ICD-10-CM/PCS MS-DRG v37.2 Definitions Manual
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ICD-10-CM/PCS MS-DRG v37.2 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 33 of 72 |
| A000 B309 C601 C8445 D3142 E103293 E881 G4453 H15109 H40819 H90A12 I6381 J029 K50918 L509 M02822 M1A3190 M4205 M67841 M84461D M8719 N4231 O2330 O354XX1 O418X92 O99612 Q51818 R627 S0211FB S06336D S12191G S20301D S24101D S31123D S32451A S36430D S42019D S42413D S45899S S52026H S52261K S52513Q S55112S S59902A S61326A S62291G S62636D S63431S S66327S S72019D S72133G S72366K S73129A S81059D S82153F S82434H S82875K S86329A S91124S S92241D S93429D S99209P T22311A T24292S T365X6D T4276XA T474X3S T543X4S T653X1S T82199D T86849 Z8545 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S24101D | 23 | 949-950 | S25512S | 05 | 299-301 | S29021D | 23 | 949-950 | ||
| S24101S | 01 | 052-053 | S25519A | 21 | 913-914 | S29021S | 09 | 604-605 | ||
| S24102A | 01 | 052-053 | S25519A | 24 | 955-965 | S29022A | 09 | 604-605 | ||
| S24102A | 24 | 955-965 | S25519D | 23 | 949-950 | S29022A | 24 | 955-965 | ||
| S24102D | 23 | 949-950 | S25519S | 05 | 299-301 | S29022D | 23 | 949-950 | ||
| S24102S | 01 | 052-053 | S25591A | 21 | 913-914 | S29022S | 09 | 604-605 | ||
| S24103A | 01 | 052-053 | S25591A | 24 | 955-965 | S29029A | 09 | 604-605 | ||
| S24103A | 24 | 955-965 | S25591D | 23 | 949-950 | S29029A | 24 | 955-965 | ||
| S24103D | 23 | 949-950 | S25591S | 05 | 299-301 | S29029D | 23 | 949-950 | ||
| S24103S | 01 | 052-053 | S25592A | 21 | 913-914 | S29029S | 09 | 604-605 | ||
| S24104A | 01 | 052-053 | S25592A | 24 | 955-965 | S29091A | 21 | 913-914 | ||
| S24104A | 24 | 955-965 | S25592D | 23 | 949-950 | S29091A | 24 | 955-965 | ||
| S24104D | 23 | 949-950 | S25592S | 05 | 299-301 | S29091D | 23 | 949-950 | ||
| S24104S | 01 | 052-053 | S25599A | 21 | 913-914 | S29091S | 21 | 913-914 | ||
| S24109A | 01 | 052-053 | S25599A | 24 | 955-965 | S29092A | 21 | 913-914 | ||
| S24109A | 24 | 955-965 | S25599D | 23 | 949-950 | S29092A | 24 | 955-965 | ||
| S24109D | 23 | 949-950 | S25599S | 05 | 299-301 | S29092D | 23 | 949-950 | ||
| S24109S | 01 | 052-053 | S25801A | 21 | 913-914 | S29092S | 21 | 913-914 | ||
| S24111A | 01 | 052-053 | S25801A | 24 | 955-965 | S29099A | 21 | 913-914 | ||
| S24111A | 24 | 955-965 | S25801D | 23 | 949-950 | S29099A | 24 | 955-965 | ||
| S24111D | 23 | 949-950 | S25801S | 05 | 299-301 | S29099D | 23 | 949-950 | ||
| S24111S | 01 | 052-053 | S25802A | 21 | 913-914 | S29099S | 21 | 913-914 | ||
| S24112A | 01 | 052-053 | S25802A | 24 | 955-965 | S298XXA | 21 | 913-914 | ||
| S24112A | 24 | 955-965 | S25802D | 23 | 949-950 | S298XXA | 24 | 955-965 | ||
| S24112D | 23 | 949-950 | S25802S | 05 | 299-301 | S298XXD | 23 | 949-950 | ||
| S24112S | 01 | 052-053 | S25809A | 21 | 913-914 | S298XXS | 21 | 913-914 | ||
| S24113A | 01 | 052-053 | S25809A | 24 | 955-965 | S299XXA | 21 | 913-914 | ||
| S24113A | 24 | 955-965 | S25809D | 23 | 949-950 | S299XXA | 24 | 955-965 | ||
| S24113D | 23 | 949-950 | S25809S | 05 | 299-301 | S299XXD | 23 | 949-950 | ||
| S24113S | 01 | 052-053 | S25811A | 21 | 913-914 | S299XXS | 21 | 913-914 | ||
| S24114A | 01 | 052-053 | S25811A | 24 | 955-965 | S300XXA | 09 | 604-605 | ||
| S24114A | 24 | 955-965 | S25811D | 23 | 949-950 | S300XXA | 24 | 955-965 | ||
| S24114D | 23 | 949-950 | S25811S | 05 | 299-301 | S300XXD | 23 | 949-950 | ||
| S24114S | 01 | 052-053 | S25812A | 21 | 913-914 | S300XXS | 09 | 604-605 | ||
| S24119A | 01 | 052-053 | S25812A | 24 | 955-965 | S301XXA | 09 | 604-605 | ||
| S24119A | 24 | 955-965 | S25812D | 23 | 949-950 | S301XXA | 24 | 955-965 | ||
| S24119D | 23 | 949-950 | S25812S | 05 | 299-301 | S301XXD | 23 | 949-950 | ||
| S24119S | 01 | 052-053 | S25819A | 21 | 913-914 | S301XXS | 09 | 604-605 | ||
| S24131A | 01 | 052-053 | S25819A | 24 | 955-965 | S30201A | 12 | 729-730 | ||
| S24131A | 24 | 955-965 | S25819D | 23 | 949-950 | S30201A | 24 | 955-965 | ||
| S24131D | 23 | 949-950 | S25819S | 05 | 299-301 | S30201D | 23 | 949-950 | ||
