|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$12,976.44
|
|
|
Service Code
|
MSDRG 947
|
| Min. Negotiated Rate |
$9,862.09 |
| Max. Negotiated Rate |
$12,976.44 |
| Rate for Payer: Aetna Medicare |
$10,796.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,976.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,976.44
|
| Rate for Payer: BCBS MAPPO |
$10,381.15
|
| Rate for Payer: BCN Medicare Advantage |
$10,381.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,381.15
|
| Rate for Payer: Mclaren Medicare |
$10,381.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,900.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,938.32
|
| Rate for Payer: PACE Medicare |
$9,862.09
|
| Rate for Payer: PACE SWMI |
$10,381.15
|
| Rate for Payer: PHP Medicare Advantage |
$10,381.15
|
| Rate for Payer: Priority Health Medicare |
$10,381.15
|
| Rate for Payer: Railroad Medicare Medicare |
$10,381.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,381.15
|
| Rate for Payer: UHC Medicare Advantage |
$10,381.15
|
| Rate for Payer: VA VA |
$10,381.15
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$8,240.04
|
|
|
Service Code
|
MSDRG 948
|
| Min. Negotiated Rate |
$6,262.43 |
| Max. Negotiated Rate |
$8,240.04 |
| Rate for Payer: Aetna Medicare |
$6,855.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,240.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,240.04
|
| Rate for Payer: BCBS MAPPO |
$6,592.03
|
| Rate for Payer: BCN Medicare Advantage |
$6,592.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,592.03
|
| Rate for Payer: Mclaren Medicare |
$6,592.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,921.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,580.83
|
| Rate for Payer: PACE Medicare |
$6,262.43
|
| Rate for Payer: PACE SWMI |
$6,592.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,592.03
|
| Rate for Payer: Priority Health Medicare |
$6,592.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6,592.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,592.03
|
| Rate for Payer: UHC Medicare Advantage |
$6,592.03
|
| Rate for Payer: VA VA |
$6,592.03
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
|
IP
|
$8,485.66
|
|
|
Service Code
|
MSDRG 194
|
| Min. Negotiated Rate |
$6,449.10 |
| Max. Negotiated Rate |
$8,485.66 |
| Rate for Payer: Aetna Medicare |
$7,060.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,485.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,485.66
|
| Rate for Payer: BCBS MAPPO |
$6,788.53
|
| Rate for Payer: BCN Medicare Advantage |
$6,788.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,788.53
|
| Rate for Payer: Mclaren Medicare |
$6,788.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,127.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,806.81
|
| Rate for Payer: PACE Medicare |
$6,449.10
|
| Rate for Payer: PACE SWMI |
$6,788.53
|
| Rate for Payer: PHP Medicare Advantage |
$6,788.53
|
| Rate for Payer: Priority Health Medicare |
$6,788.53
|
| Rate for Payer: Railroad Medicare Medicare |
$6,788.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,788.53
|
| Rate for Payer: UHC Medicare Advantage |
$6,788.53
|
| Rate for Payer: VA VA |
$6,788.53
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
|
IP
|
$13,279.88
|
|
|
Service Code
|
MSDRG 193
|
| Min. Negotiated Rate |
$10,092.70 |
| Max. Negotiated Rate |
$13,279.88 |
| Rate for Payer: Aetna Medicare |
$11,048.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,279.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,279.88
|
| Rate for Payer: BCBS MAPPO |
$10,623.90
|
| Rate for Payer: BCN Medicare Advantage |
$10,623.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,623.90
|
| Rate for Payer: Mclaren Medicare |
$10,623.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,155.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,217.49
|
| Rate for Payer: PACE Medicare |
$10,092.70
|
| Rate for Payer: PACE SWMI |
$10,623.90
|
| Rate for Payer: PHP Medicare Advantage |
$10,623.90
|
| Rate for Payer: Priority Health Medicare |
$10,623.90
|
| Rate for Payer: Railroad Medicare Medicare |
$10,623.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,623.90
|
| Rate for Payer: UHC Medicare Advantage |
$10,623.90
|
| Rate for Payer: VA VA |
$10,623.90
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
|
IP
|
$6,585.15
|
|
|
Service Code
|
MSDRG 195
|
| Min. Negotiated Rate |
$5,004.71 |
| Max. Negotiated Rate |
$6,585.15 |
| Rate for Payer: Aetna Medicare |
