|
MS-DRG 42.00: AICD LEAD PROCEDURES
|
Facility
|
IP
|
$34,948.64
|
|
|
Service Code
|
MSDRG 265
|
| Min. Negotiated Rate |
$26,560.96 |
| Max. Negotiated Rate |
$34,948.64 |
| Rate for Payer: Aetna Medicare |
$29,077.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,948.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,948.64
|
| Rate for Payer: BCBS MAPPO |
$27,958.91
|
| Rate for Payer: BCN Medicare Advantage |
$27,958.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,958.91
|
| Rate for Payer: Mclaren Medicare |
$27,958.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,356.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,152.75
|
| Rate for Payer: PACE Medicare |
$26,560.96
|
| Rate for Payer: PACE SWMI |
$27,958.91
|
| Rate for Payer: PHP Medicare Advantage |
$27,958.91
|
| Rate for Payer: Priority Health Medicare |
$27,958.91
|
| Rate for Payer: Railroad Medicare Medicare |
$27,958.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,958.91
|
| Rate for Payer: UHC Medicare Advantage |
$27,958.91
|
| Rate for Payer: VA VA |
$27,958.91
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA
|
Facility
|
IP
|
$6,598.61
|
|
|
Service Code
|
MSDRG 894
|
| Min. Negotiated Rate |
$5,014.95 |
| Max. Negotiated Rate |
$6,598.61 |
| Rate for Payer: Aetna Medicare |
$5,490.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,598.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,598.61
|
| Rate for Payer: BCBS MAPPO |
$5,278.89
|
| Rate for Payer: BCN Medicare Advantage |
$5,278.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,278.89
|
| Rate for Payer: Mclaren Medicare |
$5,278.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,542.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,070.72
|
| Rate for Payer: PACE Medicare |
$5,014.95
|
| Rate for Payer: PACE SWMI |
$5,278.89
|
| Rate for Payer: PHP Medicare Advantage |
$5,278.89
|
| Rate for Payer: Priority Health Medicare |
$5,278.89
|
| Rate for Payer: Railroad Medicare Medicare |
$5,278.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,278.89
|
| Rate for Payer: UHC Medicare Advantage |
$5,278.89
|
| Rate for Payer: VA VA |
$5,278.89
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
|
Facility
|
IP
|
$17,740.78
|
|
|
Service Code
|
MSDRG 896
|
| Min. Negotiated Rate |
$13,482.99 |
| Max. Negotiated Rate |
$17,740.78 |
| Rate for Payer: Aetna Medicare |
$14,760.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,740.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,740.78
|
| Rate for Payer: BCBS MAPPO |
$14,192.62
|
| Rate for Payer: BCN Medicare Advantage |
$14,192.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,192.62
|
| Rate for Payer: Mclaren Medicare |
$14,192.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,902.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,321.51
|
| Rate for Payer: PACE Medicare |
$13,482.99
|
| Rate for Payer: PACE SWMI |
$14,192.62
|
| Rate for Payer: PHP Medicare Advantage |
$14,192.62
|
| Rate for Payer: Priority Health Medicare |
$14,192.62
|
| Rate for Payer: Railroad Medicare Medicare |
$14,192.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,192.62
|
| Rate for Payer: UHC Medicare Advantage |
$14,192.62
|
| Rate for Payer: VA VA |
$14,192.62
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC
|
Facility
|
IP
|
$9,084.83
|
|
|
Service Code
|
MSDRG 897
|
| Min. Negotiated Rate |
$6,904.47 |
| Max. Negotiated Rate |
$9,084.83 |
| Rate for Payer: Aetna Medicare |
$7,558.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,084.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,084.83
|
| Rate for Payer: BCBS MAPPO |
$7,267.86
|
| Rate for Payer: BCN Medicare Advantage |
$7,267.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,267.86
|
| Rate for Payer: Mclaren Medicare |
$7,267.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,631.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,358.04
|
| Rate for Payer: PACE Medicare |
$6,904.47
|
| Rate for Payer: PACE SWMI |
$7,267.86
|
| Rate for Payer: PHP Medicare Advantage |
$7,267.86
|
| Rate for Payer: Priority Health Medicare |
$7,267.86
|
| Rate for Payer: Railroad Medicare Medicare |
$7,267.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,267.86
|
| Rate for Payer: UHC Medicare Advantage |
$7,267.86
|
| Rate for Payer: VA VA |
$7,267.86
|
|
|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY
|
Facility
|
IP
|
$14,534.04
|
|
|
Service Code
|
MSDRG 895
|
| Min. Negotiated Rate |
$11,045.87 |
