|
MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC
|
Facility
|
IP
|
$271,923.79
|
|
|
Service Code
|
MSDRG 001
|
| Min. Negotiated Rate |
$206,662.08 |
| Max. Negotiated Rate |
$271,923.79 |
| Rate for Payer: Aetna Medicare |
$226,240.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271,923.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271,923.79
|
| Rate for Payer: BCBS MAPPO |
$217,539.03
|
| Rate for Payer: BCN Medicare Advantage |
$217,539.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217,539.03
|
| Rate for Payer: Mclaren Medicare |
$217,539.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228,415.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250,169.88
|
| Rate for Payer: PACE Medicare |
$206,662.08
|
| Rate for Payer: PACE SWMI |
$217,539.03
|
| Rate for Payer: PHP Medicare Advantage |
$217,539.03
|
| Rate for Payer: Priority Health Medicare |
$217,539.03
|
| Rate for Payer: Railroad Medicare Medicare |
$217,539.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$217,539.03
|
| Rate for Payer: UHC Medicare Advantage |
$217,539.03
|
| Rate for Payer: VA VA |
$217,539.03
|
|
|
MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$106,736.38
|
|
|
Service Code
|
MSDRG 002
|
| Min. Negotiated Rate |
$81,119.65 |
| Max. Negotiated Rate |
$106,736.38 |
| Rate for Payer: Aetna Medicare |
$88,804.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106,736.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106,736.38
|
| Rate for Payer: BCBS MAPPO |
$85,389.10
|
| Rate for Payer: BCN Medicare Advantage |
$85,389.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85,389.10
|
| Rate for Payer: Mclaren Medicare |
$85,389.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89,658.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98,197.46
|
| Rate for Payer: PACE Medicare |
$81,119.65
|
| Rate for Payer: PACE SWMI |
$85,389.10
|
| Rate for Payer: PHP Medicare Advantage |
$85,389.10
|
| Rate for Payer: Priority Health Medicare |
$85,389.10
|
| Rate for Payer: Railroad Medicare Medicare |
$85,389.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$85,389.10
|
| Rate for Payer: UHC Medicare Advantage |
$85,389.10
|
| Rate for Payer: VA VA |
$85,389.10
|
|
|
MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$16,361.36
|
|
|
Service Code
|
MSDRG 421
|
| Min. Negotiated Rate |
$12,434.64 |
| Max. Negotiated Rate |
$16,361.36 |
| Rate for Payer: Aetna Medicare |
$13,612.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,361.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,361.36
|
| Rate for Payer: BCBS MAPPO |
$13,089.09
|
| Rate for Payer: BCN Medicare Advantage |
$13,089.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,089.09
|
| Rate for Payer: Mclaren Medicare |
$13,089.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,743.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,052.45
|
| Rate for Payer: PACE Medicare |
$12,434.64
|
| Rate for Payer: PACE SWMI |
$13,089.09
|
| Rate for Payer: PHP Medicare Advantage |
$13,089.09
|
| Rate for Payer: Priority Health Medicare |
$13,089.09
|
| Rate for Payer: Railroad Medicare Medicare |
$13,089.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,089.09
|
| Rate for Payer: UHC Medicare Advantage |
$13,089.09
|
| Rate for Payer: VA VA |
$13,089.09
|
|
|
MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$34,585.47
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$26,284.96 |
| Max. Negotiated Rate |
$34,585.47 |
| Rate for Payer: Aetna Medicare |
$28,775.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,585.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,585.47
|
| Rate for Payer: BCBS MAPPO |
$27,668.38
|
| Rate for Payer: BCN Medicare Advantage |
$27,668.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,668.38
|
| Rate for Payer: Mclaren Medicare |
$27,668.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,051.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,818.64
|
| Rate for Payer: PACE Medicare |
$26,284.96
|
| Rate for Payer: PACE SWMI |
$27,668.38
|
| Rate for Payer: PHP Medicare Advantage |
$27,668.38
|
| Rate for Payer: Priority Health Medicare |
$27,668.38
|
| Rate for Payer: Railroad Medicare Medicare |
$27,668.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,668.38
|
| Rate for Payer: UHC Medicare Advantage |
$27,668.38
|
| Rate for Payer: VA VA |
$27,668.38
|
|
|
MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$14,741.12
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$11,203.25 |