| S24131S | 01 | 052-053 | S25891A | 21 | 913-914 | S30201S | 09 | 604-605 | ||
| S24132A | 01 | 052-053 | S25891A | 24 | 955-965 | S30202A | 13 | 742-743 | ||
| S24132A | 24 | 955-965 | S25891D | 23 | 949-950 | S30202A | 13 | 760-761 | ||
| S24132D | 23 | 949-950 | S25891S | 05 | 299-301 | S30202A | 24 | 955-965 | ||
| S24132S | 01 | 052-053 | S25892A | 21 | 913-914 | S30202D | 23 | 949-950 | ||
| S24133A | 01 | 052-053 | S25892A | 24 | 955-965 | S30202S | 09 | 604-605 | ||
| S24133A | 24 | 955-965 | S25892D | 23 | 949-950 | S3021XA | 12 | 729-730 | ||
| S24133D | 23 | 949-950 | S25892S | 05 | 299-301 | S3021XA | 24 | 955-965 | ||
| S24133S | 01 | 052-053 | S25899A | 21 | 913-914 | S3021XD | 23 | 949-950 | ||
| S24134A | 01 | 052-053 | S25899A | 24 | 955-965 | S3021XS | 09 | 604-605 | ||
| S24134A | 24 | 955-965 | S25899D | 23 | 949-950 | S3022XA | 12 | 729-730 | ||
| S24134D | 23 | 949-950 | S25899S | 05 | 299-301 | S3022XA | 24 | 955-965 | ||
| S24134S | 01 | 052-053 | S2590XA | 21 | 913-914 | S3022XD | 23 | 949-950 | ||
| S24139A | 01 | 052-053 | S2590XA | 24 | 955-965 | S3022XS | 09 | 604-605 | ||
| S24139A | 24 | 955-965 | S2590XD | 23 | 949-950 | S3023XA | 13 | 742-743 | ||
| S24139D | 23 | 949-950 | S2590XS | 05 | 299-301 | S3023XA | 13 | 760-761 | ||
| S24139S | 01 | 052-053 | S2591XA | 21 | 913-914 | S3023XA | 24 | 955-965 | ||
| S24141A | 01 | 052-053 | S2591XA | 24 | 955-965 | S3023XD | 23 | 949-950 | ||
| S24141A | 24 | 955-965 | S2591XD | 23 | 949-950 | S3023XS | 09 | 604-605 | ||
| S24141D | 23 | 949-950 | S2591XS | 05 | 299-301 | S303XXA | 09 | 604-605 | ||
| S24141S | 01 | 052-053 | S2599XA | 21 | 913-914 | S303XXA | 24 | 955-965 | ||
| S24142A | 01 | 052-053 | S2599XA | 24 | 955-965 | S303XXD | 23 | 949-950 | ||
| S24142A | 24 | 955-965 | S2599XD | 23 | 949-950 | S303XXS | 09 | 604-605 | ||
| S24142D | 23 | 949-950 | S2599XS | 05 | 299-301 | S30810A | 09 | 604-605 | ||
| S24142S | 01 | 052-053 | S2600XA | 05 | 314-316 | S30810A | 24 | 955-965 | ||
| S24143A | 01 | 052-053 | S2600XA | 24 | 955-965 | S30810D | 23 | 949-950 | ||
| S24143A | 24 | 955-965 | S2600XD | 23 | 949-950 | S30810S | 09 | 604-605 | ||
| S24143D | 23 | 949-950 | S2600XS | 04 | 205-206 | S30811A | 09 | 604-605 | ||
| S24143S | 01 | 052-053 | S2601XA | 05 | 314-316 | S30811A | 24 | 955-965 | ||
| S24144A | 01 | 052-053 | S2601XA | 24 | 955-965 | S30811D | 23 | 949-950 | ||
| S24144A | 24 | 955-965 | S2601XD | 23 | 949-950 | S30811S | 09 | 604-605 | ||
| S24144D | 23 | 949-950 | S2601XS | 04 | 205-206 | S30812A | 09 | 604-605 | ||
| S24144S | 01 | 052-053 | S26020A | 05 | 314-316 | S30812A | 24 | 955-965 | ||
| S24149A | 01 | 052-053 | S26020A | 24 | 955-965 | S30812D | 23 | 949-950 | ||
| S24149A | 24 | 955-965 | S26020D | 23 | 949-950 | S30812S | 09 | 604-605 | ||
| S24149D | 23 | 949-950 | S26020S | 04 | 205-206 | S30813A | 09 | 604-605 | ||
| S24149S | 01 | 052-053 | S26021A | 05 | 314-316 | S30813A | 24 | 955-965 | ||
| S24151A | 01 | 052-053 | S26021A | 24 | 955-965 | S30813D | 23 | 949-950 | ||
| S24151A | 24 | 955-965 | S26021D | 23 | 949-950 | S30813S | 09 | 604-605 | ||
| S24151D | 23 | 949-950 | S26021S | 04 | 205-206 | S30814A | 09 | 604-605 | ||
| S24151S | 01 | 052-053 | S26022A | 05 | 314-316 | S30814A | 24 | 955-965 | ||
| S24152A | 01 | 052-053 | S26022A | 24 | 955-965 | S30814D | 23 | 949-950 | ||
| S24152A | 24 | 955-965 | S26022D | 23 | 949-950 | S30814S | 09 | 604-605 | ||
| S24152D | 23 | 949-950 | S26022S | 04 | 205-206 | S30815A | 09 | 604-605 | ||
| S24152S | 01 | 052-053 | S2609XA | 05 | 314-316 | S30815A | 24 | 955-965 | ||
| S24153A | 01 | 052-053 | S2609XA | 24 | 955-965 | S30815D | 23 | 949-950 | ||
| S24153A | 24 | 955-965 | S2609XD | 23 | 949-950 | S30815S | 09 | 604-605 | ||
| S24153D | 23 | 949-950 | S2609XS | 04 | 205-206 | S30816A | 09 | 604-605 | ||
| S24153S | 01 | 052-053 | S2610XA | 05 | 314-316 | S30816A | 24 | 955-965 | ||
| S24154A | 01 | 052-053 | S2610XA | 24 | 955-965 | S30816D | 23 | 949-950 | ||
| S24154A | 24 | 955-965 | S2610XD | 23 | 949-950 | S30816S | 09 | 604-605 | ||
