ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 37 of 75 |
| A000 B302 C577 C8442 D309 E093393 E1344 F19280 G9761 H21341 H52203 I369 I70221 J682 K7031 L89200 M06812 M23203 M4841XS M71811 M84529D M87842 N468 O1214 O336XX3 O368234 O714 P913 R062 S0092XA S0303XA S069X2A S14106D S21312S S25809S S31811D S32499S S37012A S42123D S42449D S46329S S52045R S52291A S52552B S56112S S60359A S61509A S62321G S62660D S63637S S66529S S72024G S72114B S72326D S72451B S7711XD S82045J S82251P S8261XA S83521A S89309D S92044S S92426G S96802A T20219S T23229S T25739S T391X5S T444X2S T498X3S T602X4S T7805XS T83728S Z315 Z96641 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S32499S | 08 | 551-552 | S348XXA | 01 | 073-074 | S36119S | 06 | 393-395 | ||
| S32501A | 08 | 535-536 | S348XXA | 24 | 963-965 | S36122A | 07 | 444-446 | ||
| S32501A | 24 | 963-965 | S348XXD | 23 | 949-950 | S36122A | 24 | 963-965 | ||
| S32501B | 08 | 535-536 | S348XXS | 01 | 091-093 | S36122D | 23 | 949-950 | ||
| S32501B | 24 | 963-965 | S349XXA | 01 | 073-074 | S36122S | 06 | 393-395 | ||
| S32501D | 08 | 559-561 | S349XXA | 24 | 963-965 | S36123A | 07 | 444-446 | ||
| S32501G | 08 | 559-561 | S349XXD | 23 | 949-950 | S36123A | 24 | 963-965 | ||
| S32501K | 08 | 564-566 | S349XXS | 01 | 091-093 | S36123D | 23 | 949-950 | ||
| S32501S | 08 | 551-552 | S3500XA | 15 | 791 | S36123S | 06 | 393-395 | ||
| S32502A | 08 | 535-536 | S3500XA | 15 | 793 | S36128A | 07 | 444-446 | ||
| S32502A | 24 | 963-965 | S3500XA | 21 | 913-914 | S36128A | 24 | 963-965 | ||
| S32502B | 08 | 535-536 | S3500XA | 24 | 963-965 | S36128D | 23 | 949-950 | ||
| S32502B | 24 | 963-965 | S3500XD | 23 | 949-950 | S36128S | 06 | 393-395 | ||
| S32502D | 08 | 559-561 | S3500XS | 05 | 299-301 | S36129A | 07 | 444-446 | ||
| S32502G | 08 | 559-561 | S3501XA | 15 | 791 | S36129A | 24 | 963-965 | ||
| S32502K | 08 | 564-566 | S3501XA | 15 | 793 | S36129D | 23 | 949-950 | ||
| S32502S | 08 | 551-552 | S3501XA | 21 | 913-914 | S36129S | 06 | 393-395 | ||
| S32509A | 08 | 535-536 | S3501XA | 24 | 963-965 | S3613XA | 07 | 444-446 | ||
| S32509A | 24 | 963-965 | S3501XD | 23 | 949-950 | S3613XA | 24 | 963-965 | ||
| S32509B | 08 | 535-536 | S3501XS | 05 | 299-301 | S3613XD | 23 | 949-950 | ||
| S32509B | 24 | 963-965 | S3502XA | 15 | 791 | S3613XS | 06 | 393-395 | ||
| S32509D | 08 | 559-561 | S3502XA | 15 | 793 | S36200A | 07 | 438-440 | ||
| S32509G | 08 | 559-561 | S3502XA | 21 | 913-914 | S36200A | 24 | 963-965 | ||
| S32509K | 08 | 564-566 | S3502XA | 24 | 963-965 | S36200D | 23 | 949-950 | ||
| S32509S | 08 | 551-552 | S3502XD | 23 | 949-950 | S36200S | 06 | 393-395 | ||
| S32511A | 08 | 535-536 | S3502XS | 05 | 299-301 | S36201A | 07 | 438-440 | ||
| S32511A | 24 | 963-965 | S3509XA | 15 | 791 | S36201A | 24 | 963-965 | ||
| S32511B | 08 | 535-536 | S3509XA | 15 | 793 | S36201D | 23 | 949-950 | ||
| S32511B | 24 | 963-965 | S3509XA | 21 | 913-914 | S36201S | 06 | 393-395 | ||
| S32511D | 08 | 559-561 | S3509XA | 24 | 963-965 | S36202A | 07 | 438-440 | ||
| S32511G | 08 | 559-561 | S3509XD | 23 | 949-950 | S36202A | 24 | 963-965 | ||
| S32511K | 08 | 564-566 | S3509XS | 05 | 299-301 | S36202D | 23 | 949-950 | ||
| S32511S | 08 | 551-552 | S3510XA | 15 | 791 | S36202S | 06 | 393-395 | ||
| S32512A | 08 | 535-536 | S3510XA | 15 | 793 | S36209A | 07 | 438-440 | ||
| S32512A | 24 | 963-965 | S3510XA | 21 | 913-914 | S36209A | 24 | 963-965 | ||
| S32512B | 08 | 535-536 | S3510XA | 24 | 963-965 | S36209D | 23 | 949-950 | ||
| S32512B | 24 | 963-965 | S3510XD | 23 | 949-950 | S36209S | 06 | 393-395 | ||
| S32512D | 08 | 559-561 | S3510XS | 05 | 299-301 | S36220A | 07 | 438-440 | ||
| S32512G | 08 | 559-561 | S3511XA | 15 | 791 | S36220A | 24 | 963-965 | ||
| S32512K | 08 | 564-566 | S3511XA | 15 | 793 | S36220D | 23 | 949-950 | ||
| S32512S | 08 | 551-552 | S3511XA | 21 | 913-914 | S36220S | 06 | 393-395 | ||
| S32519A | 08 | 535-536 | S3511XA | 24 | 963-965 | S36221A | 07 | 438-440 | ||
| S32519A | 24 | 963-965 | S3511XD | 23 | 949-950 | S36221A | 24 | 963-965 | ||
