|
MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$8,299.75
|
|
|
Service Code
|
MSDRG 148
|
| Min. Negotiated Rate |
$6,307.81 |
| Max. Negotiated Rate |
$8,299.75 |
| Rate for Payer: Aetna Medicare |
$6,905.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,299.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,299.75
|
| Rate for Payer: BCBS MAPPO |
$6,639.80
|
| Rate for Payer: BCN Medicare Advantage |
$6,639.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,639.80
|
| Rate for Payer: Mclaren Medicare |
$6,639.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,971.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,635.77
|
| Rate for Payer: PACE Medicare |
$6,307.81
|
| Rate for Payer: PACE SWMI |
$6,639.80
|
| Rate for Payer: PHP Medicare Advantage |
$6,639.80
|
| Rate for Payer: Priority Health Medicare |
$6,639.80
|
| Rate for Payer: Railroad Medicare Medicare |
$6,639.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,639.80
|
| Rate for Payer: UHC Medicare Advantage |
$6,639.80
|
| Rate for Payer: VA VA |
$6,639.80
|
|
|
MS-DRG 42.00: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$207,031.15
|
|
|
Service Code
|
MSDRG 003
|
| Min. Negotiated Rate |
$157,343.67 |
| Max. Negotiated Rate |
$207,031.15 |
| Rate for Payer: Aetna Medicare |
$172,249.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207,031.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207,031.15
|
| Rate for Payer: BCBS MAPPO |
$165,624.92
|
| Rate for Payer: BCN Medicare Advantage |
$165,624.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165,624.92
|
| Rate for Payer: Mclaren Medicare |
$165,624.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173,906.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190,468.66
|
| Rate for Payer: PACE Medicare |
$157,343.67
|
| Rate for Payer: PACE SWMI |
$165,624.92
|
| Rate for Payer: PHP Medicare Advantage |
$165,624.92
|
| Rate for Payer: Priority Health Medicare |
$165,624.92
|
| Rate for Payer: Railroad Medicare Medicare |
$165,624.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$165,624.92
|
| Rate for Payer: UHC Medicare Advantage |
$165,624.92
|
| Rate for Payer: VA VA |
$165,624.92
|
|
|
MS-DRG 42.00: ENDOCRINE DISORDERS WITH CC
|
Facility
|
IP
|
$10,541.30
|
|
|
Service Code
|
MSDRG 644
|
| Min. Negotiated Rate |
$8,011.39 |
| Max. Negotiated Rate |
$10,541.30 |
| Rate for Payer: Aetna Medicare |
$8,770.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,541.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,541.30
|
| Rate for Payer: BCBS MAPPO |
$8,433.04
|
| Rate for Payer: BCN Medicare Advantage |
$8,433.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,433.04
|
| Rate for Payer: Mclaren Medicare |
$8,433.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,854.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,698.00
|
| Rate for Payer: PACE Medicare |
$8,011.39
|
| Rate for Payer: PACE SWMI |
$8,433.04
|
| Rate for Payer: PHP Medicare Advantage |
$8,433.04
|
| Rate for Payer: Priority Health Medicare |
$8,433.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8,433.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,433.04
|
| Rate for Payer: UHC Medicare Advantage |
$8,433.04
|
| Rate for Payer: VA VA |
$8,433.04
|
|
|
MS-DRG 42.00: ENDOCRINE DISORDERS WITH MCC
|
Facility
|
IP
|
$16,551.14
|
|
|
Service Code
|
MSDRG 643
|
| Min. Negotiated Rate |
$12,578.86 |
| Max. Negotiated Rate |
$16,551.14 |
| Rate for Payer: Aetna Medicare |
$13,770.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,551.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,551.14
|
| Rate for Payer: BCBS MAPPO |
$13,240.91
|
| Rate for Payer: BCN Medicare Advantage |
$13,240.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,240.91
|
| Rate for Payer: Mclaren Medicare |
$13,240.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,902.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,227.05
|
| Rate for Payer: PACE Medicare |
$12,578.86
|
| Rate for Payer: PACE SWMI |
$13,240.91
|
| Rate for Payer: PHP Medicare Advantage |
$13,240.91
|
| Rate for Payer: Priority Health Medicare |
$13,240.91
|
| Rate for Payer: Railroad Medicare Medicare |
$13,240.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,240.91
|
| Rate for Payer: UHC Medicare Advantage |
$13,240.91
|
| Rate for Payer: VA VA |
$13,240.91
|
|
|
MS-DRG 42.00: ENDOCRINE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,087.82
|
|
|
Service Code
|
MSDRG 645
|
| Min. Negotiated Rate |
$6,146.75 |