| Max. Negotiated Rate |
$14,741.12 |
| Rate for Payer: Aetna Medicare |
$12,264.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,741.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,741.12
|
| Rate for Payer: BCBS MAPPO |
$11,792.90
|
| Rate for Payer: BCN Medicare Advantage |
$11,792.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,792.90
|
| Rate for Payer: Mclaren Medicare |
$11,792.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,382.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,561.83
|
| Rate for Payer: PACE Medicare |
$11,203.25
|
| Rate for Payer: PACE SWMI |
$11,792.90
|
| Rate for Payer: PHP Medicare Advantage |
$11,792.90
|
| Rate for Payer: Priority Health Medicare |
$11,792.90
|
| Rate for Payer: Railroad Medicare Medicare |
$11,792.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,792.90
|
| Rate for Payer: UHC Medicare Advantage |
$11,792.90
|
| Rate for Payer: VA VA |
$11,792.90
|
|
|
MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$16,973.03
|
|
|
Service Code
|
MSDRG 354
|
| Min. Negotiated Rate |
$12,899.50 |
| Max. Negotiated Rate |
$16,973.03 |
| Rate for Payer: Aetna Medicare |
$14,121.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,973.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,973.03
|
| Rate for Payer: BCBS MAPPO |
$13,578.42
|
| Rate for Payer: BCN Medicare Advantage |
$13,578.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,578.42
|
| Rate for Payer: Mclaren Medicare |
$13,578.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,257.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,615.18
|
| Rate for Payer: PACE Medicare |
$12,899.50
|
| Rate for Payer: PACE SWMI |
$13,578.42
|
| Rate for Payer: PHP Medicare Advantage |
$13,578.42
|
| Rate for Payer: Priority Health Medicare |
$13,578.42
|
| Rate for Payer: Railroad Medicare Medicare |
$13,578.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,578.42
|
| Rate for Payer: UHC Medicare Advantage |
$13,578.42
|
| Rate for Payer: VA VA |
$13,578.42
|
|
|
MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$28,839.56
|
|
|
Service Code
|
MSDRG 353
|
| Min. Negotiated Rate |
$21,918.07 |
| Max. Negotiated Rate |
$28,839.56 |
| Rate for Payer: Aetna Medicare |
$23,994.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,839.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,839.56
|
| Rate for Payer: BCBS MAPPO |
$23,071.65
|
| Rate for Payer: BCN Medicare Advantage |
$23,071.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,071.65
|
| Rate for Payer: Mclaren Medicare |
$23,071.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,225.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,532.40
|
| Rate for Payer: PACE Medicare |
$21,918.07
|
| Rate for Payer: PACE SWMI |
$23,071.65
|
| Rate for Payer: PHP Medicare Advantage |
$23,071.65
|
| Rate for Payer: Priority Health Medicare |
$23,071.65
|
| Rate for Payer: Railroad Medicare Medicare |
$23,071.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,071.65
|
| Rate for Payer: UHC Medicare Advantage |
$23,071.65
|
| Rate for Payer: VA VA |
$23,071.65
|
|
|
MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$13,429.17
|
|
|
Service Code
|
MSDRG 355
|
| Min. Negotiated Rate |
$10,206.17 |
| Max. Negotiated Rate |
$13,429.17 |
| Rate for Payer: Aetna Medicare |
$11,173.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,429.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,429.17
|
| Rate for Payer: BCBS MAPPO |
$10,743.34
|
| Rate for Payer: BCN Medicare Advantage |
$10,743.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,743.34
|
| Rate for Payer: Mclaren Medicare |
$10,743.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,280.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,354.84
|
| Rate for Payer: PACE Medicare |
$10,206.17
|
| Rate for Payer: PACE SWMI |
$10,743.34
|
| Rate for Payer: PHP Medicare Advantage |
$10,743.34
|
| Rate for Payer: Priority Health Medicare |
$10,743.34
|
| Rate for Payer: Railroad Medicare Medicare |
$10,743.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,743.34
|
| Rate for Payer: UHC Medicare Advantage |
$10,743.34
|
| Rate for Payer: VA VA |
$10,743.34
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$20,573.76
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$15,636.06 |
| Max. Negotiated Rate |
$20,573.76 |
| Rate for Payer: Aetna Medicare |
$17,117.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,573.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,573.76
