|
MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$11,412.08
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$8,673.18 |
| Max. Negotiated Rate |
$11,412.08 |
| Rate for Payer: Aetna Medicare |
$9,494.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,412.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,412.08
|
| Rate for Payer: BCBS MAPPO |
$9,129.66
|
| Rate for Payer: BCN Medicare Advantage |
$9,129.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,129.66
|
| Rate for Payer: Mclaren Medicare |
$9,129.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,586.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,499.11
|
| Rate for Payer: PACE Medicare |
$8,673.18
|
| Rate for Payer: PACE SWMI |
$9,129.66
|
| Rate for Payer: PHP Medicare Advantage |
$9,129.66
|
| Rate for Payer: Priority Health Medicare |
$9,129.66
|
| Rate for Payer: Railroad Medicare Medicare |
$9,129.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,129.66
|
| Rate for Payer: UHC Medicare Advantage |
$9,129.66
|
| Rate for Payer: VA VA |
$9,129.66
|
|
|
MS-DRG 42.00: ARTHROSCOPY
|
Facility
|
IP
|
$17,508.62
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$13,306.56 |
| Max. Negotiated Rate |
$17,508.62 |
| Rate for Payer: Aetna Medicare |
$14,567.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,508.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,508.62
|
| Rate for Payer: BCBS MAPPO |
$14,006.90
|
| Rate for Payer: BCN Medicare Advantage |
$14,006.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,006.90
|
| Rate for Payer: Mclaren Medicare |
$14,006.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,707.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,107.93
|
| Rate for Payer: PACE Medicare |
$13,306.56
|
| Rate for Payer: PACE SWMI |
$14,006.90
|
| Rate for Payer: PHP Medicare Advantage |
$14,006.90
|
| Rate for Payer: Priority Health Medicare |
$14,006.90
|
| Rate for Payer: Railroad Medicare Medicare |
$14,006.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,006.90
|
| Rate for Payer: UHC Medicare Advantage |
$14,006.90
|
| Rate for Payer: VA VA |
$14,006.90
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC
|
Facility
|
IP
|
$11,792.59
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$8,962.37 |
| Max. Negotiated Rate |
$11,792.59 |
| Rate for Payer: Aetna Medicare |
$9,811.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,792.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,792.59
|
| Rate for Payer: BCBS MAPPO |
$9,434.07
|
| Rate for Payer: BCN Medicare Advantage |
$9,434.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,434.07
|
| Rate for Payer: Mclaren Medicare |
$9,434.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,905.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,849.18
|
| Rate for Payer: PACE Medicare |
$8,962.37
|
| Rate for Payer: PACE SWMI |
$9,434.07
|
| Rate for Payer: PHP Medicare Advantage |
$9,434.07
|
| Rate for Payer: Priority Health Medicare |
$9,434.07
|
| Rate for Payer: Railroad Medicare Medicare |
$9,434.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,434.07
|
| Rate for Payer: UHC Medicare Advantage |
$9,434.07
|
| Rate for Payer: VA VA |
$9,434.07
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
|
IP
|
$7,063.88
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$5,368.55 |
| Max. Negotiated Rate |
$7,063.88 |
| Rate for Payer: Aetna Medicare |
$5,877.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,063.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,063.88
|
| Rate for Payer: BCBS MAPPO |
$5,651.10
|
| Rate for Payer: BCN Medicare Advantage |
$5,651.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,651.10
|
| Rate for Payer: Mclaren Medicare |
$5,651.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,933.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,498.77
|
| Rate for Payer: PACE Medicare |
$5,368.55
|
| Rate for Payer: PACE SWMI |
$5,651.10
|
| Rate for Payer: PHP Medicare Advantage |
$5,651.10
|
| Rate for Payer: Priority Health Medicare |
$5,651.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5,651.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,651.10
|
| Rate for Payer: UHC Medicare Advantage |
$5,651.10
|
| Rate for Payer: VA VA |
$5,651.10
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
|
Facility
|
IP
|
$58,728.90
|
|
|
Service Code
|
MSDRG 016
|
| Min. Negotiated Rate |
$44,633.96 |
| Max. Negotiated Rate |
$58,728.90 |
| Rate for Payer: Aetna Medicare |
