|
MS-DRG 42.00: RESPIRATORY NEOPLASMS WITH MCC
|
Facility
|
IP
|
$17,422.89
|
|
|
Service Code
|
MSDRG 180
|
| Min. Negotiated Rate |
$13,241.39 |
| Max. Negotiated Rate |
$17,422.89 |
| Rate for Payer: Aetna Medicare |
$14,495.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,422.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,422.89
|
| Rate for Payer: BCBS MAPPO |
$13,938.31
|
| Rate for Payer: BCN Medicare Advantage |
$13,938.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,938.31
|
| Rate for Payer: Mclaren Medicare |
$13,938.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,635.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,029.06
|
| Rate for Payer: PACE Medicare |
$13,241.39
|
| Rate for Payer: PACE SWMI |
$13,938.31
|
| Rate for Payer: PHP Medicare Advantage |
$13,938.31
|
| Rate for Payer: Priority Health Medicare |
$13,938.31
|
| Rate for Payer: Railroad Medicare Medicare |
$13,938.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,938.31
|
| Rate for Payer: UHC Medicare Advantage |
$13,938.31
|
| Rate for Payer: VA VA |
$13,938.31
|
|
|
MS-DRG 42.00: RESPIRATORY NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,654.24
|
|
|
Service Code
|
MSDRG 182
|
| Min. Negotiated Rate |
$6,577.22 |
| Max. Negotiated Rate |
$8,654.24 |
| Rate for Payer: Aetna Medicare |
$7,200.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,654.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,654.24
|
| Rate for Payer: BCBS MAPPO |
$6,923.39
|
| Rate for Payer: BCN Medicare Advantage |
$6,923.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,923.39
|
| Rate for Payer: Mclaren Medicare |
$6,923.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,269.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,961.90
|
| Rate for Payer: PACE Medicare |
$6,577.22
|
| Rate for Payer: PACE SWMI |
$6,923.39
|
| Rate for Payer: PHP Medicare Advantage |
$6,923.39
|
| Rate for Payer: Priority Health Medicare |
$6,923.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6,923.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,923.39
|
| Rate for Payer: UHC Medicare Advantage |
$6,923.39
|
| Rate for Payer: VA VA |
$6,923.39
|
|
|
MS-DRG 42.00: RESPIRATORY SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$8,398.98
|
|
|
Service Code
|
MSDRG 204
|
| Min. Negotiated Rate |
$6,383.22 |
| Max. Negotiated Rate |
$8,398.98 |
| Rate for Payer: Aetna Medicare |
$6,987.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,398.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,398.98
|
| Rate for Payer: BCBS MAPPO |
$6,719.18
|
| Rate for Payer: BCN Medicare Advantage |
$6,719.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,719.18
|
| Rate for Payer: Mclaren Medicare |
$6,719.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,055.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,727.06
|
| Rate for Payer: PACE Medicare |
$6,383.22
|
| Rate for Payer: PACE SWMI |
$6,719.18
|
| Rate for Payer: PHP Medicare Advantage |
$6,719.18
|
| Rate for Payer: Priority Health Medicare |
$6,719.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6,719.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,719.18
|
| Rate for Payer: UHC Medicare Advantage |
$6,719.18
|
| Rate for Payer: VA VA |
$6,719.18
|
|
|
MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS
|
Facility
|
IP
|
$26,439.10
|
|
|
Service Code
|
MSDRG 208
|
| Min. Negotiated Rate |
$20,093.72 |
| Max. Negotiated Rate |
$26,439.10 |
| Rate for Payer: Aetna Medicare |
$21,997.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,439.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,439.10
|
| Rate for Payer: BCBS MAPPO |
$21,151.28
|
| Rate for Payer: BCN Medicare Advantage |
$21,151.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,151.28
|
| Rate for Payer: Mclaren Medicare |
$21,151.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,208.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,323.97
|
| Rate for Payer: PACE Medicare |
$20,093.72
|
| Rate for Payer: PACE SWMI |
$21,151.28
|
| Rate for Payer: PHP Medicare Advantage |
$21,151.28
|
| Rate for Payer: Priority Health Medicare |
$21,151.28
|
| Rate for Payer: Railroad Medicare Medicare |
$21,151.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,151.28
|
| Rate for Payer: UHC Medicare Advantage |
$21,151.28
|
| Rate for Payer: VA VA |
$21,151.28
|
|
|
MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS
|
Facility
|
IP
|
$62,883.49
|
|
|
Service Code
|
MSDRG 207
|
| Min. Negotiated Rate |