| Max. Negotiated Rate |
$14,534.04 |
| Rate for Payer: Aetna Medicare |
$12,092.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,534.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,534.04
|
| Rate for Payer: BCBS MAPPO |
$11,627.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,627.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,627.23
|
| Rate for Payer: Mclaren Medicare |
$11,627.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,208.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,371.31
|
| Rate for Payer: PACE Medicare |
$11,045.87
|
| Rate for Payer: PACE SWMI |
$11,627.23
|
| Rate for Payer: PHP Medicare Advantage |
$11,627.23
|
| Rate for Payer: Priority Health Medicare |
$11,627.23
|
| Rate for Payer: Railroad Medicare Medicare |
$11,627.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,627.23
|
| Rate for Payer: UHC Medicare Advantage |
$11,627.23
|
| Rate for Payer: VA VA |
$11,627.23
|
|
|
MS-DRG 42.00: ALLERGIC REACTIONS WITH MCC
|
Facility
|
IP
|
$17,327.51
|
|
|
Service Code
|
MSDRG 915
|
| Min. Negotiated Rate |
$13,168.91 |
| Max. Negotiated Rate |
$17,327.51 |
| Rate for Payer: Aetna Medicare |
$14,416.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,327.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,327.51
|
| Rate for Payer: BCBS MAPPO |
$13,862.01
|
| Rate for Payer: BCN Medicare Advantage |
$13,862.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,862.01
|
| Rate for Payer: Mclaren Medicare |
$13,862.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,555.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,941.31
|
| Rate for Payer: PACE Medicare |
$13,168.91
|
| Rate for Payer: PACE SWMI |
$13,862.01
|
| Rate for Payer: PHP Medicare Advantage |
$13,862.01
|
| Rate for Payer: Priority Health Medicare |
$13,862.01
|
| Rate for Payer: Railroad Medicare Medicare |
$13,862.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,862.01
|
| Rate for Payer: UHC Medicare Advantage |
$13,862.01
|
| Rate for Payer: VA VA |
$13,862.01
|
|
|
MS-DRG 42.00: ALLERGIC REACTIONS WITHOUT MCC
|
Facility
|
IP
|
$6,983.93
|
|
|
Service Code
|
MSDRG 916
|
| Min. Negotiated Rate |
$5,307.78 |
| Max. Negotiated Rate |
$6,983.93 |
| Rate for Payer: Aetna Medicare |
$5,810.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,983.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,983.93
|
| Rate for Payer: BCBS MAPPO |
$5,587.14
|
| Rate for Payer: BCN Medicare Advantage |
$5,587.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,587.14
|
| Rate for Payer: Mclaren Medicare |
$5,587.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,866.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,425.21
|
| Rate for Payer: PACE Medicare |
$5,307.78
|
| Rate for Payer: PACE SWMI |
$5,587.14
|
| Rate for Payer: PHP Medicare Advantage |
$5,587.14
|
| Rate for Payer: Priority Health Medicare |
$5,587.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5,587.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,587.14
|
| Rate for Payer: UHC Medicare Advantage |
$5,587.14
|
| Rate for Payer: VA VA |
$5,587.14
|
|
|
MS-DRG 42.00: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$126,792.62
|
|
|
Service Code
|
MSDRG 014
|
| Min. Negotiated Rate |
$96,362.40 |
| Max. Negotiated Rate |
$126,792.62 |
| Rate for Payer: Aetna Medicare |
$105,491.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126,792.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126,792.62
|
| Rate for Payer: BCBS MAPPO |
$101,434.10
|
| Rate for Payer: BCN Medicare Advantage |
$101,434.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101,434.10
|
| Rate for Payer: Mclaren Medicare |
$101,434.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106,505.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116,649.21
|
| Rate for Payer: PACE Medicare |
$96,362.40
|
| Rate for Payer: PACE SWMI |
$101,434.10
|
| Rate for Payer: PHP Medicare Advantage |
$101,434.10
|
| Rate for Payer: Priority Health Medicare |
$101,434.10
|
| Rate for Payer: Railroad Medicare Medicare |
$101,434.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$101,434.10
|
| Rate for Payer: UHC Medicare Advantage |
$101,434.10
|
| Rate for Payer: VA VA |
$101,434.10
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC
|
Facility
|
IP
|
$28,639.21
|
|
|
Service Code
|
MSDRG 240
|
| Min. Negotiated Rate |
$21,765.80 |
| Max. Negotiated Rate |
$28,639.21 |
| Rate for Payer: Aetna Medicare |
