|
MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,596.86
|
|
|
Service Code
|
MSDRG 655
|
| Min. Negotiated Rate |
$15,653.62 |
| Max. Negotiated Rate |
$20,596.86 |
| Rate for Payer: Aetna Medicare |
$17,136.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,596.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,596.86
|
| Rate for Payer: BCBS MAPPO |
$16,477.49
|
| Rate for Payer: BCN Medicare Advantage |
$16,477.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,477.49
|
| Rate for Payer: Mclaren Medicare |
$16,477.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,301.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,949.11
|
| Rate for Payer: PACE Medicare |
$15,653.62
|
| Rate for Payer: PACE SWMI |
$16,477.49
|
| Rate for Payer: PHP Medicare Advantage |
$16,477.49
|
| Rate for Payer: Priority Health Medicare |
$16,477.49
|
| Rate for Payer: Railroad Medicare Medicare |
$16,477.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,477.49
|
| Rate for Payer: UHC Medicare Advantage |
$16,477.49
|
| Rate for Payer: VA VA |
$16,477.49
|
|
|
MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH CC
|
Facility
|
IP
|
$24,832.35
|
|
|
Service Code
|
MSDRG 164
|
| Min. Negotiated Rate |
$18,872.59 |
| Max. Negotiated Rate |
$24,832.35 |
| Rate for Payer: Aetna Medicare |
$20,660.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,832.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,832.35
|
| Rate for Payer: BCBS MAPPO |
$19,865.88
|
| Rate for Payer: BCN Medicare Advantage |
$19,865.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,865.88
|
| Rate for Payer: Mclaren Medicare |
$19,865.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,859.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,845.76
|
| Rate for Payer: PACE Medicare |
$18,872.59
|
| Rate for Payer: PACE SWMI |
$19,865.88
|
| Rate for Payer: PHP Medicare Advantage |
$19,865.88
|
| Rate for Payer: Priority Health Medicare |
$19,865.88
|
| Rate for Payer: Railroad Medicare Medicare |
$19,865.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,865.88
|
| Rate for Payer: UHC Medicare Advantage |
$19,865.88
|
| Rate for Payer: VA VA |
$19,865.88
|
|
|
MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH MCC
|
Facility
|
IP
|
$44,985.91
|
|
|
Service Code
|
MSDRG 163
|
| Min. Negotiated Rate |
$34,189.29 |
| Max. Negotiated Rate |
$44,985.91 |
| Rate for Payer: Aetna Medicare |
$37,428.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,985.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,985.91
|
| Rate for Payer: BCBS MAPPO |
$35,988.73
|
| Rate for Payer: BCN Medicare Advantage |
$35,988.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,988.73
|
| Rate for Payer: Mclaren Medicare |
$35,988.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37,788.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,387.04
|
| Rate for Payer: PACE Medicare |
$34,189.29
|
| Rate for Payer: PACE SWMI |
$35,988.73
|
| Rate for Payer: PHP Medicare Advantage |
$35,988.73
|
| Rate for Payer: Priority Health Medicare |
$35,988.73
|
| Rate for Payer: Railroad Medicare Medicare |
$35,988.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,988.73
|
| Rate for Payer: UHC Medicare Advantage |
$35,988.73
|
| Rate for Payer: VA VA |
$35,988.73
|
|
|
MS-DRG 42.00: MAJOR CHEST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,542.20
|
|
|
Service Code
|
MSDRG 165
|
| Min. Negotiated Rate |
$14,092.07 |
| Max. Negotiated Rate |
$18,542.20 |
| Rate for Payer: Aetna Medicare |
$15,427.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,542.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,542.20
|
| Rate for Payer: BCBS MAPPO |
$14,833.76
|
| Rate for Payer: BCN Medicare Advantage |
$14,833.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,833.76
|
| Rate for Payer: Mclaren Medicare |
$14,833.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,575.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,058.82
|
| Rate for Payer: PACE Medicare |
$14,092.07
|
| Rate for Payer: PACE SWMI |
$14,833.76
|
| Rate for Payer: PHP Medicare Advantage |
$14,833.76
|
| Rate for Payer: Priority Health Medicare |
$14,833.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14,833.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,833.76
|
| Rate for Payer: UHC Medicare Advantage |
$14,833.76
|
| Rate for Payer: VA VA |
$14,833.76
|
|
|
MS-DRG 42.00: MAJOR CHEST TRAUMA WITH CC
|
Facility
|
IP
|
$10,875.56
|
|
|
Service Code
|
MSDRG 184
|