$5,478.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,585.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,585.15
|
| Rate for Payer: BCBS MAPPO |
$5,268.12
|
| Rate for Payer: BCN Medicare Advantage |
$5,268.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,268.12
|
| Rate for Payer: Mclaren Medicare |
$5,268.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,531.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,058.34
|
| Rate for Payer: PACE Medicare |
$5,004.71
|
| Rate for Payer: PACE SWMI |
$5,268.12
|
| Rate for Payer: PHP Medicare Advantage |
$5,268.12
|
| Rate for Payer: Priority Health Medicare |
$5,268.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5,268.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,268.12
|
| Rate for Payer: UHC Medicare Advantage |
$5,268.12
|
| Rate for Payer: VA VA |
$5,268.12
|
|
|
MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT
|
Facility
|
IP
|
$52,999.35
|
|
|
Service Code
|
MSDRG 008
|
| Min. Negotiated Rate |
$40,279.51 |
| Max. Negotiated Rate |
$52,999.35 |
| Rate for Payer: Aetna Medicare |
$44,095.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,999.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,999.35
|
| Rate for Payer: BCBS MAPPO |
$42,399.48
|
| Rate for Payer: BCN Medicare Advantage |
$42,399.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42,399.48
|
| Rate for Payer: Mclaren Medicare |
$42,399.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,519.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48,759.40
|
| Rate for Payer: PACE Medicare |
$40,279.51
|
| Rate for Payer: PACE SWMI |
$42,399.48
|
| Rate for Payer: PHP Medicare Advantage |
$42,399.48
|
| Rate for Payer: Priority Health Medicare |
$42,399.48
|
| Rate for Payer: Railroad Medicare Medicare |
$42,399.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$42,399.48
|
| Rate for Payer: UHC Medicare Advantage |
$42,399.48
|
| Rate for Payer: VA VA |
$42,399.48
|
|
|
MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
|
IP
|
$76,948.20
|
|
|
Service Code
|
MSDRG 019
|
| Min. Negotiated Rate |
$58,480.63 |
| Max. Negotiated Rate |
$76,948.20 |
| Rate for Payer: Aetna Medicare |
$64,020.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76,948.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76,948.20
|
| Rate for Payer: BCBS MAPPO |
$61,558.56
|
| Rate for Payer: BCN Medicare Advantage |
$61,558.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61,558.56
|
| Rate for Payer: Mclaren Medicare |
$61,558.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64,636.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70,792.34
|
| Rate for Payer: PACE Medicare |
$58,480.63
|
| Rate for Payer: PACE SWMI |
$61,558.56
|
| Rate for Payer: PHP Medicare Advantage |
$61,558.56
|
| Rate for Payer: Priority Health Medicare |
$61,558.56
|
| Rate for Payer: Railroad Medicare Medicare |
$61,558.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$61,558.56
|
| Rate for Payer: UHC Medicare Advantage |
$61,558.56
|
| Rate for Payer: VA VA |
$61,558.56
|
|
|
MS-DRG 42.00: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
|
Facility
|
IP
|
$38,271.90
|
|
|
Service Code
|
MSDRG 402
|
| Min. Negotiated Rate |
$29,086.64 |
| Max. Negotiated Rate |
$38,271.90 |
| Rate for Payer: Aetna Medicare |
$31,842.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,271.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,271.90
|
| Rate for Payer: BCBS MAPPO |
$30,617.52
|
| Rate for Payer: BCN Medicare Advantage |
$30,617.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,617.52
|
| Rate for Payer: Mclaren Medicare |
$30,617.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,148.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,210.15
|
| Rate for Payer: PACE Medicare |
$29,086.64
|
| Rate for Payer: PACE SWMI |
$30,617.52
|
| Rate for Payer: PHP Medicare Advantage |
$30,617.52
|
| Rate for Payer: Priority Health Medicare |
$30,617.52
|
| Rate for Payer: Railroad Medicare Medicare |
$30,617.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,617.52
|
| Rate for Payer: UHC Medicare Advantage |
$30,617.52
|
| Rate for Payer: VA VA |
$30,617.52
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$50,196.25
|
|
|
Service Code
|
MSDRG 450
|
| Min. Negotiated Rate |
$38,149.15 |
| Max. Negotiated Rate |
$50,196.25 |
| Rate for Payer: Aetna Medicare |
$41,763.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50,196.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50,196.25
|
