"CORRECTING AMENDMENT NEW TECHNOLOGY ADD-ON PAYMENTS THRESHOLDS1,2 FOR APPLICATIONS FOR FY 2023"								
MS?DRG	Number of Cases	Threshold						
001	2236	"$751,815"						
002	122	"$412,153"						
003	14272	"$456,234"						
004	12962	"$281,598"						
005	1236	"$289,710"						
006	507	"$172,225"						
007	595	"$361,963"						
008	347	"$186,472"						
010	29	"$128,717"						
011	1885	"$141,647"						
012	1863	"$124,241"						
013	545	"$88,668"						
014	1100	"$256,321"						
016	2127	"$181,715"						
017	114	"$132,551"						
018	145	"$1,256,379"						
019	86	"$218,653"						
020	1732	"$289,227"						
021	444	"$208,683"						
022	144	"$139,115"						
023	12870	"$164,359"						
024	4624	"$125,402"						
025	21967	"$134,440"						
026	9535	"$99,845"						
027	10467	"$87,512"						
028	2247	"$157,829"						
029	3863	"$102,183"						
030	1432	"$81,303"						
031	975	"$116,536"						
032	2234	"$77,895"						
033	2794	"$68,417"						
034	1372	"$121,502"						
035	3671	"$84,121"						
036	5157	"$71,246"						
037	3530	"$105,672"						
038	11624	"$68,829"						
039	22007	"$56,197"						
040	3779	"$112,028"						
041	6393	"$85,543"						
042	2442	"$74,119"						
052	1043	"$61,145"						
053	229	"$47,174"						
054	12661	"$52,132"						
055	3929	"$46,545"						
056	11984	"$60,151"						
057	29958	"$45,917"						
058	814	"$59,256"						
059	2783	"$47,834"						
060	2316	"$42,813"						
061	5519	"$107,416"						
062	10541	"$88,237"						
063	2206	"$81,550"						
064	77950	"$64,468"						
065	107754	"$49,814"						
066	31628	"$39,291"						
067	992	"$59,323"						
068	4402	"$47,317"						
069	37298	"$43,732"						
070	18437	"$56,754"						
071	18410	"$44,636"						
072	3717	"$38,879"						
073	7431	"$52,244"						
074	16110	"$45,708"						
075	646	"$60,407"						
076	165	"$45,885"						
077	2111	"$59,502"						
078	2942	"$47,668"						
079	530	"$40,185"						
080	834	"$63,642"						
081	578	"$35,507"						
082	6984	"$71,030"						
083	10064	"$53,387"						
084	4884	"$43,411"						
085	8182	"$69,518"						
086	16037	"$52,327"						
087	8139	"$41,932"						
088	622	"$59,139"						
089	1937	"$50,068"						
090	624	"$45,055"						
091	16181	"$56,556"						
092	22779	"$44,120"						
093	7376	"$39,011"						
094	1465	"$98,938"						
095	1362	"$78,428"						
096	436	"$79,455"						
097	2056	"$103,234"						
098	1569	"$69,372"						
099	494	"$57,649"						
100	25493	"$61,215"						
101	41071	"$42,043"						
102	1217	"$49,223"						
103	9533	"$41,409"						
113	475	"$77,327"						
114	132	"$60,482"						
115	713	"$59,663"						
116	384	"$65,035"						
117	162	"$50,280"						
121	580	"$43,413"						
122	173	"$24,577"						
123	3099	"$41,808"						
124	1008	"$50,984"						
125	3349	"$38,849"						
135	286	"$76,917"						
136	94	"$58,050"						
137	743	"$54,583"						
138	329	"$41,706"						
139	340	"$53,714"						
140	649	"$122,109"						
141	2483	"$82,129"						
142	1360	"$67,794"						
143	767	"$92,964"						
144	1615	"$66,532"						
145	1102	"$54,490"						
146	1110	"$61,154"						
147	932	"$47,669"						
148	230	"$37,523"						
149	15218	"$38,001"						
150	1070	"$47,906"						
151	2492	"$31,192"						
152	3064	"$45,188"						
153	7421	"$32,206"						
154	2033	"$54,590"						
155	3935	"$41,066"						
156	1470	"$31,234"						
157	2024	"$55,260"						