| S32519B | 08 | 535-536 | S3511XS | 05 | 299-301 | S36221D | 23 | 949-950 | ||
| S32519B | 24 | 963-965 | S3512XA | 15 | 791 | S36221S | 06 | 393-395 | ||
| S32519D | 08 | 559-561 | S3512XA | 15 | 793 | S36222A | 07 | 438-440 | ||
| S32519G | 08 | 559-561 | S3512XA | 21 | 913-914 | S36222A | 24 | 963-965 | ||
| S32519K | 08 | 564-566 | S3512XA | 24 | 963-965 | S36222D | 23 | 949-950 | ||
| S32519S | 08 | 551-552 | S3512XD | 23 | 949-950 | S36222S | 06 | 393-395 | ||
| S32591A | 08 | 535-536 | S3512XS | 05 | 299-301 | S36229A | 07 | 438-440 | ||
| S32591A | 24 | 963-965 | S3519XA | 15 | 791 | S36229A | 24 | 963-965 | ||
| S32591B | 08 | 535-536 | S3519XA | 15 | 793 | S36229D | 23 | 949-950 | ||
| S32591B | 24 | 963-965 | S3519XA | 21 | 913-914 | S36229S | 06 | 393-395 | ||
| S32591D | 08 | 559-561 | S3519XA | 24 | 963-965 | S36230A | 07 | 438-440 | ||
| S32591G | 08 | 559-561 | S3519XD | 23 | 949-950 | S36230A | 24 | 963-965 | ||
| S32591K | 08 | 564-566 | S3519XS | 05 | 299-301 | S36230D | 23 | 949-950 | ||
| S32591S | 08 | 551-552 | S35211A | 21 | 913-914 | S36230S | 06 | 393-395 | ||
| S32592A | 08 | 535-536 | S35211A | 24 | 963-965 | S36231A | 07 | 438-440 | ||
| S32592A | 24 | 963-965 | S35211D | 23 | 949-950 | S36231A | 24 | 963-965 | ||
| S32592B | 08 | 535-536 | S35211S | 05 | 299-301 | S36231D | 23 | 949-950 | ||
| S32592B | 24 | 963-965 | S35212A | 21 | 913-914 | S36231S | 06 | 393-395 | ||
| S32592D | 08 | 559-561 | S35212A | 24 | 963-965 | S36232A | 07 | 438-440 | ||
| S32592G | 08 | 559-561 | S35212D | 23 | 949-950 | S36232A | 24 | 963-965 | ||
| S32592K | 08 | 564-566 | S35212S | 05 | 299-301 | S36232D | 23 | 949-950 | ||
| S32592S | 08 | 551-552 | S35218A | 21 | 913-914 | S36232S | 06 | 393-395 | ||
| S32599A | 08 | 535-536 | S35218A | 24 | 963-965 | S36239A | 07 | 438-440 | ||
| S32599A | 24 | 963-965 | S35218D | 23 | 949-950 | S36239A | 24 | 963-965 | ||
| S32599B | 08 | 535-536 | S35218S | 05 | 299-301 | S36239D | 23 | 949-950 | ||
| S32599B | 24 | 963-965 | S35219A | 21 | 913-914 | S36239S | 06 | 393-395 | ||
| S32599D | 08 | 559-561 | S35219A | 24 | 963-965 | S36240A | 07 | 438-440 | ||
| S32599G | 08 | 559-561 | S35219D | 23 | 949-950 | S36240A | 24 | 963-965 | ||
| S32599K | 08 | 564-566 | S35219S | 05 | 299-301 | S36240D | 23 | 949-950 | ||
| S32599S | 08 | 551-552 | S35221A | 21 | 913-914 | S36240S | 06 | 393-395 | ||
| S32601A | 08 | 535-536 | S35221A | 24 | 963-965 | S36241A | 07 | 438-440 | ||
| S32601A | 24 | 963-965 | S35221D | 23 | 949-950 | S36241A | 24 | 963-965 | ||
| S32601B | 08 | 535-536 | S35221S | 05 | 299-301 | S36241D | 23 | 949-950 | ||
| S32601B | 24 | 963-965 | S35222A | 21 | 913-914 | S36241S | 06 | 393-395 | ||
| S32601D | 08 | 559-561 | S35222A | 24 | 963-965 | S36242A | 07 | 438-440 | ||
| S32601G | 08 | 559-561 | S35222D | 23 | 949-950 | S36242A | 24 | 963-965 | ||
| S32601K | 08 | 564-566 | S35222S | 05 | 299-301 | S36242D | 23 | 949-950 | ||
| S32601S | 08 | 551-552 | S35228A | 21 | 913-914 | S36242S | 06 | 393-395 | ||
| S32602A | 08 | 535-536 | S35228A | 24 | 963-965 | S36249A | 07 | 438-440 | ||
| S32602A | 24 | 963-965 | S35228D | 23 | 949-950 | S36249A | 24 | 963-965 | ||
| S32602B | 08 | 535-536 | S35228S | 05 | 299-301 | S36249D | 23 | 949-950 | ||
| S32602B | 24 | 963-965 | S35229A | 21 | 913-914 | S36249S | 06 | 393-395 | ||
| S32602D | 08 | 559-561 | S35229A | 24 | 963-965 | S36250A | 07 | 438-440 | ||
| S32602G | 08 | 559-561 | S35229D | 23 | 949-950 | S36250A | 24 | 963-965 | ||
| S32602K | 08 | 564-566 | S35229S | 05 | 299-301 | S36250D | 23 | 949-950 | ||
| S32602S | 08 | 551-552 | S35231A | 21 | 913-914 | S36250S | 06 | 393-395 | ||
| S32609A | 08 | 535-536 | S35231A | 24 | 963-965 | S36251A | 07 | 438-440 | ||
| S32609A | 24 | 963-965 | S35231D | 23 | 949-950 | S36251A | 24 | 963-965 | ||
| S32609B | 08 | 535-536 | S35231S | 05 | 299-301 | S36251D | 23 | 949-950 | ||
| S32609B | 24 | 963-965 | S35232A | 21 | 913-914 | S36251S | 06 | 393-395 | ||
| S32609D | 08 | 559-561 | S35232A | 24 | 963-965 | S36252A | 07 | 438-440 | ||
| S32609G | 08 | 559-561 | S35232D | 23 | 949-950 | S36252A | 24 | 963-965 | ||
