|
MS-DRG 42.00: NON-EXTENSIVE BURNS
|
Facility
|
IP
|
$22,774.59
|
|
|
Service Code
|
MSDRG 935
|
| Min. Negotiated Rate |
$17,308.69 |
| Max. Negotiated Rate |
$22,774.59 |
| Rate for Payer: Aetna Medicare |
$18,948.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,774.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,774.59
|
| Rate for Payer: BCBS MAPPO |
$18,219.67
|
| Rate for Payer: BCN Medicare Advantage |
$18,219.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,219.67
|
| Rate for Payer: Mclaren Medicare |
$18,219.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,130.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,952.62
|
| Rate for Payer: PACE Medicare |
$17,308.69
|
| Rate for Payer: PACE SWMI |
$18,219.67
|
| Rate for Payer: PHP Medicare Advantage |
$18,219.67
|
| Rate for Payer: Priority Health Medicare |
$18,219.67
|
| Rate for Payer: Railroad Medicare Medicare |
$18,219.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,219.67
|
| Rate for Payer: UHC Medicare Advantage |
$18,219.67
|
| Rate for Payer: VA VA |
$18,219.67
|
|
|
MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$17,913.78
|
|
|
Service Code
|
MSDRG 988
|
| Min. Negotiated Rate |
$13,614.47 |
| Max. Negotiated Rate |
$17,913.78 |
| Rate for Payer: Aetna Medicare |
$14,904.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,913.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,913.78
|
| Rate for Payer: BCBS MAPPO |
$14,331.02
|
| Rate for Payer: BCN Medicare Advantage |
$14,331.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,331.02
|
| Rate for Payer: Mclaren Medicare |
$14,331.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,047.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,480.67
|
| Rate for Payer: PACE Medicare |
$13,614.47
|
| Rate for Payer: PACE SWMI |
$14,331.02
|
| Rate for Payer: PHP Medicare Advantage |
$14,331.02
|
| Rate for Payer: Priority Health Medicare |
$14,331.02
|
| Rate for Payer: Railroad Medicare Medicare |
$14,331.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,331.02
|
| Rate for Payer: UHC Medicare Advantage |
$14,331.02
|
| Rate for Payer: VA VA |
$14,331.02
|
|
|
MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$35,992.05
|
|
|
Service Code
|
MSDRG 987
|
| Min. Negotiated Rate |
$27,353.96 |
| Max. Negotiated Rate |
$35,992.05 |
| Rate for Payer: Aetna Medicare |
$29,945.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,992.05
|
| Rate for Payer: BCBS MAPPO |
$28,793.64
|
| Rate for Payer: BCN Medicare Advantage |
$28,793.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,793.64
|
| Rate for Payer: Mclaren Medicare |
$28,793.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,233.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,112.69
|
| Rate for Payer: PACE Medicare |
$27,353.96
|
| Rate for Payer: PACE SWMI |
$28,793.64
|
| Rate for Payer: PHP Medicare Advantage |
$28,793.64
|
| Rate for Payer: Priority Health Medicare |
$28,793.64
|
| Rate for Payer: Railroad Medicare Medicare |
$28,793.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$28,793.64
|
| Rate for Payer: UHC Medicare Advantage |
$28,793.64
|
| Rate for Payer: VA VA |
$28,793.64
|
|
|
MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$12,242.49
|
|
|
Service Code
|
MSDRG 989
|
| Min. Negotiated Rate |
$9,304.29 |
| Max. Negotiated Rate |
$12,242.49 |
| Rate for Payer: Aetna Medicare |
$10,185.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,242.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,242.49
|
| Rate for Payer: BCBS MAPPO |
$9,793.99
|
| Rate for Payer: BCN Medicare Advantage |
$9,793.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,793.99
|
| Rate for Payer: Mclaren Medicare |
$9,793.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,283.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,263.09
|
| Rate for Payer: PACE Medicare |