$23,827.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,639.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,639.21
|
| Rate for Payer: BCBS MAPPO |
$22,911.37
|
| Rate for Payer: BCN Medicare Advantage |
$22,911.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,911.37
|
| Rate for Payer: Mclaren Medicare |
$22,911.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,056.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,348.08
|
| Rate for Payer: PACE Medicare |
$21,765.80
|
| Rate for Payer: PACE SWMI |
$22,911.37
|
| Rate for Payer: PHP Medicare Advantage |
$22,911.37
|
| Rate for Payer: Priority Health Medicare |
$22,911.37
|
| Rate for Payer: Railroad Medicare Medicare |
$22,911.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,911.37
|
| Rate for Payer: UHC Medicare Advantage |
$22,911.37
|
| Rate for Payer: VA VA |
$22,911.37
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC
|
Facility
|
IP
|
$49,105.84
|
|
|
Service Code
|
MSDRG 239
|
| Min. Negotiated Rate |
$37,320.44 |
| Max. Negotiated Rate |
$49,105.84 |
| Rate for Payer: Aetna Medicare |
$40,856.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,105.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,105.84
|
| Rate for Payer: BCBS MAPPO |
$39,284.67
|
| Rate for Payer: BCN Medicare Advantage |
$39,284.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,284.67
|
| Rate for Payer: Mclaren Medicare |
$39,284.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41,248.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,177.37
|
| Rate for Payer: PACE Medicare |
$37,320.44
|
| Rate for Payer: PACE SWMI |
$39,284.67
|
| Rate for Payer: PHP Medicare Advantage |
$39,284.67
|
| Rate for Payer: Priority Health Medicare |
$39,284.67
|
| Rate for Payer: Railroad Medicare Medicare |
$39,284.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$39,284.67
|
| Rate for Payer: UHC Medicare Advantage |
$39,284.67
|
| Rate for Payer: VA VA |
$39,284.67
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC
|
Facility
|
IP
|
$15,131.26
|
|
|
Service Code
|
MSDRG 241
|
| Min. Negotiated Rate |
$11,499.76 |
| Max. Negotiated Rate |
$15,131.26 |
| Rate for Payer: Aetna Medicare |
$12,589.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,131.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,131.26
|
| Rate for Payer: BCBS MAPPO |
$12,105.01
|
| Rate for Payer: BCN Medicare Advantage |
$12,105.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,105.01
|
| Rate for Payer: Mclaren Medicare |
$12,105.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,710.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,920.76
|
| Rate for Payer: PACE Medicare |
$11,499.76
|
| Rate for Payer: PACE SWMI |
$12,105.01
|
| Rate for Payer: PHP Medicare Advantage |
$12,105.01
|
| Rate for Payer: Priority Health Medicare |
$12,105.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,105.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,105.01
|
| Rate for Payer: UHC Medicare Advantage |
$12,105.01
|
| Rate for Payer: VA VA |
$12,105.01
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$21,367.46
|
|
|
Service Code
|
MSDRG 475
|
| Min. Negotiated Rate |
$16,239.27 |
| Max. Negotiated Rate |
$21,367.46 |
| Rate for Payer: Aetna Medicare |
$17,777.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,367.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,367.46
|
| Rate for Payer: BCBS MAPPO |
$17,093.97
|
| Rate for Payer: BCN Medicare Advantage |
$17,093.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,093.97
|
| Rate for Payer: Mclaren Medicare |
$17,093.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,948.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,658.07
|
| Rate for Payer: PACE Medicare |
$16,239.27
|
| Rate for Payer: PACE SWMI |
$17,093.97
|
| Rate for Payer: PHP Medicare Advantage |
$17,093.97
|
| Rate for Payer: Priority Health Medicare |
$17,093.97
|
| Rate for Payer: Railroad Medicare Medicare |
$17,093.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,093.97
|
| Rate for Payer: UHC Medicare Advantage |
$17,093.97
|
| Rate for Payer: VA VA |
$17,093.97
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$43,786.65
|
|
|
Service Code
|
MSDRG 474
|
| Min. Negotiated Rate |
$33,277.85 |
| Max. Negotiated Rate |
$43,786.65 |
| Rate for Payer: Aetna Medicare |
$36,430.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43,786.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43,786.65
|
| Rate for Payer: BCBS MAPPO |
$35,029.32
|
| Rate for Payer: BCN Medicare Advantage |
