|
MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
|
IP
|
$13,547.74
|
|
|
Service Code
|
MSDRG 391
|
| Min. Negotiated Rate |
$10,296.28 |
| Max. Negotiated Rate |
$13,547.74 |
| Rate for Payer: Aetna Medicare |
$11,271.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,547.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,547.74
|
| Rate for Payer: BCBS MAPPO |
$10,838.19
|
| Rate for Payer: BCN Medicare Advantage |
$10,838.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,838.19
|
| Rate for Payer: Mclaren Medicare |
$10,838.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,380.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,463.92
|
| Rate for Payer: PACE Medicare |
$10,296.28
|
| Rate for Payer: PACE SWMI |
$10,838.19
|
| Rate for Payer: PHP Medicare Advantage |
$10,838.19
|
| Rate for Payer: Priority Health Medicare |
$10,838.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10,838.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,838.19
|
| Rate for Payer: UHC Medicare Advantage |
$10,838.19
|
| Rate for Payer: VA VA |
$10,838.19
|
|
|
MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$8,446.14
|
|
|
Service Code
|
MSDRG 392
|
| Min. Negotiated Rate |
$6,419.06 |
| Max. Negotiated Rate |
$8,446.14 |
| Rate for Payer: Aetna Medicare |
$7,027.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,446.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,446.14
|
| Rate for Payer: BCBS MAPPO |
$6,756.91
|
| Rate for Payer: BCN Medicare Advantage |
$6,756.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,756.91
|
| Rate for Payer: Mclaren Medicare |
$6,756.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,094.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,770.45
|
| Rate for Payer: PACE Medicare |
$6,419.06
|
| Rate for Payer: PACE SWMI |
$6,756.91
|
| Rate for Payer: PHP Medicare Advantage |
$6,756.91
|
| Rate for Payer: Priority Health Medicare |
$6,756.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6,756.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,756.91
|
| Rate for Payer: UHC Medicare Advantage |
$6,756.91
|
| Rate for Payer: VA VA |
$6,756.91
|
|
|
MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$44,331.53
|
|
|
Service Code
|
MSDRG 933
|
| Min. Negotiated Rate |
$33,691.96 |
| Max. Negotiated Rate |
$44,331.53 |
| Rate for Payer: Aetna Medicare |
$36,883.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,331.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,331.53
|
| Rate for Payer: BCBS MAPPO |
$35,465.22
|
| Rate for Payer: BCN Medicare Advantage |
$35,465.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,465.22
|
| Rate for Payer: Mclaren Medicare |
$35,465.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37,238.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,785.00
|
| Rate for Payer: PACE Medicare |
$33,691.96
|
| Rate for Payer: PACE SWMI |
$35,465.22
|
| Rate for Payer: PHP Medicare Advantage |
$35,465.22
|
| Rate for Payer: Priority Health Medicare |
$35,465.22
|
| Rate for Payer: Railroad Medicare Medicare |
$35,465.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,465.22
|
| Rate for Payer: UHC Medicare Advantage |
$35,465.22
|
| Rate for Payer: VA VA |
$35,465.22
|
|
|
MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT
|
Facility
|
IP
|
$240,584.09
|
|
|
Service Code
|
MSDRG 927
|
| Min. Negotiated Rate |
$182,843.91 |
| Max. Negotiated Rate |
$240,584.09 |
| Rate for Payer: Aetna Medicare |
$200,165.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240,584.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240,584.09
|
| Rate for Payer: BCBS MAPPO |
$192,467.27
|
| Rate for Payer: BCN Medicare Advantage |
$192,467.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192,467.27
|
| Rate for Payer: Mclaren Medicare |
$192,467.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202,090.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221,337.36
|
| Rate for Payer: PACE Medicare |
$182,843.91
|
| Rate for Payer: PACE SWMI |
$192,467.27
|
| Rate for Payer: PHP Medicare Advantage |
$192,467.27
|
| Rate for Payer: Priority Health Medicare |
$192,467.27
|
| Rate for Payer: Railroad Medicare Medicare |
$192,467.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$192,467.27
|
| Rate for Payer: UHC Medicare Advantage |
$192,467.27
|
| Rate for Payer: VA VA |
$192,467.27
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$25,323.38
|
|
|
Service Code
|
MSDRG 982
|
| Min. Negotiated Rate |
$19,245.76 |
| Max. Negotiated Rate |