$47,791.45 |
| Max. Negotiated Rate |
$62,883.49 |
| Rate for Payer: Aetna Medicare |
$52,319.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,883.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,883.49
|
| Rate for Payer: BCBS MAPPO |
$50,306.79
|
| Rate for Payer: BCN Medicare Advantage |
$50,306.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50,306.79
|
| Rate for Payer: Mclaren Medicare |
$50,306.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,822.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,852.81
|
| Rate for Payer: PACE Medicare |
$47,791.45
|
| Rate for Payer: PACE SWMI |
$50,306.79
|
| Rate for Payer: PHP Medicare Advantage |
$50,306.79
|
| Rate for Payer: Priority Health Medicare |
$50,306.79
|
| Rate for Payer: Railroad Medicare Medicare |
$50,306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$50,306.79
|
| Rate for Payer: UHC Medicare Advantage |
$50,306.79
|
| Rate for Payer: VA VA |
$50,306.79
|
|
|
MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC
|
Facility
|
IP
|
$10,374.62
|
|
|
Service Code
|
MSDRG 815
|
| Min. Negotiated Rate |
$7,884.72 |
| Max. Negotiated Rate |
$10,374.62 |
| Rate for Payer: Aetna Medicare |
$8,631.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,374.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,374.62
|
| Rate for Payer: BCBS MAPPO |
$8,299.70
|
| Rate for Payer: BCN Medicare Advantage |
$8,299.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,299.70
|
| Rate for Payer: Mclaren Medicare |
$8,299.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,714.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,544.66
|
| Rate for Payer: PACE Medicare |
$7,884.72
|
| Rate for Payer: PACE SWMI |
$8,299.70
|
| Rate for Payer: PHP Medicare Advantage |
$8,299.70
|
| Rate for Payer: Priority Health Medicare |
$8,299.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8,299.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,299.70
|
| Rate for Payer: UHC Medicare Advantage |
$8,299.70
|
| Rate for Payer: VA VA |
$8,299.70
|
|
|
MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC
|
Facility
|
IP
|
$20,724.01
|
|
|
Service Code
|
MSDRG 814
|
| Min. Negotiated Rate |
$15,750.25 |
| Max. Negotiated Rate |
$20,724.01 |
| Rate for Payer: Aetna Medicare |
$17,242.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,724.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,724.01
|
| Rate for Payer: BCBS MAPPO |
$16,579.21
|
| Rate for Payer: BCN Medicare Advantage |
$16,579.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,579.21
|
| Rate for Payer: Mclaren Medicare |
$16,579.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,408.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,066.09
|
| Rate for Payer: PACE Medicare |
$15,750.25
|
| Rate for Payer: PACE SWMI |
$16,579.21
|
| Rate for Payer: PHP Medicare Advantage |
$16,579.21
|
| Rate for Payer: Priority Health Medicare |
$16,579.21
|
| Rate for Payer: Railroad Medicare Medicare |
$16,579.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,579.21
|
| Rate for Payer: UHC Medicare Advantage |
$16,579.21
|
| Rate for Payer: VA VA |
$16,579.21
|
|
|
MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$6,938.66
|
|
|
Service Code
|
MSDRG 816
|
| Min. Negotiated Rate |
$5,273.38 |
| Max. Negotiated Rate |
$6,938.66 |
| Rate for Payer: Aetna Medicare |
$5,772.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,938.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,938.66
|
| Rate for Payer: BCBS MAPPO |
$5,550.93
|
| Rate for Payer: BCN Medicare Advantage |
$5,550.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,550.93
|
| Rate for Payer: Mclaren Medicare |
$5,550.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,828.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,383.57
|
| Rate for Payer: PACE Medicare |
$5,273.38
|
| Rate for Payer: PACE SWMI |
$5,550.93
|
| Rate for Payer: PHP Medicare Advantage |
$5,550.93
|
| Rate for Payer: Priority Health Medicare |
$5,550.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5,550.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,550.93
|
| Rate for Payer: UHC Medicare Advantage |
$5,550.93
|
| Rate for Payer: VA VA |
$5,550.93
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
|
IP
|
$33,580.80
|
|
|
Service Code
|
MSDRG 467
|
| Min. Negotiated Rate |
$25,521.41 |
| Max. Negotiated Rate |
$33,580.80 |
| Rate for Payer: Aetna Medicare |
$27,939.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,580.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,580.80
