|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC
|
Facility
|
IP
|
$51,515.46
|
|
|
Service Code
|
MSDRG 239
|
| Min. Negotiated Rate |
$39,151.75 |
| Max. Negotiated Rate |
$51,515.46 |
| Rate for Payer: Aetna Medicare |
$42,860.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51,515.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51,515.46
|
| Rate for Payer: BCBS MAPPO |
$41,212.37
|
| Rate for Payer: BCN Medicare Advantage |
$41,212.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,212.37
|
| Rate for Payer: Mclaren Medicare |
$41,212.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43,272.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47,394.23
|
| Rate for Payer: PACE Medicare |
$39,151.75
|
| Rate for Payer: PACE SWMI |
$41,212.37
|
| Rate for Payer: PHP Medicare Advantage |
$41,212.37
|
| Rate for Payer: Priority Health Medicare |
$41,212.37
|
| Rate for Payer: Railroad Medicare Medicare |
$41,212.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$41,212.37
|
| Rate for Payer: UHC Medicare Advantage |
$41,212.37
|
| Rate for Payer: VA VA |
$41,212.37
|
|
|
MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC
|
Facility
|
IP
|
$15,828.40
|
|
|
Service Code
|
MSDRG 241
|
| Min. Negotiated Rate |
$12,029.58 |
| Max. Negotiated Rate |
$15,828.40 |
| Rate for Payer: Aetna Medicare |
$13,169.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,828.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,828.40
|
| Rate for Payer: BCBS MAPPO |
$12,662.72
|
| Rate for Payer: BCN Medicare Advantage |
$12,662.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,662.72
|
| Rate for Payer: Mclaren Medicare |
$12,662.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,295.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,562.13
|
| Rate for Payer: PACE Medicare |
$12,029.58
|
| Rate for Payer: PACE SWMI |
$12,662.72
|
| Rate for Payer: PHP Medicare Advantage |
$12,662.72
|
| Rate for Payer: Priority Health Medicare |
$12,662.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12,662.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,662.72
|
| Rate for Payer: UHC Medicare Advantage |
$12,662.72
|
| Rate for Payer: VA VA |
$12,662.72
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$22,378.95
|
|
|
Service Code
|
MSDRG 475
|
| Min. Negotiated Rate |
$17,008.00 |
| Max. Negotiated Rate |
$22,378.95 |
| Rate for Payer: Aetna Medicare |
$18,619.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,378.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,378.95
|
| Rate for Payer: BCBS MAPPO |
$17,903.16
|
| Rate for Payer: BCN Medicare Advantage |
$17,903.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,903.16
|
| Rate for Payer: Mclaren Medicare |
$17,903.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,798.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,588.63
|
| Rate for Payer: PACE Medicare |
$17,008.00
|
| Rate for Payer: PACE SWMI |
$17,903.16
|
| Rate for Payer: PHP Medicare Advantage |
$17,903.16
|
| Rate for Payer: Priority Health Medicare |
$17,903.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17,903.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,903.16
|
| Rate for Payer: UHC Medicare Advantage |
$17,903.16
|
| Rate for Payer: VA VA |
$17,903.16
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$45,928.18
|
|
|
Service Code
|
MSDRG 474
|
| Min. Negotiated Rate |
$34,905.41 |
| Max. Negotiated Rate |
$45,928.18 |
| Rate for Payer: Aetna Medicare |
$38,212.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,928.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,928.18
|
| Rate for Payer: BCBS MAPPO |
$36,742.54
|
| Rate for Payer: BCN Medicare Advantage |
$36,742.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,742.54
|
| Rate for Payer: Mclaren Medicare |
$36,742.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38,579.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,253.92
|
| Rate for Payer: PACE Medicare |
$34,905.41
|
| Rate for Payer: PACE SWMI |
$36,742.54
|
| Rate for Payer: PHP Medicare Advantage |
$36,742.54
|
| Rate for Payer: Priority Health Medicare |
$36,742.54
|
| Rate for Payer: Railroad Medicare Medicare |
$36,742.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,742.54
|
| Rate for Payer: UHC Medicare Advantage |
$36,742.54
|
| Rate for Payer: VA VA |
$36,742.54
|
|
|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,319.38
|
|
|
Service Code
|
MSDRG 476
|
| Min. Negotiated Rate |