| Rate for Payer: BCBS MAPPO |
$40,157.00
|
| Rate for Payer: BCN Medicare Advantage |
$40,157.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40,157.00
|
| Rate for Payer: Mclaren Medicare |
$40,157.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42,164.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46,180.55
|
| Rate for Payer: PACE Medicare |
$38,149.15
|
| Rate for Payer: PACE SWMI |
$40,157.00
|
| Rate for Payer: PHP Medicare Advantage |
$40,157.00
|
| Rate for Payer: Priority Health Medicare |
$40,157.00
|
| Rate for Payer: Railroad Medicare Medicare |
$40,157.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$40,157.00
|
| Rate for Payer: UHC Medicare Advantage |
$40,157.00
|
| Rate for Payer: VA VA |
$40,157.00
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$30,313.35
|
|
|
Service Code
|
MSDRG 451
|
| Min. Negotiated Rate |
$23,038.15 |
| Max. Negotiated Rate |
$30,313.35 |
| Rate for Payer: Aetna Medicare |
$25,220.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,313.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,313.35
|
| Rate for Payer: BCBS MAPPO |
$24,250.68
|
| Rate for Payer: BCN Medicare Advantage |
$24,250.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,250.68
|
| Rate for Payer: Mclaren Medicare |
$24,250.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,463.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,888.28
|
| Rate for Payer: PACE Medicare |
$23,038.15
|
| Rate for Payer: PACE SWMI |
$24,250.68
|
| Rate for Payer: PHP Medicare Advantage |
$24,250.68
|
| Rate for Payer: Priority Health Medicare |
$24,250.68
|
| Rate for Payer: Railroad Medicare Medicare |
$24,250.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,250.68
|
| Rate for Payer: UHC Medicare Advantage |
$24,250.68
|
| Rate for Payer: VA VA |
$24,250.68
|
|
|
MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$23,812.29
|
|
|
Service Code
|
MSDRG 135
|
| Min. Negotiated Rate |
$18,097.34 |
| Max. Negotiated Rate |
$23,812.29 |
| Rate for Payer: Aetna Medicare |
$19,811.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,812.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,812.29
|
| Rate for Payer: BCBS MAPPO |
$19,049.83
|
| Rate for Payer: BCN Medicare Advantage |
$19,049.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,049.83
|
| Rate for Payer: Mclaren Medicare |
$19,049.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,002.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,907.30
|
| Rate for Payer: PACE Medicare |
$18,097.34
|
| Rate for Payer: PACE SWMI |
$19,049.83
|
| Rate for Payer: PHP Medicare Advantage |
$19,049.83
|
| Rate for Payer: Priority Health Medicare |
$19,049.83
|
| Rate for Payer: Railroad Medicare Medicare |
$19,049.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,049.83
|
| Rate for Payer: UHC Medicare Advantage |
$19,049.83
|
| Rate for Payer: VA VA |
$19,049.83
|
|
|
MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$10,009.55
|
|
|
Service Code
|
MSDRG 136
|
| Min. Negotiated Rate |
$7,607.26 |
| Max. Negotiated Rate |
$10,009.55 |
| Rate for Payer: Aetna Medicare |
$8,327.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,009.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,009.55
|
| Rate for Payer: BCBS MAPPO |
$8,007.64
|
| Rate for Payer: BCN Medicare Advantage |
$8,007.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,007.64
|
| Rate for Payer: Mclaren Medicare |
$8,007.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,408.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,208.79
|
| Rate for Payer: PACE Medicare |
$7,607.26
|
| Rate for Payer: PACE SWMI |
$8,007.64
|
| Rate for Payer: PHP Medicare Advantage |
$8,007.64
|
| Rate for Payer: Priority Health Medicare |
$8,007.64
|
| Rate for Payer: Railroad Medicare Medicare |
$8,007.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,007.64
|
| Rate for Payer: UHC Medicare Advantage |
$8,007.64
|
| Rate for Payer: VA VA |
$8,007.64
|
|
|
MS-DRG 42.00: SKIN DEBRIDEMENT WITH CC
|
Facility
|
IP
|
$16,714.90
|
|
|
Service Code
|
MSDRG 571
|
| Min. Negotiated Rate |
$12,703.32 |
| Max. Negotiated Rate |
$16,714.90 |
| Rate for Payer: Aetna Medicare |
$13,906.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,714.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,714.90
|
| Rate for Payer: BCBS MAPPO |
$13,371.92
|
| Rate for Payer: BCN Medicare Advantage |
$13,371.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,371.92
|
| Rate for Payer: Mclaren Medicare |