| S24154D | 23 | 949-950 | S2610XS | 04 | 205-206 | S30817A | 09 | 604-605 | ||
| S24154S | 01 | 052-053 | S2611XA | 05 | 314-316 | S30817A | 24 | 955-965 | ||
| S24159A | 01 | 052-053 | S2611XA | 24 | 955-965 | S30817D | 23 | 949-950 | ||
| S24159A | 24 | 955-965 | S2611XD | 23 | 949-950 | S30817S | 09 | 604-605 | ||
| S24159D | 23 | 949-950 | S2611XS | 04 | 205-206 | S30820A | 09 | 606-607 | ||
| S24159S | 01 | 052-053 | S2612XA | 05 | 314-316 | S30820A | 24 | 955-965 | ||
| S242XXA | 01 | 073-074 | S2612XA | 24 | 955-965 | S30820D | 23 | 949-950 | ||
| S242XXA | 24 | 955-965 | S2612XD | 23 | 949-950 | S30820S | 09 | 604-605 | ||
| S242XXD | 23 | 949-950 | S2612XS | 04 | 205-206 | S30821A | 09 | 606-607 | ||
| S242XXS | 01 | 091-093 | S2619XA | 05 | 314-316 | S30821A | 24 | 955-965 | ||
| S243XXA | 01 | 073-074 | S2619XA | 24 | 955-965 | S30821D | 23 | 949-950 | ||
| S243XXA | 24 | 955-965 | S2619XD | 23 | 949-950 | S30821S | 09 | 604-605 | ||
| S243XXD | 23 | 949-950 | S2619XS | 04 | 205-206 | S30822A | 09 | 606-607 | ||
| S243XXS | 01 | 091-093 | S2690XA | 05 | 314-316 | S30822A | 24 | 955-965 | ||
| S244XXA | 01 | 073-074 | S2690XA | 24 | 955-965 | S30822D | 23 | 949-950 | ||
| S244XXA | 24 | 955-965 | S2690XD | 23 | 949-950 | S30822S | 09 | 604-605 | ||
| S244XXD | 23 | 949-950 | S2690XS | 04 | 205-206 | S30823A | 09 | 606-607 | ||
| S244XXS | 01 | 091-093 | S2691XA | 05 | 314-316 | S30823A | 24 | 955-965 | ||
| S248XXA | 01 | 073-074 | S2691XA | 24 | 955-965 | S30823D | 23 | 949-950 | ||
| S248XXA | 24 | 955-965 | S2691XD | 23 | 949-950 | S30823S | 09 | 604-605 | ||
| S248XXD | 23 | 949-950 | S2691XS | 04 | 205-206 | S30824A | 09 | 606-607 | ||
| S248XXS | 01 | 091-093 | S2692XA | 05 | 314-316 | S30824A | 24 | 955-965 | ||
| S249XXA | 01 | 073-074 | S2692XA | 24 | 955-965 | S30824D | 23 | 949-950 | ||
| S249XXA | 24 | 955-965 | S2692XD | 23 | 949-950 | S30824S | 09 | 604-605 | ||
| S249XXD | 23 | 949-950 | S2692XS | 04 | 205-206 | S30825A | 09 | 606-607 | ||
| S249XXS | 01 | 091-093 | S2699XA | 05 | 314-316 | S30825A | 24 | 955-965 | ||
| S2500XA | 15 | 791 | S2699XA | 24 | 955-965 | S30825D | 23 | 949-950 | ||
| S2500XA | 15 | 793 | S2699XD | 23 | 949-950 | S30825S | 09 | 604-605 | ||
| S2500XA | 21 | 913-914 | S2699XS | 04 | 205-206 | S30826A | 09 | 606-607 | ||
| S2500XA | 24 | 955-965 | S270XXA | 04 | 199-201 | S30826A | 24 | 955-965 | ||
| S2500XD | 23 | 949-950 | S270XXA | 15 | 791 | S30826D | 23 | 949-950 | ||
| S2500XS | 05 | 299-301 | S270XXA | 15 | 793 | S30826S | 09 | 604-605 | ||
| S2501XA | 15 | 791 | S270XXA | 24 | 955-965 | S30827A | 09 | 606-607 | ||
| S2501XA | 15 | 793 | S270XXD | 23 | 949-950 | S30827A | 24 | 955-965 | ||
| S2501XA | 21 | 913-914 | S270XXS | 04 | 205-206 | S30827D | 23 | 949-950 | ||
| S2501XA | 24 | 955-965 | S271XXA | 04 | 199-201 | S30827S | 09 | 604-605 | ||
| S2501XD | 23 | 949-950 | S271XXA | 15 | 791 | S30840A | 09 | 604-605 | ||
| S2501XS | 05 | 299-301 | S271XXA | 15 | 793 | S30840A | 24 | 955-965 | ||
| S2502XA | 15 | 791 | S271XXA | 24 | 955-965 | S30840D | 23 | 949-950 | ||
| S2502XA | 15 | 793 | S271XXD | 23 | 949-950 | S30840S | 09 | 604-605 | ||
| S2502XA | 21 | 913-914 | S271XXS | 04 | 205-206 | S30841A | 09 | 604-605 | ||
| S2502XA | 24 | 955-965 | S272XXA | 04 | 199-201 | S30841A | 24 | 955-965 | ||
| S2502XD | 23 | 949-950 | S272XXA | 15 | 791 | S30841D | 23 | 949-950 | ||
| S2502XS | 05 | 299-301 | S272XXA | 15 | 793 | S30841S | 09 | 604-605 | ||
| S2509XA | 15 | 791 | S272XXA | 24 | 955-965 | S30842A | 09 | 604-605 | ||
| S2509XA | 15 | 793 | S272XXD | 23 | 949-950 | S30842A | 24 | 955-965 | ||
| S2509XA | 21 | 913-914 | S272XXS | 04 | 205-206 | S30842D | 23 | 949-950 | ||
| S2509XA | 24 | 955-965 | S27301A | 04 | 205-206 | S30842S | 09 | 604-605 | ||
| S2509XD | 23 | 949-950 | S27301A | 24 | 955-965 | S30843A | 09 | 604-605 | ||
| S2509XS | 05 | 299-301 | S27301D | 23 | 949-950 | S30843A | 24 | 955-965 | ||
| S25101A | 15 | 791 | S27301S | 04 | 205-206 | S30843D | 23 | 949-950 | ||
| S25101A | 15 | 793 | S27302A | 04 | 205-206 | S30843S | 09 | 604-605 | ||