$9,362.73 |
| Max. Negotiated Rate |
$12,319.38 |
| Rate for Payer: Aetna Medicare |
$10,249.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,319.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,319.38
|
| Rate for Payer: BCBS MAPPO |
$9,855.50
|
| Rate for Payer: BCN Medicare Advantage |
$9,855.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,855.50
|
| Rate for Payer: Mclaren Medicare |
$9,855.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,348.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,333.83
|
| Rate for Payer: PACE Medicare |
$9,362.73
|
| Rate for Payer: PACE SWMI |
$9,855.50
|
| Rate for Payer: PHP Medicare Advantage |
$9,855.50
|
| Rate for Payer: Priority Health Medicare |
$9,855.50
|
| Rate for Payer: Railroad Medicare Medicare |
$9,855.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,855.50
|
| Rate for Payer: UHC Medicare Advantage |
$9,855.50
|
| Rate for Payer: VA VA |
$9,855.50
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$20,095.26
|
|
|
Service Code
|
MSDRG 617
|
| Min. Negotiated Rate |
$15,272.40 |
| Max. Negotiated Rate |
$20,095.26 |
| Rate for Payer: Aetna Medicare |
$16,719.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,095.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,095.26
|
| Rate for Payer: BCBS MAPPO |
$16,076.21
|
| Rate for Payer: BCN Medicare Advantage |
$16,076.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,076.21
|
| Rate for Payer: Mclaren Medicare |
$16,076.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,880.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,487.64
|
| Rate for Payer: PACE Medicare |
$15,272.40
|
| Rate for Payer: PACE SWMI |
$16,076.21
|
| Rate for Payer: PHP Medicare Advantage |
$16,076.21
|
| Rate for Payer: Priority Health Medicare |
$16,076.21
|
| Rate for Payer: Railroad Medicare Medicare |
$16,076.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,076.21
|
| Rate for Payer: UHC Medicare Advantage |
$16,076.21
|
| Rate for Payer: VA VA |
$16,076.21
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$39,657.88
|
|
|
Service Code
|
MSDRG 616
|
| Min. Negotiated Rate |
$30,139.99 |
| Max. Negotiated Rate |
$39,657.88 |
| Rate for Payer: Aetna Medicare |
$32,995.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,657.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,657.88
|
| Rate for Payer: BCBS MAPPO |
$31,726.30
|
| Rate for Payer: BCN Medicare Advantage |
$31,726.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,726.30
|
| Rate for Payer: Mclaren Medicare |
$31,726.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,312.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,485.25
|
| Rate for Payer: PACE Medicare |
$30,139.99
|
| Rate for Payer: PACE SWMI |
$31,726.30
|
| Rate for Payer: PHP Medicare Advantage |
$31,726.30
|
| Rate for Payer: Priority Health Medicare |
$31,726.30
|
| Rate for Payer: Railroad Medicare Medicare |
$31,726.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,726.30
|
| Rate for Payer: UHC Medicare Advantage |
$31,726.30
|
| Rate for Payer: VA VA |
$31,726.30
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$13,149.08
|
|
|
Service Code
|
MSDRG 618
|
| Min. Negotiated Rate |
$9,993.30 |
| Max. Negotiated Rate |
$13,149.08 |
| Rate for Payer: Aetna Medicare |
$10,940.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,149.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,149.08
|
| Rate for Payer: BCBS MAPPO |
$10,519.26
|
| Rate for Payer: BCN Medicare Advantage |
$10,519.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,519.26
|
| Rate for Payer: Mclaren Medicare |
$10,519.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,045.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,097.15
|
| Rate for Payer: PACE Medicare |
$9,993.30
|
| Rate for Payer: PACE SWMI |
$10,519.26
|
| Rate for Payer: PHP Medicare Advantage |
$10,519.26
|
| Rate for Payer: Priority Health Medicare |
$10,519.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10,519.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,519.26
|
| Rate for Payer: UHC Medicare Advantage |
$10,519.26
|
| Rate for Payer: VA VA |
$10,519.26
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$13,288.74
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$10,099.44 |
| Max. Negotiated Rate |
$13,288.74 |
| Rate for Payer: Aetna Medicare |
$11,056.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,288.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,288.74