$13,371.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,040.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,377.71
|
| Rate for Payer: PACE Medicare |
$12,703.32
|
| Rate for Payer: PACE SWMI |
$13,371.92
|
| Rate for Payer: PHP Medicare Advantage |
$13,371.92
|
| Rate for Payer: Priority Health Medicare |
$13,371.92
|
| Rate for Payer: Railroad Medicare Medicare |
$13,371.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,371.92
|
| Rate for Payer: UHC Medicare Advantage |
$13,371.92
|
| Rate for Payer: VA VA |
$13,371.92
|
|
|
MS-DRG 42.00: SKIN DEBRIDEMENT WITH MCC
|
Facility
|
IP
|
$29,583.21
|
|
|
Service Code
|
MSDRG 570
|
| Min. Negotiated Rate |
$22,483.24 |
| Max. Negotiated Rate |
$29,583.21 |
| Rate for Payer: Aetna Medicare |
$24,613.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,583.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,583.21
|
| Rate for Payer: BCBS MAPPO |
$23,666.57
|
| Rate for Payer: BCN Medicare Advantage |
$23,666.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,666.57
|
| Rate for Payer: Mclaren Medicare |
$23,666.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,849.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,216.56
|
| Rate for Payer: PACE Medicare |
$22,483.24
|
| Rate for Payer: PACE SWMI |
$23,666.57
|
| Rate for Payer: PHP Medicare Advantage |
$23,666.57
|
| Rate for Payer: Priority Health Medicare |
$23,666.57
|
| Rate for Payer: Railroad Medicare Medicare |
$23,666.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,666.57
|
| Rate for Payer: UHC Medicare Advantage |
$23,666.57
|
| Rate for Payer: VA VA |
$23,666.57
|
|
|
MS-DRG 42.00: SKIN DEBRIDEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$11,591.26
|
|
|
Service Code
|
MSDRG 572
|
| Min. Negotiated Rate |
$8,809.36 |
| Max. Negotiated Rate |
$11,591.26 |
| Rate for Payer: Aetna Medicare |
$9,643.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,591.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,591.26
|
| Rate for Payer: BCBS MAPPO |
$9,273.01
|
| Rate for Payer: BCN Medicare Advantage |
$9,273.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,273.01
|
| Rate for Payer: Mclaren Medicare |
$9,273.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,736.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,663.96
|
| Rate for Payer: PACE Medicare |
$8,809.36
|
| Rate for Payer: PACE SWMI |
$9,273.01
|
| Rate for Payer: PHP Medicare Advantage |
$9,273.01
|
| Rate for Payer: Priority Health Medicare |
$9,273.01
|
| Rate for Payer: Railroad Medicare Medicare |
$9,273.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,273.01
|
| Rate for Payer: UHC Medicare Advantage |
$9,273.01
|
| Rate for Payer: VA VA |
$9,273.01
|
|
|
MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$26,236.81
|
|
|
Service Code
|
MSDRG 577
|
| Min. Negotiated Rate |
$19,939.98 |
| Max. Negotiated Rate |
$26,236.81 |
| Rate for Payer: Aetna Medicare |
$21,829.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,236.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,236.81
|
| Rate for Payer: BCBS MAPPO |
$20,989.45
|
| Rate for Payer: BCN Medicare Advantage |
$20,989.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,989.45
|
| Rate for Payer: Mclaren Medicare |
$20,989.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,038.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,137.87
|
| Rate for Payer: PACE Medicare |
$19,939.98
|
| Rate for Payer: PACE SWMI |
$20,989.45
|
| Rate for Payer: PHP Medicare Advantage |
$20,989.45
|
| Rate for Payer: Priority Health Medicare |
$20,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$20,989.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,989.45
|
| Rate for Payer: UHC Medicare Advantage |
$20,989.45
|
| Rate for Payer: VA VA |
$20,989.45
|
|
|
MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$52,558.18
|
|
|
Service Code
|
MSDRG 576
|
| Min. Negotiated Rate |
$39,944.21 |
| Max. Negotiated Rate |
$52,558.18 |
| Rate for Payer: Aetna Medicare |
$43,728.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,558.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,558.18
|
| Rate for Payer: BCBS MAPPO |
$42,046.54
|
| Rate for Payer: BCN Medicare Advantage |
$42,046.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42,046.54
|
| Rate for Payer: Mclaren Medicare |
$42,046.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,148.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48,353.52
|
| Rate for Payer: PACE Medicare |
$39,944.21
|
| Rate for Payer: PACE SWMI |