| S25101A | 21 | 913-914 | S27302A | 24 | 955-965 | S30844A | 09 | 604-605 | ||
| S25101A | 24 | 955-965 | S27302D | 23 | 949-950 | S30844A | 24 | 955-965 | ||
| S25101D | 23 | 949-950 | S27302S | 04 | 205-206 | S30844D | 23 | 949-950 | ||
| S25101S | 05 | 299-301 | S27309A | 04 | 205-206 | S30844S | 09 | 604-605 | ||
| S25102A | 15 | 791 | S27309A | 24 | 955-965 | S30845A | 09 | 604-605 | ||
| S25102A | 15 | 793 | S27309D | 23 | 949-950 | S30845A | 24 | 955-965 | ||
| S25102A | 21 | 913-914 | S27309S | 04 | 205-206 | S30845D | 23 | 949-950 | ||
| S25102A | 24 | 955-965 | S27311A | 04 | 205-206 | S30845S | 09 | 604-605 | ||
| S25102D | 23 | 949-950 | S27311A | 24 | 955-965 | S30846A | 09 | 604-605 | ||
| S25102S | 05 | 299-301 | S27311D | 23 | 949-950 | S30846A | 24 | 955-965 | ||
| S25109A | 15 | 791 | S27311S | 04 | 205-206 | S30846D | 23 | 949-950 | ||
| S25109A | 15 | 793 | S27312A | 04 | 205-206 | S30846S | 09 | 604-605 | ||
| S25109A | 21 | 913-914 | S27312A | 24 | 955-965 | S30850A | 09 | 604-605 | ||
| S25109A | 24 | 955-965 | S27312D | 23 | 949-950 | S30850A | 24 | 955-965 | ||
| S25109D | 23 | 949-950 | S27312S | 04 | 205-206 | S30850D | 23 | 949-950 | ||
| S25109S | 05 | 299-301 | S27319A | 04 | 205-206 | S30850S | 09 | 604-605 | ||
| S25111A | 15 | 791 | S27319A | 24 | 955-965 | S30851A | 09 | 604-605 | ||
| S25111A | 15 | 793 | S27319D | 23 | 949-950 | S30851A | 24 | 955-965 | ||
| S25111A | 21 | 913-914 | S27319S | 04 | 205-206 | S30851D | 23 | 949-950 | ||
| S25111A | 24 | 955-965 | S27321A | 04 | 205-206 | S30851S | 09 | 604-605 | ||
| S25111D | 23 | 949-950 | S27321A | 24 | 955-965 | S30852A | 09 | 604-605 | ||
| S25111S | 05 | 299-301 | S27321D | 23 | 949-950 | S30852A | 24 | 955-965 | ||
| S25112A | 15 | 791 | S27321S | 04 | 205-206 | S30852D | 23 | 949-950 | ||
| S25112A | 15 | 793 | S27322A | 04 | 205-206 | S30852S | 09 | 604-605 | ||
| S25112A | 21 | 913-914 | S27322A | 24 | 955-965 | S30853A | 09 | 604-605 | ||
| S25112A | 24 | 955-965 | S27322D | 23 | 949-950 | S30853A | 24 | 955-965 | ||
| S25112D | 23 | 949-950 | S27322S | 04 | 205-206 | S30853D | 23 | 949-950 | ||
| S25112S | 05 | 299-301 | S27329A | 04 | 205-206 | S30853S | 09 | 604-605 | ||
| S25119A | 15 | 791 | S27329A | 24 | 955-965 | S30854A | 09 | 604-605 | ||
| S25119A | 15 | 793 | S27329D | 23 | 949-950 | S30854A | 24 | 955-965 | ||
| S25119A | 21 | 913-914 | S27329S | 04 | 205-206 | S30854D | 23 | 949-950 | ||
| S25119A | 24 | 955-965 | S27331A | 04 | 183-185 | S30854S | 09 | 604-605 | ||
| S25119D | 23 | 949-950 | S27331A | 24 | 955-965 | S30855A | 09 | 604-605 | ||
| S25119S | 05 | 299-301 | S27331D | 23 | 949-950 | S30855A | 24 | 955-965 | ||
| S25121A | 15 | 791 | S27331S | 04 | 205-206 | S30855D | 23 | 949-950 | ||
| S25121A | 15 | 793 | S27332A | 04 | 183-185 | S30855S | 09 | 604-605 | ||
| S25121A | 21 | 913-914 | S27332A | 24 | 955-965 | S30856A | 09 | 604-605 | ||
| S25121A | 24 | 955-965 | S27332D | 23 | 949-950 | S30856A | 24 | 955-965 | ||
| S25121D | 23 | 949-950 | S27332S | 04 | 205-206 | S30856D | 23 | 949-950 | ||
| S25121S | 05 | 299-301 | S27339A | 04 | 183-185 | S30856S | 09 | 604-605 | ||
| S25122A | 15 | 791 | S27339A | 24 | 955-965 | S30857A | 09 | 604-605 | ||
| S25122A | 15 | 793 | S27339D | 23 | 949-950 | S30857A | 24 | 955-965 | ||
| S25122A | 21 | 913-914 | S27339S | 04 | 205-206 | S30857D | 23 | 949-950 | ||
| S25122A | 24 | 955-965 | S27391A | 04 | 205-206 | S30857S | 09 | 604-605 | ||
| S25122D | 23 | 949-950 | S27391A | 24 | 955-965 | S30860A | 09 | 606-607 | ||
| S25122S | 05 | 299-301 | S27391D | 23 | 949-950 | S30860A | 24 | 955-965 | ||
| S25129A | 15 | 791 | S27391S | 04 | 205-206 | S30860D | 23 | 949-950 | ||
| S25129A | 15 | 793 | S27392A | 04 | 205-206 | S30860S | 09 | 604-605 | ||
| S25129A | 21 | 913-914 | S27392A | 24 | 955-965 | S30861A | 09 | 606-607 | ||
| S25129A | 24 | 955-965 | S27392D | 23 | 949-950 | S30861A | 24 | 955-965 | ||
| S25129D | 23 | 949-950 | S27392S | 04 | 205-206 | S30861D | 23 | 949-950 | ||
| S25129S | 05 | 299-301 | S27399A | 04 | 205-206 | S30861S | 09 | 604-605 | ||