|
| Rate for Payer: BCBS MAPPO |
$26,864.64
|
| Rate for Payer: BCN Medicare Advantage |
$26,864.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,864.64
|
| Rate for Payer: Mclaren Medicare |
$26,864.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,207.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,894.34
|
| Rate for Payer: PACE Medicare |
$25,521.41
|
| Rate for Payer: PACE SWMI |
$26,864.64
|
| Rate for Payer: PHP Medicare Advantage |
$26,864.64
|
| Rate for Payer: Priority Health Medicare |
$26,864.64
|
| Rate for Payer: Railroad Medicare Medicare |
$26,864.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,864.64
|
| Rate for Payer: UHC Medicare Advantage |
$26,864.64
|
| Rate for Payer: VA VA |
$26,864.64
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$49,661.61
|
|
|
Service Code
|
MSDRG 466
|
| Min. Negotiated Rate |
$37,742.83 |
| Max. Negotiated Rate |
$49,661.61 |
| Rate for Payer: Aetna Medicare |
$41,318.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,661.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,661.61
|
| Rate for Payer: BCBS MAPPO |
$39,729.29
|
| Rate for Payer: BCN Medicare Advantage |
$39,729.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,729.29
|
| Rate for Payer: Mclaren Medicare |
$39,729.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41,715.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,688.68
|
| Rate for Payer: PACE Medicare |
$37,742.83
|
| Rate for Payer: PACE SWMI |
$39,729.29
|
| Rate for Payer: PHP Medicare Advantage |
$39,729.29
|
| Rate for Payer: Priority Health Medicare |
$39,729.29
|
| Rate for Payer: Railroad Medicare Medicare |
$39,729.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$39,729.29
|
| Rate for Payer: UHC Medicare Advantage |
$39,729.29
|
| Rate for Payer: VA VA |
$39,729.29
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$25,856.30
|
|
|
Service Code
|
MSDRG 468
|
| Min. Negotiated Rate |
$19,650.79 |
| Max. Negotiated Rate |
$25,856.30 |
| Rate for Payer: Aetna Medicare |
$21,512.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,856.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,856.30
|
| Rate for Payer: BCBS MAPPO |
$20,685.04
|
| Rate for Payer: BCN Medicare Advantage |
$20,685.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,685.04
|
| Rate for Payer: Mclaren Medicare |
$20,685.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,719.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,787.80
|
| Rate for Payer: PACE Medicare |
$19,650.79
|
| Rate for Payer: PACE SWMI |
$20,685.04
|
| Rate for Payer: PHP Medicare Advantage |
$20,685.04
|
| Rate for Payer: Priority Health Medicare |
$20,685.04
|
| Rate for Payer: Railroad Medicare Medicare |
$20,685.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,685.04
|
| Rate for Payer: UHC Medicare Advantage |
$20,685.04
|
| Rate for Payer: VA VA |
$20,685.04
|
|
|
MS-DRG 42.00: SALIVARY GLAND PROCEDURES
|
Facility
|
IP
|
$13,812.55
|
|
|
Service Code
|
MSDRG 139
|
| Min. Negotiated Rate |
$10,497.54 |
| Max. Negotiated Rate |
$13,812.55 |
| Rate for Payer: Aetna Medicare |
$11,492.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,812.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,812.55
|
| Rate for Payer: BCBS MAPPO |
$11,050.04
|
| Rate for Payer: BCN Medicare Advantage |
$11,050.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,050.04
|
| Rate for Payer: Mclaren Medicare |
$11,050.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,602.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,707.55
|
| Rate for Payer: PACE Medicare |
$10,497.54
|
| Rate for Payer: PACE SWMI |
$11,050.04
|
| Rate for Payer: PHP Medicare Advantage |
$11,050.04
|
| Rate for Payer: Priority Health Medicare |
$11,050.04
|
| Rate for Payer: Railroad Medicare Medicare |
$11,050.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,050.04
|
| Rate for Payer: UHC Medicare Advantage |
$11,050.04
|
| Rate for Payer: VA VA |
$11,050.04
|
|
|
MS-DRG 42.00: SEIZURES WITH MCC
|
Facility
|
IP
|
$19,710.67
|
|
|
Service Code
|
MSDRG 100
|
| Min. Negotiated Rate |
$14,980.11 |
| Max. Negotiated Rate |
$19,710.67 |
| Rate for Payer: Aetna Medicare |
$16,399.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,710.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,710.67
|
| Rate for Payer: BCBS MAPPO |
$15,768.54
|
| Rate for Payer: BCN Medicare Advantage |
$15,768.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,768.54
|