|
| Rate for Payer: BCBS MAPPO |
$16,459.01
|
| Rate for Payer: BCN Medicare Advantage |
$16,459.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,459.01
|
| Rate for Payer: Mclaren Medicare |
$16,459.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,281.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,927.86
|
| Rate for Payer: PACE Medicare |
$15,636.06
|
| Rate for Payer: PACE SWMI |
$16,459.01
|
| Rate for Payer: PHP Medicare Advantage |
$16,459.01
|
| Rate for Payer: Priority Health Medicare |
$16,459.01
|
| Rate for Payer: Railroad Medicare Medicare |
$16,459.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,459.01
|
| Rate for Payer: UHC Medicare Advantage |
$16,459.01
|
| Rate for Payer: VA VA |
$16,459.01
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$28,916.62
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$21,976.63 |
| Max. Negotiated Rate |
$28,916.62 |
| Rate for Payer: Aetna Medicare |
$24,058.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,916.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,916.62
|
| Rate for Payer: BCBS MAPPO |
$23,133.30
|
| Rate for Payer: BCN Medicare Advantage |
$23,133.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,133.30
|
| Rate for Payer: Mclaren Medicare |
$23,133.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,289.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,603.29
|
| Rate for Payer: PACE Medicare |
$21,976.63
|
| Rate for Payer: PACE SWMI |
$23,133.30
|
| Rate for Payer: PHP Medicare Advantage |
$23,133.30
|
| Rate for Payer: Priority Health Medicare |
$23,133.30
|
| Rate for Payer: Railroad Medicare Medicare |
$23,133.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,133.30
|
| Rate for Payer: UHC Medicare Advantage |
$23,133.30
|
| Rate for Payer: VA VA |
$23,133.30
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$15,868.17
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$12,059.81 |
| Max. Negotiated Rate |
$15,868.17 |
| Rate for Payer: Aetna Medicare |
$13,202.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,868.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,868.17
|
| Rate for Payer: BCBS MAPPO |
$12,694.54
|
| Rate for Payer: BCN Medicare Advantage |
$12,694.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,694.54
|
| Rate for Payer: Mclaren Medicare |
$12,694.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,329.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,598.72
|
| Rate for Payer: PACE Medicare |
$12,059.81
|
| Rate for Payer: PACE SWMI |
$12,694.54
|
| Rate for Payer: PHP Medicare Advantage |
$12,694.54
|
| Rate for Payer: Priority Health Medicare |
$12,694.54
|
| Rate for Payer: Railroad Medicare Medicare |
$12,694.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,694.54
|
| Rate for Payer: UHC Medicare Advantage |
$12,694.54
|
| Rate for Payer: VA VA |
$12,694.54
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$28,663.31
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$21,784.12 |
| Max. Negotiated Rate |
$28,663.31 |
| Rate for Payer: Aetna Medicare |
$23,847.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,663.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,663.31
|
| Rate for Payer: BCBS MAPPO |
$22,930.65
|
| Rate for Payer: BCN Medicare Advantage |
$22,930.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,930.65
|
| Rate for Payer: Mclaren Medicare |
$22,930.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,077.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,370.25
|
| Rate for Payer: PACE Medicare |
$21,784.12
|
| Rate for Payer: PACE SWMI |
$22,930.65
|
| Rate for Payer: PHP Medicare Advantage |
$22,930.65
|
| Rate for Payer: Priority Health Medicare |
$22,930.65
|
| Rate for Payer: Railroad Medicare Medicare |
$22,930.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,930.65
|
| Rate for Payer: UHC Medicare Advantage |
$22,930.65
|
| Rate for Payer: VA VA |
$22,930.65
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$20,893.54
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$15,879.09 |
| Max. Negotiated Rate |
$20,893.54 |
| Rate for Payer: Aetna Medicare |
$17,383.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,893.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,893.54
|
| Rate for Payer: BCBS MAPPO |
$16,714.83
|
| Rate for Payer: BCN Medicare Advantage |
$16,714.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,714.83
|
| Rate for Payer: Mclaren Medicare |