| S32609K | 08 | 564-566 | S35232S | 05 | 299-301 | S36252D | 23 | 949-950 | ||
| S32609S | 08 | 551-552 | S35238A | 21 | 913-914 | S36252S | 06 | 393-395 | ||
| S32611A | 08 | 535-536 | S35238A | 24 | 963-965 | S36259A | 07 | 438-440 | ||
| S32611A | 24 | 963-965 | S35238D | 23 | 949-950 | S36259A | 24 | 963-965 | ||
| S32611B | 08 | 535-536 | S35238S | 05 | 299-301 | S36259D | 23 | 949-950 | ||
| S32611B | 24 | 963-965 | S35239A | 21 | 913-914 | S36259S | 06 | 393-395 | ||
| S32611D | 08 | 559-561 | S35239A | 24 | 963-965 | S36260A | 07 | 438-440 | ||
| S32611G | 08 | 559-561 | S35239D | 23 | 949-950 | S36260A | 24 | 963-965 | ||
| S32611K | 08 | 564-566 | S35239S | 05 | 299-301 | S36260D | 23 | 949-950 | ||
| S32611S | 08 | 551-552 | S35291A | 21 | 913-914 | S36260S | 06 | 393-395 | ||
| S32612A | 08 | 535-536 | S35291A | 24 | 963-965 | S36261A | 07 | 438-440 | ||
| S32612A | 24 | 963-965 | S35291D | 23 | 949-950 | S36261A | 24 | 963-965 | ||
| S32612B | 08 | 535-536 | S35291S | 05 | 299-301 | S36261D | 23 | 949-950 | ||
| S32612B | 24 | 963-965 | S35292A | 21 | 913-914 | S36261S | 06 | 393-395 | ||
| S32612D | 08 | 559-561 | S35292A | 24 | 963-965 | S36262A | 07 | 438-440 | ||
| S32612G | 08 | 559-561 | S35292D | 23 | 949-950 | S36262A | 24 | 963-965 | ||
| S32612K | 08 | 564-566 | S35292S | 05 | 299-301 | S36262D | 23 | 949-950 | ||
| S32612S | 08 | 551-552 | S35298A | 21 | 913-914 | S36262S | 06 | 393-395 | ||
| S32613A | 08 | 535-536 | S35298A | 24 | 963-965 | S36269A | 07 | 438-440 | ||
| S32613A | 24 | 963-965 | S35298D | 23 | 949-950 | S36269A | 24 | 963-965 | ||
| S32613B | 08 | 535-536 | S35298S | 05 | 299-301 | S36269D | 23 | 949-950 | ||
| S32613B | 24 | 963-965 | S35299A | 21 | 913-914 | S36269S | 06 | 393-395 | ||
| S32613D | 08 | 559-561 | S35299A | 24 | 963-965 | S36290A | 07 | 438-440 | ||
| S32613G | 08 | 559-561 | S35299D | 23 | 949-950 | S36290A | 24 | 963-965 | ||
| S32613K | 08 | 564-566 | S35299S | 05 | 299-301 | S36290D | 23 | 949-950 | ||
| S32613S | 08 | 551-552 | S35311A | 21 | 913-914 | S36290S | 06 | 393-395 | ||
| S32614A | 08 | 535-536 | S35311A | 24 | 963-965 | S36291A | 07 | 438-440 | ||
| S32614A | 24 | 963-965 | S35311D | 23 | 949-950 | S36291A | 24 | 963-965 | ||
| S32614B | 08 | 535-536 | S35311S | 05 | 299-301 | S36291D | 23 | 949-950 | ||
| S32614B | 24 | 963-965 | S35318A | 21 | 913-914 | S36291S | 06 | 393-395 | ||
| S32614D | 08 | 559-561 | S35318A | 24 | 963-965 | S36292A | 07 | 438-440 | ||
| S32614G | 08 | 559-561 | S35318D | 23 | 949-950 | S36292A | 24 | 963-965 | ||
| S32614K | 08 | 564-566 | S35318S | 05 | 299-301 | S36292D | 23 | 949-950 | ||
| S32614S | 08 | 551-552 | S35319A | 21 | 913-914 | S36292S | 06 | 393-395 | ||
| S32615A | 08 | 535-536 | S35319A | 24 | 963-965 | S36299A | 07 | 438-440 | ||
| S32615A | 24 | 963-965 | S35319D | 23 | 949-950 | S36299A | 24 | 963-965 | ||
| S32615B | 08 | 535-536 | S35319S | 05 | 299-301 | S36299D | 23 | 949-950 | ||
| S32615B | 24 | 963-965 | S35321A | 21 | 913-914 | S36299S | 06 | 393-395 | ||
| S32615D | 08 | 559-561 | S35321A | 24 | 963-965 | S3630XA | 06 | 393-395 | ||
| S32615G | 08 | 559-561 | S35321D | 23 | 949-950 | S3630XA | 24 | 963-965 | ||
| S32615K | 08 | 564-566 | S35321S | 05 | 299-301 | S3630XD | 23 | 949-950 | ||
| S32615S | 08 | 551-552 | S35328A | 21 | 913-914 | S3630XS | 06 | 393-395 | ||
| S32616A | 08 | 535-536 | S35328A | 24 | 963-965 | S3632XA | 06 | 393-395 | ||
| S32616A | 24 | 963-965 | S35328D | 23 | 949-950 | S3632XA | 24 | 963-965 | ||
| S32616B | 08 | 535-536 | S35328S | 05 | 299-301 | S3632XD | 23 | 949-950 | ||
| S32616B | 24 | 963-965 | S35329A | 21 | 913-914 | S3632XS | 06 | 393-395 | ||
| S32616D | 08 | 559-561 | S35329A | 24 | 963-965 | S3633XA | 06 | 393-395 | ||
| S32616G | 08 | 559-561 | S35329D | 23 | 949-950 | S3633XA | 24 | 963-965 | ||
| S32616K | 08 | 564-566 | S35329S | 05 | 299-301 | S3633XD | 23 | 949-950 | ||
| S32616S | 08 | 551-552 | S35331A | 21 | 913-914 | S3633XS | 06 | 393-395 | ||
| S32691A | 08 | 535-536 | S35331A | 24 | 963-965 | S3639XA | 06 | 393-395 | ||