158	3563	"$40,165"						
159	900	"$31,313"						
163	11068	"$142,333"						
164	15837	"$92,606"						
165	8161	"$75,318"						
166	9960	"$104,404"						
167	6419	"$68,650"						
168	2407	"$59,573"						
175	31544	"$57,568"						
176	29111	"$41,293"						
177	77099	"$61,136"						
178	30449	"$48,338"						
179	5060	"$37,423"						
180	18941	"$62,036"						
181	9697	"$48,875"						
182	611	"$41,578"						
183	5038	"$57,024"						
184	10767	"$47,285"						
185	2906	"$36,469"						
186	10140	"$55,781"						
187	6455	"$46,063"						
188	1177	"$34,346"						
189	145593	"$49,583"						
190	129171	"$47,176"						
191	65306	"$38,483"						
192	23188	"$31,009"						
193	149981	"$51,475"						
194	102452	"$38,123"						
195	23575	"$30,011"						
196	9322	"$58,010"						
197	2949	"$44,583"						
198	724	"$34,901"						
199	6474	"$61,180"						
200	9960	"$46,460"						
201	1822	"$31,523"						
202	41212	"$42,410"						
203	8281	"$31,418"						
204	7662	"$38,598"						
205	9677	"$55,720"						
206	9441	"$40,436"						
207	18419	"$161,346"						
208	54938	"$83,827"						
215	4408	"$300,876"						
216	7517	"$302,107"						
217	2610	"$213,409"						
218	479	"$203,500"						
219	15807	"$238,460"						
220	15223	"$176,757"						
221	2484	"$148,155"						
222	2079	"$248,328"						
223	404	"$195,021"						
224	2118	"$235,297"						
225	1628	"$189,267"						
226	5316	"$199,440"						
227	4196	"$163,490"						
228	2747	"$159,507"						
229	3513	"$118,072"						
231	1060	"$293,984"						
232	720	"$212,608"						
233	13679	"$247,962"						
234	15310	"$185,399"						
235	11855	"$190,737"						
236	20081	"$144,507"						
239	9937	"$116,865"						
240	7796	"$80,563"						
241	702	"$58,667"						
242	19295	"$117,154"						
243	24916	"$91,036"						
244	14442	"$79,815"						
245	1888	"$164,143"						
246	52445	"$123,266"						
247	84857	"$94,230"						
248	2461	"$122,897"						
249	3042	"$90,598"						
250	4471	"$100,660"						
251	5131	"$80,953"						
252	33467	"$100,975"						
253	23991	"$92,332"						
254	10594	"$71,589"						
255	2312	"$77,587"						
256	2099	"$59,785"						
257	139	"$47,161"						
258	592	"$102,382"						
259	857	"$77,292"						
260	2706	"$109,249"						
261	3618	"$75,187"						
262	1353	"$69,673"						
263	262	"$76,513"						
264	10415	"$87,534"						
265	580	"$99,379"						
266	20609	"$202,606"						
267	29682	"$165,746"						
268	3672	"$200,058"						
269	16295	"$130,508"						
270	19003	"$152,290"						
271	14510	"$116,043"						
272	5319	"$91,585"						
273	7699	"$135,016"						
274	26451	"$117,136"						
280	94135	"$57,477"						
281	46125	"$46,414"						
282	19802	"$40,767"						
283	10318	"$61,302"						
284	1053	"$37,165"						
285	266	"$25,844"						
286	50165	"$78,282"						
287	51780	"$58,446"						
288	1376	"$76,130"						
289	715	"$57,115"						
290	60	"$44,429"						
291	466291	"$48,215"						
292	28936	"$36,037"						
293	5789	"$26,521"						
294	285	"$48,276"						
295	27	"$37,006"						
296	3854	"$59,872"						
297	404	"$36,014"						
298	159	"$25,894"						
299	19587	"$52,671"						
300	28604	"$42,830"						
301	7619	"$32,447"						
302	3677	"$45,637"						
303	12093	"$32,522"						
304	16719	"$46,403"						
305	30520	"$36,071"						
306	4265	"$50,892"						
307	3301	"$39,252"						
