|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$13,785.59
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$10,477.05 |
| Max. Negotiated Rate |
$13,785.59 |
| Rate for Payer: Aetna Medicare |
$11,469.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,785.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,785.59
|
| Rate for Payer: BCBS MAPPO |
$11,028.47
|
| Rate for Payer: BCN Medicare Advantage |
$11,028.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,028.47
|
| Rate for Payer: Mclaren Medicare |
$11,028.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,579.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,682.74
|
| Rate for Payer: PACE Medicare |
$10,477.05
|
| Rate for Payer: PACE SWMI |
$11,028.47
|
| Rate for Payer: PHP Medicare Advantage |
$11,028.47
|
| Rate for Payer: Priority Health Medicare |
$11,028.47
|
| Rate for Payer: Railroad Medicare Medicare |
$11,028.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,028.47
|
| Rate for Payer: UHC Medicare Advantage |
$11,028.47
|
| Rate for Payer: VA VA |
$11,028.47
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
|
IP
|
$21,119.92
|
|
|
Service Code
|
MSDRG 412
|
| Min. Negotiated Rate |
$16,051.14 |
| Max. Negotiated Rate |
$21,119.92 |
| Rate for Payer: Aetna Medicare |
$17,571.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,119.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,119.92
|
| Rate for Payer: BCBS MAPPO |
$16,895.94
|
| Rate for Payer: BCN Medicare Advantage |
$16,895.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,895.94
|
| Rate for Payer: Mclaren Medicare |
$16,895.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,740.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,430.33
|
| Rate for Payer: PACE Medicare |
$16,051.14
|
| Rate for Payer: PACE SWMI |
$16,895.94
|
| Rate for Payer: PHP Medicare Advantage |
$16,895.94
|
| Rate for Payer: Priority Health Medicare |
$16,895.94
|
| Rate for Payer: Railroad Medicare Medicare |
$16,895.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,895.94
|
| Rate for Payer: UHC Medicare Advantage |
$16,895.94
|
| Rate for Payer: VA VA |
$16,895.94
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
|
IP
|
$26,945.80
|
|
|
Service Code
|
MSDRG 411
|
| Min. Negotiated Rate |
$20,478.81 |
| Max. Negotiated Rate |
$26,945.80 |
| Rate for Payer: Aetna Medicare |
$22,418.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,945.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,945.80
|
| Rate for Payer: BCBS MAPPO |
$21,556.64
|
| Rate for Payer: BCN Medicare Advantage |
$21,556.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,556.64
|
| Rate for Payer: Mclaren Medicare |
$21,556.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,634.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,790.14
|
| Rate for Payer: PACE Medicare |
$20,478.81
|
| Rate for Payer: PACE SWMI |
$21,556.64
|
| Rate for Payer: PHP Medicare Advantage |
$21,556.64
|
| Rate for Payer: Priority Health Medicare |
$21,556.64
|
| Rate for Payer: Railroad Medicare Medicare |
$21,556.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,556.64
|
| Rate for Payer: UHC Medicare Advantage |
$21,556.64
|
| Rate for Payer: VA VA |
$21,556.64
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$16,601.21
|
|
|
Service Code
|
MSDRG 413
|
| Min. Negotiated Rate |
$12,616.92 |
| Max. Negotiated Rate |
$16,601.21 |
| Rate for Payer: Aetna Medicare |
$13,812.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,601.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,601.21
|
| Rate for Payer: BCBS MAPPO |
$13,280.97
|
| Rate for Payer: BCN Medicare Advantage |
$13,280.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,280.97
|
| Rate for Payer: Mclaren Medicare |
$13,280.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,945.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,273.12
|
| Rate for Payer: PACE Medicare |
$12,616.92
|
| Rate for Payer: PACE SWMI |
$13,280.97
|
| Rate for Payer: PHP Medicare Advantage |
$13,280.97
|
| Rate for Payer: Priority Health Medicare |
$13,280.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13,280.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,280.97
|
| Rate for Payer: UHC Medicare Advantage |
$13,280.97
|
| Rate for Payer: VA VA |
$13,280.97
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
|
IP
|
$8,862.30
|
|
|
Service Code
|
MSDRG 191
|
| Min. Negotiated Rate |
$6,735.35 |
| Max. Negotiated Rate |
