGE 050232 0.0103 SAN LUIS OBISPO 050236 * 0.0156 VENTURA 050242 0.0052 SANTA CRUZ 050245 * * 0.0152 SAN BERNARDINO 050272 * * 0.0152 SAN BERNARDINO 050279 * * 0.0152 SAN BERNARDINO 050291 * * 0.0308 SONOMA 050298 * * 0.0152 SAN BERNARDINO 050300 * * 0.0152 SAN BERNARDINO 050313 0.0555 SAN JOAQUIN 050325 0.0176 TUOLUMNE 050327 * * 0.0152 SAN BERNARDINO 050335 0.0176 TUOLUMNE 050336 0.0555 SAN JOAQUIN 050348 * * 0.0029 ORANGE 050367 * * 0.0269 SOLANO 050385 * * 0.0308 SONOMA 050394 * 0.0156 VENTURA 050407 0.0026 SAN FRANCISCO 050426 * * 0.0029 ORANGE 050444 0.0463 MERCED 050454 0.0026 SAN FRANCISCO 050457 0.0026 SAN FRANCISCO 050469 * * 0.0152 SAN BERNARDINO 050476 0.0257 LAKE 050494 * 0.0316 NEVADA 050506 0.0103 SAN LUIS OBISPO 050517 * * 0.0152 SAN BERNARDINO 050526 * * 0.0029 ORANGE 050528 * * 0.0463 MERCED 050535 * * 0.0029 ORANGE Start Printed Page 60006 050543 * * 0.0029 ORANGE 050547 * * 0.0308 SONOMA 050548 * * 0.0029 ORANGE 050549 * * 0.0156 VENTURA 050550 * * 0.0029 ORANGE 050551 * * 0.0029 ORANGE 050567 * * 0.0029 ORANGE 050568 0.0062 MADERA 050570 * * 0.0029 ORANGE 050580 * * 0.0029 ORANGE 050584 * * 0.0152 SAN BERNARDINO 050585 * * 0.0029 ORANGE 050586 * * 0.0152 SAN BERNARDINO 050589 * * 0.0029 ORANGE 050592 * * 0.0029 ORANGE 050594 * * 0.0029 ORANGE 050603 * * 0.0029 ORANGE 050609 * * 0.0029 ORANGE 050616 * 0.0156 VENTURA 050618 * * 0.0152 SAN BERNARDINO 050633 0.0103 SAN LUIS OBISPO 050667 * * 0.0478 NAPA 050668 0.0026 SAN FRANCISCO 050678 * * 0.0029 ORANGE 050680 * * 0.0269 SOLANO 050690 * * 0.0308 SONOMA 050693 * * 0.0029 ORANGE 050695 0.0555 SAN JOAQUIN 050714 0.0052 SANTA CRUZ 050720 * * 0.0029 ORANGE 050728 * * 0.0308 SONOMA 050744 0.0029 ORANGE 050745 0.0029 ORANGE 050746 0.0029 ORANGE 050747 0.0029 ORANGE 050749 * 0.0156 VENTURA 060001 * * 0.0294 WELD 060003 * * 0.0203 BOULDER 060010 0.0153 LARIMER 060027 * * 0.0203 BOULDER 060030 0.0153 LARIMER 060103 * * 0.0203 BOULDER 060116 0.0203 BOULDER 070003 * * 0.0009 WINDHAM 070006 * * 0.0047 FAIRFIELD 070010 * * 0.0047 FAIRFIELD 070018 * * 0.0047 FAIRFIELD 070020 0.0073 MIDDLESEX 070021 0.0009 WINDHAM 070028 * * 0.0047 FAIRFIELD 070033 * * 0.0047 FAIRFIELD 070034 * * 0.0047 FAIRFIELD 080001 0.0063 NEW CASTLE 080003 0.0063 NEW CASTLE 100014 0.0118 VOLUSIA 100017 0.0118 VOLUSIA 100045 * * 0.0118 VOLUSIA 100047 0.0021 CHARLOTTE 100062 0.0060 MARION 100068 0.0118 VOLUSIA 100072 0.0118 VOLUSIA 100077 0.0021 CHARLOTTE 100102 0.0125 COLUMBIA 100118 0.0398 FLAGLER 100156 0.0125 COLUMBIA 100175 0.0231 DE SOTO 100212 0.0060 MARION 100232 * * 0.0347 PUTNAM 100236 0.0021 CHARLOTTE Start Printed Page 60007 100252 * * 0.0233 OKEECHOBEE 100290 0.0582 SUMTER 110023 * * 0.0500 GORDON 110027 0.0387 FRANKLIN 110029 * * 0.0063 HALL 110041 * * 0.0777 HABERSHAM 110069 * * 0.0474 HOUSTON 110124 0.0428 WAYNE 110146 0.0805 CAMDEN 110150 * * 0.0261 BALDWIN 110153 * * 0.0474 HOUSTON 110187 * * 0.1172 LUMPKIN 110189 * * 0.0031 FANNIN 110190 0.0182 MACON 110205 * * 0.0779 GILMER 130003 * * 0.0095 NEZ PERCE 130024 0.0275 BONNER 130049 * * 0.0349 KOOTENAI 130066 0.0349 KOOTENAI 140012 * * 0.0220 LEE 140026 0.0346 LA SALLE 140033 0.0147 LAKE 140043 * * 0.0046 WHITESIDE 140058 * * 0.0081 MORGAN 140084 0.0147 LAKE 140100 0.0147 LAKE 140110 * * 0.0346 LA SALLE 140130 0.0147 LAKE 140155 * * 0.0027 KANKAKEE 140160 * * 0.0286 STEPHENSON 140161 * * 0.0138 LIVINGSTON 140186 * * 0.0027 KANKAKEE 140202 0.0147 LAKE 140205 0.0163 BOONE 140234 * * 0.0346 LA SALLE 140291 * * 0.0147 LAKE 150006 * * 0.0113 LA PORTE 150015 * * 0.0113 LA PORTE 150022 0.0249 MONTGOMERY 150030 * * 0.0201 HENRY 150035 0.0083 PORTER 150045 0.0416 DE KALB 150065 * * 0.0139 JACKSON 150076 * * 0.0189 MARSHALL 150088 * * 0.0196 MADISON 150091 0.0573 HUNTINGTON 150102 * * 0.0160 STARKE 150113 * * 0.0196 MADISON 150122 * * 0.0199 RIPLEY 150146 * * 0.0319 NOBLE 160013 0.0218 MUSCATINE 160030 0.0040 STORY 160032 0.0272 JASPER 160080 * * 0.0049 CLINTON 170137 * * 0.0336 DOUGLAS 180012 * * 0.0083 HARDIN 180066 * * 0.0567 LOGAN 180127 * * 0.0352 FRANKLIN 180128 0.0282 LAWRENCE 190001 * * 0.0645 WASHINGTON 190003 * * 0.0107 IBERIA 190015 * * 0.0401 TANGIPAHOA 190017 0.0235 ST. LANDRY 190054 0.0107 IBERIA 190078 0.0235 ST. LANDRY 190088 0.0705 WEBSTER 190099 * * 0.0390 AVOYELLES 190106 * * 0.0238 ALLEN 190133 0.0238 ALLEN Start Printed Page 60008 190144 0.0705 WEBSTER 190184 0.0161 CALDWELL 190190 0.0161 CALDWELL 190191 * * 0.0235 ST. LANDRY 190246 0.0161 CALDWELL 200002 0.0129 LINCOLN 200024 * * 0.0071 ANDROSCOGGIN 200032 0.0466 OXFORD 200034 * * 0.0071 ANDROSCOGGIN 200050 * * 0.0140 HANCOCK 210001 0.0129 WASHINGTON 210004 0.0040 MONTGOMERY 210016 0.0040 MONTGOMERY 210018 0.0040 MONTGOMERY 210022 0.0040 MONTGOMERY 210023 0.0209 ANNE ARUNDEL 210028 0.0512 ST. MARYS 210043 0.0209 ANNE ARUNDEL 210048 0.0287 HOWARD 210057 0.0040 MONTGOMERY 220001 * * 0.0056 WORCESTER 220002 * * 0.0249 MIDDLESEX 220010 * * 0.0306 ESSEX 220011 * * 0.0249 MIDDLESEX 220019 * * 0.0056 WORCESTER 220025 * * 0.0056 WORCESTER 220028 * * 0.0056 WORCESTER 220029 * * 0.0306 ESSEX 220033 * * 0.0306 ESSEX 220035 * * 0.0306 ESSEX 220049 * * 0.0249 MIDDLESEX 220058 * * 0.0056 WORCESTER 220062 * * 0.0056 WORCESTER 220063 * * 0.0249 MIDDLESEX 220070 * * 0.0249 MIDDLESEX 220080 * * 0.0306 ESSEX 220082 * * 0.0249 MIDDLESEX 220084 * * 0.0249 MIDDLESEX 220089 0.0249 MIDDLESEX 220090 * * 0.0056 WORCESTER 220095 * * 0.0056 WORCESTER 220098 * * 0.0249 MIDDLESEX 220101 * * 0.0249 MIDDLESEX 220105 * * 0.0249 MIDDLESEX 220163 * * 0.0056 WORCESTER 220171 * * 0.0249 MIDDLESEX 220174 * * 0.0306 ESSEX 220176 0.0056 WORCESTER 230003 * * 0.0035 OTTAWA 230013 * * 0.0091 OAKLAND 230015 0.0359 ST. JOSEPH 230019 * * 0.0091 OAKLAND 230021 0.0136 BERRIEN 230022 * * 0.0113 BRANCH 230029 * * 0.0091 OAKLAND 230037 * * 0.0178 HILLSDALE 230041 0.0099 BAY 230047 * * 0.0082 MACOMB 230069 * * 0.0487 LIVINGSTON 230071 * * 0.0091 OAKLAND 230072 * * 0.0035 OTTAWA 230075 0.0145 CALHOUN 230078 * * 0.0136 BERRIEN 230092 0.0389 JACKSON 230093 * * 0.0079 MECOSTA 230096 * * 0.0359 ST. JOSEPH 230099 * * 0.0339 MONROE 230106 * 0.0030 NEWAYGO 230121 * * 0.0691 SHIAWASSEE Start Printed Page 60009 230130 * * 0.0091 OAKLAND 230151 * * 0.0091 OAKLAND 230174 * * 0.0035 OTTAWA 230195 * * 0.0082 MACOMB 230204 * * 0.0082 MACOMB 230207 * * 0.0091 OAKLAND 230217 * * 0.0145 CALHOUN 230222 0.0228 MIDLAND 230223 * * 0.0091 OAKLAND 230227 * * 0.0082 MACOMB 230254 * * 0.0091 OAKLAND 230257 * * 0.0082 MACOMB 230264 * * 0.0082 MACOMB 230269 * * 0.0091 OAKLAND 230277 * * 0.0091 OAKLAND 230279 * * 0.0487 LIVINGSTON 240018 * * 0.1196 GOODHUE 240044 0.0868 WINONA 240064 * * 0.0138 ITASCA 240069 * * 0.0419 STEELE 240071 * * 0.0454 RICE 240187 * * 0.0506 MC LEOD 240211 * * 0.0705 PINE 250040 * * 0.0294 JACKSON 260011 0.0007 COLE 260047 * * 0.0007 COLE 260074 0.0158 RANDOLPH 260097 0.0425 JOHNSON 280077 * * 0.0089 DODGE 280123 0.0137 GAGE 290019 * * 0.0026 CARSON CITY 290049 0.0026 CARSON CITY 290051 0.0026 CARSON CITY 300011 0.0069 HILLSBOROUGH 300012 0.0069 HILLSBOROUGH 300017 0.0361 ROCKINGHAM 300020 0.0069 HILLSBOROUGH 300023 0.0361 ROCKINGHAM 300029 0.0361 ROCKINGHAM 300034 0.0069 HILLSBOROUGH 310002 * * 0.0351 ESSEX 310009 * * 0.0351 ESSEX 310010 0.0092 MERCER 310011 0.0115 CAPE MAY 310013 * * 0.0351 ESSEX 310018 * * 0.0351 ESSEX 310021 * * 0.0092 MERCER 310038 * * 0.0350 MIDDLESEX 310039 * * 0.0350 MIDDLESEX 310044 0.0092 MERCER 310054 * * 0.0351 ESSEX 310070 * * 0.0350 MIDDLESEX 310076 * * 0.0351 ESSEX 310083 * * 0.0351 ESSEX 310092 0.0092 MERCER 310093 * * 0.0351 ESSEX 310096 * * 0.0351 ESSEX 310108 * * 0.0350 MIDDLESEX 310110 0.0092 MERCER 310119 * * 0.0351 ESSEX 310123 0.0351 ESSEX 310124 0.0350 MIDDLESEX 320003 0.0629 SAN MIGUEL 320011 0.0442 RIO ARRIBA 320018 0.0063 DONA ANA 320085 0.0063 DONA ANA 330004 * * 0.0959 ULSTER 330008 * * 0.0470 WYOMING 330027 * * 0.0137 NASSAU Start Printed Page 60010 330094 * * 0.0778 COLUMBIA 330106 * * 0.0137 NASSAU 330126 * 0.0560 ORANGE 330135 * 0.0560 ORANGE 330167 * 0.0137 NASSAU 330181 * 0.0137 NASSAU 330182 * * 0.0137 NASSAU 330191 * * 0.0026 WARREN 330198 * 0.0137 NASSAU 330205 * 0.0560 ORANGE 330224 * * 0.0959 ULSTER 330225 * 0.0137 NASSAU 330235 * * 0.0270 CAYUGA 330259 * 0.0137 NASSAU 330264 * 0.0560 ORANGE 330276 0.0063 FULTON 330331 * 0.0137 NASSAU 330332 * 0.0137 NASSAU 330372 * 0.0137 NASSAU 330386 * * 0.1139 SULLIVAN 340015 0.0267 ROWAN 340020 0.0207 LEE 340021 * * 0.0216 CLEVELAND 340037 0.0216 CLEVELAND 340039 * * 0.0144 IREDELL 340069 0.0053 WAKE 340070 0.0448 ALAMANCE 340073 * 0.0053 WAKE 340085 0.0377 DAVIDSON 340096 0.0377 DAVIDSON 340104 0.0216 CLEVELAND 340114 0.0053 WAKE 340126 * * 0.0161 WILSON 340127 * * 0.0961 GRANVILLE 340129 * * 0.0144 IREDELL 340133 0.0308 MARTIN 340138 0.0053 WAKE 340144 * * 0.0144 IREDELL 340145 * * 0.0563 LINCOLN 340173 0.0053 WAKE 360013 * * 0.0166 SHELBY 360025 0.0087 ERIE 360036 * * 0.0263 WAYNE 360065 * * 0.0141 HURON 360070 0.0028 STARK 360078 * * 0.0159 PORTAGE 360084 0.0028 STARK 360086 * * 0.0168 CLARK 360095 * * 0.0087 HANCOCK 360100 0.0028 STARK 360107 * * 0.0213 SANDUSKY 360131 0.0028 STARK 360151 0.0028 STARK 360156 0.0213 SANDUSKY 360175 * * 0.0159 CLINTON 360187 * * 0.0168 CLARK 360197 * * 0.0092 LOGAN 360270 0.0120 DEFIANCE 370004 * * 0.0193 OTTAWA 370014 0.0831 BRYAN 370015 * * 0.0463 MAYES 370023 0.0084 STEPHENS 370065 0.0121 CRAIG 370113 * * 0.0205 DELAWARE 370149 0.0356 POTTAWATOMIE 370219 0.0356 POTTAWATOMIE 380002 0.0130 JOSEPHINE 380022 * * 0.0201 LINN 380029 0.0075 MARION Start Printed Page 60011 380051 0.0075 MARION 380056 0.0075 MARION 390011 0.0012 CAMBRIA 390030 * * 0.0284 SCHUYLKILL 390031 * * 0.0284 SCHUYLKILL 390044 * * 0.0200 BERKS 390046 * * 0.0098 YORK 390056 0.0042 HUNTINGDON 390065 * * 0.0501 ADAMS 390066 * * 0.0259 LEBANON 390096 * * 0.0200 BERKS 390101 0.0098 YORK 390110 0.0012 CAMBRIA 390130 0.0012 CAMBRIA 390138 * * 0.0325 FRANKLIN 390146 0.0053 WARREN 390150 0.0206 GREENE 390151 * * 0.0325 FRANKLIN 390162 0.0200 NORTHAMPTON 390181 0.0284 SCHUYLKILL 390183 0.0284 SCHUYLKILL 390201 0.1127 MONROE 390233 0.0098 YORK 420007 * * 0.0001 SPARTANBURG 420009 * * 0.0113 OCONEE 420020 * * 0.0035 GEORGETOWN 420027 * * 0.0210 ANDERSON 420030 * * 0.0103 COLLETON 420039 * * 0.0153 UNION 420043 0.0177 CHEROKEE 420062 0.0109 CHESTERFIELD 420068 * * 0.0097 ORANGEBURG 420070 * * 0.0101 SUMTER 420083 * * 0.0001 SPARTANBURG 420098 0.0035 GEORGETOWN 440008 0.0663 HENDERSON 440024 * * 0.0387 BRADLEY 440030 0.0056 HAMBLEN 440035 * * 0.0441 MONTGOMERY 440047 0.0499 GIBSON 440056 0.0321 JEFFERSON 440060 0.0499 GIBSON 440063 0.0011 WASHINGTON 440067 * * 0.0056 HAMBLEN 440073 * * 0.0513 MAURY 440105 0.0011 WASHINGTON 440115 0.0499 GIBSON 440148 * * 0.0568 DE KALB 440153 0.0007 COCKE 440174 0.0372 HAYWOOD 440181 0.0407 HARDEMAN 440184 0.0011 WASHINGTON 440185 * * 0.0387 BRADLEY 450032 * * 0.0416 HARRISON 450039 * * 0.0097 TARRANT 450059 * * 0.0073 COMAL 450064 * * 0.0097 TARRANT 450087 * * 0.0097 TARRANT 450099 * * 0.0180 GRAY 450121 * * 0.0097 TARRANT 450135 * * 0.0097 TARRANT 450137 * * 0.0097 TARRANT 450144 * * 0.0573 ANDREWS 450163 0.0134 KLEBERG 450187 * * 0.0264 WASHINGTON 450194 * * 0.0328 CHEROKEE 450214 * * 0.0368 WHARTON 450224 * * 0.0411 WOOD 450324 * * 0.0132 GRAYSON Start Printed Page 60012 450347 * * 0.0427 WALKER 450370 0.0258 COLORADO 450389 * * 0.0881 HENDERSON 450393 * * 0.0132 GRAYSON 450395 * * 0.0484 POLK 450419 * * 0.0097 TARRANT 450438 * * 0.0258 COLORADO 450447 * * 0.0358 NAVARRO 450451 * * 0.0551 SOMERVELL 450465 0.0435 MATAGORDA 450469 * * 0.0132 GRAYSON 450547 * * 0.0411 WOOD 450563 * * 0.0097 TARRANT 450565 0.0486 PALO PINTO 450596 0.0808 HOOD 450597 0.0077 DE WITT 450639 * * 0.0097 TARRANT 450672 * * 0.0097 TARRANT 450675 * * 0.0097 TARRANT 450677 * * 0.0097 TARRANT 450694 * * 0.0368 WHARTON 450747 * * 0.0195 ANDERSON 450755 0.0484 HOCKLEY 450779 * * 0.0097 TARRANT 450813 * * 0.0195 ANDERSON 450872 * * 0.0097 TARRANT 450880 * * 0.0097 TARRANT 450886 0.0097 TARRANT 450888 0.0097 TARRANT 460017 0.0392 BOX ELDER 460039 * * 0.0392 BOX ELDER 490019 0.1240 CULPEPER 490038 0.0022 SMYTH 490084 0.0167 ESSEX 490105 * * 0.0022 SMYTH 490110 0.0082 MONTGOMERY 500003 * * 0.0208 SKAGIT 500007 0.0208 SKAGIT 500019 0.0213 LEWIS 500021 * * 0.0055 PIERCE 500024 0.0023 THURSTON 500039 * * 0.0174 KITSAP 500041 * * 0.0118 COWLITZ 500079 * * 0.0055 PIERCE 500108 * * 0.0055 PIERCE 500129 * * 0.0055 PIERCE 500139 0.0023 THURSTON 500143 0.0023 THURSTON 510018 * * 0.0209 JACKSON 510039 0.0112 OHIO 510047 * * 0.0275 MARION 510050 0.0112 OHIO 510077 * * 0.0021 MINGO 520028 * * 0.0157 GREEN 520035 0.0077 SHEBOYGAN 520044 0.0077 SHEBOYGAN 520057 0.0118 SAUK 520059 * * 0.0200 RACINE 520071 * * 0.0239 JEFFERSON 520095 * * 0.0118 SAUK 520096 * * 0.0200 RACINE 520102 * * 0.0298 WALWORTH 520116 * * 0.0239 JEFFERSON 520132 0.0077 SHEBOYGAN Start Printed Page 60026Table 5.