| Min. Negotiated Rate |
$8,265.43 |
| Max. Negotiated Rate |
$10,875.56 |
| Rate for Payer: Aetna Medicare |
$9,048.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,875.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,875.56
|
| Rate for Payer: BCBS MAPPO |
$8,700.45
|
| Rate for Payer: BCN Medicare Advantage |
$8,700.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,700.45
|
| Rate for Payer: Mclaren Medicare |
$8,700.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,135.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,005.52
|
| Rate for Payer: PACE Medicare |
$8,265.43
|
| Rate for Payer: PACE SWMI |
$8,700.45
|
| Rate for Payer: PHP Medicare Advantage |
$8,700.45
|
| Rate for Payer: Priority Health Medicare |
$8,700.45
|
| Rate for Payer: Railroad Medicare Medicare |
$8,700.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,700.45
|
| Rate for Payer: UHC Medicare Advantage |
$8,700.45
|
| Rate for Payer: VA VA |
$8,700.45
|
|
|
MS-DRG 42.00: MAJOR CHEST TRAUMA WITH MCC
|
Facility
|
IP
|
$15,876.85
|
|
|
Service Code
|
MSDRG 183
|
| Min. Negotiated Rate |
$12,066.41 |
| Max. Negotiated Rate |
$15,876.85 |
| Rate for Payer: Aetna Medicare |
$13,209.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,876.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,876.85
|
| Rate for Payer: BCBS MAPPO |
$12,701.48
|
| Rate for Payer: BCN Medicare Advantage |
$12,701.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,701.48
|
| Rate for Payer: Mclaren Medicare |
$12,701.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,336.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,606.70
|
| Rate for Payer: PACE Medicare |
$12,066.41
|
| Rate for Payer: PACE SWMI |
$12,701.48
|
| Rate for Payer: PHP Medicare Advantage |
$12,701.48
|
| Rate for Payer: Priority Health Medicare |
$12,701.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12,701.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,701.48
|
| Rate for Payer: UHC Medicare Advantage |
$12,701.48
|
| Rate for Payer: VA VA |
$12,701.48
|
|
|
MS-DRG 42.00: MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$8,078.20
|
|
|
Service Code
|
MSDRG 185
|
| Min. Negotiated Rate |
$6,139.43 |
| Max. Negotiated Rate |
$8,078.20 |
| Rate for Payer: Aetna Medicare |
$6,721.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,078.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,078.20
|
| Rate for Payer: BCBS MAPPO |
$6,462.56
|
| Rate for Payer: BCN Medicare Advantage |
$6,462.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,462.56
|
| Rate for Payer: Mclaren Medicare |
$6,462.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,785.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,431.94
|
| Rate for Payer: PACE Medicare |
$6,139.43
|
| Rate for Payer: PACE SWMI |
$6,462.56
|
| Rate for Payer: PHP Medicare Advantage |
$6,462.56
|
| Rate for Payer: Priority Health Medicare |
$6,462.56
|
| Rate for Payer: Railroad Medicare Medicare |
$6,462.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,462.56
|
| Rate for Payer: UHC Medicare Advantage |
$6,462.56
|
| Rate for Payer: VA VA |
$6,462.56
|
|
|
MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
|
IP
|
$10,389.09
|
|
|
Service Code
|
MSDRG 369
|
| Min. Negotiated Rate |
$7,895.71 |
| Max. Negotiated Rate |
$10,389.09 |
| Rate for Payer: Aetna Medicare |
$8,643.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,389.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,389.09
|
| Rate for Payer: BCBS MAPPO |
$8,311.27
|
| Rate for Payer: BCN Medicare Advantage |
$8,311.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,311.27
|
| Rate for Payer: Mclaren Medicare |
$8,311.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,726.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,557.96
|
| Rate for Payer: PACE Medicare |
$7,895.71
|
| Rate for Payer: PACE SWMI |
$8,311.27
|
| Rate for Payer: PHP Medicare Advantage |
$8,311.27
|
| Rate for Payer: Priority Health Medicare |
$8,311.27
|
| Rate for Payer: Railroad Medicare Medicare |
$8,311.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,311.27
|
| Rate for Payer: UHC Medicare Advantage |
$8,311.27
|
| Rate for Payer: VA VA |
$8,311.27
|
|
|
MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
|
IP
|
$16,673.45
|
|
|
Service Code
|
MSDRG 368
|
| Min. Negotiated Rate |
$12,671.82 |
| Max. Negotiated Rate |
$16,673.45 |
| Rate for Payer: Aetna Medicare |
$13,872.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,673.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,673.45
