Table 5. Comparison of existing DRG splits and alternative severity groups for selected adjacent diagnosis-related groups (DRG's).

Principal diagnosis	Stage	Age	Complications or comorbidity (DRG definition)	Unrelated comorbidity	N	Mean cost
Adjacent DRG: Biliary tract procedures
Total DRG-splits					1,265	$3,653.54
DRG 197: Total cholecystectomy w/o CDE 1	–	70+ (or)	Yes	–	917	3,945.48
DRG 198: Total cholecystectomy w/o CDE 1	–	0-69	No	–	348	2,884.25
Severity groups
Total cholecystectomy w/o CDE 1 and all others	1	All	–	No	852	3,266.59
Total cholecystectomy w/o CDE 1 and all others	1,2	All	–	1 (yes), 2 (all)	351	4,247.81
Total cholecystectomy w/o CDE 1 and all others	3,4	All	–	All	62	5,606.64
Adjacent DRG: Cirrhosis and alcoholic hepatitis
Total DRG splits					299	2,762.57
DRG 202: Cirrhosis and alcoholic hepatitis (Only DRG in category)	–	All	All	–	299	2,762.57
Severity Groups
Cirrhosis and all others	1	All	–	No	35	2,173.67
Cirrhosis and all others	1, 2	All	–	1 (yes), 2 (all)	156	2,453.62
Cirrhosis and all others	3, 4	All	–	All	108	3,399.69
Adjacent DRG: Diabetes mellitus
Total DRG splits					2,274	2,016.14
DRG 294: Diabetes mellitus	–	36 +	All	–	2,247	2,014.11
DRG 295: Diabetes mellitus	–	0-35	All	–	27	2,185.30
Severity groups
Diabetes mellitus	1	All	–	No	920	1,655.45
Diabetes mellitus	1, 2	All	–	1 (yes), 2 (no)	886	2,085.38
Diabetes mellitus	2, 3, 4	All	–	2(yes), 3-4 (all)	168	2,594.12
Adjacent DRG: Benign prostatic hypertrophy
Total DRG splits					368	1,373.81
DRG 348: Benign prostatic hypertrophy	–	70+ (or)	Yes	–	275	1,465.29
DRG 349: Benign prostatic hypertrophy	–	0-69	No	–	93	1,103.33
Severity groups
Benign prostatic hypertrophy	1	1 or 0-69	–	No	255	1,155.59
Benign prostatic hypertrophy	1,	1 or 0-69	–	Yes	113	1,866.27
	2, 3, 4	and 70 +		All

¹CDE = common bile duct exploration.