| S25191A | 15 | 791 | S27399A | 24 | 955-965 | S30862A | 09 | 606-607 | ||
| S25191A | 15 | 793 | S27399D | 23 | 949-950 | S30862A | 24 | 955-965 | ||
| S25191A | 21 | 913-914 | S27399S | 04 | 205-206 | S30862D | 23 | 949-950 | ||
| S25191A | 24 | 955-965 | S27401A | 04 | 183-185 | S30862S | 09 | 604-605 | ||
| S25191D | 23 | 949-950 | S27401A | 24 | 955-965 | S30863A | 09 | 606-607 | ||
| S25191S | 05 | 299-301 | S27401D | 23 | 949-950 | S30863A | 24 | 955-965 | ||
| S25192A | 15 | 791 | S27401S | 04 | 205-206 | S30863D | 23 | 949-950 | ||
| S25192A | 15 | 793 | S27402A | 04 | 183-185 | S30863S | 09 | 604-605 | ||
| S25192A | 21 | 913-914 | S27402A | 24 | 955-965 | S30864A | 09 | 606-607 | ||
| S25192A | 24 | 955-965 | S27402D | 23 | 949-950 | S30864A | 24 | 955-965 | ||
| S25192D | 23 | 949-950 | S27402S | 04 | 205-206 | S30864D | 23 | 949-950 | ||
| S25192S | 05 | 299-301 | S27409A | 04 | 183-185 | S30864S | 09 | 604-605 | ||
| S25199A | 15 | 791 | S27409A | 24 | 955-965 | S30865A | 09 | 606-607 | ||
| S25199A | 15 | 793 | S27409D | 23 | 949-950 | S30865A | 24 | 955-965 | ||
| S25199A | 21 | 913-914 | S27409S | 04 | 205-206 | S30865D | 23 | 949-950 | ||
| S25199A | 24 | 955-965 | S27411A | 04 | 183-185 | S30865S | 09 | 604-605 | ||
| S25199D | 23 | 949-950 | S27411A | 24 | 955-965 | S30866A | 09 | 606-607 | ||
| S25199S | 05 | 299-301 | S27411D | 23 | 949-950 | S30866A | 24 | 955-965 | ||
| S2520XA | 15 | 791 | S27411S | 04 | 205-206 | S30866D | 23 | 949-950 | ||
| S2520XA | 15 | 793 | S27412A | 04 | 183-185 | S30866S | 09 | 604-605 | ||
| S2520XA | 21 | 913-914 | S27412A | 24 | 955-965 | S30867A | 09 | 606-607 | ||
| S2520XA | 24 | 955-965 | S27412D | 23 | 949-950 | S30867A | 24 | 955-965 | ||
| S2520XD | 23 | 949-950 | S27412S | 04 | 205-206 | S30867D | 23 | 949-950 | ||
| S2520XS | 05 | 299-301 | S27419A | 04 | 183-185 | S30867S | 09 | 604-605 | ||
| S2521XA | 15 | 791 | S27419A | 24 | 955-965 | S30870A | 09 | 604-605 | ||
| S2521XA | 15 | 793 | S27419D | 23 | 949-950 | S30870A | 24 | 955-965 | ||
| S2521XA | 21 | 913-914 | S27419S | 04 | 205-206 | S30870D | 23 | 949-950 | ||
| S2521XA | 24 | 955-965 | S27421A | 04 | 183-185 | S30870S | 09 | 604-605 | ||
| S2521XD | 23 | 949-950 | S27421A | 24 | 955-965 | S30871A | 09 | 604-605 | ||
| S2521XS | 05 | 299-301 | S27421D | 23 | 949-950 | S30871A | 24 | 955-965 | ||
| S2522XA | 15 | 791 | S27421S | 04 | 205-206 | S30871D | 23 | 949-950 | ||
| S2522XA | 15 | 793 | S27422A | 04 | 183-185 | S30871S | 09 | 604-605 | ||
| S2522XA | 21 | 913-914 | S27422A | 24 | 955-965 | S30872A | 09 | 604-605 | ||
| S2522XA | 24 | 955-965 | S27422D | 23 | 949-950 | S30872A | 24 | 955-965 | ||
| S2522XD | 23 | 949-950 | S27422S | 04 | 205-206 | S30872D | 23 | 949-950 | ||
| S2522XS | 05 | 299-301 | S27429A | 04 | 183-185 | S30872S | 09 | 604-605 | ||
| S2529XA | 15 | 791 | S27429A | 24 | 955-965 | S30873A | 09 | 604-605 | ||
| S2529XA | 15 | 793 | S27429D | 23 | 949-950 | S30873A | 24 | 955-965 | ||
| S2529XA | 21 | 913-914 | S27429S | 04 | 205-206 | S30873D | 23 | 949-950 | ||
| S2529XA | 24 | 955-965 | S27431A | 04 | 183-185 | S30873S | 09 | 604-605 | ||
| S2529XD | 23 | 949-950 | S27431A | 24 | 955-965 | S30874A | 09 | 604-605 | ||
| S2529XS | 05 | 299-301 | S27431D | 23 | 949-950 | S30874A | 24 | 955-965 | ||
| S25301A | 15 | 791 | S27431S | 04 | 205-206 | S30874D | 23 | 949-950 | ||
| S25301A | 15 | 793 | S27432A | 04 | 183-185 | S30874S | 09 | 604-605 | ||
| S25301A | 21 | 913-914 | S27432A | 24 | 955-965 | S30875A | 09 | 604-605 | ||
| S25301A | 24 | 955-965 | S27432D | 23 | 949-950 | S30875A | 24 | 955-965 | ||
| S25301D | 23 | 949-950 | S27432S | 04 | 205-206 | S30875D | 23 | 949-950 | ||
| S25301S | 05 | 299-301 | S27439A | 04 | 183-185 | S30875S | 09 | 604-605 | ||
| S25302A | 15 | 791 | S27439A | 24 | 955-965 | S30876A | 09 | 604-605 | ||
| S25302A | 15 | 793 | S27439D | 23 | 949-950 | S30876A | 24 | 955-965 | ||
| S25302A | 21 | 913-914 | S27439S | 04 | 205-206 | S30876D | 23 | 949-950 | ||
| S25302A | 24 | 955-965 | S27491A | 04 | 183-185 | S30876S | 09 | 604-605 | ||