$9,304.29
|
| Rate for Payer: PACE SWMI |
$9,793.99
|
| Rate for Payer: PHP Medicare Advantage |
$9,793.99
|
| Rate for Payer: Priority Health Medicare |
$9,793.99
|
| Rate for Payer: Railroad Medicare Medicare |
$9,793.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,793.99
|
| Rate for Payer: UHC Medicare Advantage |
$9,793.99
|
| Rate for Payer: VA VA |
$9,793.99
|
|
|
MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$10,229.96
|
|
|
Service Code
|
MSDRG 600
|
| Min. Negotiated Rate |
$7,774.77 |
| Max. Negotiated Rate |
$10,229.96 |
| Rate for Payer: Aetna Medicare |
$8,511.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,229.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,229.96
|
| Rate for Payer: BCBS MAPPO |
$8,183.97
|
| Rate for Payer: BCN Medicare Advantage |
$8,183.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,183.97
|
| Rate for Payer: Mclaren Medicare |
$8,183.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,593.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,411.57
|
| Rate for Payer: PACE Medicare |
$7,774.77
|
| Rate for Payer: PACE SWMI |
$8,183.97
|
| Rate for Payer: PHP Medicare Advantage |
$8,183.97
|
| Rate for Payer: Priority Health Medicare |
$8,183.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8,183.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,183.97
|
| Rate for Payer: UHC Medicare Advantage |
$8,183.97
|
| Rate for Payer: VA VA |
$8,183.97
|
|
|
MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$6,616.76
|
|
|
Service Code
|
MSDRG 601
|
| Min. Negotiated Rate |
$5,028.74 |
| Max. Negotiated Rate |
$6,616.76 |
| Rate for Payer: Aetna Medicare |
$5,505.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,616.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,616.76
|
| Rate for Payer: BCBS MAPPO |
$5,293.41
|
| Rate for Payer: BCN Medicare Advantage |
$5,293.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,293.41
|
| Rate for Payer: Mclaren Medicare |
$5,293.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,558.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,087.42
|
| Rate for Payer: PACE Medicare |
$5,028.74
|
| Rate for Payer: PACE SWMI |
$5,293.41
|
| Rate for Payer: PHP Medicare Advantage |
$5,293.41
|
| Rate for Payer: Priority Health Medicare |
$5,293.41
|
| Rate for Payer: Railroad Medicare Medicare |
$5,293.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,293.41
|
| Rate for Payer: UHC Medicare Advantage |
$5,293.41
|
| Rate for Payer: VA VA |
$5,293.41
|
|
|
MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC
|
Facility
|
IP
|
$11,214.46
|
|
|
Service Code
|
MSDRG 071
|
| Min. Negotiated Rate |
$8,522.99 |
| Max. Negotiated Rate |
$11,214.46 |
| Rate for Payer: Aetna Medicare |
$9,330.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,214.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,214.46
|
| Rate for Payer: BCBS MAPPO |
$8,971.57
|
| Rate for Payer: BCN Medicare Advantage |
$8,971.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,971.57
|
| Rate for Payer: Mclaren Medicare |
$8,971.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,420.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,317.31
|
| Rate for Payer: PACE Medicare |
$8,522.99
|
| Rate for Payer: PACE SWMI |
$8,971.57
|
| Rate for Payer: PHP Medicare Advantage |
$8,971.57
|
| Rate for Payer: Priority Health Medicare |
$8,971.57
|
| Rate for Payer: Railroad Medicare Medicare |
$8,971.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,971.57
|
| Rate for Payer: UHC Medicare Advantage |
$8,971.57
|
| Rate for Payer: VA VA |
$8,971.57
|
|
|
MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$18,144.46
|
|
|
Service Code
|
MSDRG 070
|
| Min. Negotiated Rate |
$13,789.79 |
| Max. Negotiated Rate |
$18,144.46 |
| Rate for Payer: Aetna Medicare |