| Max. Negotiated Rate |
$8,087.82 |
| Rate for Payer: Aetna Medicare |
$6,729.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,087.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,087.82
|
| Rate for Payer: BCBS MAPPO |
$6,470.26
|
| Rate for Payer: BCN Medicare Advantage |
$6,470.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,470.26
|
| Rate for Payer: Mclaren Medicare |
$6,470.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,793.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,440.80
|
| Rate for Payer: PACE Medicare |
$6,146.75
|
| Rate for Payer: PACE SWMI |
$6,470.26
|
| Rate for Payer: PHP Medicare Advantage |
$6,470.26
|
| Rate for Payer: Priority Health Medicare |
$6,470.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6,470.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,470.26
|
| Rate for Payer: UHC Medicare Advantage |
$6,470.26
|
| Rate for Payer: VA VA |
$6,470.26
|
|
|
MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$58,294.46
|
|
|
Service Code
|
MSDRG 266
|
| Min. Negotiated Rate |
$44,303.79 |
| Max. Negotiated Rate |
$58,294.46 |
| Rate for Payer: Aetna Medicare |
$48,500.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,294.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,294.46
|
| Rate for Payer: BCBS MAPPO |
$46,635.57
|
| Rate for Payer: BCN Medicare Advantage |
$46,635.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,635.57
|
| Rate for Payer: Mclaren Medicare |
$46,635.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48,967.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53,630.91
|
| Rate for Payer: PACE Medicare |
$44,303.79
|
| Rate for Payer: PACE SWMI |
$46,635.57
|
| Rate for Payer: PHP Medicare Advantage |
$46,635.57
|
| Rate for Payer: Priority Health Medicare |
$46,635.57
|
| Rate for Payer: Railroad Medicare Medicare |
$46,635.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,635.57
|
| Rate for Payer: UHC Medicare Advantage |
$46,635.57
|
| Rate for Payer: VA VA |
$46,635.57
|
|
|
MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$45,905.82
|
|
|
Service Code
|
MSDRG 267
|
| Min. Negotiated Rate |
$34,888.43 |
| Max. Negotiated Rate |
$45,905.82 |
| Rate for Payer: Aetna Medicare |
$38,193.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,905.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,905.82
|
| Rate for Payer: BCBS MAPPO |
$36,724.66
|
| Rate for Payer: BCN Medicare Advantage |
$36,724.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,724.66
|
| Rate for Payer: Mclaren Medicare |
$36,724.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,560.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,233.36
|
| Rate for Payer: PACE Medicare |
$34,888.43
|
| Rate for Payer: PACE SWMI |
$36,724.66
|
| Rate for Payer: PHP Medicare Advantage |
$36,724.66
|
| Rate for Payer: Priority Health Medicare |
$36,724.66
|
| Rate for Payer: Railroad Medicare Medicare |
$36,724.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,724.66
|
| Rate for Payer: UHC Medicare Advantage |
$36,724.66
|
| Rate for Payer: VA VA |
$36,724.66
|
|
|
MS-DRG 42.00: EPISTAXIS WITH MCC
|
Facility
|
IP
|
$13,901.17
|
|
|
Service Code
|
MSDRG 150
|
| Min. Negotiated Rate |
$10,564.89 |
| Max. Negotiated Rate |
$13,901.17 |
| Rate for Payer: Aetna Medicare |
$11,565.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,901.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,901.17
|
| Rate for Payer: BCBS MAPPO |
$11,120.94
|
| Rate for Payer: BCN Medicare Advantage |
$11,120.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,120.94
|
| Rate for Payer: Mclaren Medicare |
$11,120.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,676.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,789.08
|
| Rate for Payer: PACE Medicare |
$10,564.89
|
| Rate for Payer: PACE SWMI |
$11,120.94
|
| Rate for Payer: PHP Medicare Advantage |
$11,120.94
|
| Rate for Payer: Priority Health Medicare |
$11,120.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11,120.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,120.94
|
| Rate for Payer: UHC Medicare Advantage |
$11,120.94
|
| Rate for Payer: VA VA |
$11,120.94
|
|
|
MS-DRG 42.00: EPISTAXIS WITHOUT MCC
|
Facility
|
IP
|
$7,888.44
|
|
|
Service Code
|
MSDRG 151
|
| Min. Negotiated Rate |
$5,995.21 |
| Max. Negotiated Rate |
$7,888.44 |
| Rate for Payer: Aetna Medicare |
$6,563.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,888.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,888.44
|