— List of Diagnosis-Related Groups (DRGS), Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay (LOS)
DRG FY 07 final rule post-acute care DRG FY 07 final rule special pay DRG MDC TYPE DRG title Weights Geometric mean LOS Arithmetic mean LOS 1 Yes No 01 SURG Craniotomy Age >17 W CC 3.4651 7.3 9.8 2 Yes No 01 SURG Craniotomy Age >17 W/O CC 1.9525 3.4 4.4 3 No No 01 SURG * Craniotomy Age 0-17 2.0113 12.7 12.7 4 No No 01 SURG No Longer Valid 0.0000 0.0 0.0 5 No No 01 SURG No Longer Valid 0.0000 0.0 0.0 6 No No 01 SURG Carpal Tunnel Release 0.7910 2.1 3.1 7 Yes Yes 01 SURG Periph & Cranial Nerve & Other Nerv Syst Proc W CC 2.6609 6.5 9.4 8 Yes Yes 01 SURG Periph & Cranial Nerve & Other Nerv Syst Proc W/O CC 1.5953 2.0 2.8 9 No No 01 MED Spinal Disorders & Injuries 1.3647 4.4 6.2 10 Yes No 01 MED Nervous System Neoplasms W CC 1.2556 4.6 6.0 11 Yes No 01 MED Nervous System Neoplasms W/O CC 0.8592 2.7 3.6 12 Yes No 01 MED Degenerative Nervous System Disorders 0.9322 4.3 5.5 13 Yes No 01 MED Multiple Sclerosis & Cerebellar Ataxia 0.8541 4.0 4.9 14 Yes No 01 MED Intracranial Hemorrhage or Cerebral Infarction 1.2118 4.3 5.5 15 Yes No 01 MED Nonspecific CVA & Precerebral Occlusion w/o Infarct 0.9442 3.1 4.0 16 Yes No 01 MED Nonspecific Cerebrovascular Disorders w CC 1.3579 5.0 6.5 17 Yes No 01 MED Nonspecific Cerebrovascular Disorders w/o CC 0.7141 2.4 3.0 18 Yes No 01 MED Cranial & Peripheral Nerve Disorders w CC 1.0038 4.1 5.2 19 Yes No 01 MED Cranial & Peripheral Nerve Disorders w/o CC 0.7194 2.7 3.4 20 No No 01 MED No Longer Valid 0.0000 0.0 0.0 21 No No 01 MED Viral Meningitis 1.4130 4.7 6.2 22 No No 01 MED Hypertensive Encephalopathy 1.1652 3.9 5.0 23 No No 01 MED Nontraumatic Stupor & Coma 0.8015 3.0 3.9 24 No No 01 MED No Longer Valid 0.0000 0.0 0.0 25 No No 01 MED No Longer Valid 0.0000 0.0 0.0 26 No No 01 MED Seizure & Headache Age 0-17 1.0076 2.7 3.8 27 No No 01 MED Traumatic Stupor & Coma, Coma >1 Hr 1.3499 3.1 4.7 28 Yes No 01 MED Traumatic Stupor & Coma, Coma <1 Hr Age >17 w CC 1.3357 4.2 5.7 29 Yes No 01 MED Traumatic Stupor & Coma, Coma <1 Hr Age >17 w/o CC 0.7401 2.6 3.2 30 No No 01 MED * Traumatic Stupor & Coma, Coma <1 Hr Age 0-17 0.3402 31 No No 01 MED Concussion Age >17 w CC 0.9796 3.0 3.9 32 No No 01 MED Concussion Age >17 w/o CC 0.6408 1.9 2.3 33 No No 01 MED * Concussion Age 0-17 0.2136 34 Yes No 01 MED Other Disorders Of Nervous System w CC 1.0175 3.6 4.8 35 Yes No 01 MED Other Disorders Of Nervous System w/o CC 0.6587 2.5 3.1 36 No No 02 SURG Retinal Procedures 0.8056 1.4 1.9 37 No No 02 SURG Orbital Procedures 1.2064 2.7 4.1 38 No No 02 SURG Primary Iris Procedures 0.6195 2.2 2.8 39 No No 02 SURG Lens Procedures With Or Without Vitrectomy 0.6461 1.6 2.1 40 No No 02 SURG Extraocular Procedures Except Orbit Age >17 1.0309 3.1 4.2 41 No No 02 SURG * Extraocular Procedures Except Orbit Age 0-17 0.3462 42 No No 02 SURG Intraocular Procedures Except Retina, Iris & Lens 0.7717 1.7 2.5 43 No No 02 MED Hyphema 0.6192 2.4 3.0 44 No No 02 MED Acute Major Eye Infections 0.7186 3.8 4.8 45 No No 02 MED Neurological Eye Disorders 0.7434 2.5 3.0 46 No No 02 MED Other Disorders Of The Eye Age >17 w CC 0.7915 3.2 4.2 47 No No 02 MED Other Disorders Of The Eye Age >17 w/o CC 0.5520 2.4 3.0 48 No No 02 MED * Other Disorders Of The Eye Age 0-17 0.3050 49 No No 03 SURG Major Head & Neck Procedures 1.6684 3.2 4.5 Start Printed Page 60014 50 No No 03 SURG Sialoadenectomy 0.8800 1.5 1.9 51 No No 03 SURG Salivary Gland Procedures Except Sialoadenectomy 0.8788 1.9 2.7 52 No No 03 SURG Cleft Lip & Palate Repair 0.6498 1.3 1.5 53 No No 03 SURG Sinus & Mastoid Procedures Age >17 1.3540 2.5 4.0 54 No No 03 SURG * Sinus & Mastoid Procedures Age 0-17 0.4944 55 No No 03 SURG Miscellaneous Ear, Nose, Mouth & Throat Procedures 0.9652 1.9 2.9 56 No No 03 SURG Rhinoplasty 0.8936 1.9 2.7 57 No No 03 SURG T&A Proc, Except Tonsillectomy &/Or Adenoidectomy Only, Age >17 0.9975 2.1 3.3 58 No No 03 SURG * T&A Proc, Except Tonsillectomy &/Or Adenoidectomy Only, Age 0-17 0.2807 59 No No 03 SURG Tonsillectomy &/Or Adenoidectomy Only, Age >17 0.6812 1.8 2.4 60 No No 03 SURG * Tonsillectomy &/Or Adenoidectomy Only, Age 0-17 0.2137 1.5 1.5 61 No No 03 SURG Myringotomy W Tube Insertion Age >17 1.5987 3.7 6.1 62 No No 03 SURG * Myringotomy W Tube Insertion Age 0-17 0.3027 1.3 1.3 63 No No 03 SURG Other Ear, Nose, Mouth & Throat O.R. Procedures 1.3959 3.0 4.5 64 No No 03 MED Ear, Nose, Mouth & Throat Malignancy 1.2498 4.2 6.2 65 No No 03 MED Dysequilibrium 0.6159 2.3 2.8 66 No No 03 MED Epistaxis 0.6280 2.4 3.1 67 No No 03 MED Epiglottitis 0.8242 2.8 3.7 68 No No 03 MED Otitis Media & Uri Age &>17 w CC 0.6605 3.2 3.9 69 No No 03 MED Otitis Media & Uri Age &>17 w/o CC 0.4910 2.5 3.0 70 No No 03 MED Otitis Media & Uri Age 0-17 0.3579 2.1 2.4 71 No No 03 MED Laryngotracheitis 0.7758 3.4 4.4 72 No No 03 MED Nasal Trauma & Deformity 0.7784 2.6 3.3 73 Yes No 03 MED Other Ear, Nose, Mouth & Throat Diagnoses Age >17 0.8500 3.3 4.3 74 No No 03 MED * Other Ear, Nose, Mouth & Throat Diagnoses Age 0-17 0.3441 2.1 2.1 75 Yes No 04 SURG Major Chest Procedures 3.0350 7.4 9.7 76 Yes No 04 SURG Other Resp System O.R. Procedures w CC 2.8386 8.2 10.7 77 Yes No 04 SURG Other Resp System O.R. Procedures w/o CC 1.1886 3.3 4.5 78 Yes No 04 MED Pulmonary Embolism 1.2357 5.3 6.2 79 Yes No 04 MED Respiratory Infections & Inflammations Age >17 w CC 1.6268 6.7 8.3 80 Yes No 04 MED Respiratory Infections & Inflammations Age >17 w/o CC 0.8943 4.3 5.3 81 No No 04 MED * Respiratory Infections & Inflammations Age 0-17 1.5579 6.1 6.1 82 Yes No 04 MED Respiratory Neoplasms 1.4121 5.1 6.8 83 Yes No 04 MED Major Chest Trauma w CC 1.0308 4.2 5.3 84 Yes No 04 MED Major Chest Trauma w/o CCc 0.6028 2.6 3.1 85 Yes No 04 MED Pleural Effusion w CC 1.2459 4.7 6.2 86 Yes No 04 MED Pleural Effusion w/o CC 0.7132 2.7 3.5 87 No No 04 MED Pulmonary Edema & Respiratory Failure 1.3838 4.9 6.4 88 No No 04 MED Chronic Obstructive Pulmonary Disease 0.8878 4.0 4.9 89 Yes No 04 MED Simple Pneumonia & Pleurisy Age >17 w CC 1.0376 4.6 5.6 90 Yes No 04 MED Simple Pneumonia & Pleurisy Age >17 w/o CCc 0.6148 3.2 3.7 91 No No 04 MED Simple Pneumonia & Pleurisy Age 0-17 0.5598 2.5 3.4 92 Yes No 04 MED Interstitial Lung Disease w CC 1.1979 4.8 6.0 93 Yes No 04 MED Interstitial Lung Disease w/o CC 0.7437 3.0 3.8 94 No No 04 MED Pneumothorax w CC 1.1474 4.5 5.9 95 No No 04 MED Pneumothorax w/o CC 0.5871 2.7 3.4 96 No No 04 MED Bronchitis & Asthma Age >17 w CC 0.7350 3.5 4.3 97 No No 04 MED Bronchitis & Asthma Age >17 w/o CC 0.5429 2.8 3.4 98 No No 04 MED Bronchitis & Asthma Age 0-17 0.5870 2.8 3.1 99 No No 04 MED Respiratory Signs & Symptoms w CC 0.7155 2.4 3.1 100 No No 04 MED Respiratory Signs & Symptoms w/o CC 0.5411 1.7 2.1 Start Printed Page 60015 101 Yes No 04 MED Other Respiratory System Diagnoses w CC 0.8614 3.2 4.2 102 Yes No 04 MED Other Respiratory System Diagnoses w/o CC 0.5622 2.0 2.5 103 No No PRE SURG Heart Transplant Or Implant Of Heart Assist System 18.8653 22.2 35.4 104 Yes No 05 SURG Cardiac Valve & Oth Major Cardiothoracic Proc w Card Cath 8.2903 12.8 15.1 105 Yes No 05 SURG Cardiac Valve & Oth Major Cardiothoracic Proc w/o Card Cath 6.0567 8.4 10.2 106 No No 05 SURG Coronary Bypass w Ptca 6.7383 9.3 10.9 107 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 108 Yes No 05 SURG Other Cardiothoracic Procedures 5.7544 8.8 10.9 109 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 110 No No 05 SURG Major Cardiovascular Procedures w CC 3.8064 5.4 8.1 111 No No 05 SURG Major Cardiovascular Procedures w/o CC 2.4879 2.3 3.1 112 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 113 Yes No 05 SURG Amputation For Circ System Disorders Except Upper Limb & Toe 3.2646 10.8 13.7 114 Yes No 05 SURG Upper Limb & Toe Amputation For Circ System Disorders 1.7527 6.6 8.7 115 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 116 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 117 No No 05 SURG Cardiac Pacemaker Revision Except Device Replacement 1.3713 2.6 4.3 118 No No 05 SURG Cardiac Pacemaker Device Replacement 1.6687 2.0 3.0 119 No No 05 SURG Vein Ligation & Stripping 1.4554 3.3 5.4 120 Yes No 05 SURG Other Circulatory System O.R. Procedures 2.4173 6.0 9.2 121 Yes No 05 MED Circulatory Disorders w AMI & Major Comp, Discharged Alive 1.6166 5.2 6.5 122 No No 05 MED Circulatory Disorders w AMI w/o Major Comp, Discharged Alive 0.9621 2.7 3.4 123 No No 05 MED Circulatory Disorders w AMI, Expired 1.4902 2.9 4.7 124 No No 05 MED Circulatory Disorders Except AMI, w Card Cath & Complex Diag 1.4099 3.3 4.4 125 No No 05 MED Circulatory Disorders Except Ami, w Card Cath w/o Complex Diag 1.0530 2.1 2.7 126 Yes No 05 MED Acute & Subacute Endocarditis 2.6653 9.0 11.2 127 Yes No 05 MED Heart Failure & Shock 1.0490 4.1 5.2 128 No No 05 MED Deep Vein Thrombophlebitis 0.7499 4.4 5.2 129 No No 05 MED Cardiac Arrest, Unexplained 1.0118 1.6 2.5 130 Yes No 05 MED Peripheral Vascular Disorders w CC 0.9712 4.3 5.5 131 Yes No 05 MED Peripheral Vascular Disorders w/o CC 0.5755 3.1 3.7 132 No No 05 MED Atherosclerosis w CC 0.6318 2.2 2.8 133 No No 05 MED Atherosclerosis w/o CC 0.5494 1.8 2.1 134 No No 05 MED Hypertension 0.6189 2.5 3.1 135 No No 05 MED Cardiac Congenital & Valvular Disorders Age >17w CC 0.9405 3.3 4.3 136 No No 05 MED Cardiac Congenital & Valvular Disorders Age >17 w/o CC 0.6580 2.1 2.7 137 No No 05 MED * Cardiac Congenital & Valvular Disorders Age 0-17 0.8393 138 No No 05 MED Cardiac Arrhythmia & Conduction Disorders w CC 0.8365 3.0 3.9 139 No No 05 MED Cardiac Arrhythmia & Conduction Disorders w/o CC 0.5297 2.0 2.4 140 No No 05 MED Angina Pectoris 0.5041 1.9 2.4 141 No No 05 MED Syncope & Collapse w CC 0.7633 2.7 3.4 142 No No 05 MED Syncope & Collapse w/o CC 0.6012 2.1 2.5 143 No No 05 MED Chest Pain 0.5637 1.7 2.1 144 Yes No 05 MED Other Circulatory System Diagnoses w CC 1.3381 4.3 5.9 145 Yes No 05 MED Other Circulatory System Diagnoses w/o CC 0.5834 2.0 2.6 146 Yes No 06 SURG Rectal Resection w CC 2.7431 8.4 9.9 147 Yes No 06 SURG Rectal Resection w/o CC 1.5124 4.9 5.6 Start Printed Page 60016 148 No No 06 SURG No Longer Valid 0.0000 0.0 0.0 149 Yes No 06 SURG Major Small & Large Bowel Procedures w/o CC 1.4357 5.1 5.7 150 Yes No 06 SURG Peritoneal Adhesiolysis w CC 2.7871 8.7 10.8 151 Yes No 06 SURG Peritoneal Adhesiolysis w/o CC 1.2863 4.0 5.0 152 No No 06 SURG Minor Small & Large Bowel Procedures w CC 1.8859 6.5 7.9 153 No No 06 SURG Minor Small & Large Bowel Procedures w/o CC 1.0983 4.4 4.9 154 No No 06 SURG No Longer Valid 0.0000 0.0 0.0 155 Yes No 06 SURG Stomach, Esophageal & Duodenal Procedures Age >17 w/o CC 1.2948 3.0 4.0 156 No No 06 SURG * Stomach, Esophageal & Duodenal Procedures Age 0-17 0.8644 6.0 6.0 157 Yes No 06 SURG Anal & Stomal Procedures w CC 1.3430 4.1 5.8 158 Yes No 06 SURG Anal & Stomal Procedures w/o CC 0.6577 2.1 2.7 159 No No 06 SURG Hernia Procedures Except Inguinal & Femoral Age >17 w CC 1.4316 3.7 5.1 160 No No 06 SURG Hernia Procedures Except Inguinal & Femoral Age >17 w/o CC 0.8675 2.2 2.7 161 No No 06 SURG Inguinal & Femoral Hernia Procedures Age >17 w CC 1.2403 3.2 4.5 162 No No 06 SURG Inguinal & Femoral Hernia Procedures Age >17 w/o CCc 0.6916 1.7 2.1 163 No No 06 SURG * Hernia Procedures Age 0-17 0.6809 2.1 2.1 164 No No 06 SURG Appendectomy w Complicated Principal Diag w CC 2.1474 6.4 7.7 165 No No 06 SURG Appendectomy w Complicated Principal Diag w/o CC 1.1843 3.4 4.0 166 No No 06 SURG Appendectomy w/o Complicated Principal Diag w CC 1.4035 3.2 4.3 167 No No 06 SURG Appendectomy w/o Complicated Principal Diag w/o CC 0.9001 1.8 2.1 168 No No 03 SURG Mouth Procedures w CC 1.2827 3.3 4.8 169 No No 03 SURG Mouth Procedures w/o CC 0.7679 1.8 2.3 170 Yes No 06 SURG Other Digestive System O.R. Procedures w CC 2.9921 7.8 10.9 171 Yes No 06 SURG Other Digestive System O.R. Procedures w/o CC 1.2242 3.1 4.2 172 Yes No 06 MED Digestive Malignancy w CC 1.4293 5.1 6.9 173 Yes No 06 MED Digestive Malignancy w/o CC 0.7645 2.7 3.6 174 No No 06 MED G.I. Hemorrhage w CC 1.0296 3.8 4.7 175 No No 06 MED G.I. Hemorrhage w/o CC 0.5808 2.4 2.9 176 Yes No 06 MED Complicated Peptic Ulcer 1.1275 4.0 5.1 177 No No 06 MED Uncomplicated Peptic Ulcer w CC 0.9333 3.6 4.4 178 No No 06 MED Uncomplicated Peptic Ulcer w/o CCc 0.6900 2.6 3.1 179 No No 06 MED Inflammatory Bowel Disease 1.0804 4.5 5.8 180 Yes No 06 MED G.I. Obstruction w CC 0.9930 4.1 5.3 181 Yes No 06 MED G.I. Obstruction w/o CC 0.5784 2.8 3.3 182 No No 06 MED Esophagitis, Gastroent & Misc Digest Disorders Age >17 w CC 0.7853 3.2 4.1 183 No No 06 MED Esophagitis, Gastroent & Misc Digest Disorders Age >17 w/o CC 0.5841 2.3 2.8 184 No No 06 MED Esophagitis, Gastroent & Misc Digest Disorders Age 0-17 0.6192 2.5 3.7 185 No No 03 MED Dental & Oral Dis Except Extractions & Restorations, Age >17 0.8886 3.3 4.5 186 No No 03 MED * Dental & Oral Dis Except Extractions & Restorations, Age 0-17 0.3294 2.9 2.9 187 No No 03 MED Dental Extractions & Restorations 0.8421 3.1 4.2 188 Yes No 06 MED Other Digestive System Diagnoses Age >17w CC 1.0931 4.0 5.4 189 Yes No 06 MED Other Digestive System Diagnoses Age >17 w/o CC 0.5916 2.4 3.0 190 No No 06 MED Other Digestive System Diagnoses Age 0-17 0.6351 2.3 3.0 191 Yes No 07 SURG Pancreas, Liver & Shunt Procedures w CC 3.9384 8.8 12.5 Start Printed Page 60017 192 Yes No 07 SURG Pancreas, Liver & Shunt Procedures w/o CC 1.6740 4.2 5.5 193 No No 07 SURG Biliary Tract Proc Except Only Cholecyst w or w/o C.D.E. w CC 3.3831 10.1 12.6 194 No No 07 SURG Biliary Tract Proc Except Only Cholecyst w or w/o C.D.E. w/o CC 1.5879 5.4 6.3 195 No No 07 SURG Cholecystectomy w C.D.E. w CC 3.0501 8.8 10.6 196 No No 07 SURG Cholecystectomy w C.D.E. w/o CC 1.5412 4.5 5.3 197 Yes No 07 SURG Cholecystectomy Except By Laparoscope w/o C.D.E. w CC 2.5518 7.4 9.1 198 Yes No 07 SURG Cholecystectomy Except By Laparoscope w/o C.D.E. w/o CC 1.1781 3.7 4.3 199 No No 07 SURG Hepatobiliary Diagnostic Procedure For Malignancy 2.2350 6.4 9.0 200 No No 07 SURG Hepatobiliary Diagnostic Procedure For Non-Malignancy 2.8402 6.5 10.4 201 No No 07 SURG Other Hepatobiliary or Pancreas O.R. Procedures 3.7905 10.0 13.6 202 No No 07 MED Cirrhosis & Alcoholic Hepatitis 1.3396 4.6 6.2 203 No No 07 MED Malignancy of Hepatobiliary System or Pancreas 1.3672 4.8 6.5 204 No No 07 MED Disorders of Pancreas Except Malignancy 1.0989 4.1 5.4 205 Yes No 07 MED Disorders of Liver Except Malig,Cirr,Alc Hepa w CC 1.2013 4.4 5.9 206 Yes No 07 MED Disorders of Liver Except Malig,Cirr,Alc Hepa w/o CC 0.7287 3.0 3.8 207 No No 07 MED Disorders of The Biliary Tract w CC 1.1839 4.1 5.3 208 No No 07 MED Disorders of The Biliary Tract w/o CC 0.6890 2.4 3.0 209 No No 08 SURG No Longer Valid 0.0000 0.0 0.0 210 Yes Yes 08 SURG Hip & Femur Procedures Except Major Joint Age >17 w CC 1.9022 5.9 6.7 211 Yes Yes 08 SURG Hip & Femur Procedures Except Major Joint Age >17 w/o CC 1.2939 4.3 4.6 212 No No 08 SURG Hip & Femur Procedures Except Major Joint Age 0-17 0.9164 2.2 2.5 213 Yes No 08 SURG Amputation for Musculoskeletal System & Conn Tissue Disorders 2.1174 7.1 9.5 214 No No 08 SURG No Longer Valid 0.0000 0.0 0.0 215 No No 08 SURG No Longer Valid 0.0000 0.0 0.0 216 Yes No 08 SURG Biopsies of Musculoskeletal System & Connective Tissue 1.8744 3.1 5.4 217 Yes No 08 SURG Wnd Debrid & Skn Grft Except Hand,for Muscskelet & Conn Tiss Dis 3.0499 9.0 12.9 218 Yes No 08 SURG Lower Extrem & Humer Proc Except Hip,Foot,Femur Age >17 w CC 1.7053 4.4 5.5 219 Yes No 08 SURG Lower Extrem & Humer Proc Except Hip,Foot,Femur Age >17 w/o CC 1.1033 2.7 3.2 220 No No 08 SURG * Lower Extrem & Humer Proc Except Hip,Foot,Femur Age 0-17 0.5988 5.3 5.3 221 No No 08 SURG No Longer Valid 0.0000 0.0 0.0 222 No No 08 SURG No Longer Valid 0.0000 0.0 0.0 223 No No 08 SURG Major Shoulder/Elbow Proc, or Other Upper Extremity Proc w CC 1.1726 2.4 3.3 224 No No 08 SURG Shoulder,Elbow or Forearm Proc,Exc Major Joint Proc, w/o CC 0.8574 1.6 1.9 225 Yes No 08 SURG Foot Procedures 1.2775 3.8 5.4 226 Yes No 08 SURG Soft Tissue Procedures w CCc 1.6340 4.6 6.5 227 Yes No 08 SURG Soft Tissue Procedures w/o CC 0.8618 2.1 2.6 228 No No 08 SURG Major Thumb or Joint Proc,or Oth Hand or Wrist Proc w CC 1.1528 2.9 4.2 229 No No 08 SURG Hand or Wrist Proc, Except Major Joint Proc, w/o CC 0.7208 2.0 2.5 230 No No 08 SURG Local Excision & Removal of Int Fix Devices of Hip & Femur 1.3385 3.6 5.4 231 No No 08 SURG No Longer Valid 0.0000 0.0 0.0 232 No No 08 SURG Arthroscopy 0.9732 1.9 2.7 Start Printed Page 60018 233 Yes Yes 08 SURG Other Musculoskelet Sys & Conn Tiss O.R. Proc w CC 1.9033 4.3 6.4 234 Yes Yes 08 SURG Other Musculoskelet Sys & Conn Tiss O.R. Proc w/o CC 1.2565 1.9 2.7 235 Yes No 08 MED Fractures of Femur 0.8226 3.8 4.8 236 Yes No 08 MED Fractures of Hip & Pelvis 0.7688 3.8 4.5 237 No No 08 MED Sprains, Strains, & Dislocations of Hip, Pelvis & Thigh 0.6573 3.0 3.8 238 Yes No 08 MED Osteomyelitis 1.4100 6.5 8.3 239 Yes No 08 MED Pathological Fractures & Musculoskeletal & Conn Tiss Malignancy 1.1203 4.9 6.2 240 Yes No 08 MED Connective Tissue Disorders w CC 1.3807 4.9 6.5 241 Yes No 08 MED Connective Tissue Disorders w/o CC 0.6637 3.0 3.7 242 No No 08 MED Septic Arthritis 1.1045 5.1 6.5 243 No No 08 MED Medical Back Problems 0.7970 3.6 4.5 244 Yes No 08 MED Bone Diseases & Specific Arthropathies w CC 0.7394 3.6 4.5 245 Yes No 08 MED Bone Diseases & Specific Arthropathies w/o CC 0.4943 2.5 3.1 246 No No 08 MED Non-Specific Arthropathies 0.6311 2.8 3.6 247 No No 08 MED Signs & Symptoms of Musculoskeletal System & Conn Tissue 0.5934 2.6 3.3 248 No No 08 MED Tendonitis, Myositis & Bursitis 0.8876 3.8 4.8 249 No No 08 MED Aftercare, Musculoskeletal System & Connective Tissue 0.7506 2.8 4.0 250 Yes No 08 MED Fx, Sprn, Strn & Disl of Forearm, Hand, Foot Age >17 w CC 0.7230 3.2 3.9 251 Yes No 08 MED Fx, Sprn, Strn & Disl of Forearm, Hand, Foot Age >17 w/o CC 0.5122 2.3 2.8 252 No No 08 MED * Fx, Sprn, Strn & Disl of Forearm, Hand, Foot Age 0-17 0.2600 253 Yes No 08 MED Fx, Sprn, Strn & Disl of Uparm,Lowleg Ex Foot Age >17 w CC 0.8180 3.8 4.6 254 Yes No 08 MED Fx, Sprn, Strn & Disl of Uparm,Lowleg Ex Foot Age >17 w/o CC 0.4978 2.6 3.1 255 No No 08 MED * Fx, Sprn, Strn & Disl of Uparm,Lowleg Ex Foot Age 0-17 0.3028 256 Yes No 08 MED Other Musculoskeletal System & Connective Tissue Diagnoses 0.8714 3.9 5.0 257 No No 09 SURG Total Mastectomy For Malignancy w CC 0.9123 2.0 2.6 258 No No 09 SURG Total Mastectomy For Malignancy w/o CC 0.7130 1.5 1.7 259 No No 09 SURG Subtotal Mastectomy For Malignancy w CC 1.0060 1.8 2.8 260 No No 09 SURG Subtotal Mastectomy For Malignancy w/o CC 0.6819 1.2 1.4 261 No No 09 SURG Breast Proc for Non-Malignancy Except Biopsy & Local Excision 0.9535 1.6 2.2 262 No No 09 SURG Breast Biopsy & Local Excision for Non-Malignancy 0.9621 3.3 4.7 263 Yes No 09 SURG Skin Graft &/or Debrid for Skn Ulcer or Cellulitis w CC 2.1230 8.3 11.1 264 Yes No 09 SURG Skin Graft &/or Debrid for Skn Ulcer or Cellulitis w/o CC 1.0980 4.9 6.4 265 Yes No 09 SURG Skin Graft &/or Debrid Except for Skin Ulcer or Cellulitis w CC 1.6951 4.2 6.7 266 Yes No 09 SURG Skin Graft &/or Debrid Except for Skin Ulcer or Cellulitis w/o CC 0.9136 2.3 3.0 267 No No 09 SURG Perianal & Pilonidal Procedures 0.9444 2.9 4.2 268 No No 09 SURG Skin, Subcutaneous Tissue & Breast Plastic Procedures 1.2219 2.4 3.6 269 Yes No 09 SURG Other Skin, Subcut Tiss & Breast Proc w CC 1.7920 6.0 8.3 270 Yes No 09 SURG Other Skin, Subcut Tiss & Breast Proc w/o CCc 0.8209 2.7 3.6 271 Yes No 09 MED Skin Ulcers 1.0763 5.6 7.1 272 Yes No 09 MED Major Skin Disorders w CC 1.0356 4.5 5.9 273 Yes No 09 MED Major Skin Disorders w/o CC 0.5853 2.9 3.7 Start Printed Page 60019 274 No No 09 MED Malignant Breast Disorders w CC 1.1315 4.5 6.2 275 No No 09 MED Malignant Breast Disorders w/o CC 0.5954 2.4 3.3 276 No No 09 MED Non-Maligant Breast Disorders 0.7430 3.6 4.6 277 Yes No 09 MED Cellulitis Age >17 w CC 0.8958 4.5 5.5 278 Yes No 09 MED Cellulitis Age >17 w/o CC 0.5649 3.4 4.0 279 No No 09 MED * Cellulitis Age 0-17 0.7922 4.2 4.2 280 Yes No 09 MED Trauma to the Skin, Subcut Tiss & Breast Age >17 w CC 0.7716 3.2 4.0 281 Yes No 09 MED Trauma to the Skin, Subcut Tiss & Breast Age >17 w/o CC 0.5207 2.3 2.8 282 No No 09 MED * Trauma to the Skin, Subcut Tiss & Breast Age 0-17 0.2633 283 Yes No 09 MED Minor Skin Disorders w CCc 0.7605 3.4 4.6 284 Yes No 09 MED Minor Skin Disorders w/o CC 0.4584 2.3 2.9 285 Yes No 10 SURG Amputat of Lower Limb For Endocrine,Nutrit,& Metabol Disorders 2.1774 8.1 10.3 286 No No 10 SURG Adrenal & Pituitary Procedures 1.9098 3.8 5.2 287 Yes No 10 SURG Skin Grafts & Wound Debrid for Endoc, Nutrit & Metab Disorders 1.9507 7.6 9.9 288 No No 10 SURG O.R. Procedures for Obesity 1.9130 2.9 