|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$42,524.34
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$13,082.36 |
| Max. Negotiated Rate |
$42,524.34 |
| Rate for Payer: Aetna Medicare |
$14,321.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,213.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,213.64
|
| Rate for Payer: BCBS MAPPO |
$13,770.91
|
| Rate for Payer: BCBS Trust/PPO |
$42,524.34
|
| Rate for Payer: BCN Commercial |
$42,524.34
|
| Rate for Payer: BCN Medicare Advantage |
$13,770.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,770.91
|
| Rate for Payer: Mclaren Medicare |
$13,770.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,459.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,836.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,148.00
|
| Rate for Payer: Nomi Health Commercial |
$20,327.82
|
| Rate for Payer: PACE Medicare |
$13,082.36
|
| Rate for Payer: PACE SWMI |
$13,770.91
|
| Rate for Payer: PHP Medicare Advantage |
$13,770.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,405.27
|
| Rate for Payer: Priority Health Medicare |
$13,770.91
|
| Rate for Payer: Priority Health Tiered Network |
$20,324.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13,770.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,685.54
|
| Rate for Payer: UHC Core |
$21,489.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,770.91
|
| Rate for Payer: UHC Exchange |
$17,549.68
|
| Rate for Payer: VA VA |
$13,770.91
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$23,127.47
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$7,818.30 |
| Max. Negotiated Rate |
$23,127.47 |
| Rate for Payer: Aetna Medicare |
$8,558.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,287.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,287.24
|
| Rate for Payer: BCBS MAPPO |
$8,229.79
|
| Rate for Payer: BCBS Trust/PPO |
$23,127.47
|
| Rate for Payer: BCN Commercial |
$23,127.47
|
| Rate for Payer: BCN Medicare Advantage |
$8,229.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,229.79
|
| Rate for Payer: Mclaren Medicare |
$8,229.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,641.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,464.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,052.77
|
| Rate for Payer: Nomi Health Commercial |
$11,780.28
|
| Rate for Payer: PACE Medicare |
$7,818.30
|
| Rate for Payer: PACE SWMI |
$8,229.79
|
| Rate for Payer: PHP Medicare Advantage |
$8,229.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,722.74
|
| Rate for Payer: Priority Health Medicare |
$8,229.79
|
| Rate for Payer: Priority Health Tiered Network |
$11,778.19
|
| Rate for Payer: Railroad Medicare Medicare |
$8,229.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,885.16
|
| Rate for Payer: UHC Core |
$12,453.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,229.79
|
| Rate for Payer: UHC Exchange |
$10,170.31
|
| Rate for Payer: VA VA |
$8,229.79
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$165,238.55
|
|
|
Service Code
|
MSDRG 275
|
| Min. Negotiated Rate |
$57,211.20 |
| Max. Negotiated Rate |
$165,238.55 |
| Rate for Payer: Aetna Medicare |
$62,631.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75,277.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75,277.90
|
| Rate for Payer: BCBS MAPPO |
$60,222.32
|
| Rate for Payer: BCBS Trust/PPO |
$165,238.55
|
| Rate for Payer: BCN Commercial |
$165,238.55
|
| Rate for Payer: BCN Medicare Advantage |
$60,222.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60,222.32
|
| Rate for Payer: Mclaren Medicare |
$60,222.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63,233.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69,255.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$66,244.55
|
| Rate for Payer: Nomi Health Commercial |
$91,982.16
|
| Rate for Payer: PACE Medicare |
$57,211.20
|
| Rate for Payer: PACE SWMI |
$60,222.32
|
| Rate for Payer: PHP Medicare Advantage |
$60,222.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114,957.31
|
| Rate for Payer: Priority Health Medicare |
$60,222.32
|
| Rate for Payer: Priority Health Tiered Network |
$91,965.83
|
| Rate for Payer: Railroad Medicare Medicare |
$60,222.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116,225.52
|
| Rate for Payer: UHC Core |
$97,237.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60,222.32
|
| Rate for Payer: UHC Exchange |
$79,411.26
|
| Rate for Payer: VA VA |
$60,222.32
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR
|
Facility
|
IP
|
$159,849.92
|
|
|
Service Code
|
MSDRG 276
|
| Min. Negotiated Rate |
$48,283.10 |
| Max. Negotiated Rate |
$159,849.92 |
| Rate for Payer: Aetna Medicare |
$52,857.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63,530.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63,530.40
|
| Rate for Payer: BCBS MAPPO |
$50,824.32
|
| Rate for Payer: BCBS Trust/PPO |
$159,849.92
|
| Rate for Payer: BCN Commercial |
$159,849.92
|
| Rate for Payer: BCN Medicare Advantage |
$50,824.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50,824.32
|
| Rate for Payer: Mclaren Medicare |
$50,824.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53,365.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58,447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$55,906.75
|
| Rate for Payer: Nomi Health Commercial |
$77,485.14
|
| Rate for Payer: PACE Medicare |
$48,283.10
|
| Rate for Payer: PACE SWMI |
$50,824.32
|
| Rate for Payer: PHP Medicare Advantage |
$50,824.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$96,839.25
|
| Rate for Payer: Priority Health Medicare |
$50,824.32
|
| Rate for Payer: Priority Health Tiered Network |
$77,471.38
|
| Rate for Payer: Railroad Medicare Medicare |
$50,824.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97,907.58
|
| Rate for Payer: UHC Core |
$81,912.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50,824.32
|
| Rate for Payer: UHC Exchange |
$66,895.50
|
| Rate for Payer: VA VA |
$50,824.32
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
|
IP
|
$124,202.05
|
|
|
Service Code
|
MSDRG 277
|
| Min. Negotiated Rate |
$37,255.26 |
| Max. Negotiated Rate |
$124,202.05 |
| Rate for Payer: Aetna Medicare |
$40,784.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49,020.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49,020.07
|
| Rate for Payer: BCBS MAPPO |
$39,216.06
|
| Rate for Payer: BCBS Trust/PPO |
$124,202.05
|
| Rate for Payer: BCN Commercial |
$124,202.05
|
| Rate for Payer: BCN Medicare Advantage |
$39,216.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,216.06
|
| Rate for Payer: Mclaren Medicare |
$39,216.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41,176.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45,098.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$43,137.67
|
| Rate for Payer: Nomi Health Commercial |
$59,578.65
|
| Rate for Payer: PACE Medicare |
$37,255.26
|
| Rate for Payer: PACE SWMI |
$39,216.06
|
| Rate for Payer: PHP Medicare Advantage |
$39,216.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74,460.10
|
| Rate for Payer: Priority Health Medicare |
$39,216.06
|
| Rate for Payer: Priority Health Tiered Network |
$59,568.07
|
| Rate for Payer: Railroad Medicare Medicare |
$39,216.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75,281.55
|
| Rate for Payer: UHC Core |
$62,982.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39,216.06
|
| Rate for Payer: UHC Exchange |
$51,436.23
|
| Rate for Payer: VA VA |
$39,216.06
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$13,612.55
|
|
|
Service Code
|
APR-DRG 1772
|
| Min. Negotiated Rate |
$12,964.33 |
| Max. Negotiated Rate |
$13,612.55 |
| Rate for Payer: BCBS Complete |
$13,612.55
|
| Rate for Payer: Mclaren Medicaid |
$12,964.33
|
| Rate for Payer: Meridian Medicaid |
$13,612.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,964.33
|
| Rate for Payer: UHC Medicaid |
$12,964.33
|
| Rate for Payer: UHCCP Medicaid |
$12,964.33
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$9,259.05
|
|
|
Service Code
|
APR-DRG 1771
|
| Min. Negotiated Rate |
$8,818.14 |
| Max. Negotiated Rate |
$9,259.05 |
| Rate for Payer: BCBS Complete |
$9,259.05
|
| Rate for Payer: Mclaren Medicaid |
$8,818.14
|
| Rate for Payer: Meridian Medicaid |
$9,259.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,818.14
|
| Rate for Payer: UHC Medicaid |
$8,818.14
|
| Rate for Payer: UHCCP Medicaid |
$8,818.14
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$23,766.88
|
|
|
Service Code
|
APR-DRG 1774
|
| Min. Negotiated Rate |
$22,635.12 |
| Max. Negotiated Rate |
$23,766.88 |
| Rate for Payer: BCBS Complete |
$23,766.88
|
| Rate for Payer: Mclaren Medicaid |
$22,635.12
|
| Rate for Payer: Meridian Medicaid |
$23,766.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,635.12
|
| Rate for Payer: UHC Medicaid |
$22,635.12
|
| Rate for Payer: UHCCP Medicaid |
$22,635.12
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$19,711.80
|
|
|
Service Code
|
APR-DRG 1773
|
| Min. Negotiated Rate |
$18,773.15 |
| Max. Negotiated Rate |
$19,711.80 |
| Rate for Payer: BCBS Complete |
$19,711.80
|
| Rate for Payer: Mclaren Medicaid |
$18,773.15
|
| Rate for Payer: Meridian Medicaid |
$19,711.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,773.15
|
| Rate for Payer: UHC Medicaid |
$18,773.15
|
| Rate for Payer: UHCCP Medicaid |
$18,773.15
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$56,299.26
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$25,525.92 |
| Max. Negotiated Rate |
$56,299.26 |
| Rate for Payer: Aetna Medicare |
$27,944.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,586.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,586.74
|
| Rate for Payer: BCBS MAPPO |
$26,869.39
|
| Rate for Payer: BCBS Trust/PPO |
$56,299.26
|
| Rate for Payer: BCN Commercial |
$56,299.26
|
| Rate for Payer: BCN Medicare Advantage |
$26,869.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,869.39
|
| Rate for Payer: Mclaren Medicare |
$26,869.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,212.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,899.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$29,556.33
|
| Rate for Payer: Nomi Health Commercial |
$40,533.09
|
| Rate for Payer: PACE Medicare |
$25,525.92
|
| Rate for Payer: PACE SWMI |
$26,869.39
|
| Rate for Payer: PHP Medicare Advantage |
$26,869.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50,657.38
|
| Rate for Payer: Priority Health Medicare |
$26,869.39
|
| Rate for Payer: Priority Health Tiered Network |
$40,525.89
|
| Rate for Payer: Railroad Medicare Medicare |
$26,869.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51,216.23
|
| Rate for Payer: UHC Core |
$42,848.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,869.39
|
| Rate for Payer: UHC Exchange |
$34,993.57
|
| Rate for Payer: VA VA |
$26,869.39
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$36,232.57
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$16,628.01 |
| Max. Negotiated Rate |
$36,232.57 |
| Rate for Payer: Aetna Medicare |
$18,203.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,878.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,878.96
|
| Rate for Payer: BCBS MAPPO |
$17,503.17
|
| Rate for Payer: BCBS Trust/PPO |
$36,232.57
|
| Rate for Payer: BCN Commercial |
$36,232.57
|
| Rate for Payer: BCN Medicare Advantage |
$17,503.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,503.17
|
| Rate for Payer: Mclaren Medicare |
$17,503.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,378.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,128.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,253.49
|
| Rate for Payer: Nomi Health Commercial |
$26,085.09
|
| Rate for Payer: PACE Medicare |
$16,628.01
|
| Rate for Payer: PACE SWMI |
$17,503.17
|
| Rate for Payer: PHP Medicare Advantage |
$17,503.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32,600.58
|
| Rate for Payer: Priority Health Medicare |
$17,503.17
|
| Rate for Payer: Priority Health Tiered Network |
$26,080.46
|
| Rate for Payer: Railroad Medicare Medicare |
$17,503.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,960.23
|
| Rate for Payer: UHC Core |
$27,575.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,503.17
|
| Rate for Payer: UHC Exchange |
$22,520.13
|
| Rate for Payer: VA VA |
$17,503.17
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$50,257.29
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$15,582.52 |
| Max. Negotiated Rate |
$50,257.29 |
| Rate for Payer: Aetna Medicare |
$17,058.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,503.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,503.31
|
| Rate for Payer: BCBS MAPPO |
$16,402.65
|
| Rate for Payer: BCBS Trust/PPO |
$50,257.29
|
| Rate for Payer: BCN Commercial |
$50,257.29
|
| Rate for Payer: BCN Medicare Advantage |
$16,402.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,402.65
|
| Rate for Payer: Mclaren Medicare |
$16,402.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,222.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,863.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,042.92
|
| Rate for Payer: Nomi Health Commercial |
$24,387.45
|
| Rate for Payer: PACE Medicare |
$15,582.52
|
| Rate for Payer: PACE SWMI |
$16,402.65
|
| Rate for Payer: PHP Medicare Advantage |
$16,402.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,478.91
|
| Rate for Payer: Priority Health Medicare |
$16,402.65
|
| Rate for Payer: Priority Health Tiered Network |
$24,383.12
|
| Rate for Payer: Railroad Medicare Medicare |
$16,402.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,815.15
|
| Rate for Payer: UHC Core |
$25,780.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,402.65
|
| Rate for Payer: UHC Exchange |
$21,054.50
|
| Rate for Payer: VA VA |
$16,402.65
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$91,804.38
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$26,405.38 |
| Max. Negotiated Rate |
$91,804.38 |
| Rate for Payer: Aetna Medicare |
$28,906.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,743.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,743.93
|
| Rate for Payer: BCBS MAPPO |
$27,795.14
|
| Rate for Payer: BCBS Trust/PPO |
$91,804.38
|
| Rate for Payer: BCN Commercial |
$91,804.38
|
| Rate for Payer: BCN Medicare Advantage |
$27,795.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,795.14
|
| Rate for Payer: Mclaren Medicare |
$27,795.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,184.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,964.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,574.65
|
| Rate for Payer: Nomi Health Commercial |
$41,961.12
|
| Rate for Payer: PACE Medicare |
$26,405.38
|
| Rate for Payer: PACE SWMI |
$27,795.14
|
| Rate for Payer: PHP Medicare Advantage |
$27,795.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52,442.10
|
| Rate for Payer: Priority Health Medicare |
$27,795.14
|
| Rate for Payer: Priority Health Tiered Network |
$41,953.67
|
| Rate for Payer: Railroad Medicare Medicare |
$27,795.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,020.64
|
| Rate for Payer: UHC Core |
$44,358.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27,795.14
|
| Rate for Payer: UHC Exchange |
$36,226.43
|
| Rate for Payer: VA VA |
$27,795.14
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$45,521.99
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$13,512.15 |
| Max. Negotiated Rate |
$45,521.99 |
| Rate for Payer: Aetna Medicare |
$14,792.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,779.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,779.15
|
| Rate for Payer: BCBS MAPPO |
$14,223.32
|
| Rate for Payer: BCBS Trust/PPO |
$45,521.99
|
| Rate for Payer: BCN Commercial |
$45,521.99
|
| Rate for Payer: BCN Medicare Advantage |
$14,223.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,223.32
|
| Rate for Payer: Mclaren Medicare |
$14,223.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,934.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,356.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,645.65
|
| Rate for Payer: Nomi Health Commercial |
$21,025.71
|
| Rate for Payer: PACE Medicare |
$13,512.15
|
| Rate for Payer: PACE SWMI |
$14,223.32
|
| Rate for Payer: PHP Medicare Advantage |
$14,223.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,277.48
|
| Rate for Payer: Priority Health Medicare |
$14,223.32
|
| Rate for Payer: Priority Health Tiered Network |
$21,021.98
|
| Rate for Payer: Railroad Medicare Medicare |
$14,223.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,567.37
|
| Rate for Payer: UHC Core |
$22,226.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,223.32
|
| Rate for Payer: UHC Exchange |
$18,152.20
|
| Rate for Payer: VA VA |
$14,223.32
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$4,273.59
|
|
|
Service Code
|
APR-DRG 2001
|
| Min. Negotiated Rate |
$4,070.09 |
| Max. Negotiated Rate |
$4,273.59 |
| Rate for Payer: BCBS Complete |
$4,273.59
|
| Rate for Payer: Mclaren Medicaid |
$4,070.09
|
| Rate for Payer: Meridian Medicaid |
$4,273.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,070.09
|
| Rate for Payer: UHC Medicaid |
$4,070.09
|
| Rate for Payer: UHCCP Medicaid |
$4,070.09
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$5,829.28
|
|
|
Service Code
|
APR-DRG 2002
|
| Min. Negotiated Rate |
$5,551.69 |
| Max. Negotiated Rate |
$5,829.28 |
| Rate for Payer: BCBS Complete |
$5,829.28
|
| Rate for Payer: Mclaren Medicaid |
$5,551.69
|
| Rate for Payer: Meridian Medicaid |
$5,829.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,551.69
|
| Rate for Payer: UHC Medicaid |
$5,551.69
|
| Rate for Payer: UHCCP Medicaid |
$5,551.69
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$12,742.09
|
|
|
Service Code
|
APR-DRG 2003
|
| Min. Negotiated Rate |
$12,135.33 |
| Max. Negotiated Rate |
$12,742.09 |
| Rate for Payer: BCBS Complete |
$12,742.09
|
| Rate for Payer: Mclaren Medicaid |
$12,135.33
|
| Rate for Payer: Meridian Medicaid |
$12,742.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,135.33
|
| Rate for Payer: UHC Medicaid |
$12,135.33
|
| Rate for Payer: UHCCP Medicaid |
$12,135.33
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$23,926.08
|
|
|
Service Code
|
APR-DRG 2004
|
| Min. Negotiated Rate |
$22,786.74 |
| Max. Negotiated Rate |
$23,926.08 |
| Rate for Payer: BCBS Complete |
$23,926.08
|
| Rate for Payer: Mclaren Medicaid |
$22,786.74
|
| Rate for Payer: Meridian Medicaid |
$23,926.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,786.74
|
| Rate for Payer: UHC Medicaid |
$22,786.74
|
| Rate for Payer: UHCCP Medicaid |
$22,786.74
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$150,939.32
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$52,801.17 |
| Max. Negotiated Rate |
$150,939.32 |
| Rate for Payer: Aetna Medicare |
$57,803.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,475.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,475.23
|
| Rate for Payer: BCBS MAPPO |
$55,580.18
|
| Rate for Payer: BCBS Trust/PPO |
$150,939.32
|
| Rate for Payer: BCN Commercial |
$150,939.32
|
| Rate for Payer: BCN Medicare Advantage |
$55,580.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,580.18
|
| Rate for Payer: Mclaren Medicare |
$55,580.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,359.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63,917.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$61,138.20
|
| Rate for Payer: Nomi Health Commercial |
$84,821.37
|
| Rate for Payer: PACE Medicare |
$52,801.17
|
| Rate for Payer: PACE SWMI |
$55,580.18
|
| Rate for Payer: PHP Medicare Advantage |
$55,580.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$106,007.91
|
| Rate for Payer: Priority Health Medicare |
$55,580.18
|
| Rate for Payer: Priority Health Tiered Network |
$84,806.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55,580.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107,177.39
|
| Rate for Payer: UHC Core |
$89,667.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55,580.18
|
| Rate for Payer: UHC Exchange |
$73,229.12
|
| Rate for Payer: VA VA |
$55,580.18
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$225,265.65
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$78,283.35 |
| Max. Negotiated Rate |
$225,265.65 |
| Rate for Payer: Aetna Medicare |
$85,699.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103,004.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103,004.41
|
| Rate for Payer: BCBS MAPPO |
$82,403.53
|
| Rate for Payer: BCBS Trust/PPO |
$225,265.65
|
| Rate for Payer: BCN Commercial |
$225,265.65
|
| Rate for Payer: BCN Medicare Advantage |
$82,403.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82,403.53
|
| Rate for Payer: Mclaren Medicare |
$82,403.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86,523.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94,764.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$90,643.88
|
| Rate for Payer: Nomi Health Commercial |
$126,198.12
|
| Rate for Payer: PACE Medicare |
$78,283.35
|
| Rate for Payer: PACE SWMI |
$82,403.53
|
| Rate for Payer: PHP Medicare Advantage |
$82,403.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157,719.67
|
| Rate for Payer: Priority Health Medicare |
$82,403.53
|
| Rate for Payer: Priority Health Tiered Network |
$126,175.72
|
| Rate for Payer: Railroad Medicare Medicare |
$82,403.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159,459.64
|
| Rate for Payer: UHC Core |
$133,408.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82,403.53
|
| Rate for Payer: UHC Exchange |
$108,951.04
|
| Rate for Payer: VA VA |
$82,403.53
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$121,396.56
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$52,801.17 |
| Max. Negotiated Rate |
$121,396.56 |
| Rate for Payer: Aetna Medicare |
$57,803.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,475.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,475.23
|
| Rate for Payer: BCBS MAPPO |
$55,580.18
|
| Rate for Payer: BCBS Trust/PPO |
$121,396.56
|
| Rate for Payer: BCN Commercial |
$121,396.56
|
| Rate for Payer: BCN Medicare Advantage |
$55,580.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,580.18
|
| Rate for Payer: Mclaren Medicare |
$55,580.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,359.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63,917.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$61,138.20
|
| Rate for Payer: Nomi Health Commercial |
$84,821.37
|
| Rate for Payer: PACE Medicare |
$52,801.17
|
| Rate for Payer: PACE SWMI |
$55,580.18
|
| Rate for Payer: PHP Medicare Advantage |
$55,580.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$106,007.91
|
| Rate for Payer: Priority Health Medicare |
$55,580.18
|
| Rate for Payer: Priority Health Tiered Network |
$84,806.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55,580.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107,177.39
|
| Rate for Payer: UHC Core |
$89,667.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55,580.18
|
| Rate for Payer: UHC Exchange |
$73,229.12
|
| Rate for Payer: VA VA |
$55,580.18
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$121,547.54
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$42,930.04 |
| Max. Negotiated Rate |
$121,547.54 |
| Rate for Payer: Aetna Medicare |
$46,997.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56,486.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56,486.90
|
| Rate for Payer: BCBS MAPPO |
$45,189.52
|
| Rate for Payer: BCBS Trust/PPO |
$121,547.54
|
| Rate for Payer: BCN Commercial |
$121,547.54
|
| Rate for Payer: BCN Medicare Advantage |
$45,189.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45,189.52
|
| Rate for Payer: Mclaren Medicare |
$45,189.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47,449.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,967.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$49,708.47
|
| Rate for Payer: Nomi Health Commercial |
$68,793.12
|
| Rate for Payer: PACE Medicare |
$42,930.04
|
| Rate for Payer: PACE SWMI |
$45,189.52
|
| Rate for Payer: PHP Medicare Advantage |
$45,189.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85,976.15
|
| Rate for Payer: Priority Health Medicare |
$45,189.52
|
| Rate for Payer: Priority Health Tiered Network |
$68,780.91
|
| Rate for Payer: Railroad Medicare Medicare |
$45,189.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86,924.64
|
| Rate for Payer: UHC Core |
$72,723.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45,189.52
|
| Rate for Payer: UHC Exchange |
$59,391.39
|
| Rate for Payer: VA VA |
$45,189.52
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$163,596.98
|
|
|
Service Code
|
MSDRG 219
|
| Min. Negotiated Rate |
$61,564.03 |
| Max. Negotiated Rate |
$163,596.98 |
| Rate for Payer: Aetna Medicare |
$67,396.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81,005.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81,005.30
|
| Rate for Payer: BCBS MAPPO |
$64,804.24
|
| Rate for Payer: BCBS Trust/PPO |
$163,596.98
|
| Rate for Payer: BCN Commercial |
$163,596.98
|
| Rate for Payer: BCN Medicare Advantage |
$64,804.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64,804.24
|
| Rate for Payer: Mclaren Medicare |
$64,804.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68,044.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74,524.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$71,284.66
|
| Rate for Payer: Nomi Health Commercial |
$99,050.07
|
| Rate for Payer: PACE Medicare |
$61,564.03
|
| Rate for Payer: PACE SWMI |
$64,804.24
|
| Rate for Payer: PHP Medicare Advantage |
$64,804.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$123,790.63
|
| Rate for Payer: Priority Health Medicare |
$64,804.24
|
| Rate for Payer: Priority Health Tiered Network |
$99,032.49
|
| Rate for Payer: Railroad Medicare Medicare |
$64,804.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125,156.29
|
| Rate for Payer: UHC Core |
$104,708.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$64,804.24
|
| Rate for Payer: UHC Exchange |
$85,513.23
|
| Rate for Payer: VA VA |
$64,804.24
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$103,943.21
|
|
|
Service Code
|
MSDRG 221
|
| Min. Negotiated Rate |
$40,605.49 |
| Max. Negotiated Rate |
$103,943.21 |
| Rate for Payer: Aetna Medicare |
$44,452.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53,428.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53,428.28
|
| Rate for Payer: BCBS MAPPO |
$42,742.62
|
| Rate for Payer: BCBS Trust/PPO |
$103,943.21
|
| Rate for Payer: BCN Commercial |
$103,943.21
|
| Rate for Payer: BCN Medicare Advantage |
$42,742.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42,742.62
|
| Rate for Payer: Mclaren Medicare |
$42,742.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44,879.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,154.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$47,016.88
|
| Rate for Payer: Nomi Health Commercial |
$65,018.58
|
| Rate for Payer: PACE Medicare |
$40,605.49
|
| Rate for Payer: PACE SWMI |
$42,742.62
|
| Rate for Payer: PHP Medicare Advantage |
$42,742.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$81,258.81
|
| Rate for Payer: Priority Health Medicare |
$42,742.62
|
| Rate for Payer: Priority Health Tiered Network |
$65,007.04
|
| Rate for Payer: Railroad Medicare Medicare |
$42,742.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82,155.26
|
| Rate for Payer: UHC Core |
$68,733.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42,742.62
|
| Rate for Payer: UHC Exchange |
$56,132.71
|
| Rate for Payer: VA VA |
$42,742.62
|
|
|
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$28,067.10
|
|
|
Service Code
|
APR-DRG 1621
|
| Min. Negotiated Rate |
$26,730.58 |
| Max. Negotiated Rate |
$28,067.10 |
| Rate for Payer: BCBS Complete |
$28,067.10
|
| Rate for Payer: Mclaren Medicaid |
$26,730.58
|
| Rate for Payer: Meridian Medicaid |
$28,067.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$26,730.58
|
| Rate for Payer: UHC Medicaid |
$26,730.58
|
| Rate for Payer: UHCCP Medicaid |
$26,730.58
|
|