308	69808	"$48,610"						
309	86550	"$34,133"						
310	55665	"$26,479"						
311	5291	"$33,830"						
312	68104	"$39,991"						
313	38354	"$36,693"						
314	43399	"$63,025"						
315	20057	"$42,733"						
316	3356	"$34,783"						
319	1632	"$136,922"						
320	574	"$85,617"						
326	9800	"$140,800"						
327	10093	"$87,640"						
328	7763	"$67,806"						
329	35957	"$135,522"						
330	50742	"$88,177"						
331	27646	"$69,171"						
332	180	"$114,986"						
333	647	"$78,213"						
334	677	"$65,086"						
335	5344	"$116,737"						
336	9387	"$81,867"						
337	4453	"$67,010"						
338	726	"$95,547"						
339	2367	"$70,712"						
340	1997	"$58,798"						
341	766	"$83,408"						
342	2323	"$64,640"						
343	2493	"$56,226"						
344	1075	"$85,615"						
345	2126	"$61,481"						
346	1068	"$55,720"						
347	870	"$77,065"						
348	2133	"$56,171"						
349	1115	"$46,368"						
350	1386	"$85,548"						
351	3468	"$64,016"						
352	2491	"$53,769"						
353	2752	"$95,935"						
354	7264	"$69,376"						
355	5305	"$59,107"						
356	7052	"$120,718"						
357	5629	"$81,108"						
358	1294	"$59,257"						
368	3065	"$65,515"						
369	3811	"$48,906"						
370	451	"$36,834"						
371	16739	"$56,740"						
372	25084	"$43,096"						
373	5672	"$33,308"						
374	11739	"$64,114"						
375	12826	"$49,873"						
376	1128	"$43,374"						
377	68794	"$61,813"						
378	127084	"$44,935"						
379	14791	"$30,833"						
380	5897	"$64,536"						
381	7628	"$48,720"						
382	1510	"$38,070"						
383	1065	"$54,865"						
384	3693	"$45,791"						
385	2910	"$57,103"						
386	7821	"$45,001"						
387	3435	"$33,839"						
388	18919	"$53,676"						
389	49325	"$37,240"						
390	29327	"$28,132"						
391	42182	"$50,192"						
392	136958	"$37,138"						
393	26200	"$56,517"						
394	38678	"$42,766"						
395	8910	"$32,139"						
405	3984	"$155,710"						
406	4994	"$99,462"						
407	1645	"$81,199"						
408	955	"$112,366"						
409	1010	"$79,613"						
410	319	"$67,195"						
411	159	"$118,368"						
412	231	"$86,665"						
413	148	"$72,364"						
414	1822	"$112,264"						
415	2642	"$77,432"						
416	1325	"$60,941"						
417	13111	"$89,934"						
418	22325	"$73,183"						
419	14225	"$62,571"						
420	725	"$103,530"						
421	790	"$72,616"						
422	178	"$60,896"						
423	1106	"$119,687"						
424	584	"$81,206"						
425	114	"$64,772"						
432	16684	"$62,650"						
433	11978	"$46,017"						
434	675	"$29,220"						
435	13806	"$62,515"						
436	7532	"$48,976"						
437	680	"$44,122"						
438	13935	"$57,098"						
439	24509	"$40,139"						
440	12263	"$31,029"						
441	20562	"$59,699"						
442	17930	"$40,988"						
443	2661	"$32,063"						
444	12846	"$60,711"						
445	18621	"$49,508"						
446	7200	"$42,365"						
453	3904	"$245,304"						
454	21434	"$166,901"						
455	21993	"$138,606"						
456	1397	"$239,845"						
457	3754	"$180,742"						
458	1251	"$138,235"						
459	3775	"$178,010"						
460	48814	"$117,367"						
461	264	"$164,533"						
462	6089	"$103,013"						
463	5234	"$122,912"						
464	8193	"$87,078"						
465	2563	"$66,616"						
466	5388	"$143,123"						
467	24329	"$108,012"						
468	18832	"$89,951"						
469	12305	"$98,078"						
470	359140	"$71,662"						
471	3534	"$149,428"						
472	16324	"$101,208"						
473	11837	"$88,111"						