3.7 289 No No 10 SURG Parathyroid Procedures 0.9245 1.6 2.4 290 No No 10 SURG Thyroid Procedures 0.8806 1.5 2.0 291 No No 10 SURG Thyroglossal Procedures 0.5849 1.3 1.5 292 Yes No 10 SURG Other Endocrine, Nutrit & Metab O.R. Proc w CC 2.6985 7.3 10.2 293 Yes No 10 SURG Other Endocrine, Nutrit & Metab O.R. Proc w/o CC 1.3912 3.5 4.8 294 Yes No 10 MED Diabetes Age >35 0.7869 3.3 4.3 295 No No 10 MED Diabetes Age 0-35 0.7655 2.8 3.7 296 Yes No 10 MED Nutritional & Misc Metabolic Disorders Age >17 w CC 0.8334 3.6 4.7 297 Yes No 10 MED Nutritional & Misc Metabolic Disorders Age >17 w/o CC 0.5090 2.5 3.0 298 No No 10 MED Nutritional & Misc Metabolic Disorders Age 0-17 0.5753 2.5 3.5 299 No No 10 MED Inborn Errors of Metabolism 1.0490 3.7 5.1 300 Yes No 10 MED Endocrine Disorders w CC 1.1193 4.6 5.9 301 Yes No 10 MED Endocrine Disorders w/o CC 0.6209 2.7 3.4 302 No No 11 SURG Kidney Transplant 3.1152 6.7 7.9 303 No No 11 SURG Kidney And Ureter Procedures for Neoplasm 1.9776 5.0 6.3 304 Yes No 11 SURG Kidney And Ureter Procedures for Non-Neoplasm W CC 2.3473 5.8 8.3 305 Yes No 11 SURG Kidney And Ureter Procedures for Non-Neoplasm W/o CC 1.1520 2.5 3.0 306 No No 11 SURG Prostatectomy w CC 1.3390 3.6 5.6 307 No No 11 SURG Prostatectomy w/o CC 0.6411 1.7 2.0 308 No No 11 SURG Minor Bladder Procedures w CC 1.4594 3.3 5.3 309 No No 11 SURG Minor Bladder Procedures w/o CC 0.9022 1.4 1.7 310 No No 11 SURG Transurethral Procedures w CC 1.2131 3.1 4.5 311 No No 11 SURG Transurethral Procedures w/o CC 0.6552 1.5 1.9 312 No No 11 SURG Urethral Procedures, Age >17 w CC 1.1767 3.3 4.9 313 No No 11 SURG Urethral Procedures, Age >17 w/o CC 0.7465 1.8 2.4 314 No No 11 SURG * Urethral Procedures, Age 0-17 0.5076 2.3 2.3 315 No No 11 SURG Other Kidney & Urinary Tract O.R. Procedures 2.1173 3.7 6.8 316 Yes No 11 MED Renal Failure 1.2602 4.8 6.3 317 No No 11 MED Admit for Renal Dialysis 0.8067 2.4 3.5 318 No No 11 MED Kidney & Urinary Tract Neoplasms w CC 1.2376 4.4 6.0 319 No No 11 MED Kidney & Urinary Tract Neoplasms w/o CC 0.6084 1.9 2.6 320 Yes No 11 MED Kidney & Urinary Tract Infections Age >17 w CC 0.8769 4.1 5.1 321 Yes No 11 MED Kidney & Urinary Tract Infections Age >17 w/o CC 0.5793 3.0 3.6 322 No No 11 MED Kidney & Urinary Tract Infections Age 0-17 0.6160 3.1 3.6 Start Printed Page 60020 323 No No 11 MED Urinary Stones w CC, &/or ESW Lithotripsy 0.8259 2.3 3.1 324 No No 11 MED Urinary Stones w/o CC 0.5049 1.6 1.8 325 No No 11 MED Kidney & Urinary Tract Signs & Symptoms Age >17 w CC 0.6904 2.9 3.7 326 No No 11 MED Kidney & Urinary Tract Signs & Symptoms Age >17 w/o CCc 0.4544 2.1 2.6 327 No No 11 MED Kidney & Urinary Tract Signs & Symptoms Age 0-17 0.2109 1.8 2.0 328 No No 11 MED Urethral Stricture Age >17 w CC 0.7294 2.6 3.4 329 No No 11 MED Urethral Stricture Age >17 w/o CC 0.5198 1.4 1.7 330 No No 11 MED * Urethral Stricture Age 0-17 0.3268 331 Yes No 11 MED Other Kidney & Urinary Tract Diagnoses Age >17 w CC 1.0960 4.2 5.5 332 Yes No 11 MED Other Kidney & Urinary Tract Diagnoses Age >17 w/o CC 0.6255 2.4 3.1 333 No No 11 MED Other Kidney & Urinary Tract Diagnoses Age 0-17 1.0170 3.7 5.4 334 No No 12 SURG Major Male Pelvic Procedures w CC 1.4202 3.3 4.0 335 No No 12 SURG Major Male Pelvic Procedures w/o CC 1.1174 2.2 2.5 336 No No 12 SURG Transurethral Prostatectomy w CC 0.8576 2.4 3.2 337 No No 12 SURG Transurethral Prostatectomy w/o CC 0.5877 1.6 1.8 338 No No 12 SURG Testes Procedures, For Malignancy 1.3797 3.8 5.8 339 No No 12 SURG Testes Procedures, Non-Malignancy Age >17 1.2553 3.3 5.2 340 No No 12 SURG * Testes Procedures, Non-Malignancy Age 0-17 0.2904 341 No No 12 SURG Penis Procedures 1.3419 1.9 3.2 342 No No 12 SURG Circumcision Age >17 0.8103 2.3 3.0 343 No No 12 SURG * Circumcision Age 0-17 0.1579 344 No No 12 SURG Other Male Reproductive System O.R. Procedures for Malignancy 1.2124 1.7 2.7 345 No No 12 SURG Other Male Reproductive System O.R. Proc Except for Malignancy 1.2987 3.4 5.4 346 No No 12 MED Malignancy, Male Reproductive System, w CC 1.0716 4.5 5.9 347 No No 12 MED Malignancy, Male Reproductive System, w/o CC 0.5385 2.0 2.7 348 No No 12 MED Benign Prostatic Hypertrophy w CC 0.7429 3.1 4.0 349 No No 12 MED Benign Prostatic Hypertrophy w/o CC 0.4615 2.1 2.6 350 No No 12 MED Inflammation of the Male Reproductive System 0.7748 3.6 4.5 351 No No 12 MED * Sterilization, Male 0.2422 352 No No 12 MED Other Male Reproductive System Diagnoses 0.7819 3.0 4.2 353 No No 13 SURG Pelvic Evisceration, Radical Hysterectomy & Radical Vulvectomy 1.8192 4.5 6.0 354 No No 13 SURG Uterine,Adnexa Proc for Non-Ovarian/Adnexal Malig w CC 1.4966 4.5 5.6 355 No No 13 SURG Uterine,Adnexa Proc for Non-Ovarian/Adnexal Malig w/o CC 0.9074 2.8 3.0 356 No No 13 SURG Female Reproductive System Reconstructive Procedures 0.7571 1.6 1.9 357 No No 13 SURG Uterine & Adnexa Proc for Ovarian Or Adnexal Malignancy 2.2250 6.4 8.0 358 No No 13 SURG Uterine & Adnexa Proc for Non-Malignancy w CC 1.1418 3.1 3.9 359 No No 13 SURG Uterine & Adnexa Proc for Non-Malignancy w/o CC 0.8053 2.1 2.3 360 No No 13 SURG Vagina, Cervix & Vulva Procedures 0.8811 2.0 2.5 361 No No 13 SURG Laparoscopy & Incisional Tubal Interruption 1.0626 2.1 2.9 362 No No 13 SURG * Endoscopic Tubal Interruption 0.3096 1.4 1.4 363 No No 13 SURG D&C, Conization & Radio-Implant, for Malignancy 1.1028 2.9 4.2 364 No No 13 SURG D&C, Conization Except for Malignancy 0.8936 2.7 3.8 365 No No 13 SURG Other Female Reproductive System O.R. Procedures 2.0508 5.3 7.9 Start Printed Page 60021 366 No No 13 MED Malignancy, Female Reproductive System w CC 1.2466 4.6 6.3 367 No No 13 MED Malignancy, Female Reproductive System w/o CC 0.5865 2.3 3.0 368 No No 13 MED Infections, Female Reproductive System 1.1697 5.0 6.4 369 No No 13 MED Menstrual & Other Female Reproductive System Disorders 0.6598 2.5 3.3 370 No No 14 SURG Cesarean Section w CC 0.9002 4.1 5.0 371 No No 14 SURG Cesarean Section w/o CC 0.6565 3.1 3.4 372 No No 14 MED Vaginal Delivery w Complicating Diagnoses 0.5660 2.6 3.4 373 No No 14 MED Vaginal Delivery w/o Complicating Diagnoses 0.3911 2.1 2.2 374 No No 14 SURG Vaginal Delivery w Sterilization &/or D&C 0.6505 2.4 3.0 375 No No 14 SURG Vaginal Delivery w O.R. Proc Except Steril &/or D&C 1.1252 4.1 6.5 376 No No 14 MED Postpartum & Post Abortion Diagnoses w/o O.R. Procedure 0.6150 2.5 3.3 377 No No 14 SURG Postpartum & Post Abortion Diagnoses w O.R. Procedure 1.2457 3.2 4.5 378 No No 14 MED Ectopic Pregnancy 0.7163 1.8 2.2 379 No No 14 MED Threatened Abortion 0.4138 2.2 3.3 380 No No 14 MED Abortion w/o D&C 0.4430 1.5 2.0 381 No No 14 SURG Abortion w D&C, Aspiration Curettage or Hysterotomy 0.7070 1.7 2.5 382 No No 14 MED False Labor 0.1817 1.3 1.5 383 No No 14 MED Other Antepartum Diagnoses w Medical Complications 0.5103 2.6 3.7 384 No No 14 MED Other Antepartum Diagnoses w/o Medical Complications 0.3790 1.7 2.6 385 No No 15 MED * Neonates, Died or Transferred to Another Acute Care Facility 1.4107 386 No No 15 MED * Extreme Immaturity or Respiratory Distress Syndrome, Neonate 4.6519 387 No No 15 MED * Prematurity w Major Problems 3.1771 388 No No 15 MED * Prematurity w/o Major Problems 1.9170 389 No No 15 MED * Full Term Neonate w Major Problems 3.2636 4.7 4.7 390 No No 15 MED * Neonate w Other Significant Problems 1.1551 391 No No 15 MED * Normal Newborn 0.1564 392 No No 16 SURG Splenectomy Age >17 3.0202 6.3 8.9 393 No No 16 SURG * Splenectomy Age 0-17 1.3819 394 No No 16 SURG Other O.R. Procedures of the Blood and Blood Forming Organs 1.9299 4.5 7.3 395 Yes No 16 MED Red Blood Cell Disorders Age >17 0.7992 3.1 4.1 396 No No 16 MED Red Blood Cell Disorders Age 0-17 0.6654 2.6 3.1 397 No No 16 MED Coagulation Disorders 1.3267 3.7 5.1 398 Yes No 16 MED Reticuloendothelial & Immunity Disorders w CC 1.1269 4.1 5.5 399 Yes No 16 MED Reticuloendothelial & Immunity Disorders w/o CC 0.6720 2.6 3.2 400 No No 17 SURG No Longer Valid 0.0000 0.0 0.0 401 Yes No 17 SURG Lymphoma & Non-Acute Leukemia w Other O.R. Proc w CC 2.9652 8.1 11.3 402 Yes No 17 SURG Lymphoma & Non-Acute Leukemia w Other O.R. Proc w/o CC 1.1612 2.8 3.9 403 Yes No 17 MED Lymphoma & Non-Acute Leukemia w CC 1.8625 5.7 8.0 404 Yes No 17 MED Lymphoma & Non-Acute Leukemia w/o CC 0.9224 3.0 4.1 405 No No 17 MED * Acute Leukemia w/o Major O.R. Procedure Age 0-17 1.9592 406 No No 17 SURG Myeloprolif Disord or Poorly Diff Neopl w Maj O.R.Proc w CC 2.7201 6.7 9.4 407 No No 17 SURG Myeloprolif Disord or Poorly Diff Neopl w Maj O.R.Proc w/o CC 1.1545 2.8 3.5 408 No No 17 SURG Myeloprolif Disord or Poorly Diff Neopl w Other O.R.Proc 2.1651 5.1 8.2 409 No No 17 MED Radiotherapy 1.2948 4.5 6.0 Start Printed Page 60022 410 No No 17 MED Chemotherapy w/o Acute Leukemia as Secondary Diagnosis 1.0908 2.9 3.8 411 No No 17 MED * History of Malignancy w/o Endoscopy 0.3681 4.7 4.7 412 No No 17 MED * History of Malignancy w Endoscopy 0.8559 2.0 2.0 413 No No 17 MED Other Myeloprolif Dis or Poorly Diff Neopl Diag w CC 1.3347 5.0 6.7 414 No No 17 MED Other Myeloprolif Dis or Poorly Diff Neopl Diag w/o CC 0.7678 3.0 4.1 415 No No 18 SURG No Longer Valid 0.0000 0.0 0.0 416 No No 18 MED No Longer Valid 0.0000 0.0 0.0 417 No No 18 MED Septicemia Age 0-17 1.8841 5.2 6.5 418 Yes No 18 MED Postoperative & Post-Traumatic Infections 1.0993 4.7 6.1 419 No No 18 MED Fever of Unknown Origin Age >17 w CC 0.8614 3.4 4.4 420 No No 18 MED Fever of Unknown Origin Age >17 w/o CC 0.5957 2.6 3.2 421 No No 18 MED Viral Illness Age >17 0.7747 3.1 4.0 422 No No 18 MED Viral Illness & Fever of Unknown Origin Age 0-17 0.6176 2.6 3.7 423 Yes No 18 MED Other Infectious & Parasitic Diseases Diagnoses 1.8379 6.0 8.2 424 No No 19 SURG O.R. Procedure w Principal Diagnoses of Mental Illness 2.2487 7.4 11.5 425 No No 19 MED Acute Adjustment Reaction & Psychosocial Dysfunction 0.6299 2.6 3.5 426 No No 19 MED Depressive Neuroses 0.5122 3.1 4.3 427 No No 19 MED Neuroses Except Depressive 0.5580 3.1 4.6 428 No No 19 MED Disorders of Personality & Impulse Control 0.7797 4.5 7.3 429 Yes No 19 MED Organic Disturbances & Mental Retardation 0.8388 4.3 5.6 430 Yes No 19 MED Psychoses 0.7261 5.8 7.9 431 No No 19 MED Childhood Mental Disorders 0.6729 4.2 6.7 432 No No 19 MED Other Mental Disorder Diagnoses 0.6611 2.7 4.0 433 No No 20 MED Alcohol/Drug Abuse or Dependence, Left AMA 0.3284 2.1 2.8 434 No No 20 MED No Longer Valid 0.0000 0.0 0.0 435 No No 20 MED No Longer Valid 0.0000 0.0 0.0 436 No No 20 MED No Longer Valid 0.0000 0.0 0.0 437 No No 20 MED No Longer Valid 0.0000 0.0 0.0 438 No No 20 MED No Longer Valid 0.0000 0.0 0.0 439 No No 21 SURG Skin Grafts For Injuries 1.9071 5.4 8.3 440 Yes No 21 SURG Wound Debridements For Injuries 1.9291 5.6 8.5 441 No No 21 SURG Hand Procedures For Injuries 0.9920 2.3 3.4 442 Yes No 21 SURG Other O.R. Procedures For Injuries w CC 2.5533 6.0 8.9 443 Yes No 21 SURG Other O.R. Procedures For Injuries w/o CC 1.0498 2.7 3.5 444 Yes No 21 MED Traumatic Injury Age >17 w CC 0.7795 3.2 4.1 445 Yes No 21 MED Traumatic Injury Age >17 w/o CC 0.5301 2.3 2.8 446 No No 21 MED * Traumatic Injury Age 0-17 0.3037 447 No No 21 MED Allergic Reactions Age >17 0.5738 1.9 2.6 448 No No 21 MED * Allergic Reactions Age 0-17 0.1000 449 