$8,862.30 |
| Rate for Payer: Aetna Medicare |
$7,373.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,862.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,862.30
|
| Rate for Payer: BCBS MAPPO |
$7,089.84
|
| Rate for Payer: BCN Medicare Advantage |
$7,089.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,089.84
|
| Rate for Payer: Mclaren Medicare |
$7,089.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,444.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,153.32
|
| Rate for Payer: PACE Medicare |
$6,735.35
|
| Rate for Payer: PACE SWMI |
$7,089.84
|
| Rate for Payer: PHP Medicare Advantage |
$7,089.84
|
| Rate for Payer: Priority Health Medicare |
$7,089.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7,089.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,089.84
|
| Rate for Payer: UHC Medicare Advantage |
$7,089.84
|
| Rate for Payer: VA VA |
$7,089.84
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
|
IP
|
$11,404.38
|
|
|
Service Code
|
MSDRG 190
|
| Min. Negotiated Rate |
$8,667.33 |
| Max. Negotiated Rate |
$11,404.38 |
| Rate for Payer: Aetna Medicare |
$9,488.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,404.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,404.38
|
| Rate for Payer: BCBS MAPPO |
$9,123.50
|
| Rate for Payer: BCN Medicare Advantage |
$9,123.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,123.50
|
| Rate for Payer: Mclaren Medicare |
$9,123.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,579.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,492.02
|
| Rate for Payer: PACE Medicare |
$8,667.33
|
| Rate for Payer: PACE SWMI |
$9,123.50
|
| Rate for Payer: PHP Medicare Advantage |
$9,123.50
|
| Rate for Payer: Priority Health Medicare |
$9,123.50
|
| Rate for Payer: Railroad Medicare Medicare |
$9,123.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,123.50
|
| Rate for Payer: UHC Medicare Advantage |
$9,123.50
|
| Rate for Payer: VA VA |
$9,123.50
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$6,821.14
|
|
|
Service Code
|
MSDRG 192
|
| Min. Negotiated Rate |
$5,184.06 |
| Max. Negotiated Rate |
$6,821.14 |
| Rate for Payer: Aetna Medicare |
$5,675.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,821.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,821.14
|
| Rate for Payer: BCBS MAPPO |
$5,456.91
|
| Rate for Payer: BCN Medicare Advantage |
$5,456.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,456.91
|
| Rate for Payer: Mclaren Medicare |
$5,456.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,729.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,275.45
|
| Rate for Payer: PACE Medicare |
$5,184.06
|
| Rate for Payer: PACE SWMI |
$5,456.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,456.91
|
| Rate for Payer: Priority Health Medicare |
$5,456.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5,456.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,456.91
|
| Rate for Payer: UHC Medicare Advantage |
$5,456.91
|
| Rate for Payer: VA VA |
$5,456.91
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$21,906.91
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$16,649.25 |
| Max. Negotiated Rate |
$21,906.91 |
| Rate for Payer: Aetna Medicare |
$18,226.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,906.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,906.91
|
| Rate for Payer: BCBS MAPPO |
$17,525.53
|
| Rate for Payer: BCN Medicare Advantage |
$17,525.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,525.53
|
| Rate for Payer: Mclaren Medicare |
$17,525.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,401.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,154.36
|
| Rate for Payer: PACE Medicare |
$16,649.25
|
| Rate for Payer: PACE SWMI |
$17,525.53
|
| Rate for Payer: PHP Medicare Advantage |
$17,525.53
|
| Rate for Payer: Priority Health Medicare |
$17,525.53
|
| Rate for Payer: Railroad Medicare Medicare |
$17,525.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,525.53
|
| Rate for Payer: UHC Medicare Advantage |
$17,525.53
|
| Rate for Payer: VA VA |
$17,525.53
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$11,083.61
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$8,423.55 |
| Max. Negotiated Rate |
$11,083.61 |
| Rate for Payer: Aetna Medicare |
$9,221.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,083.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,083.61
|
| Rate for Payer: BCBS MAPPO |
$8,866.89
|