| Rate for Payer: BCBS MAPPO |
$6,310.75
|
| Rate for Payer: BCN Medicare Advantage |
$6,310.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,310.75
|
| Rate for Payer: Mclaren Medicare |
$6,310.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,626.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,257.36
|
| Rate for Payer: PACE Medicare |
$5,995.21
|
| Rate for Payer: PACE SWMI |
$6,310.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,310.75
|
| Rate for Payer: Priority Health Medicare |
$6,310.75
|
| Rate for Payer: Railroad Medicare Medicare |
$6,310.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,310.75
|
| Rate for Payer: UHC Medicare Advantage |
$6,310.75
|
| Rate for Payer: VA VA |
$6,310.75
|
|
|
MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
|
IP
|
$12,960.05
|
|
|
Service Code
|
MSDRG 391
|
| Min. Negotiated Rate |
$9,849.64 |
| Max. Negotiated Rate |
$12,960.05 |
| Rate for Payer: Aetna Medicare |
$10,782.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,960.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,960.05
|
| Rate for Payer: BCBS MAPPO |
$10,368.04
|
| Rate for Payer: BCN Medicare Advantage |
$10,368.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,368.04
|
| Rate for Payer: Mclaren Medicare |
$10,368.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,886.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,923.25
|
| Rate for Payer: PACE Medicare |
$9,849.64
|
| Rate for Payer: PACE SWMI |
$10,368.04
|
| Rate for Payer: PHP Medicare Advantage |
$10,368.04
|
| Rate for Payer: Priority Health Medicare |
$10,368.04
|
| Rate for Payer: Railroad Medicare Medicare |
$10,368.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,368.04
|
| Rate for Payer: UHC Medicare Advantage |
$10,368.04
|
| Rate for Payer: VA VA |
$10,368.04
|
|
|
MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$8,103.24
|
|
|
Service Code
|
MSDRG 392
|
| Min. Negotiated Rate |
$6,158.46 |
| Max. Negotiated Rate |
$8,103.24 |
| Rate for Payer: Aetna Medicare |
$6,741.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,103.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,103.24
|
| Rate for Payer: BCBS MAPPO |
$6,482.59
|
| Rate for Payer: BCN Medicare Advantage |
$6,482.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,482.59
|
| Rate for Payer: Mclaren Medicare |
$6,482.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,806.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,454.98
|
| Rate for Payer: PACE Medicare |
$6,158.46
|
| Rate for Payer: PACE SWMI |
$6,482.59
|
| Rate for Payer: PHP Medicare Advantage |
$6,482.59
|
| Rate for Payer: Priority Health Medicare |
$6,482.59
|
| Rate for Payer: Railroad Medicare Medicare |
$6,482.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,482.59
|
| Rate for Payer: UHC Medicare Advantage |
$6,482.59
|
| Rate for Payer: VA VA |
$6,482.59
|
|
|
MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$42,266.61
|
|
|
Service Code
|
MSDRG 933
|
| Min. Negotiated Rate |
$32,122.63 |
| Max. Negotiated Rate |
$42,266.61 |
| Rate for Payer: Aetna Medicare |
$35,165.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,266.61
|
| Rate for Payer: BCBS MAPPO |
$33,813.29
|
| Rate for Payer: BCN Medicare Advantage |
$33,813.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,813.29
|
| Rate for Payer: Mclaren Medicare |
$33,813.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,503.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,885.28
|
| Rate for Payer: PACE Medicare |
$32,122.63
|
| Rate for Payer: PACE SWMI |
$33,813.29
|
| Rate for Payer: PHP Medicare Advantage |
$33,813.29
|
| Rate for Payer: Priority Health Medicare |
$33,813.29
|
| Rate for Payer: Railroad Medicare Medicare |
$33,813.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$33,813.29
|
| Rate for Payer: UHC Medicare Advantage |
$33,813.29
|
| Rate for Payer: VA VA |
$33,813.29
|
|
|
MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT
|
Facility
|
IP
|
$229,101.60
|
|
|
Service Code
|
MSDRG 927
|
| Min. Negotiated Rate |
$174,117.22 |
| Max. Negotiated Rate |
$229,101.60 |
| Rate for Payer: Aetna Medicare |
$190,612.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229,101.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229,101.60
|
| Rate for Payer: BCBS MAPPO |
$183,281.28
|
| Rate for Payer: BCN Medicare Advantage |
$183,281.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183,281.28
|
| Rate for Payer: Mclaren Medicare |