474	3585	"$106,176"						
475	3644	"$71,478"						
476	712	"$51,245"						
477	3539	"$99,011"						
478	6812	"$82,721"						
479	1597	"$69,050"						
480	28804	"$97,577"						
481	79919	"$77,575"						
482	21359	"$65,811"						
483	68049	"$84,125"						
485	1526	"$106,801"						
486	3131	"$78,239"						
487	979	"$65,818"						
488	2641	"$68,754"						
489	2652	"$56,565"						
492	6314	"$107,097"						
493	19805	"$82,258"						
494	12199	"$70,616"						
495	500	"$106,960"						
496	1889	"$71,674"						
497	1224	"$58,814"						
498	1121	"$81,520"						
499	211	"$53,152"						
500	2669	"$91,244"						
501	5771	"$64,415"						
502	2999	"$55,561"						
503	1090	"$82,331"						
504	3066	"$64,346"						
505	1137	"$64,346"						
506	476	"$58,239"						
507	449	"$72,072"						
508	161	"$59,149"						
509	48	"$62,594"						
510	1081	"$91,422"						
511	3516	"$75,663"						
512	2162	"$65,234"						
513	1772	"$60,475"						
514	529	"$47,685"						
515	4843	"$98,196"						
516	14113	"$74,141"						
517	12677	"$60,240"						
518	2684	"$109,174"						
519	8454	"$73,477"						
520	6509	"$60,679"						
521	14982	"$101,088"						
522	50297	"$81,671"						
533	961	"$48,921"						
534	2730	"$31,401"						
535	7918	"$47,368"						
536	23954	"$32,362"						
537	904	"$39,754"						
538	329	"$30,928"						
539	3138	"$57,537"						
540	3367	"$47,537"						
541	570	"$34,092"						
542	7609	"$57,957"						
543	14612	"$44,451"						
544	3913	"$33,591"						
545	3739	"$66,736"						
546	4136	"$47,145"						
547	1277	"$36,628"						
548	657	"$63,464"						
549	1328	"$48,393"						
550	367	"$37,026"						
551	13420	"$57,265"						
552	53385	"$42,997"						
553	2443	"$47,429"						
554	11997	"$32,643"						
555	2294	"$50,840"						
556	9102	"$36,344"						
557	3584	"$52,930"						
558	10343	"$36,916"						
559	3062	"$56,230"						
560	5582	"$40,305"						
561	2625	"$31,342"						
562	6828	"$51,840"						
563	25604	"$37,115"						
564	5111	"$55,673"						
565	8583	"$44,062"						
566	2081	"$34,515"						
570	3103	"$76,254"						
571	6325	"$57,388"						
572	1393	"$48,304"						
573	788	"$120,201"						
574	1433	"$85,310"						
575	222	"$60,123"						
576	450	"$130,170"						
577	1590	"$83,514"						
578	849	"$62,929"						
579	4221	"$85,422"						
580	8970	"$62,082"						
581	3242	"$57,179"						
582	682	"$65,360"						
583	659	"$60,468"						
584	715	"$68,028"						
585	746	"$66,939"						
592	3057	"$51,620"						
593	4608	"$41,348"						
594	553	"$30,313"						
595	1041	"$57,736"						
596	2681	"$39,238"						
597	1492	"$56,991"						
598	1470	"$47,342"						
599	59	"$28,540"						
600	820	"$39,974"						
601	330	"$27,476"						
602	26446	"$50,533"						
603	99476	"$33,556"						
604	3326	"$54,707"						
605	13400	"$41,192"						
606	1871	"$49,256"						
607	5853	"$33,508"						
614	2161	"$86,189"						
615	1172	"$69,450"						
616	3129	"$107,313"						
617	15043	"$68,603"						
618	103	"$53,135"						
619	956	"$91,893"						
620	3732	"$69,404"						
621	11815	"$64,648"						
622	2083	"$89,395"						
623	6015	"$61,991"						
624	229	"$46,591"						
625	837	"$94,286"						
626	1195	"$70,026"						
627	1334	"$57,641"						
628	3382	"$103,770"						
629	5478	"$75,049"						
630	227	"$59,087"						
637	34287	"$51,113"						
638	53729	"$36,944"						