|
| Rate for Payer: BCBS MAPPO |
$13,338.76
|
| Rate for Payer: BCN Medicare Advantage |
$13,338.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,338.76
|
| Rate for Payer: Mclaren Medicare |
$13,338.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,005.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,339.57
|
| Rate for Payer: PACE Medicare |
$12,671.82
|
| Rate for Payer: PACE SWMI |
$13,338.76
|
| Rate for Payer: PHP Medicare Advantage |
$13,338.76
|
| Rate for Payer: Priority Health Medicare |
$13,338.76
|
| Rate for Payer: Railroad Medicare Medicare |
$13,338.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,338.76
|
| Rate for Payer: UHC Medicare Advantage |
$13,338.76
|
| Rate for Payer: VA VA |
$13,338.76
|
|
|
MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$7,310.48
|
|
|
Service Code
|
MSDRG 370
|
| Min. Negotiated Rate |
$5,555.96 |
| Max. Negotiated Rate |
$7,310.48 |
| Rate for Payer: Aetna Medicare |
$6,082.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,310.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,310.48
|
| Rate for Payer: BCBS MAPPO |
$5,848.38
|
| Rate for Payer: BCN Medicare Advantage |
$5,848.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,848.38
|
| Rate for Payer: Mclaren Medicare |
$5,848.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,140.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,725.64
|
| Rate for Payer: PACE Medicare |
$5,555.96
|
| Rate for Payer: PACE SWMI |
$5,848.38
|
| Rate for Payer: PHP Medicare Advantage |
$5,848.38
|
| Rate for Payer: Priority Health Medicare |
$5,848.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5,848.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,848.38
|
| Rate for Payer: UHC Medicare Advantage |
$5,848.38
|
| Rate for Payer: VA VA |
$5,848.38
|
|
|
MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$10,501.79
|
|
|
Service Code
|
MSDRG 372
|
| Min. Negotiated Rate |
$7,981.36 |
| Max. Negotiated Rate |
$10,501.79 |
| Rate for Payer: Aetna Medicare |
$8,737.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,501.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,501.79
|
| Rate for Payer: BCBS MAPPO |
$8,401.43
|
| Rate for Payer: BCN Medicare Advantage |
$8,401.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,401.43
|
| Rate for Payer: Mclaren Medicare |
$8,401.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,821.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,661.64
|
| Rate for Payer: PACE Medicare |
$7,981.36
|
| Rate for Payer: PACE SWMI |
$8,401.43
|
| Rate for Payer: PHP Medicare Advantage |
$8,401.43
|
| Rate for Payer: Priority Health Medicare |
$8,401.43
|
| Rate for Payer: Railroad Medicare Medicare |
$8,401.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,401.43
|
| Rate for Payer: UHC Medicare Advantage |
$8,401.43
|
| Rate for Payer: VA VA |
$8,401.43
|
|
|
MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$17,424.80
|
|
|
Service Code
|
MSDRG 371
|
| Min. Negotiated Rate |
$13,242.85 |
| Max. Negotiated Rate |
$17,424.80 |
| Rate for Payer: Aetna Medicare |
$14,497.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,424.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,424.80
|
| Rate for Payer: BCBS MAPPO |
$13,939.84
|
| Rate for Payer: BCN Medicare Advantage |
$13,939.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,939.84
|
| Rate for Payer: Mclaren Medicare |
$13,939.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,636.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,030.82
|
| Rate for Payer: PACE Medicare |
$13,242.85
|
| Rate for Payer: PACE SWMI |
$13,939.84
|
| Rate for Payer: PHP Medicare Advantage |
$13,939.84
|
| Rate for Payer: Priority Health Medicare |
$13,939.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13,939.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,939.84
|
| Rate for Payer: UHC Medicare Advantage |
$13,939.84
|
| Rate for Payer: VA VA |
$13,939.84
|
|
|
MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$7,574.41
|
|
|
Service Code
|
MSDRG 373
|
| Min. Negotiated Rate |
$5,756.55 |
| Max. Negotiated Rate |
$7,574.41 |
| Rate for Payer: Aetna Medicare |
$6,301.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,574.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,574.41
|
| Rate for Payer: BCBS MAPPO |
$6,059.53
|
| Rate for Payer: BCN Medicare Advantage |
$6,059.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,059.53