$25,323.38 |
| Rate for Payer: Aetna Medicare |
$21,069.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,323.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,323.38
|
| Rate for Payer: BCBS MAPPO |
$20,258.70
|
| Rate for Payer: BCN Medicare Advantage |
$20,258.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,258.70
|
| Rate for Payer: Mclaren Medicare |
$20,258.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,271.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,297.51
|
| Rate for Payer: PACE Medicare |
$19,245.76
|
| Rate for Payer: PACE SWMI |
$20,258.70
|
| Rate for Payer: PHP Medicare Advantage |
$20,258.70
|
| Rate for Payer: Priority Health Medicare |
$20,258.70
|
| Rate for Payer: Railroad Medicare Medicare |
$20,258.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,258.70
|
| Rate for Payer: UHC Medicare Advantage |
$20,258.70
|
| Rate for Payer: VA VA |
$20,258.70
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$48,652.00
|
|
|
Service Code
|
MSDRG 981
|
| Min. Negotiated Rate |
$36,975.52 |
| Max. Negotiated Rate |
$48,652.00 |
| Rate for Payer: Aetna Medicare |
$40,478.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48,652.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48,652.00
|
| Rate for Payer: BCBS MAPPO |
$38,921.60
|
| Rate for Payer: BCN Medicare Advantage |
$38,921.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,921.60
|
| Rate for Payer: Mclaren Medicare |
$38,921.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40,867.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,759.84
|
| Rate for Payer: PACE Medicare |
$36,975.52
|
| Rate for Payer: PACE SWMI |
$38,921.60
|
| Rate for Payer: PHP Medicare Advantage |
$38,921.60
|
| Rate for Payer: Priority Health Medicare |
$38,921.60
|
| Rate for Payer: Railroad Medicare Medicare |
$38,921.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$38,921.60
|
| Rate for Payer: UHC Medicare Advantage |
$38,921.60
|
| Rate for Payer: VA VA |
$38,921.60
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$17,430.12
|
|
|
Service Code
|
MSDRG 983
|
| Min. Negotiated Rate |
$13,246.90 |
| Max. Negotiated Rate |
$17,430.12 |
| Rate for Payer: Aetna Medicare |
$14,501.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,430.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,430.12
|
| Rate for Payer: BCBS MAPPO |
$13,944.10
|
| Rate for Payer: BCN Medicare Advantage |
$13,944.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,944.10
|
| Rate for Payer: Mclaren Medicare |
$13,944.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,641.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,035.72
|
| Rate for Payer: PACE Medicare |
$13,246.90
|
| Rate for Payer: PACE SWMI |
$13,944.10
|
| Rate for Payer: PHP Medicare Advantage |
$13,944.10
|
| Rate for Payer: Priority Health Medicare |
$13,944.10
|
| Rate for Payer: Railroad Medicare Medicare |
$13,944.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,944.10
|
| Rate for Payer: UHC Medicare Advantage |
$13,944.10
|
| Rate for Payer: VA VA |
$13,944.10
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$16,854.39
|
|
|
Service Code
|
MSDRG 038
|
| Min. Negotiated Rate |
$12,809.33 |
| Max. Negotiated Rate |
$16,854.39 |
| Rate for Payer: Aetna Medicare |
$14,022.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,854.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,854.39
|
| Rate for Payer: BCBS MAPPO |
$13,483.51
|
| Rate for Payer: BCN Medicare Advantage |
$13,483.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,483.51
|
| Rate for Payer: Mclaren Medicare |
$13,483.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,157.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,506.04
|
| Rate for Payer: PACE Medicare |
$12,809.33
|
| Rate for Payer: PACE SWMI |
$13,483.51
|
| Rate for Payer: PHP Medicare Advantage |
$13,483.51
|
| Rate for Payer: Priority Health Medicare |
$13,483.51
|
| Rate for Payer: Railroad Medicare Medicare |
$13,483.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,483.51
|
| Rate for Payer: UHC Medicare Advantage |
$13,483.51
|
| Rate for Payer: VA VA |
$13,483.51
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$34,152.55
|
|
|
Service Code
|
MSDRG 037
|
| Min. Negotiated Rate |
$25,955.94 |
| Max. Negotiated Rate |
$34,152.55 |
| Rate for Payer: Aetna Medicare |
$28,414.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,152.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,152.55
|
| Rate for Payer: BCBS MAPPO |
$27,322.04
|