| S32691A | 24 | 963-965 | S35331D | 23 | 949-950 | S3639XA | 24 | 963-965 | ||
| S32691B | 08 | 535-536 | S35331S | 05 | 299-301 | S3639XD | 23 | 949-950 | ||
| S32691B | 24 | 963-965 | S35338A | 21 | 913-914 | S3639XS | 06 | 393-395 | ||
| S32691D | 08 | 559-561 | S35338A | 24 | 963-965 | S36400A | 06 | 393-395 | ||
| S32691G | 08 | 559-561 | S35338D | 23 | 949-950 | S36400A | 24 | 963-965 | ||
| S32691K | 08 | 564-566 | S35338S | 05 | 299-301 | S36400D | 23 | 949-950 | ||
| S32691S | 08 | 551-552 | S35339A | 21 | 913-914 | S36400S | 06 | 393-395 | ||
| S32692A | 08 | 535-536 | S35339A | 24 | 963-965 | S36408A | 06 | 393-395 | ||
| S32692A | 24 | 963-965 | S35339D | 23 | 949-950 | S36408A | 24 | 963-965 | ||
| S32692B | 08 | 535-536 | S35339S | 05 | 299-301 | S36408D | 23 | 949-950 | ||
| S32692B | 24 | 963-965 | S35341A | 21 | 913-914 | S36408S | 06 | 393-395 | ||
| S32692D | 08 | 559-561 | S35341A | 24 | 963-965 | S36409A | 06 | 393-395 | ||
| S32692G | 08 | 559-561 | S35341D | 23 | 949-950 | S36409A | 24 | 963-965 | ||
| S32692K | 08 | 564-566 | S35341S | 05 | 299-301 | S36409D | 23 | 949-950 | ||
| S32692S | 08 | 551-552 | S35348A | 21 | 913-914 | S36409S | 06 | 393-395 | ||
| S32699A | 08 | 535-536 | S35348A | 24 | 963-965 | S36410A | 06 | 393-395 | ||
| S32699A | 24 | 963-965 | S35348D | 23 | 949-950 | S36410A | 24 | 963-965 | ||
| S32699B | 08 | 535-536 | S35348S | 05 | 299-301 | S36410D | 23 | 949-950 | ||
| S32699B | 24 | 963-965 | S35349A | 21 | 913-914 | S36410S | 06 | 393-395 | ||
| S32699D | 08 | 559-561 | S35349A | 24 | 963-965 | S36418A | 06 | 393-395 | ||
| S32699G | 08 | 559-561 | S35349D | 23 | 949-950 | S36418A | 24 | 963-965 | ||
| S32699K | 08 | 564-566 | S35349S | 05 | 299-301 | S36418D | 23 | 949-950 | ||
| S32699S | 08 | 551-552 | S35401A | 21 | 913-914 | S36418S | 06 | 393-395 | ||
| S32810A | 08 | 535-536 | S35401A | 24 | 963-965 | S36419A | 06 | 393-395 | ||
| S32810A | 24 | 963-965 | S35401D | 23 | 949-950 | S36419A | 24 | 963-965 | ||
| S32810B | 08 | 535-536 | S35401S | 05 | 299-301 | S36419D | 23 | 949-950 | ||
| S32810B | 24 | 963-965 | S35402A | 21 | 913-914 | S36419S | 06 | 393-395 | ||
| S32810D | 08 | 559-561 | S35402A | 24 | 963-965 | S36420A | 06 | 393-395 | ||
| S32810G | 08 | 559-561 | S35402D | 23 | 949-950 | S36420A | 24 | 963-965 | ||
| S32810K | 08 | 564-566 | S35402S | 05 | 299-301 | S36420D | 23 | 949-950 | ||
| S32810S | 08 | 551-552 | S35403A | 21 | 913-914 | S36420S | 06 | 393-395 | ||
| S32811A | 08 | 535-536 | S35403A | 24 | 963-965 | S36428A | 06 | 393-395 | ||
| S32811A | 24 | 963-965 | S35403D | 23 | 949-950 | S36428A | 24 | 963-965 | ||
| S32811B | 08 | 535-536 | S35403S | 05 | 299-301 | S36428D | 23 | 949-950 | ||
| S32811B | 24 | 963-965 | S35404A | 21 | 913-914 | S36428S | 06 | 393-395 | ||
| S32811D | 08 | 559-561 | S35404A | 24 | 963-965 | S36429A | 06 | 393-395 | ||
| S32811G | 08 | 559-561 | S35404D | 23 | 949-950 | S36429A | 24 | 963-965 | ||
| S32811K | 08 | 564-566 | S35404S | 05 | 299-301 | S36429D | 23 | 949-950 | ||
| S32811S | 08 | 551-552 | S35405A | 21 | 913-914 | S36429S | 06 | 393-395 | ||
| S3282XA | 08 | 535-536 | S35405A | 24 | 963-965 | S36430A | 06 | 393-395 | ||
| S3282XA | 24 | 963-965 | S35405D | 23 | 949-950 | S36430A | 24 | 963-965 | ||
| S3282XB | 08 | 535-536 | S35405S | 05 | 299-301 | S36430D | 23 | 949-950 | ||
| S3282XB | 24 | 963-965 | S35406A | 21 | 913-914 | S36430S | 06 | 393-395 | ||
| S3282XD | 08 | 559-561 | S35406A | 24 | 963-965 | S36438A | 06 | 393-395 | ||
| S3282XG | 08 | 559-561 | S35406D | 23 | 949-950 | S36438A | 24 | 963-965 | ||
| S3282XK | 08 | 564-566 | S35406S | 05 | 299-301 | S36438D | 23 | 949-950 | ||
| S3282XS | 08 | 551-552 | S35411A | 21 | 913-914 | S36438S | 06 | 393-395 | ||
| S3289XA | 08 | 535-536 | S35411A | 24 | 963-965 | S36439A | 06 | 393-395 | ||
| S3289XA | 24 | 963-965 | S35411D | 23 | 949-950 | S36439A | 24 | 963-965 | ||
| S3289XB | 08 | 535-536 | S35411S | 05 | 299-301 | S36439D | 23 | 949-950 | ||
| S3289XB | 24 | 963-965 | S35412A | 21 | 913-914 | S36439S | 06 | 393-395 | ||