$15,096.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,144.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,144.46
|
| Rate for Payer: BCBS MAPPO |
$14,515.57
|
| Rate for Payer: BCN Medicare Advantage |
$14,515.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,515.57
|
| Rate for Payer: Mclaren Medicare |
$14,515.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,241.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,692.91
|
| Rate for Payer: PACE Medicare |
$13,789.79
|
| Rate for Payer: PACE SWMI |
$14,515.57
|
| Rate for Payer: PHP Medicare Advantage |
$14,515.57
|
| Rate for Payer: Priority Health Medicare |
$14,515.57
|
| Rate for Payer: Railroad Medicare Medicare |
$14,515.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,515.57
|
| Rate for Payer: UHC Medicare Advantage |
$14,515.57
|
| Rate for Payer: VA VA |
$14,515.57
|
|
|
MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$8,141.59
|
|
|
Service Code
|
MSDRG 072
|
| Min. Negotiated Rate |
$6,187.61 |
| Max. Negotiated Rate |
$8,141.59 |
| Rate for Payer: Aetna Medicare |
$6,773.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,141.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,141.59
|
| Rate for Payer: BCBS MAPPO |
$6,513.27
|
| Rate for Payer: BCN Medicare Advantage |
$6,513.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,513.27
|
| Rate for Payer: Mclaren Medicare |
$6,513.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,838.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,490.26
|
| Rate for Payer: PACE Medicare |
$6,187.61
|
| Rate for Payer: PACE SWMI |
$6,513.27
|
| Rate for Payer: PHP Medicare Advantage |
$6,513.27
|
| Rate for Payer: Priority Health Medicare |
$6,513.27
|
| Rate for Payer: Railroad Medicare Medicare |
$6,513.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,513.27
|
| Rate for Payer: UHC Medicare Advantage |
$6,513.27
|
| Rate for Payer: VA VA |
$6,513.27
|
|
|
MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC
|
Facility
|
IP
|
$15,271.91
|
|
|
Service Code
|
MSDRG 067
|
| Min. Negotiated Rate |
$11,606.65 |
| Max. Negotiated Rate |
$15,271.91 |
| Rate for Payer: Aetna Medicare |
$12,706.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,271.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,271.91
|
| Rate for Payer: BCBS MAPPO |
$12,217.53
|
| Rate for Payer: BCN Medicare Advantage |
$12,217.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,217.53
|
| Rate for Payer: Mclaren Medicare |
$12,217.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,828.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,050.16
|
| Rate for Payer: PACE Medicare |
$11,606.65
|
| Rate for Payer: PACE SWMI |
$12,217.53
|
| Rate for Payer: PHP Medicare Advantage |
$12,217.53
|
| Rate for Payer: Priority Health Medicare |
$12,217.53
|
| Rate for Payer: Railroad Medicare Medicare |
$12,217.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,217.53
|
| Rate for Payer: UHC Medicare Advantage |
$12,217.53
|
| Rate for Payer: VA VA |
$12,217.53
|
|
|
MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC
|
Facility
|
IP
|
$9,470.09
|
|
|
Service Code
|
MSDRG 068
|
| Min. Negotiated Rate |
$7,197.27 |
| Max. Negotiated Rate |
$9,470.09 |
| Rate for Payer: Aetna Medicare |
$7,879.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,470.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,470.09
|
| Rate for Payer: BCBS MAPPO |
$7,576.07
|
| Rate for Payer: BCN Medicare Advantage |
$7,576.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,576.07
|
| Rate for Payer: Mclaren Medicare |
$7,576.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,954.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,712.48
|
| Rate for Payer: PACE Medicare |
$7,197.27
|
| Rate for Payer: PACE SWMI |
$7,576.07
|
| Rate for Payer: PHP Medicare Advantage |
$7,576.07
|
| Rate for Payer: Priority Health Medicare |
$7,576.07
|
| Rate for Payer: Railroad Medicare Medicare |