|
| Rate for Payer: BCBS MAPPO |
$10,630.99
|
| Rate for Payer: BCN Medicare Advantage |
$10,630.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,630.99
|
| Rate for Payer: Mclaren Medicare |
$10,630.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,162.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,225.64
|
| Rate for Payer: PACE Medicare |
$10,099.44
|
| Rate for Payer: PACE SWMI |
$10,630.99
|
| Rate for Payer: PHP Medicare Advantage |
$10,630.99
|
| Rate for Payer: Priority Health Medicare |
$10,630.99
|
| Rate for Payer: Railroad Medicare Medicare |
$10,630.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,630.99
|
| Rate for Payer: UHC Medicare Advantage |
$10,630.99
|
| Rate for Payer: VA VA |
$10,630.99
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$24,498.75
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$18,619.05 |
| Max. Negotiated Rate |
$24,498.75 |
| Rate for Payer: Aetna Medicare |
$20,382.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,498.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,498.75
|
| Rate for Payer: BCBS MAPPO |
$19,599.00
|
| Rate for Payer: BCN Medicare Advantage |
$19,599.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,599.00
|
| Rate for Payer: Mclaren Medicare |
$19,599.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,578.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,538.85
|
| Rate for Payer: PACE Medicare |
$18,619.05
|
| Rate for Payer: PACE SWMI |
$19,599.00
|
| Rate for Payer: PHP Medicare Advantage |
$19,599.00
|
| Rate for Payer: Priority Health Medicare |
$19,599.00
|
| Rate for Payer: Railroad Medicare Medicare |
$19,599.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,599.00
|
| Rate for Payer: UHC Medicare Advantage |
$19,599.00
|
| Rate for Payer: VA VA |
$19,599.00
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$9,464.02
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$7,192.66 |
| Max. Negotiated Rate |
$9,464.02 |
| Rate for Payer: Aetna Medicare |
$7,874.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,464.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,464.02
|
| Rate for Payer: BCBS MAPPO |
$7,571.22
|
| Rate for Payer: BCN Medicare Advantage |
$7,571.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,571.22
|
| Rate for Payer: Mclaren Medicare |
$7,571.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,949.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,706.90
|
| Rate for Payer: PACE Medicare |
$7,192.66
|
| Rate for Payer: PACE SWMI |
$7,571.22
|
| Rate for Payer: PHP Medicare Advantage |
$7,571.22
|
| Rate for Payer: Priority Health Medicare |
$7,571.22
|
| Rate for Payer: Railroad Medicare Medicare |
$7,571.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,571.22
|
| Rate for Payer: UHC Medicare Advantage |
$7,571.22
|
| Rate for Payer: VA VA |
$7,571.22
|
|
|
MS-DRG 42.00: ANGINA PECTORIS
|
Facility
|
IP
|
$7,616.44
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$5,788.49 |
| Max. Negotiated Rate |
$7,616.44 |
| Rate for Payer: Aetna Medicare |
$6,336.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,616.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,616.44
|
| Rate for Payer: BCBS MAPPO |
$6,093.15
|
| Rate for Payer: BCN Medicare Advantage |
$6,093.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,093.15
|
| Rate for Payer: Mclaren Medicare |
$6,093.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,397.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,007.12
|
| Rate for Payer: PACE Medicare |
$5,788.49
|
| Rate for Payer: PACE SWMI |
$6,093.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,093.15
|
| Rate for Payer: Priority Health Medicare |
$6,093.15
|
| Rate for Payer: Railroad Medicare Medicare |
$6,093.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,093.15
|
| Rate for Payer: UHC Medicare Advantage |
$6,093.15
|
| Rate for Payer: VA VA |
$6,093.15
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
|
IP
|
$68,015.30
|
|
|
Service Code
|
MSDRG 268
|
| Min. Negotiated Rate |
$51,691.63 |
| Max. Negotiated Rate |
$68,015.30 |
| Rate for Payer: Aetna Medicare |
$56,588.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68,015.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68,015.30
|
| Rate for Payer: BCBS MAPPO |
$54,412.24
|
| Rate for Payer: BCN Medicare Advantage |
$54,412.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54,412.24
|
| Rate for Payer: Mclaren Medicare |