| S3289XD | 08 | 559-561 | S35412A | 24 | 963-965 | S36490A | 06 | 393-395 | ||
| S3289XG | 08 | 559-561 | S35412D | 23 | 949-950 | S36490A | 24 | 963-965 | ||
| S3289XK | 08 | 564-566 | S35412S | 05 | 299-301 | S36490D | 23 | 949-950 | ||
| S3289XS | 08 | 551-552 | S35413A | 21 | 913-914 | S36490S | 06 | 393-395 | ||
| S329XXA | 08 | 535-536 | S35413A | 24 | 963-965 | S36498A | 06 | 393-395 | ||
| S329XXA | 24 | 963-965 | S35413D | 23 | 949-950 | S36498A | 24 | 963-965 | ||
| S329XXB | 08 | 535-536 | S35413S | 05 | 299-301 | S36498D | 23 | 949-950 | ||
| S329XXB | 24 | 963-965 | S35414A | 21 | 913-914 | S36498S | 06 | 393-395 | ||
| S329XXD | 08 | 559-561 | S35414A | 24 | 963-965 | S36499A | 06 | 393-395 | ||
| S329XXG | 08 | 559-561 | S35414D | 23 | 949-950 | S36499A | 24 | 963-965 | ||
| S329XXK | 08 | 564-566 | S35414S | 05 | 299-301 | S36499D | 23 | 949-950 | ||
| S329XXS | 08 | 551-552 | S35415A | 21 | 913-914 | S36499S | 06 | 393-395 | ||
| S330XXA | 08 | 551-552 | S35415A | 24 | 963-965 | S36500A | 06 | 393-395 | ||
| S330XXA | 24 | 963-965 | S35415D | 23 | 949-950 | S36500A | 24 | 963-965 | ||
| S330XXD | 23 | 949-950 | S35415S | 05 | 299-301 | S36500D | 23 | 949-950 | ||
| S330XXS | 08 | 562-563 | S35416A | 21 | 913-914 | S36500S | 06 | 393-395 | ||
| S33100A | 08 | 551-552 | S35416A | 24 | 963-965 | S36501A | 06 | 393-395 | ||
| S33100A | 24 | 963-965 | S35416D | 23 | 949-950 | S36501A | 24 | 963-965 | ||
| S33100D | 23 | 949-950 | S35416S | 05 | 299-301 | S36501D | 23 | 949-950 | ||
| S33100S | 08 | 562-563 | S35491A | 21 | 913-914 | S36501S | 06 | 393-395 | ||
| S33101A | 08 | 551-552 | S35491A | 24 | 963-965 | S36502A | 06 | 393-395 | ||
| S33101A | 24 | 963-965 | S35491D | 23 | 949-950 | S36502A | 24 | 963-965 | ||
| S33101D | 23 | 949-950 | S35491S | 05 | 299-301 | S36502D | 23 | 949-950 | ||
| S33101S | 08 | 562-563 | S35492A | 21 | 913-914 | S36502S | 06 | 393-395 | ||
| S33110A | 08 | 551-552 | S35492A | 24 | 963-965 | S36503A | 06 | 393-395 | ||
| S33110A | 24 | 963-965 | S35492D | 23 | 949-950 | S36503A | 24 | 963-965 | ||
| S33110D | 23 | 949-950 | S35492S | 05 | 299-301 | S36503D | 23 | 949-950 | ||
| S33110S | 08 | 562-563 | S35493A | 21 | 913-914 | S36503S | 06 | 393-395 | ||
| S33111A | 08 | 551-552 | S35493A | 24 | 963-965 | S36508A | 06 | 393-395 | ||
| S33111A | 24 | 963-965 | S35493D | 23 | 949-950 | S36508A | 24 | 963-965 | ||
| S33111D | 23 | 949-950 | S35493S | 05 | 299-301 | S36508D | 23 | 949-950 | ||
| S33111S | 08 | 562-563 | S35494A | 21 | 913-914 | S36508S | 06 | 393-395 | ||
| S33120A | 08 | 551-552 | S35494A | 24 | 963-965 | S36509A | 06 | 393-395 | ||
| S33120A | 24 | 963-965 | S35494D | 23 | 949-950 | S36509A | 24 | 963-965 | ||
| S33120D | 23 | 949-950 | S35494S | 05 | 299-301 | S36509D | 23 | 949-950 | ||
| S33120S | 08 | 562-563 | S35495A | 21 | 913-914 | S36509S | 06 | 393-395 | ||
| S33121A | 08 | 551-552 | S35495A | 24 | 963-965 | S36510A | 06 | 393-395 | ||
| S33121A | 24 | 963-965 | S35495D | 23 | 949-950 | S36510A | 24 | 963-965 | ||
| S33121D | 23 | 949-950 | S35495S | 05 | 299-301 | S36510D | 23 | 949-950 | ||
| S33121S | 08 | 562-563 | S35496A | 21 | 913-914 | S36510S | 06 | 393-395 | ||
| S33130A | 08 | 551-552 | S35496A | 24 | 963-965 | S36511A | 06 | 393-395 | ||
| S33130A | 24 | 963-965 | S35496D | 23 | 949-950 | S36511A | 24 | 963-965 | ||
| S33130D | 23 | 949-950 | S35496S | 05 | 299-301 | S36511D | 23 | 949-950 | ||
| S33130S | 08 | 562-563 | S3550XA | 21 | 913-914 | S36511S | 06 | 393-395 | ||
| S33131A | 08 | 551-552 | S3550XA | 24 | 963-965 | S36512A | 06 | 393-395 | ||
| S33131A | 24 | 963-965 | S3550XD | 23 | 949-950 | S36512A | 24 | 963-965 | ||
| S33131D | 23 | 949-950 | S3550XS | 05 | 299-301 | S36512D | 23 | 949-950 | ||
| S33131S | 08 | 562-563 | S35511A | 21 | 913-914 | S36512S | 06 | 393-395 | ||
| S33140A | 08 | 551-552 | S35511A | 24 | 963-965 | S36513A | 06 | 393-395 | ||
| S33140A | 24 | 963-965 | S35511D | 23 | 949-950 | S36513A | 24 | 963-965 | ||
| S33140D | 23 | 949-950 | S35511S | 05 | 299-301 | S36513D | 23 | 949-950 | ||