639	8728	"$27,667"						
640	76411	"$46,776"						
641	85509	"$33,035"						
642	1984	"$46,516"						
643	11226	"$56,944"						
644	13347	"$43,251"						
645	4342	"$33,915"						
650	2555	"$147,337"						
651	1155	"$131,038"						
652	9191	"$119,112"						
653	1668	"$149,230"						
654	4079	"$102,429"						
655	1537	"$80,652"						
656	3013	"$105,914"						
657	7455	"$76,699"						
658	5840	"$68,445"						
659	9278	"$82,340"						
660	19333	"$59,506"						
661	12847	"$52,307"						
662	694	"$86,546"						
663	1519	"$61,040"						
664	571	"$51,488"						
665	660	"$95,152"						
666	1530	"$65,321"						
667	487	"$46,627"						
668	2026	"$88,607"						
669	5059	"$62,100"						
670	1294	"$46,501"						
671	389	"$64,548"						
672	202	"$52,288"						
673	15766	"$96,243"						
674	7334	"$78,671"						
675	474	"$66,586"						
682	103515	"$52,124"						
683	126936	"$37,865"						
684	14524	"$28,274"						
686	1679	"$59,469"						
687	2519	"$45,406"						
688	288	"$36,153"						
689	79889	"$45,348"						
690	128709	"$34,627"						
693	1387	"$51,924"						
694	7215	"$38,032"						
695	1287	"$45,239"						
696	5933	"$30,209"						
697	449	"$44,442"						
698	68294	"$54,286"						
699	36804	"$42,066"						
700	3410	"$32,765"						
707	3415	"$76,910"						
708	6088	"$68,151"						
709	469	"$73,059"						
710	216	"$61,920"						
711	443	"$75,157"						
712	107	"$49,641"						
713	4768	"$58,252"						
714	1533	"$43,860"						
715	418	"$76,661"						
716	88	"$59,854"						
717	1689	"$65,907"						
718	492	"$55,338"						
722	810	"$57,224"						
723	1453	"$46,135"						
724	78	"$30,364"						
725	759	"$48,289"						
726	2923	"$32,851"						
727	1416	"$52,278"						
728	3886	"$34,719"						
729	618	"$42,652"						
730	97	"$25,311"						
734	804	"$82,907"						
735	470	"$64,709"						
736	606	"$130,259"						
737	2547	"$80,021"						
738	561	"$65,954"						
739	569	"$117,118"						
740	2283	"$74,041"						
741	1645	"$61,393"						
742	4103	"$68,039"						
743	5419	"$53,888"						
744	1423	"$65,111"						
745	205	"$51,161"						
746	1408	"$59,352"						
747	1371	"$46,391"						
748	1332	"$57,263"						
749	782	"$86,053"						
750	108	"$61,036"						
754	1795	"$59,385"						
755	2491	"$46,208"						
756	205	"$39,219"						
757	841	"$54,096"						
758	1317	"$41,810"						
759	379	"$31,704"						
760	1563	"$40,336"						
761	275	"$29,219"						
768	174	"$38,895"						
769	112	"$50,817"						
770	59	"$41,237"						
776	511	"$32,330"						
779	51	"$42,447"						
783	197	"$56,949"						
784	536	"$41,147"						
785	412	"$35,409"						
786	670	"$52,744"						
787	1649	"$39,051"						
788	1679	"$33,593"						
789	2	"$51,425"						
793	1	"$23,281"						
794	1	"$58,601"						
796	31	"$40,929"						
797	81	"$33,400"						
798	115	"$30,860"						
799	455	"$147,763"						
800	300	"$96,802"						
801	131	"$68,413"						
802	563	"$98,318"						
803	822	"$70,865"						
804	457	"$60,099"						
805	507	"$33,035"						
806	1929	"$22,953"						
807	3365	"$19,754"						
808	8269	"$65,779"						
809	13849	"$47,747"						
810	1632	"$41,524"						
811	29163	"$52,007"						
812	52613	"$38,243"						
813	17826	"$52,507"						
814	1545	"$59,835"						
815	2380	"$44,904"						
816	600	"$33,638"						
817	65	"$72,703"						
818	72	"$53,141"						
819	37	"$47,451"						