$54,412.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57,132.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62,574.08
|
| Rate for Payer: PACE Medicare |
$51,691.63
|
| Rate for Payer: PACE SWMI |
$54,412.24
|
| Rate for Payer: PHP Medicare Advantage |
$54,412.24
|
| Rate for Payer: Priority Health Medicare |
$54,412.24
|
| Rate for Payer: Railroad Medicare Medicare |
$54,412.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$54,412.24
|
| Rate for Payer: UHC Medicare Advantage |
$54,412.24
|
| Rate for Payer: VA VA |
$54,412.24
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$42,649.86
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$32,413.90 |
| Max. Negotiated Rate |
$42,649.86 |
| Rate for Payer: Aetna Medicare |
$35,484.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,649.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,649.86
|
| Rate for Payer: BCBS MAPPO |
$34,119.89
|
| Rate for Payer: BCN Medicare Advantage |
$34,119.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34,119.89
|
| Rate for Payer: Mclaren Medicare |
$34,119.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,825.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39,237.87
|
| Rate for Payer: PACE Medicare |
$32,413.90
|
| Rate for Payer: PACE SWMI |
$34,119.89
|
| Rate for Payer: PHP Medicare Advantage |
$34,119.89
|
| Rate for Payer: Priority Health Medicare |
$34,119.89
|
| Rate for Payer: Railroad Medicare Medicare |
$34,119.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$34,119.89
|
| Rate for Payer: UHC Medicare Advantage |
$34,119.89
|
| Rate for Payer: VA VA |
$34,119.89
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$15,861.79
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$12,054.96 |
| Max. Negotiated Rate |
$15,861.79 |
| Rate for Payer: Aetna Medicare |
$13,197.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,861.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,861.79
|
| Rate for Payer: BCBS MAPPO |
$12,689.43
|
| Rate for Payer: BCN Medicare Advantage |
$12,689.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,689.43
|
| Rate for Payer: Mclaren Medicare |
$12,689.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,323.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,592.84
|
| Rate for Payer: PACE Medicare |
$12,054.96
|
| Rate for Payer: PACE SWMI |
$12,689.43
|
| Rate for Payer: PHP Medicare Advantage |
$12,689.43
|
| Rate for Payer: Priority Health Medicare |
$12,689.43
|
| Rate for Payer: Railroad Medicare Medicare |
$12,689.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,689.43
|
| Rate for Payer: UHC Medicare Advantage |
$12,689.43
|
| Rate for Payer: VA VA |
$12,689.43
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$25,621.85
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$19,472.61 |
| Max. Negotiated Rate |
$25,621.85 |
| Rate for Payer: Aetna Medicare |
$21,317.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,621.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,621.85
|
| Rate for Payer: BCBS MAPPO |
$20,497.48
|
| Rate for Payer: BCN Medicare Advantage |
$20,497.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,497.48
|
| Rate for Payer: Mclaren Medicare |
$20,497.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,522.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,572.10
|
| Rate for Payer: PACE Medicare |
$19,472.61
|
| Rate for Payer: PACE SWMI |
$20,497.48
|
| Rate for Payer: PHP Medicare Advantage |
$20,497.48
|
| Rate for Payer: Priority Health Medicare |
$20,497.48
|
| Rate for Payer: Railroad Medicare Medicare |
$20,497.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,497.48
|
| Rate for Payer: UHC Medicare Advantage |
$20,497.48
|
| Rate for Payer: VA VA |
$20,497.48
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$11,921.73
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$9,060.51 |
| Max. Negotiated Rate |
$11,921.73 |
| Rate for Payer: Aetna Medicare |
$9,918.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,921.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,921.73
|
| Rate for Payer: BCBS MAPPO |
$9,537.38
|
| Rate for Payer: BCN Medicare Advantage |
$9,537.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,537.38
|
| Rate for Payer: Mclaren Medicare |
$9,537.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,014.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,967.99
|
| Rate for Payer: PACE Medicare |
$9,060.51
|
| Rate for Payer: PACE SWMI |