| S33140S | 08 | 562-563 | S35512A | 21 | 913-914 | S36513S | 06 | 393-395 | ||
| S33141A | 08 | 551-552 | S35512A | 24 | 963-965 | S36518A | 06 | 393-395 | ||
| S33141A | 24 | 963-965 | S35512D | 23 | 949-950 | S36518A | 24 | 963-965 | ||
| S33141D | 23 | 949-950 | S35512S | 05 | 299-301 | S36518D | 23 | 949-950 | ||
| S33141S | 08 | 562-563 | S35513A | 21 | 913-914 | S36518S | 06 | 393-395 | ||
| S332XXA | 08 | 551-552 | S35513A | 24 | 963-965 | S36519A | 06 | 393-395 | ||
| S332XXA | 24 | 963-965 | S35513D | 23 | 949-950 | S36519A | 24 | 963-965 | ||
| S332XXD | 23 | 949-950 | S35513S | 05 | 299-301 | S36519D | 23 | 949-950 | ||
| S332XXS | 08 | 562-563 | S35514A | 21 | 913-914 | S36519S | 06 | 393-395 | ||
| S3330XA | 08 | 562-563 | S35514A | 24 | 963-965 | S36520A | 06 | 393-395 | ||
| S3330XA | 24 | 963-965 | S35514D | 23 | 949-950 | S36520A | 24 | 963-965 | ||
| S3330XD | 23 | 949-950 | S35514S | 05 | 299-301 | S36520D | 23 | 949-950 | ||
| S3330XS | 08 | 562-563 | S35515A | 21 | 913-914 | S36520S | 06 | 393-395 | ||
| S3339XA | 08 | 562-563 | S35515A | 24 | 963-965 | S36521A | 06 | 393-395 | ||
| S3339XA | 24 | 963-965 | S35515D | 23 | 949-950 | S36521A | 24 | 963-965 | ||
| S3339XD | 23 | 949-950 | S35515S | 05 | 299-301 | S36521D | 23 | 949-950 | ||
| S3339XS | 08 | 562-563 | S35516A | 21 | 913-914 | S36521S | 06 | 393-395 | ||
| S334XXA | 08 | 537-538 | S35516A | 24 | 963-965 | S36522A | 06 | 393-395 | ||
| S334XXA | 24 | 963-965 | S35516D | 23 | 949-950 | S36522A | 24 | 963-965 | ||
| S334XXD | 23 | 949-950 | S35516S | 05 | 299-301 | S36522D | 23 | 949-950 | ||
| S334XXS | 08 | 562-563 | S35531A | 21 | 913-914 | S36522S | 06 | 393-395 | ||
| S335XXA | 08 | 551-552 | S35531A | 24 | 963-965 | S36523A | 06 | 393-395 | ||
| S335XXA | 24 | 963-965 | S35531D | 23 | 949-950 | S36523A | 24 | 963-965 | ||
| S335XXD | 23 | 949-950 | S35531S | 05 | 299-301 | S36523D | 23 | 949-950 | ||
| S335XXS | 08 | 562-563 | S35532A | 21 | 913-914 | S36523S | 06 | 393-395 | ||
| S336XXA | 08 | 551-552 | S35532A | 24 | 963-965 | S36528A | 06 | 393-395 | ||
| S336XXA | 24 | 963-965 | S35532D | 23 | 949-950 | S36528A | 24 | 963-965 | ||
| S336XXD | 23 | 949-950 | S35532S | 05 | 299-301 | S36528D | 23 | 949-950 | ||
| S336XXS | 08 | 562-563 | S35533A | 21 | 913-914 | S36528S | 06 | 393-395 | ||
| S338XXA | 08 | 551-552 | S35533A | 24 | 963-965 | S36529A | 06 | 393-395 | ||
| S338XXA | 24 | 963-965 | S35533D | 23 | 949-950 | S36529A | 24 | 963-965 | ||
| S338XXD | 23 | 949-950 | S35533S | 05 | 299-301 | S36529D | 23 | 949-950 | ||
| S338XXS | 08 | 562-563 | S35534A | 21 | 913-914 | S36529S | 06 | 393-395 | ||
| S339XXA | 08 | 551-552 | S35534A | 24 | 963-965 | S36530A | 06 | 393-395 | ||
| S339XXA | 24 | 963-965 | S35534D | 23 | 949-950 | S36530A | 24 | 963-965 | ||
| S339XXD | 23 | 949-950 | S35534S | 05 | 299-301 | S36530D | 23 | 949-950 | ||
| S339XXS | 08 | 562-563 | S35535A | 21 | 913-914 | S36530S | 06 | 393-395 | ||
| S3401XA | 01 | 052-053 | S35535A | 24 | 963-965 | S36531A | 06 | 393-395 | ||
| S3401XA | 24 | 963-965 | S35535D | 23 | 949-950 | S36531A | 24 | 963-965 | ||
| S3401XD | 23 | 949-950 | S35535S | 05 | 299-301 | S36531D | 23 | 949-950 | ||
| S3401XS | 01 | 052-053 | S35536A | 21 | 913-914 | S36531S | 06 | 393-395 | ||
| S3402XA | 01 | 052-053 | S35536A | 24 | 963-965 | S36532A | 06 | 393-395 | ||
| S3402XA | 24 | 963-965 | S35536D | 23 | 949-950 | S36532A | 24 | 963-965 | ||
| S3402XD | 23 | 949-950 | S35536S | 05 | 299-301 | S36532D | 23 | 949-950 | ||
| S3402XS | 01 | 052-053 | S3559XA | 21 | 913-914 | S36532S | 06 | 393-395 | ||
| S34101A | 01 | 052-053 | S3559XA | 24 | 963-965 | S36533A | 06 | 393-395 | ||
| S34101A | 24 | 963-965 | S3559XD | 23 | 949-950 | S36533A | 24 | 963-965 | ||
| S34101D | 23 | 949-950 | S3559XS | 05 | 299-301 | S36533D | 23 | 949-950 | ||
| S34101S | 01 | 052-053 | S358X1A | 21 | 913-914 | S36533S | 06 | 393-395 | ||
| S34102A | 01 | 052-053 | S358X1A | 24 | 963-965 | S36538A | 06 | 393-395 | ||
| S34102A | 24 | 963-965 | S358X1D | 23 | 949-950 | S36538A | 24 | 963-965 | ||