| Rate for Payer: Mclaren Medicare |
$15,768.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,556.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,133.82
|
| Rate for Payer: PACE Medicare |
$14,980.11
|
| Rate for Payer: PACE SWMI |
$15,768.54
|
| Rate for Payer: PHP Medicare Advantage |
$15,768.54
|
| Rate for Payer: Priority Health Medicare |
$15,768.54
|
| Rate for Payer: Railroad Medicare Medicare |
$15,768.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,768.54
|
| Rate for Payer: UHC Medicare Advantage |
$15,768.54
|
| Rate for Payer: VA VA |
$15,768.54
|
|
|
MS-DRG 42.00: SEIZURES WITHOUT MCC
|
Facility
|
IP
|
$9,465.31
|
|
|
Service Code
|
MSDRG 101
|
| Min. Negotiated Rate |
$7,193.64 |
| Max. Negotiated Rate |
$9,465.31 |
| Rate for Payer: Aetna Medicare |
$7,875.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,465.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,465.31
|
| Rate for Payer: BCBS MAPPO |
$7,572.25
|
| Rate for Payer: BCN Medicare Advantage |
$7,572.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,572.25
|
| Rate for Payer: Mclaren Medicare |
$7,572.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,950.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,708.09
|
| Rate for Payer: PACE Medicare |
$7,193.64
|
| Rate for Payer: PACE SWMI |
$7,572.25
|
| Rate for Payer: PHP Medicare Advantage |
$7,572.25
|
| Rate for Payer: Priority Health Medicare |
$7,572.25
|
| Rate for Payer: Railroad Medicare Medicare |
$7,572.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,572.25
|
| Rate for Payer: UHC Medicare Advantage |
$7,572.25
|
| Rate for Payer: VA VA |
$7,572.25
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC
|
Facility
|
IP
|
$12,195.20
|
|
|
Service Code
|
MSDRG 549
|
| Min. Negotiated Rate |
$9,268.35 |
| Max. Negotiated Rate |
$12,195.20 |
| Rate for Payer: Aetna Medicare |
$10,146.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,195.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,195.20
|
| Rate for Payer: BCBS MAPPO |
$9,756.16
|
| Rate for Payer: BCN Medicare Advantage |
$9,756.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,756.16
|
| Rate for Payer: Mclaren Medicare |
$9,756.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,243.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,219.58
|
| Rate for Payer: PACE Medicare |
$9,268.35
|
| Rate for Payer: PACE SWMI |
$9,756.16
|
| Rate for Payer: PHP Medicare Advantage |
$9,756.16
|
| Rate for Payer: Priority Health Medicare |
$9,756.16
|
| Rate for Payer: Railroad Medicare Medicare |
$9,756.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,756.16
|
| Rate for Payer: UHC Medicare Advantage |
$9,756.16
|
| Rate for Payer: VA VA |
$9,756.16
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC
|
Facility
|
IP
|
$19,992.89
|
|
|
Service Code
|
MSDRG 548
|
| Min. Negotiated Rate |
$15,194.59 |
| Max. Negotiated Rate |
$19,992.89 |
| Rate for Payer: Aetna Medicare |
$16,634.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,992.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,992.89
|
| Rate for Payer: BCBS MAPPO |
$15,994.31
|
| Rate for Payer: BCN Medicare Advantage |
$15,994.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,994.31
|
| Rate for Payer: Mclaren Medicare |
$15,994.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,794.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,393.46
|
| Rate for Payer: PACE Medicare |
$15,194.59
|
| Rate for Payer: PACE SWMI |
$15,994.31
|
| Rate for Payer: PHP Medicare Advantage |
$15,994.31
|
| Rate for Payer: Priority Health Medicare |
$15,994.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15,994.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,994.31
|
| Rate for Payer: UHC Medicare Advantage |
$15,994.31
|
| Rate for Payer: VA VA |
$15,994.31
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,891.17
|
|
|
Service Code
|
MSDRG 550
|
| Min. Negotiated Rate |
$6,757.29 |
| Max. Negotiated Rate |
$8,891.17 |
| Rate for Payer: Aetna Medicare |
$7,397.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,891.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,891.17
|
| Rate for Payer: BCBS MAPPO |
$7,112.94
|
| Rate for Payer: BCN Medicare Advantage |
$7,112.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,112.94
|
| Rate for Payer: Mclaren Medicare |
$7,112.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,468.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,179.88
|
| Rate for Payer: PACE Medicare |
$6,757.29
|