| Rate for Payer: BCN Medicare Advantage |
$27,322.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,322.04
|
| Rate for Payer: Mclaren Medicare |
$27,322.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,688.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,420.35
|
| Rate for Payer: PACE Medicare |
$25,955.94
|
| Rate for Payer: PACE SWMI |
$27,322.04
|
| Rate for Payer: PHP Medicare Advantage |
$27,322.04
|
| Rate for Payer: Priority Health Medicare |
$27,322.04
|
| Rate for Payer: Railroad Medicare Medicare |
$27,322.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,322.04
|
| Rate for Payer: UHC Medicare Advantage |
$27,322.04
|
| Rate for Payer: VA VA |
$27,322.04
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,067.45
|
|
|
Service Code
|
MSDRG 039
|
| Min. Negotiated Rate |
$9,171.26 |
| Max. Negotiated Rate |
$12,067.45 |
| Rate for Payer: Aetna Medicare |
$10,040.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,067.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,067.45
|
| Rate for Payer: BCBS MAPPO |
$9,653.96
|
| Rate for Payer: BCN Medicare Advantage |
$9,653.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,653.96
|
| Rate for Payer: Mclaren Medicare |
$9,653.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,136.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,102.05
|
| Rate for Payer: PACE Medicare |
$9,171.26
|
| Rate for Payer: PACE SWMI |
$9,653.96
|
| Rate for Payer: PHP Medicare Advantage |
$9,653.96
|
| Rate for Payer: Priority Health Medicare |
$9,653.96
|
| Rate for Payer: Railroad Medicare Medicare |
$9,653.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,653.96
|
| Rate for Payer: UHC Medicare Advantage |
$9,653.96
|
| Rate for Payer: VA VA |
$9,653.96
|
|
|
MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT
|
Facility
|
IP
|
$16,041.91
|
|
|
Service Code
|
MSDRG 115
|
| Min. Negotiated Rate |
$12,191.85 |
| Max. Negotiated Rate |
$16,041.91 |
| Rate for Payer: Aetna Medicare |
$13,346.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,041.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,041.91
|
| Rate for Payer: BCBS MAPPO |
$12,833.53
|
| Rate for Payer: BCN Medicare Advantage |
$12,833.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,833.53
|
| Rate for Payer: Mclaren Medicare |
$12,833.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,475.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,758.56
|
| Rate for Payer: PACE Medicare |
$12,191.85
|
| Rate for Payer: PACE SWMI |
$12,833.53
|
| Rate for Payer: PHP Medicare Advantage |
$12,833.53
|
| Rate for Payer: Priority Health Medicare |
$12,833.53
|
| Rate for Payer: Railroad Medicare Medicare |
$12,833.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,833.53
|
| Rate for Payer: UHC Medicare Advantage |
$12,833.53
|
| Rate for Payer: VA VA |
$12,833.53
|
|
|
MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE
|
Facility
|
IP
|
$60,701.84
|
|
|
Service Code
|
MSDRG 790
|
| Min. Negotiated Rate |
$46,133.40 |
| Max. Negotiated Rate |
$60,701.84 |
| Rate for Payer: Aetna Medicare |
$50,503.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60,701.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60,701.84
|
| Rate for Payer: BCBS MAPPO |
$48,561.47
|
| Rate for Payer: BCN Medicare Advantage |
$48,561.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48,561.47
|
| Rate for Payer: Mclaren Medicare |
$48,561.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,989.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,845.69
|
| Rate for Payer: PACE Medicare |
$46,133.40
|
| Rate for Payer: PACE SWMI |
$48,561.47
|
| Rate for Payer: PHP Medicare Advantage |
$48,561.47
|
| Rate for Payer: Priority Health Medicare |
$48,561.47
|
| Rate for Payer: Railroad Medicare Medicare |
$48,561.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$48,561.47
|
| Rate for Payer: UHC Medicare Advantage |
$48,561.47
|
| Rate for Payer: VA VA |
$48,561.47
|
|
|
MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
|
IP
|
$14,334.94
|
|
|
Service Code
|
MSDRG 748
|
| Min. Negotiated Rate |
$10,894.55 |
| Max. Negotiated Rate |
$14,334.94 |
| Rate for Payer: Aetna Medicare |
$11,926.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,334.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,334.94
|
| Rate for Payer: BCBS MAPPO |
$11,467.95
|
| Rate for Payer: BCN Medicare Advantage |
$11,467.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,467.95
|
| Rate for Payer: Mclaren Medicare |