$7,576.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,576.07
|
| Rate for Payer: UHC Medicare Advantage |
$7,576.07
|
| Rate for Payer: VA VA |
$7,576.07
|
|
|
MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITH MCC
|
Facility
|
IP
|
$20,663.92
|
|
|
Service Code
|
MSDRG 080
|
| Min. Negotiated Rate |
$15,704.58 |
| Max. Negotiated Rate |
$20,663.92 |
| Rate for Payer: Aetna Medicare |
$17,192.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,663.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,663.92
|
| Rate for Payer: BCBS MAPPO |
$16,531.14
|
| Rate for Payer: BCN Medicare Advantage |
$16,531.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,531.14
|
| Rate for Payer: Mclaren Medicare |
$16,531.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,357.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,010.81
|
| Rate for Payer: PACE Medicare |
$15,704.58
|
| Rate for Payer: PACE SWMI |
$16,531.14
|
| Rate for Payer: PHP Medicare Advantage |
$16,531.14
|
| Rate for Payer: Priority Health Medicare |
$16,531.14
|
| Rate for Payer: Railroad Medicare Medicare |
$16,531.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,531.14
|
| Rate for Payer: UHC Medicare Advantage |
$16,531.14
|
| Rate for Payer: VA VA |
$16,531.14
|
|
|
MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC
|
Facility
|
IP
|
$9,705.86
|
|
|
Service Code
|
MSDRG 081
|
| Min. Negotiated Rate |
$7,376.46 |
| Max. Negotiated Rate |
$9,705.86 |
| Rate for Payer: Aetna Medicare |
$8,075.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,705.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,705.86
|
| Rate for Payer: BCBS MAPPO |
$7,764.69
|
| Rate for Payer: BCN Medicare Advantage |
$7,764.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,764.69
|
| Rate for Payer: Mclaren Medicare |
$7,764.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,152.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,929.39
|
| Rate for Payer: PACE Medicare |
$7,376.46
|
| Rate for Payer: PACE SWMI |
$7,764.69
|
| Rate for Payer: PHP Medicare Advantage |
$7,764.69
|
| Rate for Payer: Priority Health Medicare |
$7,764.69
|
| Rate for Payer: Railroad Medicare Medicare |
$7,764.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,764.69
|
| Rate for Payer: UHC Medicare Advantage |
$7,764.69
|
| Rate for Payer: VA VA |
$7,764.69
|
|
|
MS-DRG 42.00: NORMAL NEWBORN
|
Facility
|
IP
|
$2,572.49
|
|
|
Service Code
|
MSDRG 795
|
| Min. Negotiated Rate |
$1,955.09 |
| Max. Negotiated Rate |
$2,572.49 |
| Rate for Payer: Aetna Medicare |
$2,140.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,572.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,572.49
|
| Rate for Payer: BCBS MAPPO |
$2,057.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,057.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,057.99
|
| Rate for Payer: Mclaren Medicare |
$2,057.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,160.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,366.69
|
| Rate for Payer: PACE Medicare |
$1,955.09
|
| Rate for Payer: PACE SWMI |
$2,057.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,057.99
|
| Rate for Payer: Priority Health Medicare |
$2,057.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2,057.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,057.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,057.99
|
| Rate for Payer: VA VA |
$2,057.99
|
|
|
MS-DRG 42.00: ORBITAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$23,383.70
|
|
|
Service Code
|
MSDRG 113
|
| Min. Negotiated Rate |
$17,771.61 |
| Max. Negotiated Rate |
$23,383.70 |
| Rate for Payer: Aetna Medicare |
$19,455.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,383.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,383.70
|
| Rate for Payer: BCBS MAPPO |
$18,706.96
|
| Rate for Payer: BCN Medicare Advantage |