No No 21 MED Poisoning & Toxic Effects of Drugs Age >17 w CC 0.8732 2.7 3.7 450 No No 21 MED Poisoning & Toxic Effects of Drugs Age >17 w/o CC 0.4420 1.6 2.0 451 No No 21 MED * Poisoning & Toxic Effects of Drugs Age 0-17 0.2697 2.1 2.1 452 No No 21 MED Complications of Treatment w CC 1.0686 3.5 5.0 453 No No 21 MED Complications of Treatment w/o CC 0.5297 2.2 2.8 454 No No 21 MED Other Injury, Poisoning & Toxic Effect Diag w CC 0.8616 3.0 4.1 455 No No 21 MED Other Injury, Poisoning & Toxic Effect Diag w/o CC 0.4864 1.8 2.3 456 No No 22 MED No Longer Valid 0.0000 0.0 0.0 457 No No 22 MED No Longer Valid 0.0000 0.0 0.0 458 No No 22 SURG No Longer Valid 0.0000 0.0 0.0 459 No No 22 SURG No Longer Valid 0.0000 0.0 0.0 Start Printed Page 60023 460 No No 22 MED No Longer Valid 0.0000 0.0 0.0 461 No No 23 SURG O.R. Proc w Diagnoses of Other Contact w Health Services 1.5707 3.3 5.6 462 Yes No 23 MED Rehabilitation 0.9460 8.4 10.0 463 Yes No 23 MED Signs & Symptoms w CC 0.7158 3.1 3.9 464 Yes No 23 MED Signs & Symptoms w/o CC 0.5271 2.4 2.9 465 No No 23 MED Aftercare w History Of Malignancy As Secondary Diagnosis 0.5954 2.4 3.5 466 No No 23 MED Aftercare w/o History of Malignancy as Secondary Diagnosis 0.7634 2.7 4.9 467 No No 23 MED Other Factors Influencing Health Status 0.4759 1.9 2.7 468 Yes No SURG Extensive O.R. Procedure Unrelated to Principal Diagnosis 3.9925 9.6 13.0 469 No No ** Principal Diagnosis Invalid as Discharge Diagnosis 0.0000 0.0 0.0 470 No No ** Ungroupable 0.0000 0.0 0.0 471 Yes Yes 08 SURG Bilateral or Multiple Major Joint Procs of Lower Extremity 3.0424 4.1 4.6 472 No No 22 SURG No Longer Valid 0.0000 0.0 0.0 473 No No 17 MED Acute Leukemia w/o Major O.R. Procedure Age >17 3.3623 7.3 12.7 474 No No 04 SURG No Longer Valid 0.0000 0.0 0.0 475 No No 04 MED No Longer Valid 0.0000 0.0 0.0 476 No No SURG Prostatic O.R. Procedure Unrelated to Principal Diagnosis 2.1654 6.9 9.9 477 Yes No SURG Non-Extensive O.R. Procedure Unrelated to Principal Diagnosis 2.0910 5.9 8.7 478 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 479 No No 05 SURG Other Vascular Procedures w/o CC 1.4401 1.9 2.6 480 No No PRE SURG Liver Transplant &/or Intestinal Transplant 9.4096 14.0 19.1 481 No No PRE SURG Bone Marrow Transplant 6.3929 18.7 22.0 482 Yes No PRE SURG Tracheostomy for Face, Mouth & Neck Diagnoses 3.3490 9.4 11.8 483 No No PRE SURG No Longer Valid 0.0000 0.0 0.0 484 No No 24 SURG Craniotomy For Multiple Significant Trauma 5.0967 8.5 12.8 485 Yes No 24 SURG Limb Reattachment, Hip And Femur Proc for Multiple Significant Trauma 3.5048 8.1 10.0 486 No No 24 SURG Other O.R. Procedures for Multiple Significant Trauma 4.8346 8.5 12.3 487 Yes No 24 MED Other Multiple Significant Trauma 1.8930 5.2 7.0 488 No No 25 SURG HIV w Extensive O.R. Procedure 5.1298 12.2 17.7 489 No No 25 MED HIV w Major Related Condition 1.7921 5.8 8.2 490 No No 25 MED HIV w or w/o Other Related Condition 1.0408 3.9 5.3 491 No No 08 SURG Major Joint & Limb Reattachment Procedures of Upper Extremity 1.7203 2.5 3.0 492 No No 17 MED Chemotherapy w Acute Leukemia or w Use of Hi Dose Chemoagent 3.4892 8.9 13.8 493 No No 07 SURG Laparoscopic Cholecystectomy w/o C.D.E. w CC 1.8280 4.6 6.0 494 No No 07 SURG Laparoscopic Cholecystectomy w/o C.D.E. w/o CC 1.0320 2.1 2.7 495 No No PRE SURG Lung Transplant 8.4182 14.2 17.3 496 No No 08 SURG Combined Anterior/Posterior Spinal Fusion 6.3782 6.4 8.8 497 Yes Yes 08 SURG Spinal Fusion Except Cervical w CC 3.8192 4.8 5.7 498 Yes Yes 08 SURG Spinal Fusion Except Cervical w/o CC 2.9896 3.3 3.7 499 No No 08 SURG Back & Neck Procedures Except Spinal Fusion w CC 1.3887 3.0 4.2 500 No No 08 SURG Back & Neck Procedures Except Spinal Fusion w/o CC 0.9223 1.8 2.2 501 Yes No 08 SURG Knee Procedures w PDX of Infection w CC 2.6427 8.4 10.4 502 Yes No 08 SURG Knee Procedures w PDX of Infection w/o CC 1.4274 4.9 5.8 503 No No 08 SURG Knee Procedures w/o PDX of Infection 1.2450 3.1 3.9 Start Printed Page 60024 504 No No 22 SURG Exten. Burns or Full Thickness Burn w/MV 96+Hrs w/Skin Gft 11.2524 20.7 28.0 505 No No 22 MED Exten. Burns Or Full Thickness Burn w/MV 96+Hrs w/o Skin Gft 2.6330 2.8 6.9 506 No No 22 SURG Full Thickness Burn w Skin Graft or Inhal Inj w CC or Sig Trauma 3.7856 10.8 15.2 507 No No 22 SURG Full Thickness Burn w Skin Grft or Inhal Inj w/o CC or Sig Trauma 1.9328 5.4 7.7 508 No No 22 MED Full Thickness Burn w/o Skin Grft or Inhal Inj w CC or Sig Trauma 1.4157 5.3 7.4 509 No No 22 MED Full Thickness Burn w/o Skin Grft Or Inh Inj w/o CC or Sig Trauma 0.8347 3.7 5.3 510 No No 22 MED Non-Extensive Burns w CC or Significant Trauma 1.2477 4.1 6.1 511 No No 22 MED Non-Extensive Burns w/o CC or Significant Trauma 0.6819 2.6 3.6 512 No No PRE SURG Simultaneous Pancreas/Kidney Transplant 6.2588 11.1 13.6 513 No No PRE SURG Pancreas Transplant 3.9771 8.9 10.6 514 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 515 No No 05 SURG Cardiac Defibrillator Implant w/o Cardiac Cath 5.2293 2.2 3.8 516 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 517 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 518 No No 05 SURG Perc Cardio Proc w/o Coronary Artery Stent or AMI 1.6388 1.8 2.5 519 No No 08 SURG Cervical Spinal Fusion w CC 2.5439 2.9 4.7 520 No No 08 SURG Cervical Spinal Fusion w/o CC 1.7569 1.6 1.9 521 Yes No 20 MED Alcohol/Drug Abuse or Dependence w CC 0.7338 4.0 5.3 522 Yes No 20 MED Alc/Drug Abuse or Depend w Rehabilitation Therapy w/o CC 0.5993 8.0 10.4 523 No No 20 MED Alc/Drug Abuse or Depend w/o Rehabilitation Therapy w/o CC 0.4196 3.1 3.8 524 No No 01 MED Transient Ischemia 0.7373 2.6 3.1 525 No No 05 SURG Other Heart Assist System Implant 1 2.2268 7.7 14.3 526 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 527 No No 05 SURG No Longer Valid 0.0000 0.0 0.0 528 No No 01 SURG Intracranial Vascular Proc w PDX Hemorrhage 7.0626 13.3 16.4 529 Yes No 01 SURG Ventricular Shunt Procedures w CC 2.1737 4.6 7.4 530 Yes No 01 SURG Ventricular Shunt Procedures w/o CC 1.2186 2.3 2.9 531 Yes No 01 SURG Spinal Procedures w CC 3.1169 6.4 9.3 532 Yes No 01 SURG Spinal Procedures w/o CC 1.4577 2.8 3.7 533 No No 01 SURG Extracranial Procedures w CC 1.5463 2.4 3.7 534 No No 01 SURG Extracranial Procedures w/o CC 0.9926 1.4 1.7 535 No No 05 SURG Cardiac Defib Implant w Cardiac Cath w AMI/HF/Shock 7.3741 6.9 9.3 536 No No 05 SURG Cardiac Defib Implant w Cardiac Cath w/o AMI/HF/Shock 6.6043 5.5 7.3 537 Yes No 08 SURG Local Excis & Remov of Int Fix Dev Except Hip & Femur w CC 1.8360 4.7 6.6 538 Yes No 08 SURG Local Excis & Remov of Int Fix Dev Except Hip & Femur w/o CC 1.0282 2.2 2.9 539 No No 17 SURG Lymphoma & Leukemia w Major or Procedure w CC 3.1907 6.8 10.6 540 No No 17 SURG Lymphoma & Leukemia w Major or Procedure w/o CC 1.1759 2.6 3.5 541 Yes No PRE SURG Ecmo or Trach w MV 96+Hrs or PDX Exc Face, Mouth & Neck w Maj O.R. 19.2551 37.0 44.3 542 Yes No PRE SURG Trach w MV 96+Hrs or PDX Exc Face, Mouth & Neck w/o Maj O.R. 11.6440 27.2 32.6 543 Yes No 01 SURG Craniotomy w Major Device Implant or Acute Complex CNS Principal Diagnosis 4.3557 7.9 11.6 544 Yes No 08 SURG Major Joint Replacement or Reattachment of Lower Extremity 1.9878 4.0 4.4 545 Yes Yes 08 SURG Revision of Hip or Knee Replacement 2.5337 4.4 5.2 Start Printed Page 60025 546 No No 08 SURG Spinal Fusion Exc Cerv with Curvature of the Spine or Malig 5.3812 7.0 8.8 547 Yes No 05 SURG Coronary Bypass w Cardiac Cath w Major CV Dx 6.1390 10.9 12.4 548 Yes No 05 SURG Coronary Bypass w Cardiac Cath w/o Major CV Dx 4.6440 8.1 8.9 549 Yes Yes 05 SURG Coronary Bypass w/o Cardiac Cath w Major CV Dx 5.0246 8.6 10.2 550 Yes Yes 05 SURG Coronary Bypass w/o Cardiac Cath w/o Major CV Dx 3.5904 6.2 6.8 551 No No 05 SURG Permanent Cardiac Pacemaker Impl w Maj CV Dx or Aicd Lead or Gnrtr 3.0364 4.2 6.1 552 No No 05 SURG Other Permanent Cardiac Pacemaker Implant w/o Major CV Dx 2.0860 2.5 3.5 553 Yes No 05 SURG Other Vascular Procedures w CC w Major CV Dx 3.0124 6.2 9.2 554 Yes No 05 SURG Other Vascular Procedures w CC w/o Major CV Dx 2.0773 3.7 5.6 555 No No 05 SURG Percutaneous Cardiovascular Proc w Major CV Dx 2.3066 3.4 4.8 556 No No 05 SURG Percutaneous Cardiovasc Proc w Non-Drug-Eluting Stent w/o Maj Cv Dx 1.7747 1.6 2.0 557 No No 05 SURG Percutaneous Cardiovascular Proc w Drug-Eluting Stent w Major Cv Dx 2.7616 3.0 4.1 558 No No 05 SURG Percutaneous Cardiovascular Proc w Drug-Eluting Stent w/o Maj Cv Dx 2.0814 1.5 1.8 559 No No 01 MED Acute Ischemic Stroke With Use of Thrombolytic Agent 2.2524 5.4 6.9 560 No No 01 MED Bacterial & Tuberculous Infections of Nervous System 2.9066 8.2 10.6 561 No No 01 MED Non-Bacterial Infections of Nervous System Except Viral Meningitis 2.2187 7.4 9.5 562 Yes No 01 MED Seizure Age > 17 w CC 1.0586 3.7 4.9 563 Yes No 01 MED Seizure Age > 17 w/o CC 0.6440 2.6 3.2 564 No No 01 MED Headaches Age >17 0.6931 2.6 3.4 565 Yes No 04 MED Respiratory System Diagnosis with Ventilator Support 96+ Hours 5.2430 13.4 15.8 566 Yes No 04 MED Respiratory System Diagnosis with Ventilator Support < 96 Hours 2.3355 5.6 7.8 567 Yes No 06 SURG Stomach, Esophageal & Duodenal Proc Age > 17 w CC w Major GI Dx 5.2210 12.7 16.0 568 Yes No 06 SURG Stomach, Esophageal & Duodenal Procedures Proc Age > 17 w CC w/o Major GI Dx 3.3666 8.3 11.5 569 Yes No 06 SURG Major Small & Large Bowel Procedures w CC w Major GI Dx 4.3427 11.9 14.6 570 Yes No 06 SURG Major Small & Large Bowel Procedures w CC w/o Major GI Dx 2.6997 8.4 10.1 571 No No 06 MED Major Esophageal Disorders 1.1109 3.8 4.8 572 Yes No 08 MED Major Gastrointestinal Disorders And Peritoneal Infections 1.3378 5.6 7.1 573 Yes No 11 SURG Major Bladder Procedures 3.3489 9.1 11.1 574 No No 16 MED Major Hematologic/Immunologic Diag Exc Sickle Cell Crisis & Coagul 1.2703 4.3 5.7 575 Yes No 18 MED Septicemia w MV96+ Hours Age >17 5.9714 13.2 16.0 576 Yes No 18 MED Septicemia w/o MV96+ Hours Age >17 1.5996 5.5 7.3 577 No No 01 SURG Carotid Artery Stent Procedure 1.7859 1.6 2.3 578 Yes No 18 SURG Infectious & Parasitic Diseases w O.R. Procedure 4.8650 12.7 16.6 579 Yes No 18 SURG Postoperative O.R. Post-Traumatic Infections w O.R. Procedure 2.8408 8.4 11.5 DRGs 469 and 470 contain cases which could not be assigned to valid drgs. Note: Arithmetic mean is presented for informational purposes only. Note: Geometric mean is used only to determine payment for transfer cases. Note: Relative weights are based on Medicare patient data and may not be appropriate for other patients. It is important to note that in some cases this Table reflects withdrawal or termination decisions CMS has made on a hospital's behalf. For example, if CMS withdrew or terminated a hospital's reclassification(s) or redesignation on the hospital's behalf, such hospital would not be shown on this Table. Requests to reverse a decision made on behalf of a hospital by CMS and to choose another wage index, reclassification, or adjustment for which the hospital is otherwise eligible must be received by CMS no later than 5 p.m., e.s.t., with a copy sent to the MGCRB, by October 30, 2006 (30 days from the date that information appears on the CMS Web site at http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp.)