| S34102D | 23 | 949-950 | S358X1S | 05 | 299-301 | S36538D | 23 | 949-950 | ||
| S34102S | 01 | 052-053 | S358X8A | 21 | 913-914 | S36538S | 06 | 393-395 | ||
| S34103A | 01 | 052-053 | S358X8A | 24 | 963-965 | S36539A | 06 | 393-395 | ||
| S34103A | 24 | 963-965 | S358X8D | 23 | 949-950 | S36539A | 24 | 963-965 | ||
| S34103D | 23 | 949-950 | S358X8S | 05 | 299-301 | S36539D | 23 | 949-950 | ||
| S34103S | 01 | 052-053 | S358X9A | 21 | 913-914 | S36539S | 06 | 393-395 | ||
| S34104A | 01 | 052-053 | S358X9A | 24 | 963-965 | S36590A | 06 | 393-395 | ||
| S34104A | 24 | 963-965 | S358X9D | 23 | 949-950 | S36590A | 24 | 963-965 | ||
| S34104D | 23 | 949-950 | S358X9S | 05 | 299-301 | S36590D | 23 | 949-950 | ||
| S34104S | 01 | 052-053 | S3590XA | 21 | 913-914 | S36590S | 06 | 393-395 | ||
| S34105A | 01 | 052-053 | S3590XA | 24 | 963-965 | S36591A | 06 | 393-395 | ||
| S34105A | 24 | 963-965 | S3590XD | 23 | 949-950 | S36591A | 24 | 963-965 | ||
| S34105D | 23 | 949-950 | S3590XS | 05 | 299-301 | S36591D | 23 | 949-950 | ||
| S34105S | 01 | 052-053 | S3591XA | 21 | 913-914 | S36591S | 06 | 393-395 | ||
| S34109A | 01 | 052-053 | S3591XA | 24 | 963-965 | S36592A | 06 | 393-395 | ||
| S34109A | 24 | 963-965 | S3591XD | 23 | 949-950 | S36592A | 24 | 963-965 | ||
| S34109D | 23 | 949-950 | S3591XS | 05 | 299-301 | S36592D | 23 | 949-950 | ||
| S34109S | 01 | 052-053 | S3599XA | 21 | 913-914 | S36592S | 06 | 393-395 | ||
| S34111A | 01 | 052-053 | S3599XA | 24 | 963-965 | S36593A | 06 | 393-395 | ||
| S34111A | 24 | 963-965 | S3599XD | 23 | 949-950 | S36593A | 24 | 963-965 | ||
| S34111D | 23 | 949-950 | S3599XS | 05 | 299-301 | S36593D | 23 | 949-950 | ||
| S34111S | 01 | 052-053 | S3600XA | 15 | 791 | S36593S | 06 | 393-395 | ||
| S34112A | 01 | 052-053 | S3600XA | 15 | 793 | S36598A | 06 | 393-395 | ||
| S34112A | 24 | 963-965 | S3600XA | 16 | 814-816 | S36598A | 24 | 963-965 | ||
| S34112D | 23 | 949-950 | S3600XA | 24 | 963-965 | S36598D | 23 | 949-950 | ||
| S34112S | 01 | 052-053 | S3600XD | 23 | 949-950 | S36598S | 06 | 393-395 | ||
| S34113A | 01 | 052-053 | S3600XS | 06 | 393-395 | S36599A | 06 | 393-395 | ||
| S34113A | 24 | 963-965 | S36020A | 15 | 791 | S36599A | 24 | 963-965 | ||
| S34113D | 23 | 949-950 | S36020A | 15 | 793 | S36599D | 23 | 949-950 | ||
| S34113S | 01 | 052-053 | S36020A | 16 | 814-816 | S36599S | 06 | 393-395 | ||
| S34114A | 01 | 052-053 | S36020A | 24 | 963-965 | S3660XA | 06 | 393-395 | ||
| S34114A | 24 | 963-965 | S36020D | 23 | 949-950 | S3660XA | 24 | 963-965 | ||
| S34114D | 23 | 949-950 | S36020S | 06 | 393-395 | S3660XD | 23 | 949-950 | ||
| S34114S | 01 | 052-053 | S36021A | 15 | 791 | S3660XS | 06 | 393-395 | ||
| S34115A | 01 | 052-053 | S36021A | 15 | 793 | S3661XA | 06 | 393-395 | ||
| S34115A | 24 | 963-965 | S36021A | 16 | 814-816 | S3661XA | 24 | 963-965 | ||
| S34115D | 23 | 949-950 | S36021A | 24 | 963-965 | S3661XD | 23 | 949-950 | ||
| S34115S | 01 | 052-053 | S36021D | 23 | 949-950 | S3661XS | 06 | 393-395 | ||
| S34119A | 01 | 052-053 | S36021S | 06 | 393-395 | S3662XA | 06 | 393-395 | ||
| S34119A | 24 | 963-965 | S36029A | 15 | 791 | S3662XA | 24 | 963-965 | ||
| S34119D | 23 | 949-950 | S36029A | 15 | 793 | S3662XD | 23 | 949-950 | ||
| S34119S | 01 | 052-053 | S36029A | 16 | 814-816 | S3662XS | 06 | 393-395 | ||
| S34121A | 01 | 052-053 | S36029A | 24 | 963-965 | S3663XA | 06 | 393-395 | ||
| S34121A | 24 | 963-965 | S36029D | 23 | 949-950 | S3663XA | 24 | 963-965 | ||
| S34121D | 23 | 949-950 | S36029S | 06 | 393-395 | S3663XD | 23 | 949-950 | ||
| S34121S | 01 | 052-053 | S36030A | 15 | 791 | S3663XS | 06 | 393-395 | ||
| S34122A | 01 | 052-053 | S36030A | 15 | 793 | S3669XA | 06 | 393-395 | ||
| S34122A | 24 | 963-965 | S36030A | 16 | 814-816 | S3669XA | 24 | 963-965 | ||
| S34122D | 23 | 949-950 | S36030A | 24 | 963-965 | S3669XD | 23 | 949-950 | ||
| S34122S | 01 | 052-053 | S36030D | 23 | 949-950 | S3669XS | 06 | 393-395 | ||
| S34123A | 01 | 052-053 | S36030S | 06 | 393-395 | S3681XA | 06 | 393-395 | ||