$11,467.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,041.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,188.14
|
| Rate for Payer: PACE Medicare |
$10,894.55
|
| Rate for Payer: PACE SWMI |
$11,467.95
|
| Rate for Payer: PHP Medicare Advantage |
$11,467.95
|
| Rate for Payer: Priority Health Medicare |
$11,467.95
|
| Rate for Payer: Railroad Medicare Medicare |
$11,467.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,467.95
|
| Rate for Payer: UHC Medicare Advantage |
$11,467.95
|
| Rate for Payer: VA VA |
$11,467.95
|
|
|
MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$9,637.05
|
|
|
Service Code
|
MSDRG 864
|
| Min. Negotiated Rate |
$7,324.16 |
| Max. Negotiated Rate |
$9,637.05 |
| Rate for Payer: Aetna Medicare |
$8,018.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,637.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,637.05
|
| Rate for Payer: BCBS MAPPO |
$7,709.64
|
| Rate for Payer: BCN Medicare Advantage |
$7,709.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,709.64
|
| Rate for Payer: Mclaren Medicare |
$7,709.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,095.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,866.09
|
| Rate for Payer: PACE Medicare |
$7,324.16
|
| Rate for Payer: PACE SWMI |
$7,709.64
|
| Rate for Payer: PHP Medicare Advantage |
$7,709.64
|
| Rate for Payer: Priority Health Medicare |
$7,709.64
|
| Rate for Payer: Railroad Medicare Medicare |
$7,709.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,709.64
|
| Rate for Payer: UHC Medicare Advantage |
$7,709.64
|
| Rate for Payer: VA VA |
$7,709.64
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH CC
|
Facility
|
IP
|
$18,308.39
|
|
|
Service Code
|
MSDRG 504
|
| Min. Negotiated Rate |
$13,914.37 |
| Max. Negotiated Rate |
$18,308.39 |
| Rate for Payer: Aetna Medicare |
$15,232.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,308.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,308.39
|
| Rate for Payer: BCBS MAPPO |
$14,646.71
|
| Rate for Payer: BCN Medicare Advantage |
$14,646.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,646.71
|
| Rate for Payer: Mclaren Medicare |
$14,646.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,379.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,843.72
|
| Rate for Payer: PACE Medicare |
$13,914.37
|
| Rate for Payer: PACE SWMI |
$14,646.71
|
| Rate for Payer: PHP Medicare Advantage |
$14,646.71
|
| Rate for Payer: Priority Health Medicare |
$14,646.71
|
| Rate for Payer: Railroad Medicare Medicare |
$14,646.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,646.71
|
| Rate for Payer: UHC Medicare Advantage |
$14,646.71
|
| Rate for Payer: VA VA |
$14,646.71
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH MCC
|
Facility
|
IP
|
$27,329.81
|
|
|
Service Code
|
MSDRG 503
|
| Min. Negotiated Rate |
$20,770.66 |
| Max. Negotiated Rate |
$27,329.81 |
| Rate for Payer: Aetna Medicare |
$22,738.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,329.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,329.81
|
| Rate for Payer: BCBS MAPPO |
$21,863.85
|
| Rate for Payer: BCN Medicare Advantage |
$21,863.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,863.85
|
| Rate for Payer: Mclaren Medicare |
$21,863.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,957.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,143.43
|
| Rate for Payer: PACE Medicare |
$20,770.66
|
| Rate for Payer: PACE SWMI |
$21,863.85
|
| Rate for Payer: PHP Medicare Advantage |
$21,863.85
|
| Rate for Payer: Priority Health Medicare |
$21,863.85
|
| Rate for Payer: Railroad Medicare Medicare |
$21,863.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,863.85
|
| Rate for Payer: UHC Medicare Advantage |
$21,863.85
|
| Rate for Payer: VA VA |
$21,863.85
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,308.39
|
|
|
Service Code
|
MSDRG 505
|
| Min. Negotiated Rate |
$13,914.37 |
| Max. Negotiated Rate |
$18,308.39 |
| Rate for Payer: Aetna Medicare |
$15,232.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,308.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,308.39
|
| Rate for Payer: BCBS MAPPO |
$14,646.71
|
| Rate for Payer: BCN Medicare Advantage |
$14,646.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,646.71
|
| Rate for Payer: Mclaren Medicare |
$14,646.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,379.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,843.72
|
| Rate for Payer: PACE Medicare |
$13,914.37
|
| Rate for Payer: PACE SWMI |
$14,646.71