820	1102	"$159,206"						
821	1111	"$79,427"						
822	915	"$59,272"						
823	2350	"$129,331"						
824	2304	"$83,456"						
825	657	"$60,977"						
826	744	"$141,520"						
827	1371	"$88,925"						
828	768	"$70,178"						
829	1763	"$93,456"						
830	335	"$63,521"						
831	748	"$40,580"						
832	1150	"$26,217"						
833	499	"$18,921"						
834	4533	"$125,577"						
835	2223	"$60,426"						
836	445	"$43,819"						
837	1899	"$116,802"						
838	1275	"$63,272"						
839	866	"$51,004"						
840	8700	"$81,613"						
841	6963	"$56,548"						
842	1349	"$45,743"						
843	2215	"$62,389"						
844	1920	"$48,852"						
845	275	"$42,170"						
846	3176	"$71,404"						
847	12012	"$50,506"						
848	228	"$41,651"						
849	345	"$68,497"						
853	84062	"$132,905"						
854	24364	"$75,305"						
855	224	"$60,593"						
856	8813	"$114,379"						
857	9030	"$69,289"						
858	1044	"$54,107"						
862	12785	"$59,811"						
863	11496	"$41,325"						
864	9419	"$40,091"						
865	3076	"$50,822"						
866	6367	"$36,604"						
867	2622	"$64,049"						
868	1944	"$43,561"						
869	379	"$32,860"						
870	32543	"$181,900"						
871	610209	"$62,752"						
872	156057	"$44,990"						
876	671	"$82,523"						
880	7347	"$39,541"						
881	4002	"$25,024"						
882	1957	"$28,779"						
883	1206	"$37,602"						
884	20219	"$45,427"						
885	68602	"$34,073"						
886	297	"$36,813"						
887	387	"$42,576"						
894	4278	"$21,567"						
895	3514	"$39,838"						
896	9565	"$56,432"						
897	30258	"$31,410"						
901	1187	"$107,157"						
902	2055	"$65,486"						
903	572	"$49,277"						
904	1036	"$98,780"						
905	253	"$60,018"						
906	571	"$62,571"						
907	10342	"$107,245"						
908	9088	"$70,535"						
909	2981	"$56,208"						
913	759	"$57,280"						
914	2420	"$41,667"						
915	2487	"$58,118"						
916	3927	"$28,512"						
917	28779	"$53,103"						
918	15928	"$33,954"						
919	14878	"$58,673"						
920	13687	"$43,778"						
921	2751	"$31,574"						
922	1696	"$54,845"						
923	1967	"$38,041"						
927	161	"$484,535"						
928	1091	"$143,797"						
929	261	"$87,459"						
933	119	"$63,984"						
934	498	"$50,914"						
935	1751	"$50,147"						
939	643	"$95,250"						
940	1414	"$74,278"						
941	738	"$67,086"						
945	2162	"$56,024"						
946	679	"$54,863"						
947	8834	"$45,877"						
948	28272	"$34,791"						
949	1185	"$39,805"						
950	235	"$26,382"						
951	3038	"$21,964"						
955	473	"$185,957"						
956	6229	"$108,183"						
957	2322	"$213,088"						
958	1844	"$132,286"						
959	130	"$92,863"						
963	3071	"$84,406"						
964	4626	"$57,534"						
965	744	"$43,781"						
969	399	"$155,930"						
970	86	"$88,977"						
974	4303	"$76,439"						
975	2066	"$50,809"						
976	354	"$41,577"						
977	1196	"$48,825"						
981	26387	"$123,324"						
982	13713	"$82,350"						
983	2652	"$64,031"						
987	9024	"$96,100"						
988	7863	"$64,302"						
989	1238	"$51,777"						
1Geometric mean plus the lesser of .75 of the national adjusted operating standardized payment amount (increased to reflect the difference between costs and charges) or .75 of one standard deviation of mean charges by Medicare Severity Diagnosis Related Group (MS-DRG)								
2Cases taken from the FY 2019 MedPAR file; MS-DRGs are from GROUPER Version39.0.								