$16,714.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,550.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,222.05
|
| Rate for Payer: PACE Medicare |
$15,879.09
|
| Rate for Payer: PACE SWMI |
$16,714.83
|
| Rate for Payer: PHP Medicare Advantage |
$16,714.83
|
| Rate for Payer: Priority Health Medicare |
$16,714.83
|
| Rate for Payer: Railroad Medicare Medicare |
$16,714.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,714.83
|
| Rate for Payer: UHC Medicare Advantage |
$16,714.83
|
| Rate for Payer: VA VA |
$16,714.83
|
|
|
MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$61,506.94
|
|
|
Service Code
|
MSDRG 969
|
| Min. Negotiated Rate |
$46,745.27 |
| Max. Negotiated Rate |
$61,506.94 |
| Rate for Payer: Aetna Medicare |
$51,173.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61,506.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61,506.94
|
| Rate for Payer: BCBS MAPPO |
$49,205.55
|
| Rate for Payer: BCN Medicare Advantage |
$49,205.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,205.55
|
| Rate for Payer: Mclaren Medicare |
$49,205.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51,665.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56,586.38
|
| Rate for Payer: PACE Medicare |
$46,745.27
|
| Rate for Payer: PACE SWMI |
$49,205.55
|
| Rate for Payer: PHP Medicare Advantage |
$49,205.55
|
| Rate for Payer: Priority Health Medicare |
$49,205.55
|
| Rate for Payer: Railroad Medicare Medicare |
$49,205.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,205.55
|
| Rate for Payer: UHC Medicare Advantage |
$49,205.55
|
| Rate for Payer: VA VA |
$49,205.55
|
|
|
MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$26,145.30
|
|
|
Service Code
|
MSDRG 970
|
| Min. Negotiated Rate |
$19,870.43 |
| Max. Negotiated Rate |
$26,145.30 |
| Rate for Payer: Aetna Medicare |
$21,752.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,145.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,145.30
|
| Rate for Payer: BCBS MAPPO |
$20,916.24
|
| Rate for Payer: BCN Medicare Advantage |
$20,916.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,916.24
|
| Rate for Payer: Mclaren Medicare |
$20,916.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,962.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,053.68
|
| Rate for Payer: PACE Medicare |
$19,870.43
|
| Rate for Payer: PACE SWMI |
$20,916.24
|
| Rate for Payer: PHP Medicare Advantage |
$20,916.24
|
| Rate for Payer: Priority Health Medicare |
$20,916.24
|
| Rate for Payer: Railroad Medicare Medicare |
$20,916.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,916.24
|
| Rate for Payer: UHC Medicare Advantage |
$20,916.24
|
| Rate for Payer: VA VA |
$20,916.24
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$14,278.77
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$10,851.87 |
| Max. Negotiated Rate |
$14,278.77 |
| Rate for Payer: Aetna Medicare |
$11,879.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,278.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,278.77
|
| Rate for Payer: BCBS MAPPO |
$11,423.02
|
| Rate for Payer: BCN Medicare Advantage |
$11,423.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,423.02
|
| Rate for Payer: Mclaren Medicare |
$11,423.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,994.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,136.47
|
| Rate for Payer: PACE Medicare |
$10,851.87
|
| Rate for Payer: PACE SWMI |
$11,423.02
|
| Rate for Payer: PHP Medicare Advantage |
$11,423.02
|
| Rate for Payer: Priority Health Medicare |
$11,423.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11,423.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,423.02
|
| Rate for Payer: UHC Medicare Advantage |
$11,423.02
|
| Rate for Payer: VA VA |
$11,423.02
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$29,352.04
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$22,307.55 |
| Max. Negotiated Rate |
$29,352.04 |
| Rate for Payer: Aetna Medicare |
$24,420.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,352.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,352.04
|
| Rate for Payer: BCBS MAPPO |
$23,481.63
|
| Rate for Payer: BCN Medicare Advantage |
$23,481.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,481.63
|
| Rate for Payer: Mclaren Medicare |
$23,481.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,655.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,003.87
|
| Rate for Payer: PACE Medicare |
$22,307.55
|
| Rate for Payer: PACE SWMI |