|
| Rate for Payer: Mclaren Medicare |
$6,059.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,362.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,968.46
|
| Rate for Payer: PACE Medicare |
$5,756.55
|
| Rate for Payer: PACE SWMI |
$6,059.53
|
| Rate for Payer: PHP Medicare Advantage |
$6,059.53
|
| Rate for Payer: Priority Health Medicare |
$6,059.53
|
| Rate for Payer: Railroad Medicare Medicare |
$6,059.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,059.53
|
| Rate for Payer: UHC Medicare Advantage |
$6,059.53
|
| Rate for Payer: VA VA |
$6,059.53
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$21,282.72
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$16,174.87 |
| Max. Negotiated Rate |
$21,282.72 |
| Rate for Payer: Aetna Medicare |
$17,707.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,282.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,282.72
|
| Rate for Payer: BCBS MAPPO |
$17,026.18
|
| Rate for Payer: BCN Medicare Advantage |
$17,026.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,026.18
|
| Rate for Payer: Mclaren Medicare |
$17,026.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,877.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,580.11
|
| Rate for Payer: PACE Medicare |
$16,174.87
|
| Rate for Payer: PACE SWMI |
$17,026.18
|
| Rate for Payer: PHP Medicare Advantage |
$17,026.18
|
| Rate for Payer: Priority Health Medicare |
$17,026.18
|
| Rate for Payer: Railroad Medicare Medicare |
$17,026.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,026.18
|
| Rate for Payer: UHC Medicare Advantage |
$17,026.18
|
| Rate for Payer: VA VA |
$17,026.18
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$41,325.50
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$31,407.38 |
| Max. Negotiated Rate |
$41,325.50 |
| Rate for Payer: Aetna Medicare |
$34,382.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41,325.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41,325.50
|
| Rate for Payer: BCBS MAPPO |
$33,060.40
|
| Rate for Payer: BCN Medicare Advantage |
$33,060.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,060.40
|
| Rate for Payer: Mclaren Medicare |
$33,060.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34,713.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,019.46
|
| Rate for Payer: PACE Medicare |
$31,407.38
|
| Rate for Payer: PACE SWMI |
$33,060.40
|
| Rate for Payer: PHP Medicare Advantage |
$33,060.40
|
| Rate for Payer: Priority Health Medicare |
$33,060.40
|
| Rate for Payer: Railroad Medicare Medicare |
$33,060.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$33,060.40
|
| Rate for Payer: UHC Medicare Advantage |
$33,060.40
|
| Rate for Payer: VA VA |
$33,060.40
|
|
|
MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$15,733.33
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$11,957.33 |
| Max. Negotiated Rate |
$15,733.33 |
| Rate for Payer: Aetna Medicare |
$13,090.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,733.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,733.33
|
| Rate for Payer: BCBS MAPPO |
$12,586.66
|
| Rate for Payer: BCN Medicare Advantage |
$12,586.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,586.66
|
| Rate for Payer: Mclaren Medicare |
$12,586.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,215.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,474.66
|
| Rate for Payer: PACE Medicare |
$11,957.33
|
| Rate for Payer: PACE SWMI |
$12,586.66
|
| Rate for Payer: PHP Medicare Advantage |
$12,586.66
|
| Rate for Payer: Priority Health Medicare |
$12,586.66
|
| Rate for Payer: Railroad Medicare Medicare |
$12,586.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,586.66
|
| Rate for Payer: UHC Medicare Advantage |
$12,586.66
|
| Rate for Payer: VA VA |
$12,586.66
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$12,516.95
|
|
|
Service Code
|
MSDRG 809
|
| Min. Negotiated Rate |
$9,512.88 |
| Max. Negotiated Rate |
$12,516.95 |
| Rate for Payer: Aetna Medicare |
$10,414.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,516.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,516.95
|
| Rate for Payer: BCBS MAPPO |
$10,013.56
|
| Rate for Payer: BCN Medicare Advantage |
$10,013.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,013.56
|
| Rate for Payer: Mclaren Medicare |
$10,013.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,514.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,515.59
|
| Rate for Payer: PACE Medicare |