| S25302D | 23 | 949-950 | S27491A | 24 | 955-965 | S30877A | 09 | 604-605 | ||
| S25302S | 05 | 299-301 | S27491D | 23 | 949-950 | S30877A | 24 | 955-965 | ||
| S25309A | 15 | 791 | S27491S | 04 | 205-206 | S30877D | 23 | 949-950 | ||
| S25309A | 15 | 793 | S27492A | 04 | 183-185 | S30877S | 09 | 604-605 | ||
| S25309A | 21 | 913-914 | S27492A | 24 | 955-965 | S3091XA | 09 | 604-605 | ||
| S25309A | 24 | 955-965 | S27492D | 23 | 949-950 | S3091XA | 24 | 955-965 | ||
| S25309D | 23 | 949-950 | S27492S | 04 | 205-206 | S3091XD | 23 | 949-950 | ||
| S25309S | 05 | 299-301 | S27499A | 04 | 183-185 | S3091XS | 09 | 604-605 | ||
| S25311A | 15 | 791 | S27499A | 24 | 955-965 | S3092XA | 09 | 604-605 | ||
| S25311A | 15 | 793 | S27499D | 23 | 949-950 | S3092XA | 24 | 955-965 | ||
| S25311A | 21 | 913-914 | S27499S | 04 | 205-206 | S3092XD | 23 | 949-950 | ||
| S25311A | 24 | 955-965 | S2750XA | 04 | 205-206 | S3092XS | 09 | 604-605 | ||
| S25311D | 23 | 949-950 | S2750XA | 24 | 955-965 | S3093XA | 09 | 604-605 | ||
| S25311S | 05 | 299-301 | S2750XD | 23 | 949-950 | S3093XA | 24 | 955-965 | ||
| S25312A | 15 | 791 | S2750XS | 04 | 205-206 | S3093XD | 23 | 949-950 | ||
| S25312A | 15 | 793 | S2751XA | 04 | 205-206 | S3093XS | 09 | 604-605 | ||
| S25312A | 21 | 913-914 | S2751XA | 24 | 955-965 | S3094XA | 09 | 604-605 | ||
| S25312A | 24 | 955-965 | S2751XD | 23 | 949-950 | S3094XA | 24 | 955-965 | ||
| S25312D | 23 | 949-950 | S2751XS | 04 | 205-206 | S3094XD | 23 | 949-950 | ||
| S25312S | 05 | 299-301 | S2752XA | 04 | 205-206 | S3094XS | 09 | 604-605 | ||
| S25319A | 15 | 791 | S2752XA | 24 | 955-965 | S3095XA | 09 | 604-605 | ||
| S25319A | 15 | 793 | S2752XD | 23 | 949-950 | S3095XA | 24 | 955-965 | ||
| S25319A | 21 | 913-914 | S2752XS | 04 | 205-206 | S3095XD | 23 | 949-950 | ||
| S25319A | 24 | 955-965 | S2753XA | 04 | 205-206 | S3095XS | 09 | 604-605 | ||
| S25319D | 23 | 949-950 | S2753XA | 24 | 955-965 | S3096XA | 09 | 604-605 | ||
| S25319S | 05 | 299-301 | S2753XD | 23 | 949-950 | S3096XA | 24 | 955-965 | ||
| S25321A | 15 | 791 | S2753XS | 04 | 205-206 | S3096XD | 23 | 949-950 | ||
| S25321A | 15 | 793 | S2759XA | 04 | 205-206 | S3096XS | 09 | 604-605 | ||
| S25321A | 21 | 913-914 | S2759XA | 24 | 955-965 | S3097XA | 09 | 604-605 | ||
| S25321A | 24 | 955-965 | S2759XD | 23 | 949-950 | S3097XA | 24 | 955-965 | ||
| S25321D | 23 | 949-950 | S2759XS | 04 | 205-206 | S3097XD | 23 | 949-950 | ||
| S25321S | 05 | 299-301 | S2760XA | 04 | 205-206 | S3097XS | 09 | 604-605 | ||
| S25322A | 15 | 791 | S2760XA | 24 | 955-965 | S3098XA | 09 | 604-605 | ||
| S25322A | 15 | 793 | S2760XD | 23 | 949-950 | S3098XA | 24 | 955-965 | ||
| S25322A | 21 | 913-914 | S2760XS | 04 | 205-206 | S3098XD | 23 | 949-950 | ||
| S25322A | 24 | 955-965 | S2763XA | 04 | 205-206 | S3098XS | 09 | 604-605 | ||
| S25322D | 23 | 949-950 | S2763XA | 24 | 955-965 | S31000A | 09 | 604-605 | ||
| S25322S | 05 | 299-301 | S2763XD | 23 | 949-950 | S31000A | 24 | 955-965 | ||
| S25329A | 15 | 791 | S2763XS | 04 | 205-206 | S31000D | 23 | 949-950 | ||
| S25329A | 15 | 793 | S2769XA | 04 | 205-206 | S31000S | 09 | 604-605 | ||
| S25329A | 21 | 913-914 | S2769XA | 24 | 955-965 | S31001A | 11 | 698-700 | ||
| S25329A | 24 | 955-965 | S2769XD | 23 | 949-950 | S31001A | 24 | 955-965 | ||
| S25329D | 23 | 949-950 | S2769XS | 04 | 205-206 | S31001D | 23 | 949-950 | ||
| S25329S | 05 | 299-301 | S27802A | 04 | 183-185 | S31001S | 09 | 604-605 | ||
| S25391A | 15 | 791 | S27802A | 24 | 955-965 | S31010A | 09 | 604-605 | ||
| S25391A | 15 | 793 | S27802D | 23 | 949-950 | S31010A | 24 | 955-965 | ||
| S25391A | 21 | 913-914 | S27802S | 04 | 205-206 | S31010D | 23 | 949-950 | ||
| S25391A | 24 | 955-965 | S27803A | 04 | 183-185 | S31010S | 09 | 604-605 | ||
| S25391D | 23 | 949-950 | S27803A | 24 | 955-965 | S31011A | 11 | 698-700 | ||
| S25391S | 05 | 299-301 | S27803D | 23 | 949-950 | S31011A | 24 | 955-965 | ||
| S25392A | 15 | 791 | S27803S | 04 | 205-206 | S31011D | 23 | 949-950 | ||
| S25392A | 15 | 793 | S27808A | 04 | 183-185 | S31011S | 09 | 604-605 | ||