$9,537.38
|
| Rate for Payer: PHP Medicare Advantage |
$9,537.38
|
| Rate for Payer: Priority Health Medicare |
$9,537.38
|
| Rate for Payer: Railroad Medicare Medicare |
$9,537.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,537.38
|
| Rate for Payer: UHC Medicare Advantage |
$9,537.38
|
| Rate for Payer: VA VA |
$9,537.38
|
|
|
MS-DRG 42.00: ARTHROSCOPY
|
Facility
|
IP
|
$18,325.59
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$13,927.45 |
| Max. Negotiated Rate |
$18,325.59 |
| Rate for Payer: Aetna Medicare |
$15,246.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,325.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,325.59
|
| Rate for Payer: BCBS MAPPO |
$14,660.47
|
| Rate for Payer: BCN Medicare Advantage |
$14,660.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,660.47
|
| Rate for Payer: Mclaren Medicare |
$14,660.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,393.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,859.54
|
| Rate for Payer: PACE Medicare |
$13,927.45
|
| Rate for Payer: PACE SWMI |
$14,660.47
|
| Rate for Payer: PHP Medicare Advantage |
$14,660.47
|
| Rate for Payer: Priority Health Medicare |
$14,660.47
|
| Rate for Payer: Railroad Medicare Medicare |
$14,660.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,660.47
|
| Rate for Payer: UHC Medicare Advantage |
$14,660.47
|
| Rate for Payer: VA VA |
$14,660.47
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC
|
Facility
|
IP
|
$12,321.40
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$9,364.26 |
| Max. Negotiated Rate |
$12,321.40 |
| Rate for Payer: Aetna Medicare |
$10,251.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,321.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,321.40
|
| Rate for Payer: BCBS MAPPO |
$9,857.12
|
| Rate for Payer: BCN Medicare Advantage |
$9,857.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,857.12
|
| Rate for Payer: Mclaren Medicare |
$9,857.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,349.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,335.69
|
| Rate for Payer: PACE Medicare |
$9,364.26
|
| Rate for Payer: PACE SWMI |
$9,857.12
|
| Rate for Payer: PHP Medicare Advantage |
$9,857.12
|
| Rate for Payer: Priority Health Medicare |
$9,857.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9,857.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,857.12
|
| Rate for Payer: UHC Medicare Advantage |
$9,857.12
|
| Rate for Payer: VA VA |
$9,857.12
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
|
IP
|
$7,354.35
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$5,589.31 |
| Max. Negotiated Rate |
$7,354.35 |
| Rate for Payer: Aetna Medicare |
$6,118.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,354.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,354.35
|
| Rate for Payer: BCBS MAPPO |
$5,883.48
|
| Rate for Payer: BCN Medicare Advantage |
$5,883.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,883.48
|
| Rate for Payer: Mclaren Medicare |
$5,883.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,177.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,766.00
|
| Rate for Payer: PACE Medicare |
$5,589.31
|
| Rate for Payer: PACE SWMI |
$5,883.48
|
| Rate for Payer: PHP Medicare Advantage |
$5,883.48
|
| Rate for Payer: Priority Health Medicare |
$5,883.48
|
| Rate for Payer: Railroad Medicare Medicare |
$5,883.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,883.48
|
| Rate for Payer: UHC Medicare Advantage |
$5,883.48
|
| Rate for Payer: VA VA |
$5,883.48
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
|
Facility
|
IP
|
$61,623.60
|
|
|
Service Code
|
MSDRG 016
|
| Min. Negotiated Rate |
$46,833.94 |
| Max. Negotiated Rate |
$61,623.60 |
| Rate for Payer: Aetna Medicare |
$51,270.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61,623.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61,623.60
|
| Rate for Payer: BCBS MAPPO |
$49,298.88
|
| Rate for Payer: BCN Medicare Advantage |
$49,298.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,298.88
|
| Rate for Payer: Mclaren Medicare |
$49,298.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51,763.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56,693.71
|
| Rate for Payer: PACE Medicare |
$46,833.94
|
| Rate for Payer: PACE SWMI |
$49,298.88
|
| Rate for Payer: PHP Medicare Advantage |
$49,298.88
|
| Rate for Payer: Priority Health Medicare |
$49,298.88
|
| Rate for Payer: Railroad Medicare Medicare |