$183,281.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192,445.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210,773.47
|
| Rate for Payer: PACE Medicare |
$174,117.22
|
| Rate for Payer: PACE SWMI |
$183,281.28
|
| Rate for Payer: PHP Medicare Advantage |
$183,281.28
|
| Rate for Payer: Priority Health Medicare |
$183,281.28
|
| Rate for Payer: Railroad Medicare Medicare |
$183,281.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$183,281.28
|
| Rate for Payer: UHC Medicare Advantage |
$183,281.28
|
| Rate for Payer: VA VA |
$183,281.28
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$24,170.60
|
|
|
Service Code
|
MSDRG 982
|
| Min. Negotiated Rate |
$18,369.66 |
| Max. Negotiated Rate |
$24,170.60 |
| Rate for Payer: Aetna Medicare |
$20,109.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,170.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,170.60
|
| Rate for Payer: BCBS MAPPO |
$19,336.48
|
| Rate for Payer: BCN Medicare Advantage |
$19,336.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,336.48
|
| Rate for Payer: Mclaren Medicare |
$19,336.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,303.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,236.95
|
| Rate for Payer: PACE Medicare |
$18,369.66
|
| Rate for Payer: PACE SWMI |
$19,336.48
|
| Rate for Payer: PHP Medicare Advantage |
$19,336.48
|
| Rate for Payer: Priority Health Medicare |
$19,336.48
|
| Rate for Payer: Railroad Medicare Medicare |
$19,336.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,336.48
|
| Rate for Payer: UHC Medicare Advantage |
$19,336.48
|
| Rate for Payer: VA VA |
$19,336.48
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$46,379.76
|
|
|
Service Code
|
MSDRG 981
|
| Min. Negotiated Rate |
$35,248.62 |
| Max. Negotiated Rate |
$46,379.76 |
| Rate for Payer: Aetna Medicare |
$38,587.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46,379.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46,379.76
|
| Rate for Payer: BCBS MAPPO |
$37,103.81
|
| Rate for Payer: BCN Medicare Advantage |
$37,103.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37,103.81
|
| Rate for Payer: Mclaren Medicare |
$37,103.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,959.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,669.38
|
| Rate for Payer: PACE Medicare |
$35,248.62
|
| Rate for Payer: PACE SWMI |
$37,103.81
|
| Rate for Payer: PHP Medicare Advantage |
$37,103.81
|
| Rate for Payer: Priority Health Medicare |
$37,103.81
|
| Rate for Payer: Railroad Medicare Medicare |
$37,103.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$37,103.81
|
| Rate for Payer: UHC Medicare Advantage |
$37,103.81
|
| Rate for Payer: VA VA |
$37,103.81
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$16,656.12
|
|
|
Service Code
|
MSDRG 983
|
| Min. Negotiated Rate |
$12,658.66 |
| Max. Negotiated Rate |
$16,656.12 |
| Rate for Payer: Aetna Medicare |
$13,857.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,656.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,656.12
|
| Rate for Payer: BCBS MAPPO |
$13,324.90
|
| Rate for Payer: BCN Medicare Advantage |
$13,324.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,324.90
|
| Rate for Payer: Mclaren Medicare |
$13,324.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,991.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,323.64
|
| Rate for Payer: PACE Medicare |
$12,658.66
|
| Rate for Payer: PACE SWMI |
$13,324.90
|
| Rate for Payer: PHP Medicare Advantage |
$13,324.90
|
| Rate for Payer: Priority Health Medicare |
$13,324.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13,324.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,324.90
|
| Rate for Payer: UHC Medicare Advantage |
$13,324.90
|
| Rate for Payer: VA VA |
$13,324.90
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$16,108.01
|
|
|
Service Code
|
MSDRG 038
|
| Min. Negotiated Rate |
$12,242.09 |
| Max. Negotiated Rate |
$16,108.01 |
| Rate for Payer: Aetna Medicare |
$13,401.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,108.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,108.01
|
| Rate for Payer: BCBS MAPPO |
$12,886.41
|
| Rate for Payer: BCN Medicare Advantage |
$12,886.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,886.41
|
| Rate for Payer: Mclaren Medicare |
$12,886.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,530.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,819.37
|
| Rate for Payer: PACE Medicare |
$12,242.09
|
| Rate for Payer: PACE SWMI |
$12,886.41
|