$48,862.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,728.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,728.90
|
| Rate for Payer: BCBS MAPPO |
$46,983.12
|
| Rate for Payer: BCN Medicare Advantage |
$46,983.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,983.12
|
| Rate for Payer: Mclaren Medicare |
$46,983.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49,332.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,030.59
|
| Rate for Payer: PACE Medicare |
$44,633.96
|
| Rate for Payer: PACE SWMI |
$46,983.12
|
| Rate for Payer: PHP Medicare Advantage |
$46,983.12
|
| Rate for Payer: Priority Health Medicare |
$46,983.12
|
| Rate for Payer: Railroad Medicare Medicare |
$46,983.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,983.12
|
| Rate for Payer: UHC Medicare Advantage |
$46,983.12
|
| Rate for Payer: VA VA |
$46,983.12
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$58,728.90
|
|
|
Service Code
|
MSDRG 017
|
| Min. Negotiated Rate |
$44,633.96 |
| Max. Negotiated Rate |
$58,728.90 |
| Rate for Payer: Aetna Medicare |
$48,862.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,728.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,728.90
|
| Rate for Payer: BCBS MAPPO |
$46,983.12
|
| Rate for Payer: BCN Medicare Advantage |
$46,983.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,983.12
|
| Rate for Payer: Mclaren Medicare |
$46,983.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49,332.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,030.59
|
| Rate for Payer: PACE Medicare |
$44,633.96
|
| Rate for Payer: PACE SWMI |
$46,983.12
|
| Rate for Payer: PHP Medicare Advantage |
$46,983.12
|
| Rate for Payer: Priority Health Medicare |
$46,983.12
|
| Rate for Payer: Railroad Medicare Medicare |
$46,983.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,983.12
|
| Rate for Payer: UHC Medicare Advantage |
$46,983.12
|
| Rate for Payer: VA VA |
$46,983.12
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
|
IP
|
$19,581.58
|
|
|
Service Code
|
MSDRG 519
|
| Min. Negotiated Rate |
$14,882.00 |
| Max. Negotiated Rate |
$19,581.58 |
| Rate for Payer: Aetna Medicare |
$16,291.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,581.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,581.58
|
| Rate for Payer: BCBS MAPPO |
$15,665.26
|
| Rate for Payer: BCN Medicare Advantage |
$15,665.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,665.26
|
| Rate for Payer: Mclaren Medicare |
$15,665.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,448.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,015.05
|
| Rate for Payer: PACE Medicare |
$14,882.00
|
| Rate for Payer: PACE SWMI |
$15,665.26
|
| Rate for Payer: PHP Medicare Advantage |
$15,665.26
|
| Rate for Payer: Priority Health Medicare |
$15,665.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15,665.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,665.26
|
| Rate for Payer: UHC Medicare Advantage |
$15,665.26
|
| Rate for Payer: VA VA |
$15,665.26
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
|
IP
|
$35,110.47
|
|
|
Service Code
|
MSDRG 518
|
| Min. Negotiated Rate |
$26,683.96 |
| Max. Negotiated Rate |
$35,110.47 |
| Rate for Payer: Aetna Medicare |
$29,211.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,110.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,110.47
|
| Rate for Payer: BCBS MAPPO |
$28,088.38
|
| Rate for Payer: BCN Medicare Advantage |
$28,088.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,088.38
|
| Rate for Payer: Mclaren Medicare |
$28,088.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,492.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,301.64
|
| Rate for Payer: PACE Medicare |
$26,683.96
|
| Rate for Payer: PACE SWMI |
$28,088.38
|
| Rate for Payer: PHP Medicare Advantage |
$28,088.38
|
| Rate for Payer: Priority Health Medicare |
$28,088.38
|
| Rate for Payer: Railroad Medicare Medicare |
$28,088.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$28,088.38
|
| Rate for Payer: UHC Medicare Advantage |
$28,088.38
|
| Rate for Payer: VA VA |
$28,088.38
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$14,392.45
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$10,938.26 |
| Max. Negotiated Rate |
$14,392.45 |
| Rate for Payer: Aetna Medicare |
$11,974.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,392.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,392.45
|
| Rate for Payer: BCBS MAPPO |
$11,513.96