| Rate for Payer: BCN Medicare Advantage |
$8,866.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,866.89
|
| Rate for Payer: Mclaren Medicare |
$8,866.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,310.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,196.92
|
| Rate for Payer: PACE Medicare |
$8,423.55
|
| Rate for Payer: PACE SWMI |
$8,866.89
|
| Rate for Payer: PHP Medicare Advantage |
$8,866.89
|
| Rate for Payer: Priority Health Medicare |
$8,866.89
|
| Rate for Payer: Railroad Medicare Medicare |
$8,866.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,866.89
|
| Rate for Payer: UHC Medicare Advantage |
$8,866.89
|
| Rate for Payer: VA VA |
$8,866.89
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$10,891.91
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$8,277.85 |
| Max. Negotiated Rate |
$10,891.91 |
| Rate for Payer: Aetna Medicare |
$9,062.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,891.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,891.91
|
| Rate for Payer: BCBS MAPPO |
$8,713.53
|
| Rate for Payer: BCN Medicare Advantage |
$8,713.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,713.53
|
| Rate for Payer: Mclaren Medicare |
$8,713.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,149.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,020.56
|
| Rate for Payer: PACE Medicare |
$8,277.85
|
| Rate for Payer: PACE SWMI |
$8,713.53
|
| Rate for Payer: PHP Medicare Advantage |
$8,713.53
|
| Rate for Payer: Priority Health Medicare |
$8,713.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8,713.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,713.53
|
| Rate for Payer: UHC Medicare Advantage |
$8,713.53
|
| Rate for Payer: VA VA |
$8,713.53
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$19,458.28
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$14,788.29 |
| Max. Negotiated Rate |
$19,458.28 |
| Rate for Payer: Aetna Medicare |
$16,189.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,458.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,458.28
|
| Rate for Payer: BCBS MAPPO |
$15,566.62
|
| Rate for Payer: BCN Medicare Advantage |
$15,566.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,566.62
|
| Rate for Payer: Mclaren Medicare |
$15,566.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,344.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,901.61
|
| Rate for Payer: PACE Medicare |
$14,788.29
|
| Rate for Payer: PACE SWMI |
$15,566.62
|
| Rate for Payer: PHP Medicare Advantage |
$15,566.62
|
| Rate for Payer: Priority Health Medicare |
$15,566.62
|
| Rate for Payer: Railroad Medicare Medicare |
$15,566.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,566.62
|
| Rate for Payer: UHC Medicare Advantage |
$15,566.62
|
| Rate for Payer: VA VA |
$15,566.62
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$7,296.02
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$5,544.98 |
| Max. Negotiated Rate |
$7,296.02 |
| Rate for Payer: Aetna Medicare |
$6,070.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,296.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,296.02
|
| Rate for Payer: BCBS MAPPO |
$5,836.82
|
| Rate for Payer: BCN Medicare Advantage |
$5,836.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,836.82
|
| Rate for Payer: Mclaren Medicare |
$5,836.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,128.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,712.34
|
| Rate for Payer: PACE Medicare |
$5,544.98
|
| Rate for Payer: PACE SWMI |
$5,836.82
|
| Rate for Payer: PHP Medicare Advantage |
$5,836.82
|
| Rate for Payer: Priority Health Medicare |
$5,836.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5,836.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,836.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,836.82
|
| Rate for Payer: VA VA |
$5,836.82
|
|
|
MS-DRG 42.00: COAGULATION DISORDERS
|
Facility
|
IP
|
$15,498.29
|
|
|
Service Code
|
MSDRG 813
|
| Min. Negotiated Rate |
$11,778.70 |
| Max. Negotiated Rate |
$15,498.29 |
| Rate for Payer: Aetna Medicare |
$12,894.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,498.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,498.29
|
| Rate for Payer: BCBS MAPPO |
$12,398.63
|
| Rate for Payer: BCN Medicare Advantage |
$12,398.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,398.63
|
| Rate for Payer: Mclaren Medicare |
$12,398.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,018.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,258.42