| Rate for Payer: PHP Medicare Advantage |
$12,886.41
|
| Rate for Payer: Priority Health Medicare |
$12,886.41
|
| Rate for Payer: Railroad Medicare Medicare |
$12,886.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,886.41
|
| Rate for Payer: UHC Medicare Advantage |
$12,886.41
|
| Rate for Payer: VA VA |
$12,886.41
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$32,576.09
|
|
|
Service Code
|
MSDRG 037
|
| Min. Negotiated Rate |
$24,757.83 |
| Max. Negotiated Rate |
$32,576.09 |
| Rate for Payer: Aetna Medicare |
$27,103.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,576.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,576.09
|
| Rate for Payer: BCBS MAPPO |
$26,060.87
|
| Rate for Payer: BCN Medicare Advantage |
$26,060.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,060.87
|
| Rate for Payer: Mclaren Medicare |
$26,060.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,363.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,970.00
|
| Rate for Payer: PACE Medicare |
$24,757.83
|
| Rate for Payer: PACE SWMI |
$26,060.87
|
| Rate for Payer: PHP Medicare Advantage |
$26,060.87
|
| Rate for Payer: Priority Health Medicare |
$26,060.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26,060.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,060.87
|
| Rate for Payer: UHC Medicare Advantage |
$26,060.87
|
| Rate for Payer: VA VA |
$26,060.87
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$11,550.79
|
|
|
Service Code
|
MSDRG 039
|
| Min. Negotiated Rate |
$8,778.60 |
| Max. Negotiated Rate |
$11,550.79 |
| Rate for Payer: Aetna Medicare |
$9,610.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,550.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,550.79
|
| Rate for Payer: BCBS MAPPO |
$9,240.63
|
| Rate for Payer: BCN Medicare Advantage |
$9,240.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,240.63
|
| Rate for Payer: Mclaren Medicare |
$9,240.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,702.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,626.72
|
| Rate for Payer: PACE Medicare |
$8,778.60
|
| Rate for Payer: PACE SWMI |
$9,240.63
|
| Rate for Payer: PHP Medicare Advantage |
$9,240.63
|
| Rate for Payer: Priority Health Medicare |
$9,240.63
|
| Rate for Payer: Railroad Medicare Medicare |
$9,240.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,240.63
|
| Rate for Payer: UHC Medicare Advantage |
$9,240.63
|
| Rate for Payer: VA VA |
$9,240.63
|
|
|
MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT
|
Facility
|
IP
|
$15,334.51
|
|
|
Service Code
|
MSDRG 115
|
| Min. Negotiated Rate |
$11,654.23 |
| Max. Negotiated Rate |
$15,334.51 |
| Rate for Payer: Aetna Medicare |
$12,758.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,334.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,334.51
|
| Rate for Payer: BCBS MAPPO |
$12,267.61
|
| Rate for Payer: BCN Medicare Advantage |
$12,267.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,267.61
|
| Rate for Payer: Mclaren Medicare |
$12,267.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,880.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,107.75
|
| Rate for Payer: PACE Medicare |
$11,654.23
|
| Rate for Payer: PACE SWMI |
$12,267.61
|
| Rate for Payer: PHP Medicare Advantage |
$12,267.61
|
| Rate for Payer: Priority Health Medicare |
$12,267.61
|
| Rate for Payer: Railroad Medicare Medicare |
$12,267.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,267.61
|
| Rate for Payer: UHC Medicare Advantage |
$12,267.61
|
| Rate for Payer: VA VA |
$12,267.61
|
|
|
MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE
|
Facility
|
IP
|
$57,851.36
|
|
|
Service Code
|
MSDRG 790
|
| Min. Negotiated Rate |
$43,967.04 |
| Max. Negotiated Rate |
$57,851.36 |
| Rate for Payer: Aetna Medicare |
$48,132.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57,851.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57,851.36
|
| Rate for Payer: BCBS MAPPO |
$46,281.09
|
| Rate for Payer: BCN Medicare Advantage |
$46,281.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46,281.09
|
| Rate for Payer: Mclaren Medicare |
$46,281.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48,595.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53,223.25
|
| Rate for Payer: PACE Medicare |
$43,967.04
|
| Rate for Payer: PACE SWMI |
$46,281.09
|
| Rate for Payer: PHP Medicare Advantage |
$46,281.09
|
| Rate for Payer: Priority Health Medicare |
$46,281.09
|
| Rate for Payer: Railroad Medicare Medicare |