|
| Rate for Payer: PHP Medicare Advantage |
$14,646.71
|
| Rate for Payer: Priority Health Medicare |
$14,646.71
|
| Rate for Payer: Railroad Medicare Medicare |
$14,646.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,646.71
|
| Rate for Payer: UHC Medicare Advantage |
$14,646.71
|
| Rate for Payer: VA VA |
$14,646.71
|
|
|
MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC
|
Facility
|
IP
|
$15,980.16
|
|
|
Service Code
|
MSDRG 533
|
| Min. Negotiated Rate |
$12,144.92 |
| Max. Negotiated Rate |
$15,980.16 |
| Rate for Payer: Aetna Medicare |
$13,295.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,980.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,980.16
|
| Rate for Payer: BCBS MAPPO |
$12,784.13
|
| Rate for Payer: BCN Medicare Advantage |
$12,784.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,784.13
|
| Rate for Payer: Mclaren Medicare |
$12,784.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,423.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,701.75
|
| Rate for Payer: PACE Medicare |
$12,144.92
|
| Rate for Payer: PACE SWMI |
$12,784.13
|
| Rate for Payer: PHP Medicare Advantage |
$12,784.13
|
| Rate for Payer: Priority Health Medicare |
$12,784.13
|
| Rate for Payer: Railroad Medicare Medicare |
$12,784.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,784.13
|
| Rate for Payer: UHC Medicare Advantage |
$12,784.13
|
| Rate for Payer: VA VA |
$12,784.13
|
|
|
MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
|
IP
|
$8,787.11
|
|
|
Service Code
|
MSDRG 534
|
| Min. Negotiated Rate |
$6,678.21 |
| Max. Negotiated Rate |
$8,787.11 |
| Rate for Payer: Aetna Medicare |
$7,310.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,787.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,787.11
|
| Rate for Payer: BCBS MAPPO |
$7,029.69
|
| Rate for Payer: BCN Medicare Advantage |
$7,029.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,029.69
|
| Rate for Payer: Mclaren Medicare |
$7,029.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,381.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,084.14
|
| Rate for Payer: PACE Medicare |
$6,678.21
|
| Rate for Payer: PACE SWMI |
$7,029.69
|
| Rate for Payer: PHP Medicare Advantage |
$7,029.69
|
| Rate for Payer: Priority Health Medicare |
$7,029.69
|
| Rate for Payer: Railroad Medicare Medicare |
$7,029.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,029.69
|
| Rate for Payer: UHC Medicare Advantage |
$7,029.69
|
| Rate for Payer: VA VA |
$7,029.69
|
|
|
MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
|
IP
|
$14,007.12
|
|
|
Service Code
|
MSDRG 535
|
| Min. Negotiated Rate |
$10,645.42 |
| Max. Negotiated Rate |
$14,007.12 |
| Rate for Payer: Aetna Medicare |
$11,653.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,007.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,007.12
|
| Rate for Payer: BCBS MAPPO |
$11,205.70
|
| Rate for Payer: BCN Medicare Advantage |
$11,205.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,205.70
|
| Rate for Payer: Mclaren Medicare |
$11,205.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,765.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,886.56
|
| Rate for Payer: PACE Medicare |
$10,645.42
|
| Rate for Payer: PACE SWMI |
$11,205.70
|
| Rate for Payer: PHP Medicare Advantage |
$11,205.70
|
| Rate for Payer: Priority Health Medicare |
$11,205.70
|
| Rate for Payer: Railroad Medicare Medicare |
$11,205.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,205.70
|
| Rate for Payer: UHC Medicare Advantage |
$11,205.70
|
| Rate for Payer: VA VA |
$11,205.70
|
|
|
MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
|
IP
|
$8,755.75
|
|
|
Service Code
|
MSDRG 536
|
| Min. Negotiated Rate |
$6,654.37 |
| Max. Negotiated Rate |
$8,755.75 |
| Rate for Payer: Aetna Medicare |
$7,284.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,755.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,755.75
|
| Rate for Payer: BCBS MAPPO |
$7,004.60
|
| Rate for Payer: BCN Medicare Advantage |
$7,004.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,004.60
|
| Rate for Payer: Mclaren Medicare |
$7,004.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,354.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,055.29
|
| Rate for Payer: PACE Medicare |
$6,654.37
|
| Rate for Payer: PACE SWMI |
$7,004.60
|
| Rate for Payer: PHP Medicare Advantage |
$7,004.60
|
| Rate for Payer: Priority Health Medicare |
$7,004.60
|
| Rate for Payer: Railroad Medicare Medicare |