$18,706.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,706.96
|
| Rate for Payer: Mclaren Medicare |
$18,706.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,642.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,513.00
|
| Rate for Payer: PACE Medicare |
$17,771.61
|
| Rate for Payer: PACE SWMI |
$18,706.96
|
| Rate for Payer: PHP Medicare Advantage |
$18,706.96
|
| Rate for Payer: Priority Health Medicare |
$18,706.96
|
| Rate for Payer: Railroad Medicare Medicare |
$18,706.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,706.96
|
| Rate for Payer: UHC Medicare Advantage |
$18,706.96
|
| Rate for Payer: VA VA |
$18,706.96
|
|
|
MS-DRG 42.00: ORBITAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$12,511.66
|
|
|
Service Code
|
MSDRG 114
|
| Min. Negotiated Rate |
$9,508.86 |
| Max. Negotiated Rate |
$12,511.66 |
| Rate for Payer: Aetna Medicare |
$10,409.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,511.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,511.66
|
| Rate for Payer: BCBS MAPPO |
$10,009.33
|
| Rate for Payer: BCN Medicare Advantage |
$10,009.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,009.33
|
| Rate for Payer: Mclaren Medicare |
$10,009.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,509.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,510.73
|
| Rate for Payer: PACE Medicare |
$9,508.86
|
| Rate for Payer: PACE SWMI |
$10,009.33
|
| Rate for Payer: PHP Medicare Advantage |
$10,009.33
|
| Rate for Payer: Priority Health Medicare |
$10,009.33
|
| Rate for Payer: Railroad Medicare Medicare |
$10,009.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,009.33
|
| Rate for Payer: UHC Medicare Advantage |
$10,009.33
|
| Rate for Payer: VA VA |
$10,009.33
|
|
|
MS-DRG 42.00: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY
|
Facility
|
IP
|
$17,450.35
|
|
|
Service Code
|
MSDRG 884
|
| Min. Negotiated Rate |
$13,262.27 |
| Max. Negotiated Rate |
$17,450.35 |
| Rate for Payer: Aetna Medicare |
$14,518.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,450.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,450.35
|
| Rate for Payer: BCBS MAPPO |
$13,960.28
|
| Rate for Payer: BCN Medicare Advantage |
$13,960.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,960.28
|
| Rate for Payer: Mclaren Medicare |
$13,960.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,658.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,054.32
|
| Rate for Payer: PACE Medicare |
$13,262.27
|
| Rate for Payer: PACE SWMI |
$13,960.28
|
| Rate for Payer: PHP Medicare Advantage |
$13,960.28
|
| Rate for Payer: Priority Health Medicare |
$13,960.28
|
| Rate for Payer: Railroad Medicare Medicare |
$13,960.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,960.28
|
| Rate for Payer: UHC Medicare Advantage |
$13,960.28
|
| Rate for Payer: VA VA |
$13,960.28
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH CC
|
Facility
|
IP
|
$16,709.70
|
|
|
Service Code
|
MSDRG 620
|
| Min. Negotiated Rate |
$12,699.37 |
| Max. Negotiated Rate |
$16,709.70 |
| Rate for Payer: Aetna Medicare |
$13,902.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,709.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,709.70
|
| Rate for Payer: BCBS MAPPO |
$13,367.76
|
| Rate for Payer: BCN Medicare Advantage |
$13,367.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,367.76
|
| Rate for Payer: Mclaren Medicare |
$13,367.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,036.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,372.92
|
| Rate for Payer: PACE Medicare |
$12,699.37
|
| Rate for Payer: PACE SWMI |
$13,367.76
|
| Rate for Payer: PHP Medicare Advantage |
$13,367.76
|
| Rate for Payer: Priority Health Medicare |
$13,367.76
|
| Rate for Payer: Railroad Medicare Medicare |
$13,367.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,367.76