$49,298.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,298.88
|
| Rate for Payer: UHC Medicare Advantage |
$49,298.88
|
| Rate for Payer: VA VA |
$49,298.88
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$61,623.60
|
|
|
Service Code
|
MSDRG 017
|
| Min. Negotiated Rate |
$46,833.94 |
| Max. Negotiated Rate |
$61,623.60 |
| Rate for Payer: Aetna Medicare |
$51,270.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61,623.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61,623.60
|
| Rate for Payer: BCBS MAPPO |
$49,298.88
|
| Rate for Payer: BCN Medicare Advantage |
$49,298.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,298.88
|
| Rate for Payer: Mclaren Medicare |
$49,298.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51,763.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56,693.71
|
| Rate for Payer: PACE Medicare |
$46,833.94
|
| Rate for Payer: PACE SWMI |
$49,298.88
|
| Rate for Payer: PHP Medicare Advantage |
$49,298.88
|
| Rate for Payer: Priority Health Medicare |
$49,298.88
|
| Rate for Payer: Railroad Medicare Medicare |
$49,298.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$49,298.88
|
| Rate for Payer: UHC Medicare Advantage |
$49,298.88
|
| Rate for Payer: VA VA |
$49,298.88
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
|
IP
|
$20,503.03
|
|
|
Service Code
|
MSDRG 519
|
| Min. Negotiated Rate |
$15,582.30 |
| Max. Negotiated Rate |
$20,503.03 |
| Rate for Payer: Aetna Medicare |
$17,058.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,503.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,503.03
|
| Rate for Payer: BCBS MAPPO |
$16,402.42
|
| Rate for Payer: BCN Medicare Advantage |
$16,402.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,402.42
|
| Rate for Payer: Mclaren Medicare |
$16,402.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,222.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,862.78
|
| Rate for Payer: PACE Medicare |
$15,582.30
|
| Rate for Payer: PACE SWMI |
$16,402.42
|
| Rate for Payer: PHP Medicare Advantage |
$16,402.42
|
| Rate for Payer: Priority Health Medicare |
$16,402.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16,402.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,402.42
|
| Rate for Payer: UHC Medicare Advantage |
$16,402.42
|
| Rate for Payer: VA VA |
$16,402.42
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
|
IP
|
$36,814.66
|
|
|
Service Code
|
MSDRG 518
|
| Min. Negotiated Rate |
$27,979.14 |
| Max. Negotiated Rate |
$36,814.66 |
| Rate for Payer: Aetna Medicare |
$30,629.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,814.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,814.66
|
| Rate for Payer: BCBS MAPPO |
$29,451.73
|
| Rate for Payer: BCN Medicare Advantage |
$29,451.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,451.73
|
| Rate for Payer: Mclaren Medicare |
$29,451.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,924.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,869.49
|
| Rate for Payer: PACE Medicare |
$27,979.14
|
| Rate for Payer: PACE SWMI |
$29,451.73
|
| Rate for Payer: PHP Medicare Advantage |
$29,451.73
|
| Rate for Payer: Priority Health Medicare |
$29,451.73
|
| Rate for Payer: Railroad Medicare Medicare |
$29,451.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,451.73
|
| Rate for Payer: UHC Medicare Advantage |
$29,451.73
|
| Rate for Payer: VA VA |
$29,451.73
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$15,052.33
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$11,439.77 |
| Max. Negotiated Rate |
$15,052.33 |
| Rate for Payer: Aetna Medicare |
$12,523.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,052.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,052.33
|
| Rate for Payer: BCBS MAPPO |
$12,041.86
|
| Rate for Payer: BCN Medicare Advantage |
$12,041.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,041.86
|
| Rate for Payer: Mclaren Medicare |
$12,041.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,643.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,848.14
|
| Rate for Payer: PACE Medicare |
$11,439.77
|
| Rate for Payer: PACE SWMI |
$12,041.86
|
| Rate for Payer: PHP Medicare Advantage |
$12,041.86
|
| Rate for Payer: Priority Health Medicare |
$12,041.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12,041.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,041.86
|
| Rate for Payer: UHC Medicare Advantage |
$12,041.86
|
| Rate for Payer: VA VA |
$12,041.86
|
|