$42,046.54
|
| Rate for Payer: PHP Medicare Advantage |
$42,046.54
|
| Rate for Payer: Priority Health Medicare |
$42,046.54
|
| Rate for Payer: Railroad Medicare Medicare |
$42,046.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$42,046.54
|
| Rate for Payer: UHC Medicare Advantage |
$42,046.54
|
| Rate for Payer: VA VA |
$42,046.54
|
|
|
MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$16,870.00
|
|
|
Service Code
|
MSDRG 578
|
| Min. Negotiated Rate |
$12,821.20 |
| Max. Negotiated Rate |
$16,870.00 |
| Rate for Payer: Aetna Medicare |
$14,035.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,870.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,870.00
|
| Rate for Payer: BCBS MAPPO |
$13,496.00
|
| Rate for Payer: BCN Medicare Advantage |
$13,496.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,496.00
|
| Rate for Payer: Mclaren Medicare |
$13,496.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,170.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,520.40
|
| Rate for Payer: PACE Medicare |
$12,821.20
|
| Rate for Payer: PACE SWMI |
$13,496.00
|
| Rate for Payer: PHP Medicare Advantage |
$13,496.00
|
| Rate for Payer: Priority Health Medicare |
$13,496.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13,496.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,496.00
|
| Rate for Payer: UHC Medicare Advantage |
$13,496.00
|
| Rate for Payer: VA VA |
$13,496.00
|
|
|
MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$33,963.20
|
|
|
Service Code
|
MSDRG 574
|
| Min. Negotiated Rate |
$25,812.03 |
| Max. Negotiated Rate |
$33,963.20 |
| Rate for Payer: Aetna Medicare |
$28,257.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,963.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,963.20
|
| Rate for Payer: BCBS MAPPO |
$27,170.56
|
| Rate for Payer: BCN Medicare Advantage |
$27,170.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,170.56
|
| Rate for Payer: Mclaren Medicare |
$27,170.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,529.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,246.14
|
| Rate for Payer: PACE Medicare |
$25,812.03
|
| Rate for Payer: PACE SWMI |
$27,170.56
|
| Rate for Payer: PHP Medicare Advantage |
$27,170.56
|
| Rate for Payer: Priority Health Medicare |
$27,170.56
|
| Rate for Payer: Railroad Medicare Medicare |
$27,170.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,170.56
|
| Rate for Payer: UHC Medicare Advantage |
$27,170.56
|
| Rate for Payer: VA VA |
$27,170.56
|
|
|
MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$59,906.96
|
|
|
Service Code
|
MSDRG 573
|
| Min. Negotiated Rate |
$45,529.29 |
| Max. Negotiated Rate |
$59,906.96 |
| Rate for Payer: Aetna Medicare |
$49,842.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59,906.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59,906.96
|
| Rate for Payer: BCBS MAPPO |
$47,925.57
|
| Rate for Payer: BCN Medicare Advantage |
$47,925.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47,925.57
|
| Rate for Payer: Mclaren Medicare |
$47,925.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,321.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,114.41
|
| Rate for Payer: PACE Medicare |
$45,529.29
|
| Rate for Payer: PACE SWMI |
$47,925.57
|
| Rate for Payer: PHP Medicare Advantage |
$47,925.57
|
| Rate for Payer: Priority Health Medicare |
$47,925.57
|
| Rate for Payer: Railroad Medicare Medicare |
$47,925.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$47,925.57
|
| Rate for Payer: UHC Medicare Advantage |
$47,925.57
|
| Rate for Payer: VA VA |
$47,925.57
|
|
|
MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$19,820.47
|
|
|
Service Code
|
MSDRG 575
|
| Min. Negotiated Rate |
$15,063.56 |
| Max. Negotiated Rate |
$19,820.47 |
| Rate for Payer: Aetna Medicare |
$16,490.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,820.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,820.47
|
| Rate for Payer: BCBS MAPPO |
$15,856.38
|
| Rate for Payer: BCN Medicare Advantage |
$15,856.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,856.38
|
| Rate for Payer: Mclaren Medicare |
$15,856.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,649.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,234.84
|
| Rate for Payer: PACE Medicare |
$15,063.56
|
| Rate for Payer: PACE SWMI |
$15,856.38
|
| Rate for Payer: PHP Medicare Advantage |
$15,856.38
|
| Rate for Payer: Priority Health Medicare |
$15,856.38
|
| Rate for Payer: Railroad Medicare Medicare |