|
| Rate for Payer: UHC Medicare Advantage |
$13,367.76
|
| Rate for Payer: VA VA |
$13,367.76
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH MCC
|
Facility
|
IP
|
$28,138.25
|
|
|
Service Code
|
MSDRG 619
|
| Min. Negotiated Rate |
$21,385.07 |
| Max. Negotiated Rate |
$28,138.25 |
| Rate for Payer: Aetna Medicare |
$23,411.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,138.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,138.25
|
| Rate for Payer: BCBS MAPPO |
$22,510.60
|
| Rate for Payer: BCN Medicare Advantage |
$22,510.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,510.60
|
| Rate for Payer: Mclaren Medicare |
$22,510.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,636.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,887.19
|
| Rate for Payer: PACE Medicare |
$21,385.07
|
| Rate for Payer: PACE SWMI |
$22,510.60
|
| Rate for Payer: PHP Medicare Advantage |
$22,510.60
|
| Rate for Payer: Priority Health Medicare |
$22,510.60
|
| Rate for Payer: Railroad Medicare Medicare |
$22,510.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,510.60
|
| Rate for Payer: UHC Medicare Advantage |
$22,510.60
|
| Rate for Payer: VA VA |
$22,510.60
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC
|
Facility
|
IP
|
$15,341.74
|
|
|
Service Code
|
MSDRG 621
|
| Min. Negotiated Rate |
$11,659.72 |
| Max. Negotiated Rate |
$15,341.74 |
| Rate for Payer: Aetna Medicare |
$12,764.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,341.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,341.74
|
| Rate for Payer: BCBS MAPPO |
$12,273.39
|
| Rate for Payer: BCN Medicare Advantage |
$12,273.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,273.39
|
| Rate for Payer: Mclaren Medicare |
$12,273.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,887.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,114.40
|
| Rate for Payer: PACE Medicare |
$11,659.72
|
| Rate for Payer: PACE SWMI |
$12,273.39
|
| Rate for Payer: PHP Medicare Advantage |
$12,273.39
|
| Rate for Payer: Priority Health Medicare |
$12,273.39
|
| Rate for Payer: Railroad Medicare Medicare |
$12,273.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,273.39
|
| Rate for Payer: UHC Medicare Advantage |
$12,273.39
|
| Rate for Payer: VA VA |
$12,273.39
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC
|
Facility
|
IP
|
$21,914.54
|
|
|
Service Code
|
MSDRG 940
|
| Min. Negotiated Rate |
$16,655.05 |
| Max. Negotiated Rate |
$21,914.54 |
| Rate for Payer: Aetna Medicare |
$18,232.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,914.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,914.54
|
| Rate for Payer: BCBS MAPPO |
$17,531.63
|
| Rate for Payer: BCN Medicare Advantage |
$17,531.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,531.63
|
| Rate for Payer: Mclaren Medicare |
$17,531.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,408.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,161.37
|
| Rate for Payer: PACE Medicare |
$16,655.05
|
| Rate for Payer: PACE SWMI |
$17,531.63
|
| Rate for Payer: PHP Medicare Advantage |
$17,531.63
|
| Rate for Payer: Priority Health Medicare |
$17,531.63
|
| Rate for Payer: Railroad Medicare Medicare |
$17,531.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,531.63
|
| Rate for Payer: UHC Medicare Advantage |
$17,531.63
|
| Rate for Payer: VA VA |
$17,531.63
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC
|
Facility
|
IP
|
$32,666.20
|
|
|
Service Code
|
MSDRG 939
|
| Min. Negotiated Rate |
$24,826.31 |
| Max. Negotiated Rate |
$32,666.20 |
| Rate for Payer: Aetna Medicare |
$27,178.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,666.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,666.20
|
| Rate for Payer: BCBS MAPPO |
$26,132.96
|
| Rate for Payer: BCN Medicare Advantage |
$26,132.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,132.96