Table 9A.—Hospital Reclassifications and Redesignations by Individual Hospitals and CBSA for FY 2007
Provider No. Geographic CBSA Reclassified CBSA 10/1/2006- 3/31/2007 Reclassified CBSA 4/1/2007- 9/30/2007 LUGAR 010005 01 13820 13820 010008 01 33860 33860 010009 19460 26620 26620 010012 01 16860 16860 010022 01 40660 40660 LUGAR 010025 01 17980 17980 010029 12220 17980 17980 010035 01 13820 13820 010044 01 13820 13820 010045 01 13820 13820 010054 19460 26620 26620 010059 19460 26620 26620 010065 01 33860 33860 010072 01 11500 11500 LUGAR 010083 01 37860 37860 010085 19460 26620 26620 010100 01 37860 37860 010101 01 11500 11500 LUGAR 010118 01 46220 46220 010126 01 33860 33860 010143 01 13820 13820 010150 01 33860 010158 01 19460 19460 010164 01 11500 11500 LUGAR 020008 02 11260 030007 03 22380 22380 030033 03 22380 22380 040014 04 30780 30780 040017 04 22220 22220 040019 04 32820 32820 040020 27860 32820 32820 040027 04 44180 44180 040039 04 26 26 040041 04 30780 30780 040047 04 26 26 040069 04 32820 32820 040071 38220 30780 30780 040076 04 30780 30780 040078 26300 30780 30780 040080 04 27860 27860 040088 04 43340 43340 040091 04 45500 45500 040100 04 30780 30780 040119 04 30780 30780 050006 05 39820 39820 050009 34900 46700 46700 050013 34900 46700 46700 050014 05 40900 40900 050022 40140 42044 42044 050042 05 39820 39820 050046 37100 31084 050054 40140 42044 42044 050065 42044 31084 31084 050069 42044 31084 31084 050071 41940 36084 36084 050073 46700 36084 36084 050076 41884 36084 36084 050082 37100 31084 050089 40140 31084 31084 050090 42220 41884 41884 050099 40140 31084 31084 Start Printed Page 60027 050101 46700 36084 36084 050102 40140 42044 42044 050129 40140 31084 31084 050136 42220 41884 41884 050140 40140 31084 31084 050150 05 40900 40900 050159 37100 31084 050168 42044 31084 31084 050173 42044 31084 31084 050174 42220 41884 41884 050193 42044 31084 31084 050197 41884 36084 36084 050224 42044 31084 31084 050226 42044 31084 31084 050228 41884 36084 36084 050230 42044 31084 31084 050236 37100 31084 050243 40140 42044 42044 050245 40140 31084 31084 050251 05 39900 39900 050272 40140 31084 31084 050279 40140 31084 31084 050291 42220 41884 41884 050292 40140 42044 42044 050298 40140 31084 31084 050300 40140 31084 31084 050327 40140 31084 31084 050329 40140 42044 42044 050348 42044 31084 31084 050367 46700 36084 36084 050385 42220 41884 41884 050390 40140 42044 42044 050394 37100 31084 050423 40140 42044 42044 050426 42044 31084 31084 050430 05 39900 39900 050510 41884 36084 36084 050517 40140 31084 31084 050526 42044 31084 31084 050534 40140 42044 42044 050535 42044 31084 31084 050541 41884 36084 36084 050543 42044 31084 31084 050547 42220 41884 41884 050548 42044 31084 31084 050549 37100 31084 050550 42044 31084 31084 050551 42044 31084 31084 050567 42044 31084 31084 050569 05 42220 42220 050570 42044 31084 31084 050573 40140 42044 42044 050580 42044 31084 31084 050584 40140 31084 31084 050585 42044 31084 31084 050586 40140 31084 31084 050589 42044 31084 31084 050592 42044 31084 31084 050594 42044 31084 31084 050603 42044 31084 31084 050609 42044 31084 31084 050616 37100 31084 050667 34900 46700 46700 050678 42044 31084 31084 050680 46700 36084 36084 050684 40140 42044 42044 050686 40140 42044 42044 050690 42220 41884 41884 Start Printed Page 60028 050693 42044 31084 31084 050694 40140 42044 42044 050701 40140 42044 42044 050709 40140 31084 31084 050718 40140 42044 42044 050720 42044 31084 31084 050728 42220 41884 41884 050749 37100 31084 060001 24540 19740 19740 060003 14500 19740 19740 060023 24300 19740 19740 060027 14500 19740 19740 060044 06 19740 19740 060049 06 22660 22660 060075 06 24300 060096 06 19740 19740 060103 14500 19740 19740 070001 35300 35004 070003 07 25540 25540 LUGAR 070005 35300 35004 070006 14860 35644 070010 14860 35644 070016 35300 35004 070017 35300 35004 070018 14860 35644 070019 35300 35004 070022 35300 35004 070028 14860 35644 070031 35300 35004 070033 14860 35644 35644 070034 14860 35644 070036 25540 35300 070038 35300 35004 070039 35300 35004 080004 20100 48864 48864 080006 08 20100 20100 080007 08 36140 36140 100022 33124 22744 22744 100023 10 36740 36740 100024 10 33124 33124 100045 19660 36740 36740 100049 10 29460 29460 100081 10 23020 23020 LUGAR 100109 10 36740 36740 100118 10 27260 27260 100139 10 23540 23540 LUGAR 100150 10 33124 33124 100157 29460 45300 45300 100176 48424 38940 38940 100217 42680 38940 38940 100232 10 27260 27260 100239 45300 42260 42260 100249 10 45300 45300 100252 10 38940 38940 100258 48424 22744 22744 100292 10 23020 23020 LUGAR 110001 19140 12060 12060 110002 11 12060 12060 110003 11 27260 27260 110023 11 12060 12060 110029 23580 12060 12060 110038 11 10 10 110040 11 12060 12060 LUGAR 110041 11 12020 12020 110052 11 16860 16860 LUGAR 110054 40660 12060 12060 110069 47580 31420 31420 110075 11 42340 42340 Start Printed Page 60029 110088 11 12060 12060 LUGAR 110095 11 46660 46660 110117 11 12060 12060 LUGAR 110122 46660 45220 45220 110125 11 31420 31420 110128 11 42340 42340 110150 11 12060 12060 110153 47580 31420 31420 110168 40660 12060 12060 110187 11 12060 12060 LUGAR 110189 11 12060 12060 110205 11 12060 12060 120028 12 26180 26180 130002 13 14260 14260 130003 30300 50 50 130018 13 38540 38540 130049 17660 44060 44060 130067 13 26820 26820 LUGAR 140012 14 16974 16974 140015 14 41180 41180 140032 14 41180 41180 140034 14 41180 41180 140040 14 37900 37900 140043 14 40420 40420 140046 14 41180 41180 140058 14 41180 41180 140064 14 37900 37900 140110 14 16974 16974 140143 14 37900 37900 140160 14 40420 40420 140161 14 16974 16974 140164 14 41180 41180 140189 14 16580 16580 140233 40420 16974 16974 140234 14 37900 37900 140236 14 28100 28100 LUGAR 140291 29404 16974 16974 150002 23844 16974 16974 150004 23844 16974 16974 150006 33140 43780 43780 150008 23844 16974 16974 150011 15 26900 26900 150015 33140 16974 16974 150030 15 26900 26900 LUGAR 150034 23844 16974 16974 150048 15 17140 17140 150051 14020 26900 26900 150065 15 26900 26900 150069 15 17140 17140 150076 15 43780 43780 150088 11300 26900 26900 150090 23844 16974 16974 150102 15 23844 23844 LUGAR 150112 18020 26900 26900 150113 11300 26900 26900 150122 15 26900 26900 150125 23844 16974 16974 150126 23844 16974 16974 150133 15 23060 23060 150146 15 23060 23060 150147 23844 16974 16974 160001 16 11180 11180 160016 16 19780 19780 160057 16 26980 26980 160064 16 24 160080 16 19340 19340 160089 16 19780 19780 160147 16 19780 19780 Start Printed Page 60030 170006 17 27900 27900 170010 17 46140 46140 170012 17 48620 48620 170013 17 48620 48620 170020 17 48620 48620 170023 17 48620 48620 170033 17 48620 48620 170058 17 28140 28140 170068 17 11100 11100 170120 17 27900 27900 170142 17 45820 45820 170175 17 48620 48620 170190 17 45820 45820 170193 17 48620 48620 180005 18 26580 26580 180011 18 30460 30460 180012 21060 31140 31140 180013 14540 34980 34980 180017 18 21060 21060 180018 18 30460 30460 180019 18 17140 17140 180024 18 31140 31140 180027 18 17300 17300 180029 18 28700 28700 180044 18 26580 26580 180048 18 31140 31140 180066 18 34980 34980 180069 18 26580 26580 180075 18 14540 14540 LUGAR 180078 18 26580 26580 180080 18 30460 30460 180093 18 21780 21780 180102 18 17300 17300 180104 18 17300 17300 180116 18 14 14 180124 14540 34980 34980 180127 18 31140 31140 180132 18 30460 30460 180139 18 30460 30460 190001 19 35380 35380 190003 19 29180 29180 190015 19 35380 35380 190086 19 33740 33740 190099 19 12940 12940 190106 19 10780 10780 190131 12940 35380 35380 190155 19 12940 12940 LUGAR 190164 19 10780 10780 190191 19 12940 12940 190208 19 4 4 190218 19 43340 43340 190223 19 12940 12940 LUGAR 200020 38860 40484 40484 200024 30340 38860 38860 200034 30340 38860 38860 200039 20 38860 38860 200050 20 12620 12620 200063 20 38860 38860 220001 49340 14484 14484 220002 15764 14484 14484 220008 39300 14484 14484 220010 21604 14484 14484 220011 15764 14484 14484 220019 49340 14484 14484 220020 39300 14484 14484 220025 49340 14484 14484 220028 49340 14484 14484 220029 21604 14484 14484 Start Printed Page 60031 220033 21604 14484 14484 220035 21604 14484 14484 220049 15764 14484 14484 220058 49340 14484 14484 220060 14484 12700 12700 220062 49340 14484 14484 220063 15764 14484 14484 220070 15764 14484 14484 220073 39300 14484 14484 220077 44140 25540 25540 220080 21604 14484 14484 220082 15764 14484 14484 220084 15764 14484 14484 220090 49340 14484 14484 220095 49340 14484 14484 220098 15764 14484 14484 220101 15764 14484 14484 220105 15764 14484 14484 220133 15764 14484 14484 220163 49340 14484 14484 220171 15764 14484 14484 220174 21604 14484 14484 230002 19804 11460 230003 26100 34740 230013 47644 19804 230019 47644 19804 230020 19804 11460 230022 23 29620 29620 230024 19804 11460 230029 47644 19804 230030 23 40980 40980 230035 23 24340 24340 LUGAR 230036 23 13020 230037 23 11460 11460 230047 47644 19804 19804 230053 19804 11460 230054 23 24580 24580 230065 19804 11460 230069 47644 22420 22420 230071 47644 19804 230072 26100 34740 230077 40980 22420 22420 230080 23 40980 40980 230089 19804 11460 230093 23 24340 24340 230096 23 28020 28020 230097 23 24340 230099 33780 11460 11460 230104 19804 11460 230105 23 13020 13020 230119 19804 11460 230121 23 29620 29620 LUGAR 230130 47644 19804 230134 23 26100 26100 LUGAR 230135 19804 11460 230142 19804 11460 230146 19804 11460 230151 47644 19804 230165 19804 11460 230174 26100 34740 230176 19804 11460 230195 47644 19804 19804 230204 47644 19804 19804 230207 47644 19804 230208 23 24340 24340 LUGAR 230217 12980 29620 29620 230223 47644 19804 230227 47644 19804 19804 Start Printed Page 60032 230244 19804 11460 230254 47644 19804 230257 47644 19804 19804 230264 47644 19804 19804 230269 47644 19804 230270 19804 11460 230273 19804 11460 230277 47644 19804 230279 47644 22420 22420 230293 19804 11460 230295 23 26100 26100 LUGAR 240018 24 33460 33460 240030 24 41060 41060 240064 24 20260 20260 240069 24 40340 40340 240071 24 40340 40340 240075 24 41060 41060 240088 24 41060 41060 240093 24 33460 33460 240105 24 40340 40340 LUGAR 240150 24 40340 40340 LUGAR 240187 24 33460 33460 240211 24 33460 33460 250002 25 22520 250004 25 32820 32820 250006 25 32820 32820 250009 25 27180 27180 250023 25 25060 25060 LUGAR 250031 25 27140 27140 250034 25 32820 32820 250040 37700 25060 25060 250042 25 32820 32820 250044 25 22520 22520 250069 25 46220 46220 250079 25 27140 27140 250081 25 46220 46220 250082 25 38220 38220 250094 25620 25060 25060 250097 25 12940 12940 250099 25 27140 27140 250100 25 46220 46220 250104 25 27140 27140 250117 25 25060 25060 LUGAR 260009 26 28140 28140 260015 26 27860 27860 260017 26 41180 41180 260022 26 16 16 260025 26 41180 41180 260049 26 44180 44180 LUGAR 260050 26 41140 41140 260064 26 17860 17860 260094 26 44180 44180 260110 26 41180 41180 260113 26 14 14 260116 26 14 14 260119 26 27860 27860 260175 26 28140 28140 260183 26 41180 41180 260186 26 17860 17860 270003 27 24500 24500 270011 27 24500 24500 270017 27 33540 33540 270051 27 33540 33540 280009 28 30700 30700 280023 28 30700 30700 280032 28 30700 30700 280061 28 53 53 280065 28 24540 24540 Start Printed Page 60033 280077 28 36540 36540 280125 28 43580 43580 290002 29 16180 16180 LUGAR 290006 29 39900 39900 290008 29 41620 41620 290019 16180 39900 39900 300005 30 31700 31700 300014 40484 31700 31700 300018 40484 31700 31700 300019 30 49340 49340 310002 35084 35644 35644 310009 35084 35644 35644 310013 35084 35644 35644 310014 15804 37964 37964 310015 35084 35644 35644 310017 35084 35644 35644 310018 35084 35644 35644 310021 45940 35084 310031 15804 20764 20764 310038 20764 35644 35644 310039 20764 35644 35644 310048 20764 35084 35084 310050 35084 35644 35644 310054 35084 35644 35644 310070 20764 35644 35644 310076 35084 35644 35644 310078 35084 35644 35644 310081 15804 37964 37964 310083 35084 35644 35644 310093 35084 35644 35644 310096 35084 35644 35644 310108 20764 35644 35644 310119 35084 35644 35644 320005 22140 10740 10740 320006 32 42140 42140 320013 