|
| Rate for Payer: BCN Medicare Advantage |
$11,513.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,513.96
|
| Rate for Payer: Mclaren Medicare |
$11,513.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,089.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,241.05
|
| Rate for Payer: PACE Medicare |
$10,938.26
|
| Rate for Payer: PACE SWMI |
$11,513.96
|
| Rate for Payer: PHP Medicare Advantage |
$11,513.96
|
| Rate for Payer: Priority Health Medicare |
$11,513.96
|
| Rate for Payer: Railroad Medicare Medicare |
$11,513.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,513.96
|
| Rate for Payer: UHC Medicare Advantage |
$11,513.96
|
| Rate for Payer: VA VA |
$11,513.96
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$23,678.36
|
|
|
Service Code
|
MSDRG 095
|
| Min. Negotiated Rate |
$17,995.56 |
| Max. Negotiated Rate |
$23,678.36 |
| Rate for Payer: Aetna Medicare |
$19,700.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,678.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,678.36
|
| Rate for Payer: BCBS MAPPO |
$18,942.69
|
| Rate for Payer: BCN Medicare Advantage |
$18,942.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,942.69
|
| Rate for Payer: Mclaren Medicare |
$18,942.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,889.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,784.09
|
| Rate for Payer: PACE Medicare |
$17,995.56
|
| Rate for Payer: PACE SWMI |
$18,942.69
|
| Rate for Payer: PHP Medicare Advantage |
$18,942.69
|
| Rate for Payer: Priority Health Medicare |
$18,942.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18,942.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,942.69
|
| Rate for Payer: UHC Medicare Advantage |
$18,942.69
|
| Rate for Payer: VA VA |
$18,942.69
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$35,733.72
|
|
|
Service Code
|
MSDRG 094
|
| Min. Negotiated Rate |
$27,157.63 |
| Max. Negotiated Rate |
$35,733.72 |
| Rate for Payer: Aetna Medicare |
$29,730.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,733.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,733.72
|
| Rate for Payer: BCBS MAPPO |
$28,586.98
|
| Rate for Payer: BCN Medicare Advantage |
$28,586.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,586.98
|
| Rate for Payer: Mclaren Medicare |
$28,586.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,016.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,875.03
|
| Rate for Payer: PACE Medicare |
$27,157.63
|
| Rate for Payer: PACE SWMI |
$28,586.98
|
| Rate for Payer: PHP Medicare Advantage |
$28,586.98
|
| Rate for Payer: Priority Health Medicare |
$28,586.98
|
| Rate for Payer: Railroad Medicare Medicare |
$28,586.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$28,586.98
|
| Rate for Payer: UHC Medicare Advantage |
$28,586.98
|
| Rate for Payer: VA VA |
$28,586.98
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$23,678.36
|
|
|
Service Code
|
MSDRG 096
|
| Min. Negotiated Rate |
$17,995.56 |
| Max. Negotiated Rate |
$23,678.36 |
| Rate for Payer: Aetna Medicare |
$19,700.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,678.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,678.36
|
| Rate for Payer: BCBS MAPPO |
$18,942.69
|
| Rate for Payer: BCN Medicare Advantage |
$18,942.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,942.69
|
| Rate for Payer: Mclaren Medicare |
$18,942.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,889.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,784.09
|
| Rate for Payer: PACE Medicare |
$17,995.56
|
| Rate for Payer: PACE SWMI |
$18,942.69
|
| Rate for Payer: PHP Medicare Advantage |
$18,942.69
|
| Rate for Payer: Priority Health Medicare |
$18,942.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18,942.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,942.69
|
| Rate for Payer: UHC Medicare Advantage |
$18,942.69
|
| Rate for Payer: VA VA |
$18,942.69
|
|
|
MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS
|
Facility
|
IP
|
$17,892.00
|
|
|
Service Code
|
MSDRG 886
|
| Min. Negotiated Rate |
$13,597.92 |
| Max. Negotiated Rate |
$17,892.00 |
| Rate for Payer: Aetna Medicare |
$14,886.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,892.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,892.00
|
| Rate for Payer: BCBS MAPPO |
$14,313.60
|
| Rate for Payer: BCN Medicare Advantage |
$14,313.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,313.60
|
| Rate for Payer: Mclaren Medicare |