|
| Rate for Payer: Mclaren Medicare |
$26,132.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,439.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,052.90
|
| Rate for Payer: PACE Medicare |
$24,826.31
|
| Rate for Payer: PACE SWMI |
$26,132.96
|
| Rate for Payer: PHP Medicare Advantage |
$26,132.96
|
| Rate for Payer: Priority Health Medicare |
$26,132.96
|
| Rate for Payer: Railroad Medicare Medicare |
$26,132.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,132.96
|
| Rate for Payer: UHC Medicare Advantage |
$26,132.96
|
| Rate for Payer: VA VA |
$26,132.96
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC
|
Facility
|
IP
|
$20,324.96
|
|
|
Service Code
|
MSDRG 941
|
| Min. Negotiated Rate |
$15,446.97 |
| Max. Negotiated Rate |
$20,324.96 |
| Rate for Payer: Aetna Medicare |
$16,910.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,324.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,324.96
|
| Rate for Payer: BCBS MAPPO |
$16,259.97
|
| Rate for Payer: BCN Medicare Advantage |
$16,259.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,259.97
|
| Rate for Payer: Mclaren Medicare |
$16,259.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,072.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,698.97
|
| Rate for Payer: PACE Medicare |
$15,446.97
|
| Rate for Payer: PACE SWMI |
$16,259.97
|
| Rate for Payer: PHP Medicare Advantage |
$16,259.97
|
| Rate for Payer: Priority Health Medicare |
$16,259.97
|
| Rate for Payer: Railroad Medicare Medicare |
$16,259.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,259.97
|
| Rate for Payer: UHC Medicare Advantage |
$16,259.97
|
| Rate for Payer: VA VA |
$16,259.97
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS
|
Facility
|
IP
|
$40,311.54
|
|
|
Service Code
|
MSDRG 876
|
| Min. Negotiated Rate |
$30,636.77 |
| Max. Negotiated Rate |
$40,311.54 |
| Rate for Payer: Aetna Medicare |
$33,539.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,311.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,311.54
|
| Rate for Payer: BCBS MAPPO |
$32,249.23
|
| Rate for Payer: BCN Medicare Advantage |
$32,249.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,249.23
|
| Rate for Payer: Mclaren Medicare |
$32,249.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,861.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,086.61
|
| Rate for Payer: PACE Medicare |
$30,636.77
|
| Rate for Payer: PACE SWMI |
$32,249.23
|
| Rate for Payer: PHP Medicare Advantage |
$32,249.23
|
| Rate for Payer: Priority Health Medicare |
$32,249.23
|
| Rate for Payer: Railroad Medicare Medicare |
$32,249.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,249.23
|
| Rate for Payer: UHC Medicare Advantage |
$32,249.23
|
| Rate for Payer: VA VA |
$32,249.23
|
|
|
MS-DRG 42.00: OSTEOMYELITIS WITH CC
|
Facility
|
IP
|
$13,644.91
|
|
|
Service Code
|
MSDRG 540
|
| Min. Negotiated Rate |
$10,370.13 |
| Max. Negotiated Rate |
$13,644.91 |
| Rate for Payer: Aetna Medicare |
$11,352.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,644.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,644.91
|
| Rate for Payer: BCBS MAPPO |
$10,915.93
|
| Rate for Payer: BCN Medicare Advantage |
$10,915.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,915.93
|
| Rate for Payer: Mclaren Medicare |
$10,915.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,461.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,553.32
|
| Rate for Payer: PACE Medicare |
$10,370.13
|
| Rate for Payer: PACE SWMI |
$10,915.93
|
| Rate for Payer: PHP Medicare Advantage |
$10,915.93
|
| Rate for Payer: Priority Health Medicare |
$10,915.93
|
| Rate for Payer: Railroad Medicare Medicare |
$10,915.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,915.93
|
| Rate for Payer: UHC Medicare Advantage |
$10,915.93
|
| Rate for Payer: VA VA |
$10,915.93
|
|