$35,029.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,029.32
|
| Rate for Payer: Mclaren Medicare |
$35,029.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36,780.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,283.72
|
| Rate for Payer: PACE Medicare |
$33,277.85
|
| Rate for Payer: PACE SWMI |
$35,029.32
|
| Rate for Payer: PHP Medicare Advantage |
$35,029.32
|
| Rate for Payer: Priority Health Medicare |
$35,029.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35,029.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,029.32
|
| Rate for Payer: UHC Medicare Advantage |
$35,029.32
|
| Rate for Payer: VA VA |
$35,029.32
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$11,790.62
|
|
|
Service Code
|
MSDRG 476
|
| Min. Negotiated Rate |
$8,960.88 |
| Max. Negotiated Rate |
$11,790.62 |
| Rate for Payer: Aetna Medicare |
$9,809.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,790.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,790.62
|
| Rate for Payer: BCBS MAPPO |
$9,432.50
|
| Rate for Payer: BCN Medicare Advantage |
$9,432.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,432.50
|
| Rate for Payer: Mclaren Medicare |
$9,432.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,904.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,847.38
|
| Rate for Payer: PACE Medicare |
$8,960.88
|
| Rate for Payer: PACE SWMI |
$9,432.50
|
| Rate for Payer: PHP Medicare Advantage |
$9,432.50
|
| Rate for Payer: Priority Health Medicare |
$9,432.50
|
| Rate for Payer: Railroad Medicare Medicare |
$9,432.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,432.50
|
| Rate for Payer: UHC Medicare Advantage |
$9,432.50
|
| Rate for Payer: VA VA |
$9,432.50
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$19,193.39
|
|
|
Service Code
|
MSDRG 617
|
| Min. Negotiated Rate |
$14,586.97 |
| Max. Negotiated Rate |
$19,193.39 |
| Rate for Payer: Aetna Medicare |
$15,968.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,193.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,193.39
|
| Rate for Payer: BCBS MAPPO |
$15,354.71
|
| Rate for Payer: BCN Medicare Advantage |
$15,354.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,354.71
|
| Rate for Payer: Mclaren Medicare |
$15,354.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,122.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,657.92
|
| Rate for Payer: PACE Medicare |
$14,586.97
|
| Rate for Payer: PACE SWMI |
$15,354.71
|
| Rate for Payer: PHP Medicare Advantage |
$15,354.71
|
| Rate for Payer: Priority Health Medicare |
$15,354.71
|
| Rate for Payer: Railroad Medicare Medicare |
$15,354.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,354.71
|
| Rate for Payer: UHC Medicare Advantage |
$15,354.71
|
| Rate for Payer: VA VA |
$15,354.71
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$37,817.25
|
|
|
Service Code
|
MSDRG 616
|
| Min. Negotiated Rate |
$28,741.11 |
| Max. Negotiated Rate |
$37,817.25 |
| Rate for Payer: Aetna Medicare |
$31,463.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,817.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,817.25
|
| Rate for Payer: BCBS MAPPO |
$30,253.80
|
| Rate for Payer: BCN Medicare Advantage |
$30,253.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,253.80
|
| Rate for Payer: Mclaren Medicare |
$30,253.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,766.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,791.87
|
| Rate for Payer: PACE Medicare |
$28,741.11
|
| Rate for Payer: PACE SWMI |
$30,253.80
|
| Rate for Payer: PHP Medicare Advantage |
$30,253.80
|
| Rate for Payer: Priority Health Medicare |
$30,253.80
|
| Rate for Payer: Railroad Medicare Medicare |
$30,253.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,253.80
|
| Rate for Payer: UHC Medicare Advantage |
$30,253.80
|
| Rate for Payer: VA VA |
$30,253.80
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,580.51
|
|
|
Service Code
|
MSDRG 618
|
| Min. Negotiated Rate |
$9,561.19 |
| Max. Negotiated Rate |
$12,580.51 |
| Rate for Payer: Aetna Medicare |
$10,466.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,580.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,580.51
|
| Rate for Payer: BCBS MAPPO |
$10,064.41
|
| Rate for Payer: BCN Medicare Advantage |
$10,064.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,064.41
|
| Rate for Payer: Mclaren Medicare |
$10,064.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,567.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,574.07