| S25392A | 21 | 913-914 | S27808A | 24 | 955-965 | S31020A | 09 | 604-605 | ||
| S25392A | 24 | 955-965 | S27808D | 23 | 949-950 | S31020A | 24 | 955-965 | ||
| S25392D | 23 | 949-950 | S27808S | 04 | 205-206 | S31020D | 23 | 949-950 | ||
| S25392S | 05 | 299-301 | S27809A | 04 | 183-185 | S31020S | 09 | 604-605 | ||
| S25399A | 15 | 791 | S27809A | 24 | 955-965 | S31021A | 11 | 698-700 | ||
| S25399A | 15 | 793 | S27809D | 23 | 949-950 | S31021A | 24 | 955-965 | ||
| S25399A | 21 | 913-914 | S27809S | 04 | 205-206 | S31021D | 23 | 949-950 | ||
| S25399A | 24 | 955-965 | S27812A | 06 | 368-370 | S31021S | 09 | 604-605 | ||
| S25399D | 23 | 949-950 | S27812A | 24 | 955-965 | S31030A | 09 | 604-605 | ||
| S25399S | 05 | 299-301 | S27812D | 23 | 949-950 | S31030A | 24 | 955-965 | ||
| S25401A | 15 | 791 | S27812S | 04 | 205-206 | S31030D | 23 | 949-950 | ||
| S25401A | 15 | 793 | S27813A | 06 | 368-370 | S31030S | 09 | 604-605 | ||
| S25401A | 21 | 913-914 | S27813A | 24 | 955-965 | S31031A | 11 | 698-700 | ||
| S25401A | 24 | 955-965 | S27813D | 23 | 949-950 | S31031A | 24 | 955-965 | ||
| S25401D | 23 | 949-950 | S27813S | 04 | 205-206 | S31031D | 23 | 949-950 | ||
| S25401S | 05 | 299-301 | S27818A | 06 | 368-370 | S31031S | 09 | 604-605 | ||
| S25402A | 15 | 791 | S27818A | 24 | 955-965 | S31040A | 09 | 604-605 | ||
| S25402A | 15 | 793 | S27818D | 23 | 949-950 | S31040A | 24 | 955-965 | ||
| S25402A | 21 | 913-914 | S27818S | 04 | 205-206 | S31040D | 23 | 949-950 | ||
| S25402A | 24 | 955-965 | S27819A | 06 | 368-370 | S31040S | 09 | 604-605 | ||
| S25402D | 23 | 949-950 | S27819A | 24 | 955-965 | S31041A | 11 | 698-700 | ||
| S25402S | 05 | 299-301 | S27819D | 23 | 949-950 | S31041A | 24 | 955-965 | ||
| S25409A | 15 | 791 | S27819S | 04 | 205-206 | S31041D | 23 | 949-950 | ||
| S25409A | 15 | 793 | S27892A | 04 | 205-206 | S31041S | 09 | 604-605 | ||
| S25409A | 21 | 913-914 | S27892A | 24 | 955-965 | S31050A | 09 | 604-605 | ||
| S25409A | 24 | 955-965 | S27892D | 23 | 949-950 | S31050A | 24 | 955-965 | ||
| S25409D | 23 | 949-950 | S27892S | 04 | 205-206 | S31050D | 23 | 949-950 | ||
| S25409S | 05 | 299-301 | S27893A | 04 | 205-206 | S31050S | 09 | 604-605 | ||
| S25411A | 15 | 791 | S27893A | 24 | 955-965 | S31051A | 11 | 698-700 | ||
| S25411A | 15 | 793 | S27893D | 23 | 949-950 | S31051A | 24 | 955-965 | ||
| S25411A | 21 | 913-914 | S27893S | 04 | 205-206 | S31051D | 23 | 949-950 | ||
| S25411A | 24 | 955-965 | S27898A | 04 | 205-206 | S31051S | 09 | 604-605 | ||
| S25411D | 23 | 949-950 | S27898A | 24 | 955-965 | S31100A | 09 | 604-605 | ||
| S25411S | 05 | 299-301 | S27898D | 23 | 949-950 | S31100A | 24 | 955-965 | ||
| S25412A | 15 | 791 | S27898S | 04 | 205-206 | S31100D | 23 | 949-950 | ||
| S25412A | 15 | 793 | S27899A | 04 | 205-206 | S31100S | 09 | 604-605 | ||
| S25412A | 21 | 913-914 | S27899A | 24 | 955-965 | S31101A | 09 | 604-605 | ||
| S25412A | 24 | 955-965 | S27899D | 23 | 949-950 | S31101A | 24 | 955-965 | ||
| S25412D | 23 | 949-950 | S27899S | 04 | 205-206 | S31101D | 23 | 949-950 | ||
| S25412S | 05 | 299-301 | S279XXA | 21 | 913-914 | S31101S | 09 | 604-605 | ||
| S25419A | 15 | 791 | S279XXA | 24 | 955-965 | S31102A | 09 | 604-605 | ||
| S25419A | 15 | 793 | S279XXD | 23 | 949-950 | S31102A | 24 | 955-965 | ||
| S25419A | 21 | 913-914 | S279XXS | 04 | 205-206 | S31102D | 23 | 949-950 | ||
| S25419A | 24 | 955-965 | S280XXA | 21 | 913-914 | S31102S | 09 | 604-605 | ||
| S25419D | 23 | 949-950 | S280XXA | 24 | 955-965 | S31103A | 09 | 604-605 | ||
| S25419S | 05 | 299-301 | S280XXD | 23 | 949-950 | S31103A | 24 | 955-965 | ||
| S25421A | 15 | 791 | S280XXS | 09 | 604-605 | S31103D | 23 | 949-950 | ||
| S25421A | 15 | 793 | S281XXA | 09 | 604-605 | S31103S | 09 | 604-605 | ||
| S25421A | 21 | 913-914 | S281XXA | 24 | 955-965 | S31104A | 09 | 604-605 | ||
| S25421A | 24 | 955-965 | S281XXD | 23 | 949-950 | S31104A | 24 | 955-965 | ||
| S25421D | 23 | 949-950 | S281XXS | 09 | 604-605 | S31104D | 23 | 949-950 | ||