$23,481.63
|
| Rate for Payer: PHP Medicare Advantage |
$23,481.63
|
| Rate for Payer: Priority Health Medicare |
$23,481.63
|
| Rate for Payer: Railroad Medicare Medicare |
$23,481.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,481.63
|
| Rate for Payer: UHC Medicare Advantage |
$23,481.63
|
| Rate for Payer: VA VA |
$23,481.63
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$10,248.45
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$7,788.82 |
| Max. Negotiated Rate |
$10,248.45 |
| Rate for Payer: Aetna Medicare |
$8,526.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,248.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,248.45
|
| Rate for Payer: BCBS MAPPO |
$8,198.76
|
| Rate for Payer: BCN Medicare Advantage |
$8,198.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,198.76
|
| Rate for Payer: Mclaren Medicare |
$8,198.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,608.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,428.57
|
| Rate for Payer: PACE Medicare |
$7,788.82
|
| Rate for Payer: PACE SWMI |
$8,198.76
|
| Rate for Payer: PHP Medicare Advantage |
$8,198.76
|
| Rate for Payer: Priority Health Medicare |
$8,198.76
|
| Rate for Payer: Railroad Medicare Medicare |
$8,198.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,198.76
|
| Rate for Payer: UHC Medicare Advantage |
$8,198.76
|
| Rate for Payer: VA VA |
$8,198.76
|
|
|
MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION
|
Facility
|
IP
|
$14,476.23
|
|
|
Service Code
|
MSDRG 977
|
| Min. Negotiated Rate |
$11,001.93 |
| Max. Negotiated Rate |
$14,476.23 |
| Rate for Payer: Aetna Medicare |
$12,044.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,476.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,476.23
|
| Rate for Payer: BCBS MAPPO |
$11,580.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,580.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,580.98
|
| Rate for Payer: Mclaren Medicare |
$11,580.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,160.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,318.13
|
| Rate for Payer: PACE Medicare |
$11,001.93
|
| Rate for Payer: PACE SWMI |
$11,580.98
|
| Rate for Payer: PHP Medicare Advantage |
$11,580.98
|
| Rate for Payer: Priority Health Medicare |
$11,580.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11,580.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,580.98
|
| Rate for Payer: UHC Medicare Advantage |
$11,580.98
|
| Rate for Payer: VA VA |
$11,580.98
|
|
|
MS-DRG 42.00: HYPERTENSION WITH MCC
|
Facility
|
IP
|
$11,903.35
|
|
|
Service Code
|
MSDRG 304
|
| Min. Negotiated Rate |
$9,046.55 |
| Max. Negotiated Rate |
$11,903.35 |
| Rate for Payer: Aetna Medicare |
$9,903.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,903.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,903.35
|
| Rate for Payer: BCBS MAPPO |
$9,522.68
|
| Rate for Payer: BCN Medicare Advantage |
$9,522.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,522.68
|
| Rate for Payer: Mclaren Medicare |
$9,522.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,998.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,951.08
|
| Rate for Payer: PACE Medicare |
$9,046.55
|
| Rate for Payer: PACE SWMI |
$9,522.68
|
| Rate for Payer: PHP Medicare Advantage |
$9,522.68
|
| Rate for Payer: Priority Health Medicare |
$9,522.68
|
| Rate for Payer: Railroad Medicare Medicare |
$9,522.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,522.68
|
| Rate for Payer: UHC Medicare Advantage |
$9,522.68
|
| Rate for Payer: VA VA |
$9,522.68
|
|
|
MS-DRG 42.00: HYPERTENSION WITHOUT MCC
|
Facility
|
IP
|
$7,818.14
|
|
|
Service Code
|
MSDRG 305
|
| Min. Negotiated Rate |
$5,941.78 |
| Max. Negotiated Rate |
$7,818.14 |
| Rate for Payer: Aetna Medicare |
$6,504.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,818.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,818.14
|
| Rate for Payer: BCBS MAPPO |
$6,254.51
|
| Rate for Payer: BCN Medicare Advantage |
$6,254.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,254.51
|
| Rate for Payer: Mclaren Medicare |
$6,254.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,567.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,192.69
|
| Rate for Payer: PACE Medicare |
$5,941.78
|
| Rate for Payer: PACE SWMI |
$6,254.51
|
| Rate for Payer: PHP Medicare Advantage |
$6,254.51
|
| Rate for Payer: Priority Health Medicare |
$6,254.51
|
| Rate for Payer: Railroad Medicare Medicare |