|
| Rate for Payer: PACE Medicare |
$9,561.19
|
| Rate for Payer: PACE SWMI |
$10,064.41
|
| Rate for Payer: PHP Medicare Advantage |
$10,064.41
|
| Rate for Payer: Priority Health Medicare |
$10,064.41
|
| Rate for Payer: Railroad Medicare Medicare |
$10,064.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,064.41
|
| Rate for Payer: UHC Medicare Advantage |
$10,064.41
|
| Rate for Payer: VA VA |
$10,064.41
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$12,713.45
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$9,662.22 |
| Max. Negotiated Rate |
$12,713.45 |
| Rate for Payer: Aetna Medicare |
$10,577.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,713.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,713.45
|
| Rate for Payer: BCBS MAPPO |
$10,170.76
|
| Rate for Payer: BCN Medicare Advantage |
$10,170.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,170.76
|
| Rate for Payer: Mclaren Medicare |
$10,170.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,679.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,696.37
|
| Rate for Payer: PACE Medicare |
$9,662.22
|
| Rate for Payer: PACE SWMI |
$10,170.76
|
| Rate for Payer: PHP Medicare Advantage |
$10,170.76
|
| Rate for Payer: Priority Health Medicare |
$10,170.76
|
| Rate for Payer: Railroad Medicare Medicare |
$10,170.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,170.76
|
| Rate for Payer: UHC Medicare Advantage |
$10,170.76
|
| Rate for Payer: VA VA |
$10,170.76
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$23,385.55
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$17,773.02 |
| Max. Negotiated Rate |
$23,385.55 |
| Rate for Payer: Aetna Medicare |
$19,456.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,385.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,385.55
|
| Rate for Payer: BCBS MAPPO |
$18,708.44
|
| Rate for Payer: BCN Medicare Advantage |
$18,708.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,708.44
|
| Rate for Payer: Mclaren Medicare |
$18,708.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,643.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,514.71
|
| Rate for Payer: PACE Medicare |
$17,773.02
|
| Rate for Payer: PACE SWMI |
$18,708.44
|
| Rate for Payer: PHP Medicare Advantage |
$18,708.44
|
| Rate for Payer: Priority Health Medicare |
$18,708.44
|
| Rate for Payer: Railroad Medicare Medicare |
$18,708.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,708.44
|
| Rate for Payer: UHC Medicare Advantage |
$18,708.44
|
| Rate for Payer: VA VA |
$18,708.44
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$9,072.30
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$6,894.95 |
| Max. Negotiated Rate |
$9,072.30 |
| Rate for Payer: Aetna Medicare |
$7,548.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,072.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,072.30
|
| Rate for Payer: BCBS MAPPO |
$7,257.84
|
| Rate for Payer: BCN Medicare Advantage |
$7,257.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,257.84
|
| Rate for Payer: Mclaren Medicare |
$7,257.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,620.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,346.52
|
| Rate for Payer: PACE Medicare |
$6,894.95
|
| Rate for Payer: PACE SWMI |
$7,257.84
|
| Rate for Payer: PHP Medicare Advantage |
$7,257.84
|
| Rate for Payer: Priority Health Medicare |
$7,257.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7,257.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,257.84
|
| Rate for Payer: UHC Medicare Advantage |
$7,257.84
|
| Rate for Payer: VA VA |
$7,257.84
|
|
|
MS-DRG 42.00: ANGINA PECTORIS
|
Facility
|
IP
|
$7,313.36
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$5,558.16 |
| Max. Negotiated Rate |
$7,313.36 |
| Rate for Payer: Aetna Medicare |
$6,084.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,313.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,313.36
|
| Rate for Payer: BCBS MAPPO |
$5,850.69
|
| Rate for Payer: BCN Medicare Advantage |
$5,850.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,850.69
|
| Rate for Payer: Mclaren Medicare |
$5,850.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,143.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,728.29
|
| Rate for Payer: PACE Medicare |
$5,558.16
|
| Rate for Payer: PACE SWMI |
$5,850.69
|
| Rate for Payer: PHP Medicare Advantage |
$5,850.69
|
| Rate for Payer: Priority Health Medicare |