| S34123A | 24 | 963-965 | S36031A | 15 | 791 | S3681XA | 24 | 963-965 | ||
| S34123D | 23 | 949-950 | S36031A | 15 | 793 | S3681XD | 23 | 949-950 | ||
| S34123S | 01 | 052-053 | S36031A | 16 | 814-816 | S3681XS | 06 | 393-395 | ||
| S34124A | 01 | 052-053 | S36031A | 24 | 963-965 | S36892A | 21 | 913-914 | ||
| S34124A | 24 | 963-965 | S36031D | 23 | 949-950 | S36892A | 24 | 963-965 | ||
| S34124D | 23 | 949-950 | S36031S | 06 | 393-395 | S36892D | 23 | 949-950 | ||
| S34124S | 01 | 052-053 | S36032A | 15 | 791 | S36892S | 06 | 393-395 | ||
| S34125A | 01 | 052-053 | S36032A | 15 | 793 | S36893A | 21 | 913-914 | ||
| S34125A | 24 | 963-965 | S36032A | 16 | 814-816 | S36893A | 24 | 963-965 | ||
| S34125D | 23 | 949-950 | S36032A | 24 | 963-965 | S36893D | 23 | 949-950 | ||
| S34125S | 01 | 052-053 | S36032D | 23 | 949-950 | S36893S | 06 | 393-395 | ||
| S34129A | 01 | 052-053 | S36032S | 06 | 393-395 | S36898A | 21 | 913-914 | ||
| S34129A | 24 | 963-965 | S36039A | 15 | 791 | S36898A | 24 | 963-965 | ||
| S34129D | 23 | 949-950 | S36039A | 15 | 793 | S36898D | 23 | 949-950 | ||
| S34129S | 01 | 052-053 | S36039A | 16 | 814-816 | S36898S | 06 | 393-395 | ||
| S34131A | 01 | 052-053 | S36039A | 24 | 963-965 | S36899A | 21 | 913-914 | ||
| S34131A | 24 | 963-965 | S36039D | 23 | 949-950 | S36899A | 24 | 963-965 | ||
| S34131D | 23 | 949-950 | S36039S | 06 | 393-395 | S36899D | 23 | 949-950 | ||
| S34131S | 01 | 052-053 | S3609XA | 15 | 791 | S36899S | 06 | 393-395 | ||
| S34132A | 01 | 052-053 | S3609XA | 15 | 793 | S3690XA | 06 | 393-395 | ||
| S34132A | 24 | 963-965 | S3609XA | 16 | 814-816 | S3690XA | 24 | 963-965 | ||
| S34132D | 23 | 949-950 | S3609XA | 24 | 963-965 | S3690XD | 23 | 949-950 | ||
| S34132S | 01 | 052-053 | S3609XD | 23 | 949-950 | S3690XS | 06 | 393-395 | ||
| S34139A | 01 | 052-053 | S3609XS | 06 | 393-395 | S3692XA | 06 | 393-395 | ||
| S34139A | 24 | 963-965 | S36112A | 07 | 441-443 | S3692XA | 24 | 963-965 | ||
| S34139D | 23 | 949-950 | S36112A | 24 | 963-965 | S3692XD | 23 | 949-950 | ||
| S34139S | 01 | 052-053 | S36112D | 23 | 949-950 | S3692XS | 06 | 393-395 | ||
| S3421XA | 01 | 073-074 | S36112S | 06 | 393-395 | S3693XA | 06 | 393-395 | ||
| S3421XA | 24 | 963-965 | S36113A | 07 | 441-443 | S3693XA | 24 | 963-965 | ||
| S3421XD | 23 | 949-950 | S36113A | 24 | 963-965 | S3693XD | 23 | 949-950 | ||
| S3421XS | 01 | 091-093 | S36113D | 23 | 949-950 | S3693XS | 06 | 393-395 | ||
| S3422XA | 01 | 073-074 | S36113S | 06 | 393-395 | S3699XA | 06 | 393-395 | ||
| S3422XA | 24 | 963-965 | S36114A | 07 | 441-443 | S3699XA | 24 | 963-965 | ||
| S3422XD | 23 | 949-950 | S36114A | 24 | 963-965 | S3699XD | 23 | 949-950 | ||
| S3422XS | 01 | 091-093 | S36114D | 23 | 949-950 | S3699XS | 06 | 393-395 | ||
| S343XXA | 01 | 052-053 | S36114S | 06 | 393-395 | S37001A | 11 | 698-700 | ||
| S343XXA | 24 | 963-965 | S36115A | 07 | 441-443 | S37001A | 24 | 963-965 | ||
| S343XXD | 23 | 949-950 | S36115A | 24 | 963-965 | S37001D | 23 | 949-950 | ||
| S343XXS | 01 | 091-093 | S36115D | 23 | 949-950 | S37001S | 06 | 393-395 | ||
| S344XXA | 01 | 073-074 | S36115S | 06 | 393-395 | S37002A | 11 | 698-700 | ||
| S344XXA | 24 | 963-965 | S36116A | 07 | 441-443 | S37002A | 24 | 963-965 | ||
| S344XXD | 23 | 949-950 | S36116A | 24 | 963-965 | S37002D | 23 | 949-950 | ||
| S344XXS | 01 | 091-093 | S36116D | 23 | 949-950 | S37002S | 06 | 393-395 | ||
| S345XXA | 01 | 073-074 | S36116S | 06 | 393-395 | S37009A | 11 | 698-700 | ||
| S345XXA | 24 | 963-965 | S36118A | 07 | 441-443 | S37009A | 24 | 963-965 | ||
| S345XXD | 23 | 949-950 | S36118A | 24 | 963-965 | S37009D | 23 | 949-950 | ||
| S345XXS | 01 | 091-093 | S36118D | 23 | 949-950 | S37009S | 06 | 393-395 | ||
| S346XXA | 01 | 073-074 | S36118S | 06 | 393-395 | S37011A | 11 | 698-700 | ||
| S346XXA | 24 | 963-965 | S36119A | 07 | 441-443 | S37011A | 24 | 963-965 | ||
| S346XXD | 23 | 949-950 | S36119A | 24 | 963-965 | S37011D | 23 | 949-950 | ||
| S346XXS | 01 | 091-093 | S36119D | 23 | 949-950 | S37011S | 06 | 393-395 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |