|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$52,099.29
|
|
|
Service Code
|
MSDRG 466
|
| Min. Negotiated Rate |
$39,595.46 |
| Max. Negotiated Rate |
$52,099.29 |
| Rate for Payer: Aetna Medicare |
$43,346.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,099.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,099.29
|
| Rate for Payer: BCBS MAPPO |
$41,679.43
|
| Rate for Payer: BCN Medicare Advantage |
$41,679.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41,679.43
|
| Rate for Payer: Mclaren Medicare |
$41,679.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43,763.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47,931.34
|
| Rate for Payer: PACE Medicare |
$39,595.46
|
| Rate for Payer: PACE SWMI |
$41,679.43
|
| Rate for Payer: PHP Medicare Advantage |
$41,679.43
|
| Rate for Payer: Priority Health Medicare |
$41,679.43
|
| Rate for Payer: Railroad Medicare Medicare |
$41,679.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$41,679.43
|
| Rate for Payer: UHC Medicare Advantage |
$41,679.43
|
| Rate for Payer: VA VA |
$41,679.43
|
|
|
MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$27,094.05
|
|
|
Service Code
|
MSDRG 468
|
| Min. Negotiated Rate |
$20,591.48 |
| Max. Negotiated Rate |
$27,094.05 |
| Rate for Payer: Aetna Medicare |
$22,542.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,094.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,094.05
|
| Rate for Payer: BCBS MAPPO |
$21,675.24
|
| Rate for Payer: BCN Medicare Advantage |
$21,675.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,675.24
|
| Rate for Payer: Mclaren Medicare |
$21,675.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,759.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,926.53
|
| Rate for Payer: PACE Medicare |
$20,591.48
|
| Rate for Payer: PACE SWMI |
$21,675.24
|
| Rate for Payer: PHP Medicare Advantage |
$21,675.24
|
| Rate for Payer: Priority Health Medicare |
$21,675.24
|
| Rate for Payer: Railroad Medicare Medicare |
$21,675.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,675.24
|
| Rate for Payer: UHC Medicare Advantage |
$21,675.24
|
| Rate for Payer: VA VA |
$21,675.24
|
|
|
MS-DRG 42.00: SALIVARY GLAND PROCEDURES
|
Facility
|
IP
|
$14,443.20
|
|
|
Service Code
|
MSDRG 139
|
| Min. Negotiated Rate |
$10,976.83 |
| Max. Negotiated Rate |
$14,443.20 |
| Rate for Payer: Aetna Medicare |
$12,016.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,443.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,443.20
|
| Rate for Payer: BCBS MAPPO |
$11,554.56
|
| Rate for Payer: BCN Medicare Advantage |
$11,554.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,554.56
|
| Rate for Payer: Mclaren Medicare |
$11,554.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,132.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,287.74
|
| Rate for Payer: PACE Medicare |
$10,976.83
|
| Rate for Payer: PACE SWMI |
$11,554.56
|
| Rate for Payer: PHP Medicare Advantage |
$11,554.56
|
| Rate for Payer: Priority Health Medicare |
$11,554.56
|
| Rate for Payer: Railroad Medicare Medicare |
$11,554.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,554.56
|
| Rate for Payer: UHC Medicare Advantage |
$11,554.56
|
| Rate for Payer: VA VA |
$11,554.56
|
|
|
MS-DRG 42.00: SEIZURES WITH MCC
|
Facility
|
IP
|
$20,638.62
|
|
|
Service Code
|
MSDRG 100
|
| Min. Negotiated Rate |
$15,685.35 |
| Max. Negotiated Rate |
$20,638.62 |
| Rate for Payer: Aetna Medicare |
$17,171.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,638.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,638.62
|
| Rate for Payer: BCBS MAPPO |
$16,510.90
|
| Rate for Payer: BCN Medicare Advantage |
$16,510.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,510.90
|
| Rate for Payer: Mclaren Medicare |
$16,510.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,336.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,987.53
|
| Rate for Payer: PACE Medicare |
$15,685.35
|
| Rate for Payer: PACE SWMI |
$16,510.90
|
| Rate for Payer: PHP Medicare Advantage |
$16,510.90
|
| Rate for Payer: Priority Health Medicare |
$16,510.90
|
| Rate for Payer: Railroad Medicare Medicare |
$16,510.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,510.90
|
| Rate for Payer: UHC Medicare Advantage |
$16,510.90
|
| Rate for Payer: VA VA |
$16,510.90
|
|
|
MS-DRG 42.00: SEIZURES WITHOUT MCC
|
Facility
|
IP
|
$9,876.85
|
|
|
Service Code
|
MSDRG 101
|
| Min. Negotiated Rate |
$7,506.41 |
| Max. Negotiated Rate |
$9,876.85 |
| Rate for Payer: Aetna Medicare |
$8,217.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,876.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,876.85
|
| Rate for Payer: BCBS MAPPO |
$7,901.48
|
| Rate for Payer: BCN Medicare Advantage |
$7,901.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,901.48
|
| Rate for Payer: Mclaren Medicare |
$7,901.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,296.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,086.70
|
| Rate for Payer: PACE Medicare |
$7,506.41
|
| Rate for Payer: PACE SWMI |
$7,901.48
|
| Rate for Payer: PHP Medicare Advantage |
$7,901.48
|
| Rate for Payer: Priority Health Medicare |
$7,901.48
|
| Rate for Payer: Railroad Medicare Medicare |
$7,901.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,901.48
|
| Rate for Payer: UHC Medicare Advantage |
$7,901.48
|
| Rate for Payer: VA VA |
$7,901.48
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC
|
Facility
|
IP
|
$12,744.35
|
|
|
Service Code
|
MSDRG 549
|
| Min. Negotiated Rate |
$9,685.71 |
| Max. Negotiated Rate |
$12,744.35 |
| Rate for Payer: Aetna Medicare |
$10,603.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,744.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,744.35
|
| Rate for Payer: BCBS MAPPO |
$10,195.48
|
| Rate for Payer: BCN Medicare Advantage |
$10,195.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,195.48
|
| Rate for Payer: Mclaren Medicare |
$10,195.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,705.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,724.80
|
| Rate for Payer: PACE Medicare |
$9,685.71
|
| Rate for Payer: PACE SWMI |
$10,195.48
|
| Rate for Payer: PHP Medicare Advantage |
$10,195.48
|
| Rate for Payer: Priority Health Medicare |
$10,195.48
|
| Rate for Payer: Railroad Medicare Medicare |
$10,195.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,195.48
|
| Rate for Payer: UHC Medicare Advantage |
$10,195.48
|
| Rate for Payer: VA VA |
$10,195.48
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC
|
Facility
|
IP
|
$20,935.09
|
|
|
Service Code
|
MSDRG 548
|
| Min. Negotiated Rate |
$15,910.67 |
| Max. Negotiated Rate |
$20,935.09 |
| Rate for Payer: Aetna Medicare |
$17,417.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,935.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,935.09
|
| Rate for Payer: BCBS MAPPO |
$16,748.07
|
| Rate for Payer: BCN Medicare Advantage |
$16,748.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,748.07
|
| Rate for Payer: Mclaren Medicare |
$16,748.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,585.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,260.28
|
| Rate for Payer: PACE Medicare |
$15,910.67
|
| Rate for Payer: PACE SWMI |
$16,748.07
|
| Rate for Payer: PHP Medicare Advantage |
$16,748.07
|
| Rate for Payer: Priority Health Medicare |
$16,748.07
|
| Rate for Payer: Railroad Medicare Medicare |
$16,748.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,748.07
|
| Rate for Payer: UHC Medicare Advantage |
$16,748.07
|
| Rate for Payer: VA VA |
$16,748.07
|
|
|
MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$9,273.79
|
|
|
Service Code
|
MSDRG 550
|
| Min. Negotiated Rate |
$7,048.08 |
| Max. Negotiated Rate |
$9,273.79 |
| Rate for Payer: Aetna Medicare |
$7,715.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,273.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,273.79
|
| Rate for Payer: BCBS MAPPO |
$7,419.03
|
| Rate for Payer: BCN Medicare Advantage |
$7,419.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,419.03
|
| Rate for Payer: Mclaren Medicare |
$7,419.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,789.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,531.88
|
| Rate for Payer: PACE Medicare |
$7,048.08
|
| Rate for Payer: PACE SWMI |
$7,419.03
|
| Rate for Payer: PHP Medicare Advantage |
$7,419.03
|
| Rate for Payer: Priority Health Medicare |
$7,419.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7,419.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,419.03
|
| Rate for Payer: UHC Medicare Advantage |
$7,419.03
|
| Rate for Payer: VA VA |
$7,419.03
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS
|
Facility
|
IP
|
$70,938.48
|
|
|
Service Code
|
MSDRG 870
|
| Min. Negotiated Rate |
$53,913.24 |
| Max. Negotiated Rate |
$70,938.48 |
| Rate for Payer: Aetna Medicare |
$59,020.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70,938.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70,938.48
|
| Rate for Payer: BCBS MAPPO |
$56,750.78
|
| Rate for Payer: BCN Medicare Advantage |
$56,750.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,750.78
|
| Rate for Payer: Mclaren Medicare |
$56,750.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,588.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,263.40
|
| Rate for Payer: PACE Medicare |
$53,913.24
|
| Rate for Payer: PACE SWMI |
$56,750.78
|
| Rate for Payer: PHP Medicare Advantage |
$56,750.78
|
| Rate for Payer: Priority Health Medicare |
$56,750.78
|
| Rate for Payer: Railroad Medicare Medicare |
$56,750.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$56,750.78
|
| Rate for Payer: UHC Medicare Advantage |
$56,750.78
|
| Rate for Payer: VA VA |
$56,750.78
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC
|
Facility
|
IP
|
$20,403.88
|
|
|
Service Code
|
MSDRG 871
|
| Min. Negotiated Rate |
$15,506.94 |
| Max. Negotiated Rate |
$20,403.88 |
| Rate for Payer: Aetna Medicare |
$16,976.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,403.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,403.88
|
| Rate for Payer: BCBS MAPPO |
$16,323.10
|
| Rate for Payer: BCN Medicare Advantage |
$16,323.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,323.10
|
| Rate for Payer: Mclaren Medicare |
$16,323.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,139.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,771.56
|
| Rate for Payer: PACE Medicare |
$15,506.94
|
| Rate for Payer: PACE SWMI |
$16,323.10
|
| Rate for Payer: PHP Medicare Advantage |
$16,323.10
|
| Rate for Payer: Priority Health Medicare |
$16,323.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16,323.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,323.10
|
| Rate for Payer: UHC Medicare Advantage |
$16,323.10
|
| Rate for Payer: VA VA |
$16,323.10
|
|
|
MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC
|
Facility
|
IP
|
$10,982.77
|
|
|
Service Code
|
MSDRG 872
|
| Min. Negotiated Rate |
$8,346.91 |
| Max. Negotiated Rate |
$10,982.77 |
| Rate for Payer: Aetna Medicare |
$9,137.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,982.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,982.77
|
| Rate for Payer: BCBS MAPPO |
$8,786.22
|
| Rate for Payer: BCN Medicare Advantage |
$8,786.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,786.22
|
| Rate for Payer: Mclaren Medicare |
$8,786.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,225.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,104.15
|
| Rate for Payer: PACE Medicare |
$8,346.91
|
| Rate for Payer: PACE SWMI |
$8,786.22
|
| Rate for Payer: PHP Medicare Advantage |
$8,786.22
|
| Rate for Payer: Priority Health Medicare |
$8,786.22
|
| Rate for Payer: Railroad Medicare Medicare |
$8,786.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,786.22
|
| Rate for Payer: UHC Medicare Advantage |
$8,786.22
|
| Rate for Payer: VA VA |
$8,786.22
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
|
IP
|
$20,394.76
|
|
|
Service Code
|
MSDRG 511
|
| Min. Negotiated Rate |
$15,500.02 |
| Max. Negotiated Rate |
$20,394.76 |
| Rate for Payer: Aetna Medicare |
$16,968.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,394.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,394.76
|
| Rate for Payer: BCBS MAPPO |
$16,315.81
|
| Rate for Payer: BCN Medicare Advantage |
$16,315.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,315.81
|
| Rate for Payer: Mclaren Medicare |
$16,315.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,131.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,763.18
|
| Rate for Payer: PACE Medicare |
$15,500.02
|
| Rate for Payer: PACE SWMI |
$16,315.81
|
| Rate for Payer: PHP Medicare Advantage |
$16,315.81
|
| Rate for Payer: Priority Health Medicare |
$16,315.81
|
| Rate for Payer: Railroad Medicare Medicare |
$16,315.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,315.81
|
| Rate for Payer: UHC Medicare Advantage |
$16,315.81
|
| Rate for Payer: VA VA |
$16,315.81
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
|
Facility
|
IP
|
$29,469.84
|
|
|
Service Code
|
MSDRG 510
|
| Min. Negotiated Rate |
$22,397.08 |
| Max. Negotiated Rate |
$29,469.84 |
| Rate for Payer: Aetna Medicare |
$24,518.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,469.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,469.84
|
| Rate for Payer: BCBS MAPPO |
$23,575.87
|
| Rate for Payer: BCN Medicare Advantage |
$23,575.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,575.87
|
| Rate for Payer: Mclaren Medicare |
$23,575.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,754.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,112.25
|
| Rate for Payer: PACE Medicare |
$22,397.08
|
| Rate for Payer: PACE SWMI |
$23,575.87
|
| Rate for Payer: PHP Medicare Advantage |
$23,575.87
|
| Rate for Payer: Priority Health Medicare |
$23,575.87
|
| Rate for Payer: Railroad Medicare Medicare |
$23,575.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,575.87
|
| Rate for Payer: UHC Medicare Advantage |
$23,575.87
|
| Rate for Payer: VA VA |
$23,575.87
|
|
|
MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,818.99
|
|
|
Service Code
|
MSDRG 512
|
| Min. Negotiated Rate |
$12,782.43 |
| Max. Negotiated Rate |
$16,818.99 |
| Rate for Payer: Aetna Medicare |
$13,993.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,818.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,818.99
|
| Rate for Payer: BCBS MAPPO |
$13,455.19
|
| Rate for Payer: BCN Medicare Advantage |
$13,455.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,455.19
|
| Rate for Payer: Mclaren Medicare |
$13,455.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,127.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,473.47
|
| Rate for Payer: PACE Medicare |
$12,782.43
|
| Rate for Payer: PACE SWMI |
$13,455.19
|
| Rate for Payer: PHP Medicare Advantage |
$13,455.19
|
| Rate for Payer: Priority Health Medicare |
$13,455.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13,455.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,455.19
|
| Rate for Payer: UHC Medicare Advantage |
$13,455.19
|
| Rate for Payer: VA VA |
$13,455.19
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$14,176.10
|
|
|
Service Code
|
MSDRG 555
|
| Min. Negotiated Rate |
$10,773.84 |
| Max. Negotiated Rate |
$14,176.10 |
| Rate for Payer: Aetna Medicare |
$11,794.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,176.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,176.10
|
| Rate for Payer: BCBS MAPPO |
$11,340.88
|
| Rate for Payer: BCN Medicare Advantage |
$11,340.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,340.88
|
| Rate for Payer: Mclaren Medicare |
$11,340.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,907.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,042.01
|
| Rate for Payer: PACE Medicare |
$10,773.84
|
| Rate for Payer: PACE SWMI |
$11,340.88
|
| Rate for Payer: PHP Medicare Advantage |
$11,340.88
|
| Rate for Payer: Priority Health Medicare |
$11,340.88
|
| Rate for Payer: Railroad Medicare Medicare |
$11,340.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,340.88
|
| Rate for Payer: UHC Medicare Advantage |
$11,340.88
|
| Rate for Payer: VA VA |
$11,340.88
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
|
Facility
|
IP
|
$8,812.40
|
|
|
Service Code
|
MSDRG 556
|
| Min. Negotiated Rate |
$6,697.42 |
| Max. Negotiated Rate |
$8,812.40 |
| Rate for Payer: Aetna Medicare |
$7,331.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,812.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,812.40
|
| Rate for Payer: BCBS MAPPO |
$7,049.92
|
| Rate for Payer: BCN Medicare Advantage |
$7,049.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,049.92
|
| Rate for Payer: Mclaren Medicare |
$7,049.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,402.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,107.41
|
| Rate for Payer: PACE Medicare |
$6,697.42
|
| Rate for Payer: PACE SWMI |
$7,049.92
|
| Rate for Payer: PHP Medicare Advantage |
$7,049.92
|
| Rate for Payer: Priority Health Medicare |
$7,049.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7,049.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,049.92
|
| Rate for Payer: UHC Medicare Advantage |
$7,049.92
|
| Rate for Payer: VA VA |
$7,049.92
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$13,564.94
|
|
|
Service Code
|
MSDRG 947
|
| Min. Negotiated Rate |
$10,309.35 |
| Max. Negotiated Rate |
$13,564.94 |
| Rate for Payer: Aetna Medicare |
$11,286.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,564.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,564.94
|
| Rate for Payer: BCBS MAPPO |
$10,851.95
|
| Rate for Payer: BCN Medicare Advantage |
$10,851.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,851.95
|
| Rate for Payer: Mclaren Medicare |
$10,851.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,394.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,479.74
|
| Rate for Payer: PACE Medicare |
$10,309.35
|
| Rate for Payer: PACE SWMI |
$10,851.95
|
| Rate for Payer: PHP Medicare Advantage |
$10,851.95
|
| Rate for Payer: Priority Health Medicare |
$10,851.95
|
| Rate for Payer: Railroad Medicare Medicare |
$10,851.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,851.95
|
| Rate for Payer: UHC Medicare Advantage |
$10,851.95
|
| Rate for Payer: VA VA |
$10,851.95
|
|
|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$8,589.81
|
|
|
Service Code
|
MSDRG 948
|
| Min. Negotiated Rate |
$6,528.26 |
| Max. Negotiated Rate |
$8,589.81 |
| Rate for Payer: Aetna Medicare |
$7,146.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,589.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,589.81
|
| Rate for Payer: BCBS MAPPO |
$6,871.85
|
| Rate for Payer: BCN Medicare Advantage |
$6,871.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,871.85
|
| Rate for Payer: Mclaren Medicare |
$6,871.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,215.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,902.63
|
| Rate for Payer: PACE Medicare |
$6,528.26
|
| Rate for Payer: PACE SWMI |
$6,871.85
|
| Rate for Payer: PHP Medicare Advantage |
$6,871.85
|
| Rate for Payer: Priority Health Medicare |
$6,871.85
|
| Rate for Payer: Railroad Medicare Medicare |
$6,871.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,871.85
|
| Rate for Payer: UHC Medicare Advantage |
$6,871.85
|
| Rate for Payer: VA VA |
$6,871.85
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
|
IP
|
$8,847.81
|
|
|
Service Code
|
MSDRG 194
|
| Min. Negotiated Rate |
$6,724.34 |
| Max. Negotiated Rate |
$8,847.81 |
| Rate for Payer: Aetna Medicare |
$7,361.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,847.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,847.81
|
| Rate for Payer: BCBS MAPPO |
$7,078.25
|
| Rate for Payer: BCN Medicare Advantage |
$7,078.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,078.25
|
| Rate for Payer: Mclaren Medicare |
$7,078.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,432.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,139.99
|
| Rate for Payer: PACE Medicare |
$6,724.34
|
| Rate for Payer: PACE SWMI |
$7,078.25
|
| Rate for Payer: PHP Medicare Advantage |
$7,078.25
|
| Rate for Payer: Priority Health Medicare |
$7,078.25
|
| Rate for Payer: Railroad Medicare Medicare |
$7,078.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,078.25
|
| Rate for Payer: UHC Medicare Advantage |
$7,078.25
|
| Rate for Payer: VA VA |
$7,078.25
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
|
IP
|
$13,883.67
|
|
|
Service Code
|
MSDRG 193
|
| Min. Negotiated Rate |
$10,551.59 |
| Max. Negotiated Rate |
$13,883.67 |
| Rate for Payer: Aetna Medicare |
$11,551.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,883.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,883.67
|
| Rate for Payer: BCBS MAPPO |
$11,106.94
|
| Rate for Payer: BCN Medicare Advantage |
$11,106.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,106.94
|
| Rate for Payer: Mclaren Medicare |
$11,106.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,662.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,772.98
|
| Rate for Payer: PACE Medicare |
$10,551.59
|
| Rate for Payer: PACE SWMI |
$11,106.94
|
| Rate for Payer: PHP Medicare Advantage |
$11,106.94
|
| Rate for Payer: Priority Health Medicare |
$11,106.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11,106.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,106.94
|
| Rate for Payer: UHC Medicare Advantage |
$11,106.94
|
| Rate for Payer: VA VA |
$11,106.94
|
|
|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
|
IP
|
$6,851.48
|
|
|
Service Code
|
MSDRG 195
|
| Min. Negotiated Rate |
$5,207.12 |
| Max. Negotiated Rate |
$6,851.48 |
| Rate for Payer: Aetna Medicare |
$5,700.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,851.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,851.48
|
| Rate for Payer: BCBS MAPPO |
$5,481.18
|
| Rate for Payer: BCN Medicare Advantage |
$5,481.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,481.18
|
| Rate for Payer: Mclaren Medicare |
$5,481.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,755.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,303.36
|
| Rate for Payer: PACE Medicare |
$5,207.12
|
| Rate for Payer: PACE SWMI |
$5,481.18
|
| Rate for Payer: PHP Medicare Advantage |
$5,481.18
|
| Rate for Payer: Priority Health Medicare |
$5,481.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5,481.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,481.18
|
| Rate for Payer: UHC Medicare Advantage |
$5,481.18
|
| Rate for Payer: VA VA |
$5,481.18
|
|
|
MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT
|
Facility
|
IP
|
$55,605.26
|
|
|
Service Code
|
MSDRG 008
|
| Min. Negotiated Rate |
$42,260.00 |
| Max. Negotiated Rate |
$55,605.26 |
| Rate for Payer: Aetna Medicare |
$46,263.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,605.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,605.26
|
| Rate for Payer: BCBS MAPPO |
$44,484.21
|
| Rate for Payer: BCN Medicare Advantage |
$44,484.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,484.21
|
| Rate for Payer: Mclaren Medicare |
$44,484.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46,708.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,156.84
|
| Rate for Payer: PACE Medicare |
$42,260.00
|
| Rate for Payer: PACE SWMI |
$44,484.21
|
| Rate for Payer: PHP Medicare Advantage |
$44,484.21
|
| Rate for Payer: Priority Health Medicare |
$44,484.21
|
| Rate for Payer: Railroad Medicare Medicare |
$44,484.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,484.21
|
| Rate for Payer: UHC Medicare Advantage |
$44,484.21
|
| Rate for Payer: VA VA |
$44,484.21
|
|
|
MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
|
IP
|
$80,761.26
|
|
|
Service Code
|
MSDRG 019
|
| Min. Negotiated Rate |
$61,378.56 |
| Max. Negotiated Rate |
$80,761.26 |
| Rate for Payer: Aetna Medicare |
$67,193.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80,761.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80,761.26
|
| Rate for Payer: BCBS MAPPO |
$64,609.01
|
| Rate for Payer: BCN Medicare Advantage |
$64,609.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64,609.01
|
| Rate for Payer: Mclaren Medicare |
$64,609.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67,839.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74,300.36
|
| Rate for Payer: PACE Medicare |
$61,378.56
|
| Rate for Payer: PACE SWMI |
$64,609.01
|
| Rate for Payer: PHP Medicare Advantage |
$64,609.01
|
| Rate for Payer: Priority Health Medicare |
$64,609.01
|
| Rate for Payer: Railroad Medicare Medicare |
$64,609.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$64,609.01
|
| Rate for Payer: UHC Medicare Advantage |
$64,609.01
|
| Rate for Payer: VA VA |
$64,609.01
|
|
|
MS-DRG 42.00: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
|
Facility
|
IP
|
$40,135.49
|
|
|
Service Code
|
MSDRG 402
|
| Min. Negotiated Rate |
$30,502.97 |
| Max. Negotiated Rate |
$40,135.49 |
| Rate for Payer: Aetna Medicare |
$33,392.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,135.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,135.49
|
| Rate for Payer: BCBS MAPPO |
$32,108.39
|
| Rate for Payer: BCN Medicare Advantage |
$32,108.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,108.39
|
| Rate for Payer: Mclaren Medicare |
$32,108.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,713.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,924.65
|
| Rate for Payer: PACE Medicare |
$30,502.97
|
| Rate for Payer: PACE SWMI |
$32,108.39
|
| Rate for Payer: PHP Medicare Advantage |
$32,108.39
|
| Rate for Payer: Priority Health Medicare |
$32,108.39
|
| Rate for Payer: Railroad Medicare Medicare |
$32,108.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,108.39
|
| Rate for Payer: UHC Medicare Advantage |
$32,108.39
|
| Rate for Payer: VA VA |
$32,108.39
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$52,660.85
|
|
|
Service Code
|
MSDRG 450
|
| Min. Negotiated Rate |
$40,022.25 |
| Max. Negotiated Rate |
$52,660.85 |
| Rate for Payer: Aetna Medicare |
$43,813.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52,660.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52,660.85
|
| Rate for Payer: BCBS MAPPO |
$42,128.68
|
| Rate for Payer: BCN Medicare Advantage |
$42,128.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42,128.68
|
| Rate for Payer: Mclaren Medicare |
$42,128.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,235.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48,447.98
|
| Rate for Payer: PACE Medicare |
$40,022.25
|
| Rate for Payer: PACE SWMI |
$42,128.68
|
| Rate for Payer: PHP Medicare Advantage |
$42,128.68
|
| Rate for Payer: Priority Health Medicare |
$42,128.68
|
| Rate for Payer: Railroad Medicare Medicare |
$42,128.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$42,128.68
|
| Rate for Payer: UHC Medicare Advantage |
$42,128.68
|
| Rate for Payer: VA VA |
$42,128.68
|
|