|
| Rate for Payer: PACE Medicare |
$11,778.70
|
| Rate for Payer: PACE SWMI |
$12,398.63
|
| Rate for Payer: PHP Medicare Advantage |
$12,398.63
|
| Rate for Payer: Priority Health Medicare |
$12,398.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12,398.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,398.63
|
| Rate for Payer: UHC Medicare Advantage |
$12,398.63
|
| Rate for Payer: VA VA |
$12,398.63
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$80,929.40
|
|
|
Service Code
|
MSDRG 429
|
| Min. Negotiated Rate |
$61,506.34 |
| Max. Negotiated Rate |
$80,929.40 |
| Rate for Payer: Aetna Medicare |
$67,333.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80,929.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80,929.40
|
| Rate for Payer: BCBS MAPPO |
$64,743.52
|
| Rate for Payer: BCN Medicare Advantage |
$64,743.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64,743.52
|
| Rate for Payer: Mclaren Medicare |
$64,743.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67,980.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74,455.05
|
| Rate for Payer: PACE Medicare |
$61,506.34
|
| Rate for Payer: PACE SWMI |
$64,743.52
|
| Rate for Payer: PHP Medicare Advantage |
$64,743.52
|
| Rate for Payer: Priority Health Medicare |
$64,743.52
|
| Rate for Payer: Railroad Medicare Medicare |
$64,743.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$64,743.52
|
| Rate for Payer: UHC Medicare Advantage |
$64,743.52
|
| Rate for Payer: VA VA |
$64,743.52
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
|
Facility
|
IP
|
$53,282.56
|
|
|
Service Code
|
MSDRG 430
|
| Min. Negotiated Rate |
$40,494.75 |
| Max. Negotiated Rate |
$53,282.56 |
| Rate for Payer: Aetna Medicare |
$44,331.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53,282.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53,282.56
|
| Rate for Payer: BCBS MAPPO |
$42,626.05
|
| Rate for Payer: BCN Medicare Advantage |
$42,626.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42,626.05
|
| Rate for Payer: Mclaren Medicare |
$42,626.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,757.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,019.96
|
| Rate for Payer: PACE Medicare |
$40,494.75
|
| Rate for Payer: PACE SWMI |
$42,626.05
|
| Rate for Payer: PHP Medicare Advantage |
$42,626.05
|
| Rate for Payer: Priority Health Medicare |
$42,626.05
|
| Rate for Payer: Railroad Medicare Medicare |
$42,626.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$42,626.05
|
| Rate for Payer: UHC Medicare Advantage |
$42,626.05
|
| Rate for Payer: VA VA |
$42,626.05
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$11,077.83
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$8,419.15 |
| Max. Negotiated Rate |
$11,077.83 |
| Rate for Payer: Aetna Medicare |
$9,216.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,077.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,077.83
|
| Rate for Payer: BCBS MAPPO |
$8,862.26
|
| Rate for Payer: BCN Medicare Advantage |
$8,862.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,862.26
|
| Rate for Payer: Mclaren Medicare |
$8,862.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,305.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,191.60
|
| Rate for Payer: PACE Medicare |
$8,419.15
|
| Rate for Payer: PACE SWMI |
$8,862.26
|
| Rate for Payer: PHP Medicare Advantage |
$8,862.26
|
| Rate for Payer: Priority Health Medicare |
$8,862.26
|
| Rate for Payer: Railroad Medicare Medicare |
$8,862.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,862.26
|
| Rate for Payer: UHC Medicare Advantage |
$8,862.26
|
| Rate for Payer: VA VA |
$8,862.26
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$19,123.08
|
|
|
Service Code
|
MSDRG 380
|
| Min. Negotiated Rate |
$14,533.54 |
| Max. Negotiated Rate |
$19,123.08 |
| Rate for Payer: Aetna Medicare |
$15,910.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,123.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,123.08
|
| Rate for Payer: BCBS MAPPO |
$15,298.46
|
| Rate for Payer: BCN Medicare Advantage |
$15,298.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,298.46
|
| Rate for Payer: Mclaren Medicare |
$15,298.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,063.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,593.23
|
| Rate for Payer: PACE Medicare |
$14,533.54
|
| Rate for Payer: PACE SWMI |
$15,298.46
|
| Rate for Payer: PHP Medicare Advantage |
$15,298.46
|
| Rate for Payer: Priority Health Medicare |
$15,298.46
|
| Rate for Payer: Railroad Medicare Medicare |
$15,298.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,298.46
|
| Rate for Payer: UHC Medicare Advantage |
$15,298.46
|
| Rate for Payer: VA VA |
$15,298.46
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
|
IP
|
$7,804.61
|
|
|
Service Code
|
MSDRG 382
|
| Min. Negotiated Rate |
$5,931.51 |
| Max. Negotiated Rate |
$7,804.61 |
| Rate for Payer: Aetna Medicare |
$6,493.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,804.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,804.61
|
| Rate for Payer: BCBS MAPPO |
$6,243.69
|
| Rate for Payer: BCN Medicare Advantage |
$6,243.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,243.69
|
| Rate for Payer: Mclaren Medicare |
$6,243.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,555.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,180.24
|
| Rate for Payer: PACE Medicare |
$5,931.51
|
| Rate for Payer: PACE SWMI |
$6,243.69
|
| Rate for Payer: PHP Medicare Advantage |
$6,243.69
|
| Rate for Payer: Priority Health Medicare |
$6,243.69
|
| Rate for Payer: Railroad Medicare Medicare |
$6,243.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,243.69
|
| Rate for Payer: UHC Medicare Advantage |
$6,243.69
|
| Rate for Payer: VA VA |
$6,243.69
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
|
IP
|
$10,372.73
|
|
|
Service Code
|
MSDRG 920
|
| Min. Negotiated Rate |
$7,883.27 |
| Max. Negotiated Rate |
$10,372.73 |
| Rate for Payer: Aetna Medicare |
$8,630.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,372.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,372.73
|
| Rate for Payer: BCBS MAPPO |
$8,298.18
|
| Rate for Payer: BCN Medicare Advantage |
$8,298.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,298.18
|
| Rate for Payer: Mclaren Medicare |
$8,298.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,713.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,542.91
|
| Rate for Payer: PACE Medicare |
$7,883.27
|
| Rate for Payer: PACE SWMI |
$8,298.18
|
| Rate for Payer: PHP Medicare Advantage |
$8,298.18
|
| Rate for Payer: Priority Health Medicare |
$8,298.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8,298.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,298.18
|
| Rate for Payer: UHC Medicare Advantage |
$8,298.18
|
| Rate for Payer: VA VA |
$8,298.18
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
|
IP
|
$18,153.04
|
|
|
Service Code
|
MSDRG 919
|
| Min. Negotiated Rate |
$13,796.31 |
| Max. Negotiated Rate |
$18,153.04 |
| Rate for Payer: Aetna Medicare |
$15,103.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,153.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,153.04
|
| Rate for Payer: BCBS MAPPO |
$14,522.43
|
| Rate for Payer: BCN Medicare Advantage |
$14,522.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,522.43
|
| Rate for Payer: Mclaren Medicare |
$14,522.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,248.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,700.79
|
| Rate for Payer: PACE Medicare |
$13,796.31
|
| Rate for Payer: PACE SWMI |
$14,522.43
|
| Rate for Payer: PHP Medicare Advantage |
$14,522.43
|
| Rate for Payer: Priority Health Medicare |
$14,522.43
|
| Rate for Payer: Railroad Medicare Medicare |
$14,522.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,522.43
|
| Rate for Payer: UHC Medicare Advantage |
$14,522.43
|
| Rate for Payer: VA VA |
$14,522.43
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$7,211.27
|
|
|
Service Code
|
MSDRG 921
|
| Min. Negotiated Rate |
$5,480.57 |
| Max. Negotiated Rate |
$7,211.27 |
| Rate for Payer: Aetna Medicare |
$5,999.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,211.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,211.27
|
| Rate for Payer: BCBS MAPPO |
$5,769.02
|
| Rate for Payer: BCN Medicare Advantage |
$5,769.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,769.02
|
| Rate for Payer: Mclaren Medicare |
$5,769.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,057.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,634.37
|
| Rate for Payer: PACE Medicare |
$5,480.57
|
| Rate for Payer: PACE SWMI |
$5,769.02
|
| Rate for Payer: PHP Medicare Advantage |
$5,769.02
|
| Rate for Payer: Priority Health Medicare |
$5,769.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5,769.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,769.02