$5,850.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5,850.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,850.69
|
| Rate for Payer: UHC Medicare Advantage |
$5,850.69
|
| Rate for Payer: VA VA |
$5,850.69
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
|
IP
|
$64,813.88
|
|
|
Service Code
|
MSDRG 268
|
| Min. Negotiated Rate |
$49,258.54 |
| Max. Negotiated Rate |
$64,813.88 |
| Rate for Payer: Aetna Medicare |
$53,925.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64,813.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64,813.88
|
| Rate for Payer: BCBS MAPPO |
$51,851.10
|
| Rate for Payer: BCN Medicare Advantage |
$51,851.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51,851.10
|
| Rate for Payer: Mclaren Medicare |
$51,851.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54,443.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59,628.76
|
| Rate for Payer: PACE Medicare |
$49,258.54
|
| Rate for Payer: PACE SWMI |
$51,851.10
|
| Rate for Payer: PHP Medicare Advantage |
$51,851.10
|
| Rate for Payer: Priority Health Medicare |
$51,851.10
|
| Rate for Payer: Railroad Medicare Medicare |
$51,851.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$51,851.10
|
| Rate for Payer: UHC Medicare Advantage |
$51,851.10
|
| Rate for Payer: VA VA |
$51,851.10
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$40,665.65
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$30,905.89 |
| Max. Negotiated Rate |
$40,665.65 |
| Rate for Payer: Aetna Medicare |
$33,833.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,665.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,665.65
|
| Rate for Payer: BCBS MAPPO |
$32,532.52
|
| Rate for Payer: BCN Medicare Advantage |
$32,532.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,532.52
|
| Rate for Payer: Mclaren Medicare |
$32,532.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34,159.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,412.40
|
| Rate for Payer: PACE Medicare |
$30,905.89
|
| Rate for Payer: PACE SWMI |
$32,532.52
|
| Rate for Payer: PHP Medicare Advantage |
$32,532.52
|
| Rate for Payer: Priority Health Medicare |
$32,532.52
|
| Rate for Payer: Railroad Medicare Medicare |
$32,532.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,532.52
|
| Rate for Payer: UHC Medicare Advantage |
$32,532.52
|
| Rate for Payer: VA VA |
$32,532.52
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$15,163.05
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$11,523.92 |
| Max. Negotiated Rate |
$15,163.05 |
| Rate for Payer: Aetna Medicare |
$12,615.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,163.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,163.05
|
| Rate for Payer: BCBS MAPPO |
$12,130.44
|
| Rate for Payer: BCN Medicare Advantage |
$12,130.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,130.44
|
| Rate for Payer: Mclaren Medicare |
$12,130.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,736.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,950.01
|
| Rate for Payer: PACE Medicare |
$11,523.92
|
| Rate for Payer: PACE SWMI |
$12,130.44
|
| Rate for Payer: PHP Medicare Advantage |
$12,130.44
|
| Rate for Payer: Priority Health Medicare |
$12,130.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,130.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,130.44
|
| Rate for Payer: UHC Medicare Advantage |
$12,130.44
|
| Rate for Payer: VA VA |
$12,130.44
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$24,454.76
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$18,585.62 |
| Max. Negotiated Rate |
$24,454.76 |
| Rate for Payer: Aetna Medicare |
$20,346.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,454.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,454.76
|
| Rate for Payer: BCBS MAPPO |
$19,563.81
|
| Rate for Payer: BCN Medicare Advantage |
$19,563.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,563.81
|
| Rate for Payer: Mclaren Medicare |
$19,563.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,542.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,498.38
|
| Rate for Payer: PACE Medicare |
$18,585.62
|
| Rate for Payer: PACE SWMI |
$19,563.81
|
| Rate for Payer: PHP Medicare Advantage |
$19,563.81
|
| Rate for Payer: Priority Health Medicare |
$19,563.81
|
| Rate for Payer: Railroad Medicare Medicare |
$19,563.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,563.81
|
| Rate for Payer: UHC Medicare Advantage |
$19,563.81
|
| Rate for Payer: VA VA |
$19,563.81
|
|