32 42140 42140 320014 32 29740 29740 320033 32 42140 42140 LUGAR 320063 32 36220 36220 320065 32 36220 36220 330004 28740 39100 39100 330008 33 15380 15380 LUGAR 330027 35004 35644 35644 330038 33 40380 40380 LUGAR 330073 33 40380 40380 LUGAR 330079 33 47 47 330085 33 45060 45060 330094 33 28740 28740 330103 33 39 39 330106 35004 35644 330136 33 45060 45060 330157 33 45060 45060 330167 35004 35644 330181 35004 35644 330182 35004 35644 35644 330191 24020 10580 10580 330198 35004 35644 330224 28740 39100 39100 330225 35004 35644 330229 27460 21500 21500 330235 33 45060 45060 LUGAR 330239 27460 21500 21500 330250 33 15540 15540 330259 35004 35644 330277 33 27060 27060 330331 35004 35644 330332 35004 35644 330359 33 39100 39100 LUGAR Start Printed Page 60034 330372 35004 35644 330386 33 39100 39100 340004 24660 49180 49180 340008 34 16740 16740 340010 24140 39580 39580 340013 34 16740 16740 340021 34 16740 16740 340027 34 24780 24780 340039 34 16740 16740 340050 34 22180 22180 340051 34 25860 25860 340068 34 48900 48900 340071 34 39580 39580 LUGAR 340091 24660 49180 49180 340109 34 47260 47260 340115 34 20500 20500 340124 34 39580 39580 LUGAR 340126 34 39580 39580 340127 34 20500 20500 340129 34 16740 16740 340131 34 24780 24780 340136 34 20500 20500 LUGAR 340144 34 16740 16740 340145 34 16740 16740 LUGAR 340147 40580 39580 39580 350003 35 13900 350006 35 13900 350009 35 22020 22020 360008 36 26580 26580 360010 36 10420 10420 360011 36 18140 18140 360013 36 30620 30620 360014 36 18140 18140 360019 10420 17460 17460 360020 10420 17460 17460 360027 10420 17460 17460 360036 36 17460 17460 360039 36 18140 18140 360054 36 26580 26580 360065 36 17460 17460 360078 10420 17460 17460 360079 19380 17140 17140 360086 44220 19380 19380 360095 36 45780 45780 360096 36 49660 49660 LUGAR 360107 36 45780 45780 360121 36 11460 11460 360150 10420 17460 17460 360159 36 18140 18140 360175 36 18140 18140 360185 36 49660 49660 LUGAR 360187 44220 19380 19380 360197 36 18140 18140 360211 48260 38300 38300 360238 36 49660 49660 LUGAR 360241 10420 17460 17460 360245 36 17460 17460 LUGAR 360253 19380 17140 17140 370004 37 27900 27900 370006 37 17 17 370015 37 46140 46140 370016 37 36420 36420 370018 37 46140 46140 370022 37 30020 30020 370025 37 46140 46140 370026 37 36420 36420 370034 37 22900 22900 370047 37 43300 43300 Start Printed Page 60035 370049 37 36420 36420 370099 37 46140 46140 370103 37 45 45 370113 37 22220 22220 380001 38 38900 38900 380022 38 18700 18700 LUGAR 380027 38 21660 21660 380050 38 32780 32780 380090 38 21660 390006 39 25420 25420 390013 39 25420 25420 390030 39 10900 10900 390031 39 39740 39740 LUGAR 390046 49620 29540 29540 390048 39 25420 25420 390052 39 11020 11020 390065 39 47894 47894 390066 30140 25420 25420 390071 39 48700 48700 LUGAR 390079 39 13780 13780 390086 39 44300 44300 390091 39 49660 49660 390093 39 38300 38300 390113 39 36 36 390133 10900 37964 37964 390138 39 47894 47894 390151 39 13644 13644 390246 39 48700 48700 400048 25020 41980 41980 410010 39300 14484 14484 410012 39300 14484 14484 410013 39300 35980 35980 420007 43900 24860 24860 420009 42 24860 24860 LUGAR 420020 42 16700 16700 420027 11340 24860 24860 420028 42 44940 44940 LUGAR 420030 42 16700 16700 420036 42 16740 16740 420039 42 43900 43900 LUGAR 420067 42 42340 42340 420068 42 12260 12260 420069 42 44940 44940 LUGAR 420070 44940 17900 17900 420071 42 24860 24860 420080 42 42340 42340 420083 43900 24860 24860 420085 34820 48900 48900 430012 43 43620 43620 430014 43 22020 22020 430094 43 53 53 440002 27180 32820 32820 440020 44 26620 26620 440024 17420 16860 16860 440025 44 34 34 440035 17300 34980 34980 440050 44 11700 11700 440058 44 16860 16860 440059 44 34980 34980 440067 34100 28940 28940 440068 44 16860 16860 440072 44 32820 32820 440073 44 34980 34980 440148 44 34980 34980 440151 44 34980 34980 440175 44 34980 34980 440180 44 28940 28940 440185 17420 16860 16860 Start Printed Page 60036 440192 44 34980 34980 450007 45 41700 41700 450032 45 43340 43340 450039 23104 19124 19124 450059 41700 12420 12420 450064 23104 19124 19124 450073 45 10180 10180 450080 45 30980 30980 450087 23104 19124 19124 450099 45 11100 11100 450121 23104 19124 19124 450135 23104 19124 19124 450137 23104 19124 19124 450144 45 36220 36220 450148 23104 19124 19124 450187 45 26420 26420 450192 45 19124 19124 450194 45 19124 19124 450196 45 19124 19124 450211 45 26420 26420 450214 45 26420 26420 450224 45 46340 46340 450283 45 19124 19124 LUGAR 450286 45 17780 17780 LUGAR 450324 43300 19124 19124 450347 45 26420 26420 450351 45 23104 23104 450389 45 19124 19124 LUGAR 450393 43300 19124 19124 450395 45 26420 26420 450400 45 47380 47380 450419 23104 19124 19124 450438 45 26420 26420 450447 45 19124 19124 450451 45 23104 23104 450469 43300 19124 19124 450484 45 30980 30980 450508 45 46340 46340 450547 45 19124 19124 450563 23104 19124 19124 450639 23104 19124 19124 450653 45 33260 33260 450656 45 46340 46340 450672 23104 19124 19124 450675 23104 19124 19124 450677 23104 19124 19124 450694 45 26420 26420 450747 45 19124 19124 450770 45 12420 12420 LUGAR 450779 23104 19124 19124 450813 45 41700 41700 450830 45 36220 36220 450839 45 43340 43340 450858 23104 19124 19124 450872 23104 19124 19124 450880 23104 19124 19124 460004 36260 41620 41620 460005 36260 41620 41620 460007 46 41100 41100 460011 46 39340 39340 460021 41100 29820 29820 460039 46 36260 36260 460041 36260 41620 41620 460042 36260 41620 41620 470001 47 30 30 470011 47 15764 15764 470012 47 38340 38340 490004 25500 16820 16820 Start Printed Page 60037 490005 49020 47894 47894 490013 49 31340 31340 490018 49 16820 16820 490042 13980 40220 40220 490079 49 49180 49180 490092 49 40060 40060 490105 49 28700 28700 490106 49 16820 16820 490109 47260 40060 40060 500002 50 28420 28420 500003 34580 42644 42644 500016 48300 42644 42644 500021 45104 42644 42644 500039 14740 42644 42644 500041 31020 38900 38900 500072 50 42644 42644 500079 45104 42644 42644 500108 45104 42644 42644 500129 45104 42644 42644 510001 34060 38300 38300 510002 51 40220 40220 510006 51 38300 38300 510018 51 16620 16620 LUGAR 510024 34060 38300 38300 510030 51 34060 34060 510046 51 16620 16620 510047 51 38300 38300 510062 51 16620 16620 510070 51 16620 16620 510071 51 16620 16620 510077 51 26580 26580 520002 52 48140 48140 520028 52 31540 31540 520037 52 48140 48140 520059 39540 29404 29404 520060 52 22540 22540 LUGAR 520066 27500 31540 31540 520071 52 33340 33340 LUGAR 520076 52 31540 31540 520094 39540 33340 33340 520095 52 31540 31540 520096 39540 33340 33340 520102 52 33340 33340 LUGAR 520107 52 24580 24580 520113 52 24580 24580 520116 52 33340 33340 LUGAR 520173 52 20260 20260 530015 53 26820 530025 53 22660 22660 It is important to note that in some cases this Table reflects termination decisions CMS has made on a hospital's behalf. For example, if CMS terminated a hospital's section 1886(d)(10) reclassification on the hospital's behalf to allow the hospital to receive a section 508 reclassification, it would be shown on this Table. Requests to reverse a decision made on behalf of a hospital by CMS and to choose another wage index, reclassification, or adjustment for which the hospital is otherwise eligible must be received by CMS no later than 5 p.m., e.s.t, with a copy sent to the MGCRB, by October 30, 2006 (30 days from the date the information appears on the CMS Web site at: http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp.)
Start Printed Page 60040TABLE 9B.—Hospital Reclassifications and Redesignations by Individual Hospital Under Section 508 of Pub. L. 108-173—FY 2007
Provider No. Note Geographic CBSA Wage Index CBSA— 10/1/2006- 3/31/2007 Wage Index CBSA— 4/1/2007- 9/30/2007 * Own Wage Index— 10/1/2006- 3/31/2007 010150 01 17980 Start Printed Page 60038 020008 02 1.2183 050494 05 42220 050549 37100 42220 060075 06 1.0877 070001 35300 35004 070005 35300 35004 070006 * 14860 35644 070010 14860 35644 070016 35300 35004 070017 35300 35004 070018 * 14860 35644 070019 35300 35004 070022 35300 35004 070028 14860 35644 070031 35300 35004 070034 * 14860 35644 070036 25540 1.2930 070039 35300 35004 140155 * 28100 16974 16974 140186 * 28100 16974 16974 160040 47940 16300 160064 16 0.9701 160067 47940 16300 160110 47940 16300 220046 38340 14484 230003 26100 28020 230004 34740 28020 230013 47644 22420 230019 47644 22420 230020 19804 11460 230024 19804 11460 230029 47644 22420 230036 23 22420 230038 24340 28020 230053 19804 11460 230059 24340 28020 230066 34740 28020 230071 47644 22420 230072 26100 28020 230089 19804 11460 230097 23 28020 230104 19804 11460 230106 24340 28020 230119 19804 11460 230130 47644 22420 230135 19804 11460 230146 19804 11460 230151 47644 22420 230165 19804 11460 230174 26100 28020 230176 19804 11460 230207 47644 22420 230223 47644 22420 230236 24340 28020 230254 47644 22420 230269 47644 22420 230270 19804 11460 230273 19804 11460 230277 47644 22420 250002 25 25060 250078 * 25620 25060 25060 250122 25 25060 270002 * 27 33540 33540 270012 * 24500 33540 33540 270023 33540 13740 270032 27 13740 270057 27 13740 310021 45940 35644 Start Printed Page 60039 310028 35084 35644 310051 35084 35644 310060 10900 35644 310115 10900 35644 310120 35084 35644 330023 * 39100 35644 35644 330049 39100 35644 330067 * 39100 35644 35644 330106 35004 -- -- -- 1.4779 330126 39100 35644 330135 39100 35644 330205 39100 35644 330209 39100 35004 330264 39100 35004 340002 11700 16740 350002 13900 22020 350003 35 22020 350006 35 22020 350010 35 22020 350014 35 22020 350015 13900 22020 350017 35 22020 350019 * 24220 22020 22020 350030 35 22020 380090 38 1.1162 390001 42540 10900 390003 39 10900 390044 *** 39 37964 37964 390045 ** 39 10900 390096 *** 39 37964 37964 390054 42540 29540 390072 39 10900 390095 42540 10900 390119 42540 10900 390137 42540 10900 390169 42540 10900 390185 42540 29540 390192 42540 10900 390237 42540 10900 390270 42540 29540 430005 43 39660 430008 * 43 43620 43620 430013 * 43 43620 43620 430015 43 43620 430048 43 43620 430060 43 43620 430064 43 43620 430077 39660 43620 430091 39660 43620 450010 48660 32580 450072 26420 26420 450591 26420 26420 470003 15540 14484 490001 49 31340 490024 40220 19260 530008 * 53 16220 16220 530010 * 53 16220 16220 530015 53 1.006 * These hospitals are assigned a wage index value under a special exceptions policy (see the FY 2005 IPPS final rule, 69 FR 49105). ** This hospital has been assigned a wage index for the 1st half of FY 2007 under a special exceptions policy (71 FR 48070). *** These hospitals are receiving the same wage index for FY 2007 as hospitals reclassified to the wage index CBSA under a special exceptions policy (71 FR 48072). Table 9C.—Hospitals Redesignated as Rural Under Section 1886(d)(8)(E) of the Act—FY 2007
Provider Number Geographic CBSA Redesignated Rural Area 50192 23420 05 050469 40140 05 050528 32900 05 050618 40140 05 070004 25540 07 100048 37860 10 100134 27260 10 140167 14 14 170137 29940 17 230078 35660 23 250126 32820 25 260006 41140 26 260047 27620 26 260195 44180 26 330044 46540 33 330245 46540 33 330268 10580 33 360125 36 36 370054 36420 37 380040 13460 38 440135 34980 44 440144 44 44 450052 45 45 450078 10180 45 450243 10180 45 450348 45 45 500148 48300 50 520060 52 52 This Table represents decisions CMS has made on a hospital's behalf to withdraw a redesignation under 1886(d)(8)(B) in order for the hospital to receive an out-migration adjustment. Because such withdrawal removes the hospital's urban status, we have published this separate Table 9D. Requests to reverse a decision made on behalf of a hospital by CMS and to choose another wage index, reclassification, or adjustment for which the hospital is otherwise eligible must be received by CMS from the date the information appears on the CMS Web site at no later than 5 p.m., e.s.t, with a copy sent to the MGCRB, by October 30, 2006 (30 days from the date the information appears on the CMS Web site at: http://www.cms.hhs.gov/AcuteInpatientPPS/WIFN/list.asp.)