| Rate for Payer: PACE SWMI |
$7,112.94
|
| Rate for Payer: PHP Medicare Advantage |
$7,112.94
|
| Rate for Payer: Priority Health Medicare |
$7,112.94
|
| Rate for Payer: Railroad Medicare Medicare |
$7,112.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,112.94
|
| Rate for Payer: UHC Medicare Advantage |
$7,112.94
|
| Rate for Payer: VA VA |
$7,112.94
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS
|
Facility
|
IP
|
$67,596.77
|
|
|
Service Code
|
MSDRG 870
|
| Min. Negotiated Rate |
$51,373.55 |
| Max. Negotiated Rate |
$67,596.77 |
| Rate for Payer: Aetna Medicare |
$56,240.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67,596.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67,596.77
|
| Rate for Payer: BCBS MAPPO |
$54,077.42
|
| Rate for Payer: BCN Medicare Advantage |
$54,077.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54,077.42
|
| Rate for Payer: Mclaren Medicare |
$54,077.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56,781.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62,189.03
|
| Rate for Payer: PACE Medicare |
$51,373.55
|
| Rate for Payer: PACE SWMI |
$54,077.42
|
| Rate for Payer: PHP Medicare Advantage |
$54,077.42
|
| Rate for Payer: Priority Health Medicare |
$54,077.42
|
| Rate for Payer: Railroad Medicare Medicare |
$54,077.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$54,077.42
|
| Rate for Payer: UHC Medicare Advantage |
$54,077.42
|
| Rate for Payer: VA VA |
$54,077.42
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC
|
Facility
|
IP
|
$19,487.19
|
|
|
Service Code
|
MSDRG 871
|
| Min. Negotiated Rate |
$14,810.26 |
| Max. Negotiated Rate |
$19,487.19 |
| Rate for Payer: Aetna Medicare |
$16,213.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,487.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,487.19
|
| Rate for Payer: BCBS MAPPO |
$15,589.75
|
| Rate for Payer: BCN Medicare Advantage |
$15,589.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,589.75
|
| Rate for Payer: Mclaren Medicare |
$15,589.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,369.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,928.21
|
| Rate for Payer: PACE Medicare |
$14,810.26
|
| Rate for Payer: PACE SWMI |
$15,589.75
|
| Rate for Payer: PHP Medicare Advantage |
$15,589.75
|
| Rate for Payer: Priority Health Medicare |
$15,589.75
|
| Rate for Payer: Railroad Medicare Medicare |
$15,589.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,589.75
|
| Rate for Payer: UHC Medicare Advantage |
$15,589.75
|
| Rate for Payer: VA VA |
$15,589.75
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC
|
Facility
|
IP
|
$10,518.17
|
|
|
Service Code
|
MSDRG 872
|
| Min. Negotiated Rate |
$7,993.81 |
| Max. Negotiated Rate |
$10,518.17 |
| Rate for Payer: Aetna Medicare |
$8,751.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,518.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,518.17
|
| Rate for Payer: BCBS MAPPO |
$8,414.54
|
| Rate for Payer: BCN Medicare Advantage |
$8,414.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,414.54
|
| Rate for Payer: Mclaren Medicare |
$8,414.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,835.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,676.72
|
| Rate for Payer: PACE Medicare |
$7,993.81
|
| Rate for Payer: PACE SWMI |
$8,414.54
|
| Rate for Payer: PHP Medicare Advantage |
$8,414.54
|
| Rate for Payer: Priority Health Medicare |
$8,414.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8,414.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,414.54
|
| Rate for Payer: UHC Medicare Advantage |
$8,414.54
|
| Rate for Payer: VA VA |
$8,414.54
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
|
IP
|
$19,478.50
|
|
|
Service Code
|
MSDRG 511
|
| Min. Negotiated Rate |
$14,803.66 |
| Max. Negotiated Rate |
$19,478.50 |
| Rate for Payer: Aetna Medicare |
$16,206.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,478.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,478.50
|
| Rate for Payer: BCBS MAPPO |
$15,582.80
|
| Rate for Payer: BCN Medicare Advantage |
$15,582.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,582.80
|
| Rate for Payer: Mclaren Medicare |
$15,582.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,361.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,920.22
|
| Rate for Payer: PACE Medicare |
$14,803.66
|
| Rate for Payer: PACE SWMI |
$15,582.80
|
| Rate for Payer: PHP Medicare Advantage |
$15,582.80
|
| Rate for Payer: Priority Health Medicare |