$46,281.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$46,281.09
|
| Rate for Payer: UHC Medicare Advantage |
$46,281.09
|
| Rate for Payer: VA VA |
$46,281.09
|
|
|
MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
|
IP
|
$13,709.48
|
|
|
Service Code
|
MSDRG 748
|
| Min. Negotiated Rate |
$10,419.20 |
| Max. Negotiated Rate |
$13,709.48 |
| Rate for Payer: Aetna Medicare |
$11,406.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,709.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,709.48
|
| Rate for Payer: BCBS MAPPO |
$10,967.58
|
| Rate for Payer: BCN Medicare Advantage |
$10,967.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,967.58
|
| Rate for Payer: Mclaren Medicare |
$10,967.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,515.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,612.72
|
| Rate for Payer: PACE Medicare |
$10,419.20
|
| Rate for Payer: PACE SWMI |
$10,967.58
|
| Rate for Payer: PHP Medicare Advantage |
$10,967.58
|
| Rate for Payer: Priority Health Medicare |
$10,967.58
|
| Rate for Payer: Railroad Medicare Medicare |
$10,967.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,967.58
|
| Rate for Payer: UHC Medicare Advantage |
$10,967.58
|
| Rate for Payer: VA VA |
$10,967.58
|
|
|
MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$9,237.02
|
|
|
Service Code
|
MSDRG 864
|
| Min. Negotiated Rate |
$7,020.14 |
| Max. Negotiated Rate |
$9,237.02 |
| Rate for Payer: Aetna Medicare |
$7,685.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,237.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,237.02
|
| Rate for Payer: BCBS MAPPO |
$7,389.62
|
| Rate for Payer: BCN Medicare Advantage |
$7,389.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,389.62
|
| Rate for Payer: Mclaren Medicare |
$7,389.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,759.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,498.06
|
| Rate for Payer: PACE Medicare |
$7,020.14
|
| Rate for Payer: PACE SWMI |
$7,389.62
|
| Rate for Payer: PHP Medicare Advantage |
$7,389.62
|
| Rate for Payer: Priority Health Medicare |
$7,389.62
|
| Rate for Payer: Railroad Medicare Medicare |
$7,389.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,389.62
|
| Rate for Payer: UHC Medicare Advantage |
$7,389.62
|
| Rate for Payer: VA VA |
$7,389.62
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH CC
|
Facility
|
IP
|
$17,492.24
|
|
|
Service Code
|
MSDRG 504
|
| Min. Negotiated Rate |
$13,294.10 |
| Max. Negotiated Rate |
$17,492.24 |
| Rate for Payer: Aetna Medicare |
$14,553.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,492.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,492.24
|
| Rate for Payer: BCBS MAPPO |
$13,993.79
|
| Rate for Payer: BCN Medicare Advantage |
$13,993.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,993.79
|
| Rate for Payer: Mclaren Medicare |
$13,993.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,693.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,092.86
|
| Rate for Payer: PACE Medicare |
$13,294.10
|
| Rate for Payer: PACE SWMI |
$13,993.79
|
| Rate for Payer: PHP Medicare Advantage |
$13,993.79
|
| Rate for Payer: Priority Health Medicare |
$13,993.79
|
| Rate for Payer: Railroad Medicare Medicare |
$13,993.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,993.79
|
| Rate for Payer: UHC Medicare Advantage |
$13,993.79
|
| Rate for Payer: VA VA |
$13,993.79
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH MCC
|
Facility
|
IP
|
$26,080.78
|
|
|
Service Code
|
MSDRG 503
|
| Min. Negotiated Rate |
$19,821.39 |
| Max. Negotiated Rate |
$26,080.78 |
| Rate for Payer: Aetna Medicare |
$21,699.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,080.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,080.78
|
| Rate for Payer: BCBS MAPPO |
$20,864.62
|
| Rate for Payer: BCN Medicare Advantage |
$20,864.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,864.62
|
| Rate for Payer: Mclaren Medicare |
$20,864.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,907.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,994.31
|
| Rate for Payer: PACE Medicare |
$19,821.39
|
| Rate for Payer: PACE SWMI |
$20,864.62
|
| Rate for Payer: PHP Medicare Advantage |
$20,864.62
|
| Rate for Payer: Priority Health Medicare |
$20,864.62
|
| Rate for Payer: Railroad Medicare Medicare |
$20,864.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,864.62
|
| Rate for Payer: UHC Medicare Advantage |
$20,864.62
|
| Rate for Payer: VA VA |
$20,864.62
|
|