$14,313.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,029.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,460.64
|
| Rate for Payer: PACE Medicare |
$13,597.92
|
| Rate for Payer: PACE SWMI |
$14,313.60
|
| Rate for Payer: PHP Medicare Advantage |
$14,313.60
|
| Rate for Payer: Priority Health Medicare |
$14,313.60
|
| Rate for Payer: Railroad Medicare Medicare |
$14,313.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,313.60
|
| Rate for Payer: UHC Medicare Advantage |
$14,313.60
|
| Rate for Payer: VA VA |
$14,313.60
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC
|
Facility
|
IP
|
$12,749.12
|
|
|
Service Code
|
MSDRG 725
|
| Min. Negotiated Rate |
$9,689.33 |
| Max. Negotiated Rate |
$12,749.12 |
| Rate for Payer: Aetna Medicare |
$10,607.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,749.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,749.12
|
| Rate for Payer: BCBS MAPPO |
$10,199.30
|
| Rate for Payer: BCN Medicare Advantage |
$10,199.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,199.30
|
| Rate for Payer: Mclaren Medicare |
$10,199.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,709.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,729.19
|
| Rate for Payer: PACE Medicare |
$9,689.33
|
| Rate for Payer: PACE SWMI |
$10,199.30
|
| Rate for Payer: PHP Medicare Advantage |
$10,199.30
|
| Rate for Payer: Priority Health Medicare |
$10,199.30
|
| Rate for Payer: Railroad Medicare Medicare |
$10,199.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,199.30
|
| Rate for Payer: UHC Medicare Advantage |
$10,199.30
|
| Rate for Payer: VA VA |
$10,199.30
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC
|
Facility
|
IP
|
$7,757.44
|
|
|
Service Code
|
MSDRG 726
|
| Min. Negotiated Rate |
$5,895.65 |
| Max. Negotiated Rate |
$7,757.44 |
| Rate for Payer: Aetna Medicare |
$6,454.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,757.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,757.44
|
| Rate for Payer: BCBS MAPPO |
$6,205.95
|
| Rate for Payer: BCN Medicare Advantage |
$6,205.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,205.95
|
| Rate for Payer: Mclaren Medicare |
$6,205.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,516.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,136.84
|
| Rate for Payer: PACE Medicare |
$5,895.65
|
| Rate for Payer: PACE SWMI |
$6,205.95
|
| Rate for Payer: PHP Medicare Advantage |
$6,205.95
|
| Rate for Payer: Priority Health Medicare |
$6,205.95
|
| Rate for Payer: Railroad Medicare Medicare |
$6,205.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,205.95
|
| Rate for Payer: UHC Medicare Advantage |
$6,205.95
|
| Rate for Payer: VA VA |
$6,205.95
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$59,699.88
|
|
|
Service Code
|
MSDRG 461
|
| Min. Negotiated Rate |
$45,371.90 |
| Max. Negotiated Rate |
$59,699.88 |
| Rate for Payer: Aetna Medicare |
$49,670.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59,699.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59,699.88
|
| Rate for Payer: BCBS MAPPO |
$47,759.90
|
| Rate for Payer: BCN Medicare Advantage |
$47,759.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47,759.90
|
| Rate for Payer: Mclaren Medicare |
$47,759.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,147.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,923.89
|
| Rate for Payer: PACE Medicare |
$45,371.90
|
| Rate for Payer: PACE SWMI |
$47,759.90
|
| Rate for Payer: PHP Medicare Advantage |
$47,759.90
|
| Rate for Payer: Priority Health Medicare |
$47,759.90
|
| Rate for Payer: Railroad Medicare Medicare |
$47,759.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$47,759.90
|
| Rate for Payer: UHC Medicare Advantage |
$47,759.90
|
| Rate for Payer: VA VA |
$47,759.90
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$28,172.99
|
|
|
Service Code
|
MSDRG 462
|
| Min. Negotiated Rate |
$21,411.47 |
| Max. Negotiated Rate |
$28,172.99 |
| Rate for Payer: Aetna Medicare |
$23,439.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,172.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,172.99
|
| Rate for Payer: BCBS MAPPO |
$22,538.39
|
| Rate for Payer: BCN Medicare Advantage |
$22,538.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,538.39
|
| Rate for Payer: Mclaren Medicare |
$22,538.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,665.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,919.15
|
| Rate for Payer: PACE Medicare |