$7,004.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,004.60
|
| Rate for Payer: UHC Medicare Advantage |
$7,004.60
|
| Rate for Payer: VA VA |
$7,004.60
|
|
|
MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC
|
Facility
|
IP
|
$15,358.91
|
|
|
Service Code
|
MSDRG 562
|
| Min. Negotiated Rate |
$11,672.77 |
| Max. Negotiated Rate |
$15,358.91 |
| Rate for Payer: Aetna Medicare |
$12,778.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,358.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,358.91
|
| Rate for Payer: BCBS MAPPO |
$12,287.13
|
| Rate for Payer: BCN Medicare Advantage |
$12,287.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,287.13
|
| Rate for Payer: Mclaren Medicare |
$12,287.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,901.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,130.20
|
| Rate for Payer: PACE Medicare |
$11,672.77
|
| Rate for Payer: PACE SWMI |
$12,287.13
|
| Rate for Payer: PHP Medicare Advantage |
$12,287.13
|
| Rate for Payer: Priority Health Medicare |
$12,287.13
|
| Rate for Payer: Railroad Medicare Medicare |
$12,287.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,287.13
|
| Rate for Payer: UHC Medicare Advantage |
$12,287.13
|
| Rate for Payer: VA VA |
$12,287.13
|
|
|
MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC
|
Facility
|
IP
|
$9,594.55
|
|
|
Service Code
|
MSDRG 563
|
| Min. Negotiated Rate |
$7,291.86 |
| Max. Negotiated Rate |
$9,594.55 |
| Rate for Payer: Aetna Medicare |
$7,982.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,594.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,594.55
|
| Rate for Payer: BCBS MAPPO |
$7,675.64
|
| Rate for Payer: BCN Medicare Advantage |
$7,675.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,675.64
|
| Rate for Payer: Mclaren Medicare |
$7,675.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,059.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,826.99
|
| Rate for Payer: PACE Medicare |
$7,291.86
|
| Rate for Payer: PACE SWMI |
$7,675.64
|
| Rate for Payer: PHP Medicare Advantage |
$7,675.64
|
| Rate for Payer: Priority Health Medicare |
$7,675.64
|
| Rate for Payer: Railroad Medicare Medicare |
$7,675.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,675.64
|
| Rate for Payer: UHC Medicare Advantage |
$7,675.64
|
| Rate for Payer: VA VA |
$7,675.64
|
|
|
MS-DRG 42.00: FULL TERM NEONATE WITH MAJOR PROBLEMS
|
Facility
|
IP
|
$42,749.01
|
|
|
Service Code
|
MSDRG 793
|
| Min. Negotiated Rate |
$32,489.25 |
| Max. Negotiated Rate |
$42,749.01 |
| Rate for Payer: Aetna Medicare |
$35,567.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,749.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,749.01
|
| Rate for Payer: BCBS MAPPO |
$34,199.21
|
| Rate for Payer: BCN Medicare Advantage |
$34,199.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34,199.21
|
| Rate for Payer: Mclaren Medicare |
$34,199.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,909.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39,329.09
|
| Rate for Payer: PACE Medicare |
$32,489.25
|
| Rate for Payer: PACE SWMI |
$34,199.21
|
| Rate for Payer: PHP Medicare Advantage |
$34,199.21
|
| Rate for Payer: Priority Health Medicare |
$34,199.21
|
| Rate for Payer: Railroad Medicare Medicare |
$34,199.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$34,199.21
|
| Rate for Payer: UHC Medicare Advantage |
$34,199.21
|
| Rate for Payer: VA VA |
$34,199.21
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY
|
Facility
|
IP
|
$22,262.61
|
|
|
Service Code
|
MSDRG 934
|
| Min. Negotiated Rate |
$16,919.59 |
| Max. Negotiated Rate |
$22,262.61 |
| Rate for Payer: Aetna Medicare |
$18,522.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,262.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,262.61
|
| Rate for Payer: BCBS MAPPO |
$17,810.09
|
| Rate for Payer: BCN Medicare Advantage |
$17,810.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,810.09
|
| Rate for Payer: Mclaren Medicare |
$17,810.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,700.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,481.60
|
| Rate for Payer: PACE Medicare |
$16,919.59
|
| Rate for Payer: PACE SWMI |
$17,810.09
|
| Rate for Payer: PHP Medicare Advantage |
$17,810.09
|
| Rate for Payer: Priority Health Medicare |
$17,810.09
|
| Rate for Payer: Railroad Medicare Medicare |
$17,810.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,810.09
|
| Rate for Payer: UHC Medicare Advantage |
$17,810.09
|
| Rate for Payer: VA VA |
$17,810.09
|
|