|
| Rate for Payer: UHC Medicare Advantage |
$5,769.02
|
| Rate for Payer: VA VA |
$5,769.02
|
|
|
MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$105,524.57
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$80,198.68 |
| Max. Negotiated Rate |
$105,524.57 |
| Rate for Payer: Aetna Medicare |
$87,796.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105,524.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105,524.57
|
| Rate for Payer: BCBS MAPPO |
$84,419.66
|
| Rate for Payer: BCN Medicare Advantage |
$84,419.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84,419.66
|
| Rate for Payer: Mclaren Medicare |
$84,419.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88,640.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97,082.61
|
| Rate for Payer: PACE Medicare |
$80,198.68
|
| Rate for Payer: PACE SWMI |
$84,419.66
|
| Rate for Payer: PHP Medicare Advantage |
$84,419.66
|
| Rate for Payer: Priority Health Medicare |
$84,419.66
|
| Rate for Payer: Railroad Medicare Medicare |
$84,419.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$84,419.66
|
| Rate for Payer: UHC Medicare Advantage |
$84,419.66
|
| Rate for Payer: VA VA |
$84,419.66
|
|
|
MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION
|
Facility
|
IP
|
$60,178.64
|
|
|
Service Code
|
MSDRG 317
|
| Min. Negotiated Rate |
$45,735.76 |
| Max. Negotiated Rate |
$60,178.64 |
| Rate for Payer: Aetna Medicare |
$50,068.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60,178.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60,178.64
|
| Rate for Payer: BCBS MAPPO |
$48,142.91
|
| Rate for Payer: BCN Medicare Advantage |
$48,142.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48,142.91
|
| Rate for Payer: Mclaren Medicare |
$48,142.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,550.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,364.35
|
| Rate for Payer: PACE Medicare |
$45,735.76
|
| Rate for Payer: PACE SWMI |
$48,142.91
|
| Rate for Payer: PHP Medicare Advantage |
$48,142.91
|
| Rate for Payer: Priority Health Medicare |
$48,142.91
|
| Rate for Payer: Railroad Medicare Medicare |
$48,142.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$48,142.91
|
| Rate for Payer: UHC Medicare Advantage |
$48,142.91
|
| Rate for Payer: VA VA |
$48,142.91
|
|
|
MS-DRG 42.00: CONCUSSION WITH CC
|
Facility
|
IP
|
$10,914.08
|
|
|
Service Code
|
MSDRG 089
|
| Min. Negotiated Rate |
$8,294.70 |
| Max. Negotiated Rate |
$10,914.08 |
| Rate for Payer: Aetna Medicare |
$9,080.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,914.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,914.08
|
| Rate for Payer: BCBS MAPPO |
$8,731.26
|
| Rate for Payer: BCN Medicare Advantage |
$8,731.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,731.26
|
| Rate for Payer: Mclaren Medicare |
$8,731.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,167.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,040.95
|
| Rate for Payer: PACE Medicare |
$8,294.70
|
| Rate for Payer: PACE SWMI |
$8,731.26
|
| Rate for Payer: PHP Medicare Advantage |
$8,731.26
|
| Rate for Payer: Priority Health Medicare |
$8,731.26
|
| Rate for Payer: Railroad Medicare Medicare |
$8,731.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,731.26
|
| Rate for Payer: UHC Medicare Advantage |
$8,731.26
|
| Rate for Payer: VA VA |
$8,731.26
|
|
|
MS-DRG 42.00: CONCUSSION WITH MCC
|
Facility
|
IP
|
$14,175.73
|
|
|
Service Code
|
MSDRG 088
|
| Min. Negotiated Rate |
$10,773.55 |
| Max. Negotiated Rate |
$14,175.73 |
| Rate for Payer: Aetna Medicare |
$11,794.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,175.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,175.73
|
| Rate for Payer: BCBS MAPPO |
$11,340.58
|
| Rate for Payer: BCN Medicare Advantage |
$11,340.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,340.58
|
| Rate for Payer: Mclaren Medicare |
$11,340.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,907.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,041.67
|
| Rate for Payer: PACE Medicare |
$10,773.55
|
| Rate for Payer: PACE SWMI |
$11,340.58
|
| Rate for Payer: PHP Medicare Advantage |
$11,340.58
|
| Rate for Payer: Priority Health Medicare |
$11,340.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11,340.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,340.58
|
| Rate for Payer: UHC Medicare Advantage |
$11,340.58
|
| Rate for Payer: VA VA |
$11,340.58
|
|