$15,582.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15,582.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,582.80
|
| Rate for Payer: UHC Medicare Advantage |
$15,582.80
|
| Rate for Payer: VA VA |
$15,582.80
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
|
Facility
|
IP
|
$28,118.08
|
|
|
Service Code
|
MSDRG 510
|
| Min. Negotiated Rate |
$21,369.74 |
| Max. Negotiated Rate |
$28,118.08 |
| Rate for Payer: Aetna Medicare |
$23,394.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,118.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,118.08
|
| Rate for Payer: BCBS MAPPO |
$22,494.46
|
| Rate for Payer: BCN Medicare Advantage |
$22,494.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,494.46
|
| Rate for Payer: Mclaren Medicare |
$22,494.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,619.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,868.63
|
| Rate for Payer: PACE Medicare |
$21,369.74
|
| Rate for Payer: PACE SWMI |
$22,494.46
|
| Rate for Payer: PHP Medicare Advantage |
$22,494.46
|
| Rate for Payer: Priority Health Medicare |
$22,494.46
|
| Rate for Payer: Railroad Medicare Medicare |
$22,494.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,494.46
|
| Rate for Payer: UHC Medicare Advantage |
$22,494.46
|
| Rate for Payer: VA VA |
$22,494.46
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,074.31
|
|
|
Service Code
|
MSDRG 512
|
| Min. Negotiated Rate |
$12,216.48 |
| Max. Negotiated Rate |
$16,074.31 |
| Rate for Payer: Aetna Medicare |
$13,373.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,074.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,074.31
|
| Rate for Payer: BCBS MAPPO |
$12,859.45
|
| Rate for Payer: BCN Medicare Advantage |
$12,859.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,859.45
|
| Rate for Payer: Mclaren Medicare |
$12,859.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,502.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,788.37
|
| Rate for Payer: PACE Medicare |
$12,216.48
|
| Rate for Payer: PACE SWMI |
$12,859.45
|
| Rate for Payer: PHP Medicare Advantage |
$12,859.45
|
| Rate for Payer: Priority Health Medicare |
$12,859.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12,859.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,859.45
|
| Rate for Payer: UHC Medicare Advantage |
$12,859.45
|
| Rate for Payer: VA VA |
$12,859.45
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$13,558.25
|
|
|
Service Code
|
MSDRG 555
|
| Min. Negotiated Rate |
$10,304.27 |
| Max. Negotiated Rate |
$13,558.25 |
| Rate for Payer: Aetna Medicare |
$11,280.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,558.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,558.25
|
| Rate for Payer: BCBS MAPPO |
$10,846.60
|
| Rate for Payer: BCN Medicare Advantage |
$10,846.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,846.60
|
| Rate for Payer: Mclaren Medicare |
$10,846.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,388.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,473.59
|
| Rate for Payer: PACE Medicare |
$10,304.27
|
| Rate for Payer: PACE SWMI |
$10,846.60
|
| Rate for Payer: PHP Medicare Advantage |
$10,846.60
|
| Rate for Payer: Priority Health Medicare |
$10,846.60
|
| Rate for Payer: Railroad Medicare Medicare |
$10,846.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,846.60
|
| Rate for Payer: UHC Medicare Advantage |
$10,846.60
|
| Rate for Payer: VA VA |
$10,846.60
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
|
Facility
|
IP
|
$8,451.96
|
|
|
Service Code
|
MSDRG 556
|
| Min. Negotiated Rate |
$6,423.49 |
| Max. Negotiated Rate |
$8,451.96 |
| Rate for Payer: Aetna Medicare |
$7,032.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,451.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,451.96
|
| Rate for Payer: BCBS MAPPO |
$6,761.57
|
| Rate for Payer: BCN Medicare Advantage |
$6,761.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,761.57
|
| Rate for Payer: Mclaren Medicare |
$6,761.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,099.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,775.81
|
| Rate for Payer: PACE Medicare |
$6,423.49
|
| Rate for Payer: PACE SWMI |
$6,761.57
|
| Rate for Payer: PHP Medicare Advantage |
$6,761.57
|
| Rate for Payer: Priority Health Medicare |
$6,761.57
|
| Rate for Payer: Railroad Medicare Medicare |
$6,761.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,761.57
|
| Rate for Payer: UHC Medicare Advantage |
$6,761.57
|
| Rate for Payer: VA VA |
$6,761.57
|
|