$21,411.47
|
| Rate for Payer: PACE SWMI |
$22,538.39
|
| Rate for Payer: PHP Medicare Advantage |
$22,538.39
|
| Rate for Payer: Priority Health Medicare |
$22,538.39
|
| Rate for Payer: Railroad Medicare Medicare |
$22,538.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,538.39
|
| Rate for Payer: UHC Medicare Advantage |
$22,538.39
|
| Rate for Payer: VA VA |
$22,538.39
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$20,781.84
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$15,794.20 |
| Max. Negotiated Rate |
$20,781.84 |
| Rate for Payer: Aetna Medicare |
$17,290.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,781.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,781.84
|
| Rate for Payer: BCBS MAPPO |
$16,625.47
|
| Rate for Payer: BCN Medicare Advantage |
$16,625.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,625.47
|
| Rate for Payer: Mclaren Medicare |
$16,625.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,456.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,119.29
|
| Rate for Payer: PACE Medicare |
$15,794.20
|
| Rate for Payer: PACE SWMI |
$16,625.47
|
| Rate for Payer: PHP Medicare Advantage |
$16,625.47
|
| Rate for Payer: Priority Health Medicare |
$16,625.47
|
| Rate for Payer: Railroad Medicare Medicare |
$16,625.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,625.47
|
| Rate for Payer: UHC Medicare Advantage |
$16,625.47
|
| Rate for Payer: VA VA |
$16,625.47
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$34,313.85
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$26,078.53 |
| Max. Negotiated Rate |
$34,313.85 |
| Rate for Payer: Aetna Medicare |
$28,549.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,313.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,313.85
|
| Rate for Payer: BCBS MAPPO |
$27,451.08
|
| Rate for Payer: BCN Medicare Advantage |
$27,451.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,451.08
|
| Rate for Payer: Mclaren Medicare |
$27,451.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,823.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,568.74
|
| Rate for Payer: PACE Medicare |
$26,078.53
|
| Rate for Payer: PACE SWMI |
$27,451.08
|
| Rate for Payer: PHP Medicare Advantage |
$27,451.08
|
| Rate for Payer: Priority Health Medicare |
$27,451.08
|
| Rate for Payer: Railroad Medicare Medicare |
$27,451.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,451.08
|
| Rate for Payer: UHC Medicare Advantage |
$27,451.08
|
| Rate for Payer: VA VA |
$27,451.08
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$15,528.12
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$11,801.38 |
| Max. Negotiated Rate |
$15,528.12 |
| Rate for Payer: Aetna Medicare |
$12,919.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,528.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,528.12
|
| Rate for Payer: BCBS MAPPO |
$12,422.50
|
| Rate for Payer: BCN Medicare Advantage |
$12,422.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,422.50
|
| Rate for Payer: Mclaren Medicare |
$12,422.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,043.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,285.88
|
| Rate for Payer: PACE Medicare |
$11,801.38
|
| Rate for Payer: PACE SWMI |
$12,422.50
|
| Rate for Payer: PHP Medicare Advantage |
$12,422.50
|
| Rate for Payer: Priority Health Medicare |
$12,422.50
|
| Rate for Payer: Railroad Medicare Medicare |
$12,422.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,422.50
|
| Rate for Payer: UHC Medicare Advantage |
$12,422.50
|
| Rate for Payer: VA VA |
$12,422.50
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$23,113.90
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$17,566.56 |
| Max. Negotiated Rate |
$23,113.90 |
| Rate for Payer: Aetna Medicare |
$19,230.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,113.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,113.90
|
| Rate for Payer: BCBS MAPPO |
$18,491.12
|
| Rate for Payer: BCN Medicare Advantage |
$18,491.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,491.12
|
| Rate for Payer: Mclaren Medicare |
$18,491.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,415.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,264.79
|
| Rate for Payer: PACE Medicare |
$17,566.56
|
| Rate for Payer: PACE SWMI |
$18,491.12
|
| Rate for Payer: PHP Medicare Advantage |
$18,491.12
|
| Rate for Payer: Priority Health Medicare |
$18,491.12
|
| Rate for Payer: Railroad Medicare Medicare |