$9,512.88
|
| Rate for Payer: PACE SWMI |
$10,013.56
|
| Rate for Payer: PHP Medicare Advantage |
$10,013.56
|
| Rate for Payer: Priority Health Medicare |
$10,013.56
|
| Rate for Payer: Railroad Medicare Medicare |
$10,013.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,013.56
|
| Rate for Payer: UHC Medicare Advantage |
$10,013.56
|
| Rate for Payer: VA VA |
$10,013.56
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$22,648.64
|
|
|
Service Code
|
MSDRG 808
|
| Min. Negotiated Rate |
$17,212.96 |
| Max. Negotiated Rate |
$22,648.64 |
| Rate for Payer: Aetna Medicare |
$18,843.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,648.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,648.64
|
| Rate for Payer: BCBS MAPPO |
$18,118.91
|
| Rate for Payer: BCN Medicare Advantage |
$18,118.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,118.91
|
| Rate for Payer: Mclaren Medicare |
$18,118.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,024.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,836.75
|
| Rate for Payer: PACE Medicare |
$17,212.96
|
| Rate for Payer: PACE SWMI |
$18,118.91
|
| Rate for Payer: PHP Medicare Advantage |
$18,118.91
|
| Rate for Payer: Priority Health Medicare |
$18,118.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18,118.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,118.91
|
| Rate for Payer: UHC Medicare Advantage |
$18,118.91
|
| Rate for Payer: VA VA |
$18,118.91
|
|
|
MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$9,755.26
|
|
|
Service Code
|
MSDRG 810
|
| Min. Negotiated Rate |
$7,414.00 |
| Max. Negotiated Rate |
$9,755.26 |
| Rate for Payer: Aetna Medicare |
$8,116.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,755.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,755.26
|
| Rate for Payer: BCBS MAPPO |
$7,804.21
|
| Rate for Payer: BCN Medicare Advantage |
$7,804.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,804.21
|
| Rate for Payer: Mclaren Medicare |
$7,804.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,194.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,974.84
|
| Rate for Payer: PACE Medicare |
$7,414.00
|
| Rate for Payer: PACE SWMI |
$7,804.21
|
| Rate for Payer: PHP Medicare Advantage |
$7,804.21
|
| Rate for Payer: Priority Health Medicare |
$7,804.21
|
| Rate for Payer: Railroad Medicare Medicare |
$7,804.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,804.21
|
| Rate for Payer: UHC Medicare Advantage |
$7,804.21
|
| Rate for Payer: VA VA |
$7,804.21
|
|
|
MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$32,073.26
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$24,375.68 |
| Max. Negotiated Rate |
$32,073.26 |
| Rate for Payer: Aetna Medicare |
$26,684.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,073.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,073.26
|
| Rate for Payer: BCBS MAPPO |
$25,658.61
|
| Rate for Payer: BCN Medicare Advantage |
$25,658.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,658.61
|
| Rate for Payer: Mclaren Medicare |
$25,658.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,941.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,507.40
|
| Rate for Payer: PACE Medicare |
$24,375.68
|
| Rate for Payer: PACE SWMI |
$25,658.61
|
| Rate for Payer: PHP Medicare Advantage |
$25,658.61
|
| Rate for Payer: Priority Health Medicare |
$25,658.61
|
| Rate for Payer: Railroad Medicare Medicare |
$25,658.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,658.61
|
| Rate for Payer: UHC Medicare Advantage |
$25,658.61
|
| Rate for Payer: VA VA |
$25,658.61
|
|
|
MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$18,749.31
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$14,249.48 |
| Max. Negotiated Rate |
$18,749.31 |
| Rate for Payer: Aetna Medicare |
$15,599.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,749.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,749.31
|
| Rate for Payer: BCBS MAPPO |
$14,999.45
|
| Rate for Payer: BCN Medicare Advantage |
$14,999.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,999.45
|
| Rate for Payer: Mclaren Medicare |
$14,999.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,749.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,249.37
|
| Rate for Payer: PACE Medicare |
$14,249.48
|
| Rate for Payer: PACE SWMI |
$14,999.45
|
| Rate for Payer: PHP Medicare Advantage |
$14,999.45
|
| Rate for Payer: Priority Health Medicare |
$14,999.45
|
| Rate for Payer: Railroad Medicare Medicare |