$6,254.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,254.51
|
| Rate for Payer: UHC Medicare Advantage |
$6,254.51
|
| Rate for Payer: VA VA |
$6,254.51
|
|
|
MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
|
IP
|
$10,199.33
|
|
|
Service Code
|
MSDRG 078
|
| Min. Negotiated Rate |
$7,751.49 |
| Max. Negotiated Rate |
$10,199.33 |
| Rate for Payer: Aetna Medicare |
$8,485.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,199.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,199.33
|
| Rate for Payer: BCBS MAPPO |
$8,159.46
|
| Rate for Payer: BCN Medicare Advantage |
$8,159.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,159.46
|
| Rate for Payer: Mclaren Medicare |
$8,159.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,567.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,383.38
|
| Rate for Payer: PACE Medicare |
$7,751.49
|
| Rate for Payer: PACE SWMI |
$8,159.46
|
| Rate for Payer: PHP Medicare Advantage |
$8,159.46
|
| Rate for Payer: Priority Health Medicare |
$8,159.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8,159.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,159.46
|
| Rate for Payer: UHC Medicare Advantage |
$8,159.46
|
| Rate for Payer: VA VA |
$8,159.46
|
|
|
MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH MCC
|
Facility
|
IP
|
$15,481.90
|
|
|
Service Code
|
MSDRG 077
|
| Min. Negotiated Rate |
$11,766.24 |
| Max. Negotiated Rate |
$15,481.90 |
| Rate for Payer: Aetna Medicare |
$12,880.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,481.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,481.90
|
| Rate for Payer: BCBS MAPPO |
$12,385.52
|
| Rate for Payer: BCN Medicare Advantage |
$12,385.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,385.52
|
| Rate for Payer: Mclaren Medicare |
$12,385.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,004.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,243.35
|
| Rate for Payer: PACE Medicare |
$11,766.24
|
| Rate for Payer: PACE SWMI |
$12,385.52
|
| Rate for Payer: PHP Medicare Advantage |
$12,385.52
|
| Rate for Payer: Priority Health Medicare |
$12,385.52
|
| Rate for Payer: Railroad Medicare Medicare |
$12,385.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,385.52
|
| Rate for Payer: UHC Medicare Advantage |
$12,385.52
|
| Rate for Payer: VA VA |
$12,385.52
|
|
|
MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC
|
Facility
|
IP
|
$7,008.98
|
|
|
Service Code
|
MSDRG 079
|
| Min. Negotiated Rate |
$5,326.82 |
| Max. Negotiated Rate |
$7,008.98 |
| Rate for Payer: Aetna Medicare |
$5,831.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,008.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,008.98
|
| Rate for Payer: BCBS MAPPO |
$5,607.18
|
| Rate for Payer: BCN Medicare Advantage |
$5,607.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,607.18
|
| Rate for Payer: Mclaren Medicare |
$5,607.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,887.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,448.26
|
| Rate for Payer: PACE Medicare |
$5,326.82
|
| Rate for Payer: PACE SWMI |
$5,607.18
|
| Rate for Payer: PHP Medicare Advantage |
$5,607.18
|
| Rate for Payer: Priority Health Medicare |
$5,607.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5,607.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,607.18
|
| Rate for Payer: UHC Medicare Advantage |
$5,607.18
|
| Rate for Payer: VA VA |
$5,607.18
|
|
|
MS-DRG 42.00: INBORN AND OTHER DISORDERS OF METABOLISM
|
Facility
|
IP
|
$12,542.00
|
|
|
Service Code
|
MSDRG 642
|
| Min. Negotiated Rate |
$9,531.92 |
| Max. Negotiated Rate |
$12,542.00 |
| Rate for Payer: Aetna Medicare |
$10,434.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,542.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,542.00
|
| Rate for Payer: BCBS MAPPO |
$10,033.60
|
| Rate for Payer: BCN Medicare Advantage |
$10,033.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,033.60
|
| Rate for Payer: Mclaren Medicare |
$10,033.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,535.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,538.64
|
| Rate for Payer: PACE Medicare |
$9,531.92
|
| Rate for Payer: PACE SWMI |
$10,033.60
|
| Rate for Payer: PHP Medicare Advantage |
$10,033.60
|
| Rate for Payer: Priority Health Medicare |
$10,033.60
|
| Rate for Payer: Railroad Medicare Medicare |
$10,033.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,033.60
|
| Rate for Payer: UHC Medicare Advantage |
$10,033.60
|
| Rate for Payer: VA VA |
$10,033.60
|
|