| S25421S | 05 | 299-301 | S28211A | 09 | 604-605 | S31104S | 09 | 604-605 | ||
| S25422A | 15 | 791 | S28211A | 24 | 955-965 | S31105A | 09 | 604-605 | ||
| S25422A | 15 | 793 | S28211D | 23 | 949-950 | S31105A | 24 | 955-965 | ||
| S25422A | 21 | 913-914 | S28211S | 09 | 604-605 | S31105D | 23 | 949-950 | ||
| S25422A | 24 | 955-965 | S28212A | 09 | 604-605 | S31105S | 09 | 604-605 | ||
| S25422D | 23 | 949-950 | S28212A | 24 | 955-965 | S31109A | 09 | 604-605 | ||
| S25422S | 05 | 299-301 | S28212D | 23 | 949-950 | S31109A | 24 | 955-965 | ||
| S25429A | 15 | 791 | S28212S | 09 | 604-605 | S31109D | 23 | 949-950 | ||
| S25429A | 15 | 793 | S28219A | 09 | 604-605 | S31109S | 09 | 604-605 | ||
| S25429A | 21 | 913-914 | S28219A | 24 | 955-965 | S31110A | 09 | 604-605 | ||
| S25429A | 24 | 955-965 | S28219D | 23 | 949-950 | S31110A | 24 | 955-965 | ||
| S25429D | 23 | 949-950 | S28219S | 09 | 604-605 | S31110D | 23 | 949-950 | ||
| S25429S | 05 | 299-301 | S28221A | 09 | 604-605 | S31110S | 09 | 604-605 | ||
| S25491A | 15 | 791 | S28221A | 24 | 955-965 | S31111A | 09 | 604-605 | ||
| S25491A | 15 | 793 | S28221D | 23 | 949-950 | S31111A | 24 | 955-965 | ||
| S25491A | 21 | 913-914 | S28221S | 09 | 604-605 | S31111D | 23 | 949-950 | ||
| S25491A | 24 | 955-965 | S28222A | 09 | 604-605 | S31111S | 09 | 604-605 | ||
| S25491D | 23 | 949-950 | S28222A | 24 | 955-965 | S31112A | 09 | 604-605 | ||
| S25491S | 05 | 299-301 | S28222D | 23 | 949-950 | S31112A | 24 | 955-965 | ||
| S25492A | 15 | 791 | S28222S | 09 | 604-605 | S31112D | 23 | 949-950 | ||
| S25492A | 15 | 793 | S28229A | 09 | 604-605 | S31112S | 09 | 604-605 | ||
| S25492A | 21 | 913-914 | S28229A | 24 | 955-965 | S31113A | 09 | 604-605 | ||
| S25492A | 24 | 955-965 | S28229D | 23 | 949-950 | S31113A | 24 | 955-965 | ||
| S25492D | 23 | 949-950 | S28229S | 09 | 604-605 | S31113D | 23 | 949-950 | ||
| S25492S | 05 | 299-301 | S29001A | 21 | 913-914 | S31113S | 09 | 604-605 | ||
| S25499A | 15 | 791 | S29001A | 24 | 955-965 | S31114A | 09 | 604-605 | ||
| S25499A | 15 | 793 | S29001D | 23 | 949-950 | S31114A | 24 | 955-965 | ||
| S25499A | 21 | 913-914 | S29001S | 21 | 913-914 | S31114D | 23 | 949-950 | ||
| S25499A | 24 | 955-965 | S29002A | 21 | 913-914 | S31114S | 09 | 604-605 | ||
| S25499D | 23 | 949-950 | S29002A | 24 | 955-965 | S31115A | 09 | 604-605 | ||
| S25499S | 05 | 299-301 | S29002D | 23 | 949-950 | S31115A | 24 | 955-965 | ||
| S25501A | 21 | 913-914 | S29002S | 21 | 913-914 | S31115D | 23 | 949-950 | ||
| S25501A | 24 | 955-965 | S29009A | 21 | 913-914 | S31115S | 09 | 604-605 | ||
| S25501D | 23 | 949-950 | S29009A | 24 | 955-965 | S31119A | 09 | 604-605 | ||
| S25501S | 05 | 299-301 | S29009D | 23 | 949-950 | S31119A | 24 | 955-965 | ||
| S25502A | 21 | 913-914 | S29009S | 21 | 913-914 | S31119D | 23 | 949-950 | ||
| S25502A | 24 | 955-965 | S29011A | 08 | 562-563 | S31119S | 09 | 604-605 | ||
| S25502D | 23 | 949-950 | S29011A | 24 | 955-965 | S31120A | 21 | 913-914 | ||
| S25502S | 05 | 299-301 | S29011D | 23 | 949-950 | S31120A | 24 | 955-965 | ||
| S25509A | 21 | 913-914 | S29011S | 08 | 562-563 | S31120D | 23 | 949-950 | ||
| S25509A | 24 | 955-965 | S29012A | 08 | 562-563 | S31120S | 09 | 604-605 | ||
| S25509D | 23 | 949-950 | S29012A | 24 | 955-965 | S31121A | 21 | 913-914 | ||
| S25509S | 05 | 299-301 | S29012D | 23 | 949-950 | S31121A | 24 | 955-965 | ||
| S25511A | 21 | 913-914 | S29012S | 08 | 562-563 | S31121D | 23 | 949-950 | ||
| S25511A | 24 | 955-965 | S29019A | 08 | 562-563 | S31121S | 09 | 604-605 | ||
| S25511D | 23 | 949-950 | S29019A | 24 | 955-965 | S31122A | 21 | 913-914 | ||
| S25511S | 05 | 299-301 | S29019D | 23 | 949-950 | S31122A | 24 | 955-965 | ||
| S25512A | 21 | 913-914 | S29019S | 08 | 562-563 | S31122D | 23 | 949-950 | ||
| S25512A | 24 | 955-965 | S29021A | 09 | 604-605 | S31122S | 09 | 604-605 | ||
| S25512D | 23 | 949-950 | S29021A | 24 | 955-965 | S31123A | 21 | 913-914 | ||
| S31123A | 24 | 955-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 09 Jul 2020 15:51:46 CMS, code-revision=268, description-revision=1285 |