$14,999.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,999.45
|
| Rate for Payer: UHC Medicare Advantage |
$14,999.45
|
| Rate for Payer: VA VA |
$14,999.45
|
|
|
MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$25,132.91
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$19,101.01 |
| Max. Negotiated Rate |
$25,132.91 |
| Rate for Payer: Aetna Medicare |
$20,910.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,132.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,132.91
|
| Rate for Payer: BCBS MAPPO |
$20,106.33
|
| Rate for Payer: BCN Medicare Advantage |
$20,106.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,106.33
|
| Rate for Payer: Mclaren Medicare |
$20,106.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,111.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,122.28
|
| Rate for Payer: PACE Medicare |
$19,101.01
|
| Rate for Payer: PACE SWMI |
$20,106.33
|
| Rate for Payer: PHP Medicare Advantage |
$20,106.33
|
| Rate for Payer: Priority Health Medicare |
$20,106.33
|
| Rate for Payer: Railroad Medicare Medicare |
$20,106.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,106.33
|
| Rate for Payer: UHC Medicare Advantage |
$20,106.33
|
| Rate for Payer: VA VA |
$20,106.33
|
|
|
MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$19,280.08
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$14,652.86 |
| Max. Negotiated Rate |
$19,280.08 |
| Rate for Payer: Aetna Medicare |
$16,041.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,280.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,280.08
|
| Rate for Payer: BCBS MAPPO |
$15,424.06
|
| Rate for Payer: BCN Medicare Advantage |
$15,424.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,424.06
|
| Rate for Payer: Mclaren Medicare |
$15,424.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,195.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,737.67
|
| Rate for Payer: PACE Medicare |
$14,652.86
|
| Rate for Payer: PACE SWMI |
$15,424.06
|
| Rate for Payer: PHP Medicare Advantage |
$15,424.06
|
| Rate for Payer: Priority Health Medicare |
$15,424.06
|
| Rate for Payer: Railroad Medicare Medicare |
$15,424.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,424.06
|
| Rate for Payer: UHC Medicare Advantage |
$15,424.06
|
| Rate for Payer: VA VA |
$15,424.06
|
|
|
MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$14,867.35
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$11,299.19 |
| Max. Negotiated Rate |
$14,867.35 |
| Rate for Payer: Aetna Medicare |
$12,369.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,867.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,867.35
|
| Rate for Payer: BCBS MAPPO |
$11,893.88
|
| Rate for Payer: BCN Medicare Advantage |
$11,893.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,893.88
|
| Rate for Payer: Mclaren Medicare |
$11,893.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,488.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,677.96
|
| Rate for Payer: PACE Medicare |
$11,299.19
|
| Rate for Payer: PACE SWMI |
$11,893.88
|
| Rate for Payer: PHP Medicare Advantage |
$11,893.88
|
| Rate for Payer: Priority Health Medicare |
$11,893.88
|
| Rate for Payer: Railroad Medicare Medicare |
$11,893.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,893.88
|
| Rate for Payer: UHC Medicare Advantage |
$11,893.88
|
| Rate for Payer: VA VA |
$11,893.88
|
|
|
MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$19,256.95
|
|
|
Service Code
|
MSDRG 507
|
| Min. Negotiated Rate |
$14,635.28 |
| Max. Negotiated Rate |
$19,256.95 |
| Rate for Payer: Aetna Medicare |
$16,021.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,256.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,256.95
|
| Rate for Payer: BCBS MAPPO |
$15,405.56
|
| Rate for Payer: BCN Medicare Advantage |
$15,405.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,405.56
|
| Rate for Payer: Mclaren Medicare |
$15,405.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,175.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,716.39
|
| Rate for Payer: PACE Medicare |
$14,635.28
|
| Rate for Payer: PACE SWMI |
$15,405.56
|
| Rate for Payer: PHP Medicare Advantage |
$15,405.56
|
| Rate for Payer: Priority Health Medicare |
$15,405.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15,405.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,405.56
|
| Rate for Payer: UHC Medicare Advantage |
$15,405.56
|
| Rate for Payer: VA VA |
$15,405.56
|
|