$15,856.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,856.38
|
| Rate for Payer: UHC Medicare Advantage |
$15,856.38
|
| Rate for Payer: VA VA |
$15,856.38
|
|
|
MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$19,012.29
|
|
|
Service Code
|
MSDRG 623
|
| Min. Negotiated Rate |
$14,449.34 |
| Max. Negotiated Rate |
$19,012.29 |
| Rate for Payer: Aetna Medicare |
$15,818.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,012.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,012.29
|
| Rate for Payer: BCBS MAPPO |
$15,209.83
|
| Rate for Payer: BCN Medicare Advantage |
$15,209.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,209.83
|
| Rate for Payer: Mclaren Medicare |
$15,209.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,970.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,491.30
|
| Rate for Payer: PACE Medicare |
$14,449.34
|
| Rate for Payer: PACE SWMI |
$15,209.83
|
| Rate for Payer: PHP Medicare Advantage |
$15,209.83
|
| Rate for Payer: Priority Health Medicare |
$15,209.83
|
| Rate for Payer: Railroad Medicare Medicare |
$15,209.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,209.83
|
| Rate for Payer: UHC Medicare Advantage |
$15,209.83
|
| Rate for Payer: VA VA |
$15,209.83
|
|
|
MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$36,632.44
|
|
|
Service Code
|
MSDRG 622
|
| Min. Negotiated Rate |
$27,840.65 |
| Max. Negotiated Rate |
$36,632.44 |
| Rate for Payer: Aetna Medicare |
$30,478.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,632.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,632.44
|
| Rate for Payer: BCBS MAPPO |
$29,305.95
|
| Rate for Payer: BCN Medicare Advantage |
$29,305.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,305.95
|
| Rate for Payer: Mclaren Medicare |
$29,305.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,771.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,701.84
|
| Rate for Payer: PACE Medicare |
$27,840.65
|
| Rate for Payer: PACE SWMI |
$29,305.95
|
| Rate for Payer: PHP Medicare Advantage |
$29,305.95
|
| Rate for Payer: Priority Health Medicare |
$29,305.95
|
| Rate for Payer: Railroad Medicare Medicare |
$29,305.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,305.95
|
| Rate for Payer: UHC Medicare Advantage |
$29,305.95
|
| Rate for Payer: VA VA |
$29,305.95
|
|
|
MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$10,249.41
|
|
|
Service Code
|
MSDRG 624
|
| Min. Negotiated Rate |
$7,789.55 |
| Max. Negotiated Rate |
$10,249.41 |
| Rate for Payer: Aetna Medicare |
$8,527.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,249.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,249.41
|
| Rate for Payer: BCBS MAPPO |
$8,199.53
|
| Rate for Payer: BCN Medicare Advantage |
$8,199.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,199.53
|
| Rate for Payer: Mclaren Medicare |
$8,199.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,609.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,429.46
|
| Rate for Payer: PACE Medicare |
$7,789.55
|
| Rate for Payer: PACE SWMI |
$8,199.53
|
| Rate for Payer: PHP Medicare Advantage |
$8,199.53
|
| Rate for Payer: Priority Health Medicare |
$8,199.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8,199.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,199.53
|
| Rate for Payer: UHC Medicare Advantage |
$8,199.53
|
| Rate for Payer: VA VA |
$8,199.53
|
|
|
MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITH CC/MCC
|
Facility
|
IP
|
$37,779.69
|
|
|
Service Code
|
MSDRG 904
|
| Min. Negotiated Rate |
$28,712.56 |
| Max. Negotiated Rate |
$37,779.69 |
| Rate for Payer: Aetna Medicare |
$31,432.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,779.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,779.69
|
| Rate for Payer: BCBS MAPPO |
$30,223.75
|
| Rate for Payer: BCN Medicare Advantage |
$30,223.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,223.75
|
| Rate for Payer: Mclaren Medicare |
$30,223.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,734.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,757.31
|
| Rate for Payer: PACE Medicare |
$28,712.56
|
| Rate for Payer: PACE SWMI |
$30,223.75
|
| Rate for Payer: PHP Medicare Advantage |
$30,223.75
|
| Rate for Payer: Priority Health Medicare |
$30,223.75
|
| Rate for Payer: Railroad Medicare Medicare |
$30,223.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,223.75
|
| Rate for Payer: UHC Medicare Advantage |
$30,223.75
|
| Rate for Payer: VA VA |
$30,223.75
|
|