TABLE 9D.—HOSPITALS WHO WAIVED LUGAR STATUS TO RECEIVE OUT-MIGRATION ADJUSTMENT
Provider No. Lugar CBSA Geographic CBSA 070021 25540 07 390150 38300 39 End Supplemental InformationTable 10.—Geometric Mean Plus the Lesser of 0.75 of the National Adjusted Operating Standardized Payment Amount (Increased to Reflect the Difference Between Costs and Charges) or 0.75 of One Standard Deviation of Mean Charges by Diagnosis-Related Group (DRG)—September 2006 1
DRG Number of cases Threshold 1 24,393 $53,936 2 10,183 $37,116 3 3 $58,151 6 288 $16,761 7 15,032 $41,305 8 3,441 $31,218 9 1,775 $25,448 10 19,625 $25,064 11 3,083 $19,015 12 55,944 $18,885 13 7,525 $17,709 14 278,664 $24,949 15 19,988 $20,868 16 17,297 $26,485 17 2,973 $15,690 18 33,443 $21,281 19 8,461 $15,797 21 2,220 $26,882 22 3,168 $23,893 23 10,670 $17,130 26 25 $20,794 27 5,971 $25,133 28 19,908 $25,479 29 6,522 $15,839 31 5,039 $21,151 32 1,903 $14,225 34 27,626 $21,196 35 7,908 $14,378 36 307 $17,809 37 1,219 $24,783 38 50 $12,362 39 328 $14,783 40 1,187 $22,552 42 1,636 $17,152 43 125 $12,945 44 1,290 $14,832 45 2,770 $16,515 46 3,929 $16,801 47 1,309 $12,127 49 2,415 $31,299 50 2,024 $19,215 51 193 $19,093 52 234 $14,094 53 2,145 $26,688 55 1,368 $20,105 56 451 $19,428 57 742 $20,317 59 126 $14,906 60 3 $18,895 61 222 $28,833 62 4 $7,231 63 2,827 $26,807 64 3,234 $23,214 65 40,485 $13,518 66 8,195 $12,932 67 379 $17,209 68 18,913 $14,133 69 5,146 $10,686 70 25 $7,496 71 70 $15,634 72 1,326 $16,706 73 9,957 $18,059 74 3 $8,077 75 46,852 $48,047 76 48,155 $43,568 77 2,111 $25,944 78 49,690 $26,250 79 160,357 $29,338 80 7,158 $18,890 81 6 $26,040 82 63,188 $26,606 83 7,153 $21,619 84 1,403 $12,794 85 22,222 $25,173 86 1,717 $15,489 87 96,688 $26,941 88 427,043 $19,079 89 553,977 $22,015 90 43,487 $13,141 91 53 $11,532 92 16,513 $24,871 93 1,440 $16,325 94 13,655 $23,739 95 1,577 $12,582 96 59,616 $15,886 97 26,688 $11,792 98 13 $12,385 99 21,386 $15,725 100 6,410 $12,207 101 23,368 $18,532 102 4,930 $12,464 103 886 $234,790 104 20,120 $123,941 105 32,626 $93,509 106 3,440 $110,979 108 8,757 $89,257 110 57,708 $59,154 111 10,783 $45,072 113 34,728 $45,319 114 7,959 $30,164 117 5,349 $25,616 118 7,619 $33,285 119 963 $25,968 120 33,555 $36,452 121 150,046 $29,680 122 54,522 $20,942 123 29,563 $25,710 124 120,511 $29,663 125 92,405 $23,754 126 5,422 $40,934 127 667,286 $21,971 128 4,210 $15,620 129 3,521 $21,831 130 87,464 $20,073 131 22,952 $12,066 132 101,373 $13,642 133 5,853 $12,329 134 39,815 $13,569 135 7,164 $19,619 Start Printed Page 60041 136 943 $14,096 138 206,123 $17,779 139 74,037 $11,515 140 31,103 $11,148 141 123,084 $16,561 142 49,143 $13,263 143 237,810 $12,620 144 104,876 $24,607 145 5,742 $12,887 146 10,269 $45,085 147 2,614 $31,236 149 19,522 $30,220 150 22,971 $44,985 151 5,403 $27,722 152 5,011 $33,345 153 1,951 $23,305 155 6,015 $27,713 156 4 $42,483 157 8,316 $25,978 158 3,718 $14,380 159 19,222 $28,297 160 11,939 $18,842 161 10,145 $25,543 162 4,950 $15,310 163 5 $14,037 164 5,996 $38,812 165 2,457 $25,557 166 5,154 $29,283 167 4,909 $19,618 168 1,640 $25,297 169 895 $16,754 170 17,930 $44,495 171 1,408 $26,705 172 33,048 $26,386 173 2,225 $17,067 174 253,126 $21,935 175 29,235 $12,619 176 14,648 $23,980 177 7,654 $20,567 178 2,557 $15,456 179 14,726 $22,991 180 91,333 $20,898 181 25,350 $12,543 182 255,695 $17,111 183 79,006 $13,062 184 72 $12,788 185 6,251 $18,891 186 7 $5,682 187 646 $18,329 188 87,004 $22,793 189 12,389 $13,014 190 10 $13,844 191 10,586 $54,763 192 1,379 $32,585 193 4,041 $51,627 194 461 $32,149 195 2,846 $50,151 196 594 $32,373 197 16,420 $41,918 198 4,109 $26,007 199 1,481 $37,168 200 1,017 $39,819 201 2,717 $52,822 202 27,495 $25,144 203 32,424 $26,193 204 69,425 $23,001 205 32,781 $23,350 206 2,069 $16,175 207 38,290 $24,723 208 9,444 $15,567 210 126,742 $36,048 211 25,766 $26,709 212 10 $18,640 213 9,549 $33,765 216 19,882 $35,321 217 15,719 $41,774 218 30,183 $32,723 219 21,169 $23,471 220 2 $23,950 223 12,680 $25,338 224 9,900 $18,613 225 6,275 $26,106 226 6,770 $29,359 227 4,857 $18,625 228 2,678 $24,536 229 1,121 $15,636 230 2,473 $26,449 232 570 $20,932 233 18,488 $34,645 234 9,054 $27,557 235 4,763 $16,225 236 41,768 $15,378 237 1,924 $13,851 238 9,693 $26,241 239 40,335 $23,048 240 12,890 $24,453 241 2,848 $14,337 242 2,722 $22,539 243 100,966 $17,005 244 16,921 $15,401 245 5,808 $10,457 246 1,393 $13,422 247 21,347 $12,738 248 16,397 $18,895 249 13,488 $15,481 250 4,164 $15,047 251 2,060 $10,726 253 24,800 $16,488 254 10,027 $10,231 256 7,605 $17,982 257 13,112 $19,590 258 11,382 $15,403 259 2,660 $21,569 260 2,420 $15,136 261 1,569 $20,684 262 602 $20,906 263 22,523 $32,388 264 3,924 $22,371 265 4,035 $28,311 266 2,229 $19,608 267 276 $20,117 268 1,007 $25,617 269 11,061 $30,458 270 2,581 $17,775 271 21,574 $21,522 272 6,063 $20,960 273 1,268 $12,686 274 2,214 $22,741 275 181 $13,452 276 1,611 $15,546 277 118,986 $18,413 278 33,859 $11,767 279 6 $9,146 280 19,325 $16,074 281 6,587 $11,105 283 6,750 $15,606 284 1,860 $9,719 285 8,075 $35,310 286 2,868 $34,890 287 5,459 $31,321 288 11,449 $36,433 289 6,343 $19,733 290 11,873 $18,847 291 60 $12,885 292 7,589 $41,617 293 318 $27,403 294 96,809 $16,328 295 4,384 $16,246 296 247,066 $17,313 297 42,865 $10,814 298 111 $11,206 299 1,529 $21,388 300 21,667 $23,240 301 3,928 $13,559 302 10,492 $53,338 303 19,976 $35,840 304 13,647 $37,446 305 2,957 $25,330 306 5,818 $25,924 307 1,947 $13,770 308 5,453 $27,143 309 2,963 $19,770 310 25,376 $25,325 311 5,890 $14,282 312 1,328 $24,333 313 505 $16,723 314 2 $63,668 315 34,913 $34,744 316 205,564 $24,392 317 2,713 $17,237 318 5,910 $24,034 319 386 $13,859 320 224,863 $18,222 321 31,969 $12,283 322 67 $13,256 323 20,412 $18,199 324 4,635 $11,384 Start Printed Page 60042 325 9,919 $14,511 326 2,592 $9,803 327 11 $4,287 328 574 $15,451 329 54 $11,775 331 56,121 $22,455 332 3,962 $13,809 333 244 $18,783 334 9,525 $29,895 335 12,194 $24,054 336 28,188 $18,058 337 21,485 $12,514 338 674 $26,937 339 1,237 $24,400 341 3,131 $26,325 342 457 $16,760 344 2,341 $26,264 345 1,390 $24,260 346 3,961 $22,442 347 235 $12,271 348 4,262 $15,658 349 554 $10,030 350 7,276 $16,403 352 1,177 $16,583 353 3,089 $31,220 354 7,566 $29,704 355 4,987 $19,286 356 22,032 $16,331 357 5,537 $37,764 358 20,928 $24,273 359 28,584 $17,298 360 13,855 $18,950 361 287 $23,686 362 2 $6,796 363 2,155 $23,016 364 1,799 $19,267 365 1,617 $32,699 366 4,645 $23,868 367 446 $12,998 368 4,145 $23,496 369 3,723 $14,363 370 2,249 $17,564 371 2,705 $12,728 372 1,376 $10,829 373 5,273 $7,559 374 153 $13,086 375 12 $22,690 376 476 $12,879 377 109 $24,191 378 201 $16,303 379 499 $8,235 380 111 $9,375 381 169 $15,153 382 48 $3,957 383 2,806 $10,566 384 151 $7,395 389 3 $47,550 392 2,139 $45,748 394 2,759 $31,095 395 101,473 $16,889 396 18 $13,731 397 16,392 $23,042 398 6,706 $23,195 399 1,080 $14,886 401 6,451 $43,898 402 1,356 $25,234 403 31,326 $29,951 404 3,820 $20,323 406 2,303 $42,395 407 615 $24,808 408 1,948 $33,924 409 1,748 $25,090 410 29,053 $23,878 411 5 $9,689 412 9 $9,325 413 5,741 $25,503 414 487 $16,459 417 33 $28,277 418 29,977 $22,170 419 17,634 $18,501 420 3,100 $12,987 421 13,255 $16,161 422 79 $11,719 423 8,962 $28,700 424 1,041 $36,317 425 13,096 $13,579 426 4,235 $10,364 427 1,579 $11,172 428 845 $13,787 429 23,937 $16,841 430 75,525 $13,560 431 333 $12,622 432 402 $14,045 433 4,471 $6,874 439 1,759 $29,662 440 5,216 $29,532 441 686 $20,412 442 18,596 $37,581 443 3,589 $22,657 444 6,012 $16,341 445 2,242 $11,493 447 6,323 $11,529 449 40,846 $18,259 450 7,445 $9,450 451 2 $19,075 452 28,815 $21,740 453 5,394 $11,430 454 4,738 $17,873 455 887 $10,736 461 2,290 $27,973 462 7,863 $17,177 463 32,884 $15,102 464 7,661 $11,329 465 163 $12,758 466 1,204 $14,616 467 1,026 $10,056 468 52,034 $57,130 470 128 $25,337 471 15,630 $55,525 473 8,578 $38,344 476 2,850 $35,320 477 28,197 $34,214 479 27,646 $30,661 480 908 $128,375 481 1,198 $89,005 482 5,081 $49,252 484 472 $75,143 485 3,713 $51,989 486 2,712 $69,289 487 5,016 $32,012 488 828 $63,441 489 13,547 $28,616 490 5,252 $21,801 491 22,663 $35,766 492 3,924 $44,487 493 61,082 $34,534 494 24,547 $22,726 495 342 $121,280 496 3,726 $96,585 497 31,201 $62,709 498 21,280 $52,054 499 35,237 $28,358 500 46,425 $19,847 501 3,200 $42,457 502 764 $29,384 503 5,910 $26,642 504 192 $146,686 505 180 $28,342 506 963 $50,252 507 323 $31,921 508 654 $23,708 509 155 $16,122 510 1,782 $21,231 511 627 $13,442 512 550 $90,296 513 226 $67,441 515 58,659 $86,726 518 23,762 $34,527 519 12,586 $44,237 520 16,525 $35,867 521 29,364 $15,479 522 3,423 $12,533 523 14,462 $8,530 524 109,013 $16,166 525 205 $156,390 528 1,845 $107,946 529 5,026 $36,171 530 3,360 $25,619 531 4,993 $45,629 532 2,882 $28,150 533 43,711 $29,870 534 40,201 $21,434 535 8,826 $119,455 536 8,259 $109,010 537 8,983 $32,598 538 5,459 $22,345 539 4,973 $44,611 Start Printed Page 60043 540 1,504 $25,501 541 25,104 $251,059 542 23,115 $151,522 543 5,718 $64,397 544 445,799 $39,439 545 44,802 $44,851 546 2,360 $83,437 547 32,710 $97,734 548 32,249 $79,397 549 13,141 $80,495 550 34,566 $63,327 551 53,869 $51,351 552 82,058 $40,481 553 39,292 $46,800 554 77,351 $36,871 555 37,378 $42,659 556 18,973 $37,602 557 124,154 $51,160 558 192,637 $42,298 559 2,894 $40,731 560 3,457 $44,405 561 2,952 $35,694 562 52,954 $22,156 563 21,145 $14,021 564 16,327 $15,310 565 46,823 $78,345 566 73,082 $39,133 567 10,363 $72,728 568 16,695 $48,820 569 60,814 $63,237 570 72,247 $44,163 571 11,153 $23,681 572 48,983 $25,165 573 6,683 $51,724 574 26,619 $24,474 575 10,978 $86,104 576 277,472 $28,309 577 5,596 $35,353 578 35,312 $65,007 579 20,665 $39,583 1 Cases taken from the FY 2005 MedPAR file; DRGs are from GROUPER Version 24.0. [FR Doc. 06-8471 Filed 9-29-06; 4:00 pm]
BILLING CODE 4120-01-P
Document Information
- Published:
- 10/11/2006
- Department:
- Centers for Medicare & Medicaid Services
- Entry Type:
- Notice
- Action:
- Notice.
- Document Number:
- 06-8471
- Pages:
- 59885-60043 (159 pages)
- Docket Numbers:
- CMS-1488-N
- RINs:
- 0938-AO12
- PDF File:
- 06-8471.pdf