$18,491.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,491.12
|
| Rate for Payer: UHC Medicare Advantage |
$18,491.12
|
| Rate for Payer: VA VA |
$18,491.12
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$33,713.74
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$25,622.44 |
| Max. Negotiated Rate |
$33,713.74 |
| Rate for Payer: Aetna Medicare |
$28,049.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,713.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,713.74
|
| Rate for Payer: BCBS MAPPO |
$26,970.99
|
| Rate for Payer: BCN Medicare Advantage |
$26,970.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,970.99
|
| Rate for Payer: Mclaren Medicare |
$26,970.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,319.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,016.64
|
| Rate for Payer: PACE Medicare |
$25,622.44
|
| Rate for Payer: PACE SWMI |
$26,970.99
|
| Rate for Payer: PHP Medicare Advantage |
$26,970.99
|
| Rate for Payer: Priority Health Medicare |
$26,970.99
|
| Rate for Payer: Railroad Medicare Medicare |
$26,970.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,970.99
|
| Rate for Payer: UHC Medicare Advantage |
$26,970.99
|
| Rate for Payer: VA VA |
$26,970.99
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$17,692.60
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$13,446.38 |
| Max. Negotiated Rate |
$17,692.60 |
| Rate for Payer: Aetna Medicare |
$14,720.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,692.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,692.60
|
| Rate for Payer: BCBS MAPPO |
$14,154.08
|
| Rate for Payer: BCN Medicare Advantage |
$14,154.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,154.08
|
| Rate for Payer: Mclaren Medicare |
$14,154.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,861.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,277.19
|
| Rate for Payer: PACE Medicare |
$13,446.38
|
| Rate for Payer: PACE SWMI |
$14,154.08
|
| Rate for Payer: PHP Medicare Advantage |
$14,154.08
|
| Rate for Payer: Priority Health Medicare |
$14,154.08
|
| Rate for Payer: Railroad Medicare Medicare |
$14,154.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,154.08
|
| Rate for Payer: UHC Medicare Advantage |
$14,154.08
|
| Rate for Payer: VA VA |
$14,154.08
|
|
|
MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
|
IP
|
$13,167.15
|
|
|
Service Code
|
MSDRG 553
|
| Min. Negotiated Rate |
$10,007.03 |
| Max. Negotiated Rate |
$13,167.15 |
| Rate for Payer: Aetna Medicare |
$10,955.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,167.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,167.15
|
| Rate for Payer: BCBS MAPPO |
$10,533.72
|
| Rate for Payer: BCN Medicare Advantage |
$10,533.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,533.72
|
| Rate for Payer: Mclaren Medicare |
$10,533.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,060.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,113.78
|
| Rate for Payer: PACE Medicare |
$10,007.03
|
| Rate for Payer: PACE SWMI |
$10,533.72
|
| Rate for Payer: PHP Medicare Advantage |
$10,533.72
|
| Rate for Payer: Priority Health Medicare |
$10,533.72
|
| Rate for Payer: Railroad Medicare Medicare |
$10,533.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,533.72
|
| Rate for Payer: UHC Medicare Advantage |
$10,533.72
|
| Rate for Payer: VA VA |
$10,533.72
|
|
|
MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
|
Facility
|
IP
|
$8,626.30
|
|
|
Service Code
|
MSDRG 554
|
| Min. Negotiated Rate |
$6,555.99 |
| Max. Negotiated Rate |
$8,626.30 |
| Rate for Payer: Aetna Medicare |
$7,177.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,626.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,626.30
|
| Rate for Payer: BCBS MAPPO |
$6,901.04
|
| Rate for Payer: BCN Medicare Advantage |
$6,901.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,901.04
|
| Rate for Payer: Mclaren Medicare |
$6,901.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,246.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,936.20
|
| Rate for Payer: PACE Medicare |
$6,555.99
|
| Rate for Payer: PACE SWMI |
$6,901.04
|
| Rate for Payer: PHP Medicare Advantage |
$6,901.04
|
| Rate for Payer: Priority Health Medicare |
$6,901.04
|
| Rate for Payer: Railroad Medicare Medicare |
$6,901.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,901.04
|
| Rate for Payer: UHC Medicare Advantage |
$6,901.04
|
| Rate for Payer: VA VA |
$6,901.04
|
|
