|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
|
IP
|
$7,921.94
|
|
|
Service Code
|
APR-DRG 1922
|
| Min. Negotiated Rate |
$7,162.38 |
| Max. Negotiated Rate |
$7,921.94 |
| Rate for Payer: BCBS Complete |
$7,921.94
|
| Rate for Payer: Mclaren Medicaid |
$7,544.70
|
| Rate for Payer: Meridian Medicaid |
$7,921.94
|
| Rate for Payer: PHP Medicaid |
$7,162.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,544.70
|
| Rate for Payer: UHC Medicaid |
$7,544.70
|
| Rate for Payer: UHCCP Medicaid |
$7,544.70
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$21,649.60
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$12,447.07 |
| Max. Negotiated Rate |
$21,649.60 |
| Rate for Payer: Aetna Medicare |
$13,102.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,377.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,377.73
|
| Rate for Payer: BCBS MAPPO |
$13,102.18
|
| Rate for Payer: BCN Medicare Advantage |
$13,102.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,102.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,102.18
|
| Rate for Payer: Mclaren Medicare |
$13,102.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,757.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,067.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,412.40
|
| Rate for Payer: PACE Medicare |
$12,447.07
|
| Rate for Payer: PACE SWMI |
$13,102.18
|
| Rate for Payer: PHP Commercial |
$14,412.40
|
| Rate for Payer: PHP Medicare Advantage |
$13,102.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21,649.60
|
| Rate for Payer: Priority Health Medicare |
$13,102.18
|
| Rate for Payer: Priority Health Narrow Network |
$17,319.68
|
| Rate for Payer: Railroad Medicare Medicare |
$13,102.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,102.18
|
| Rate for Payer: UHC Exchange |
$20,308.38
|
| Rate for Payer: UHCCP DNSP |
$13,102.18
|
| Rate for Payer: VA VA |
$13,102.18
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$12,912.49
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$7,914.11 |
| Max. Negotiated Rate |
$12,912.49 |
| Rate for Payer: Aetna Medicare |
$8,330.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,413.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,413.30
|
| Rate for Payer: BCBS MAPPO |
$8,330.64
|
| Rate for Payer: BCN Medicare Advantage |
$8,330.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,330.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,330.64
|
| Rate for Payer: Mclaren Medicare |
$8,330.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,747.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,580.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,163.70
|
| Rate for Payer: PACE Medicare |
$7,914.11
|
| Rate for Payer: PACE SWMI |
$8,330.64
|
| Rate for Payer: PHP Commercial |
$9,163.70
|
| Rate for Payer: PHP Medicare Advantage |
$8,330.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,546.27
|
| Rate for Payer: Priority Health Medicare |
$8,330.64
|
| Rate for Payer: Priority Health Narrow Network |
$10,037.02
|
| Rate for Payer: Railroad Medicare Medicare |
$8,330.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,330.64
|
| Rate for Payer: UHC Exchange |
$12,912.49
|
| Rate for Payer: UHCCP DNSP |
$8,330.64
|
| Rate for Payer: VA VA |
$8,330.64
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$97,963.14
|
|
|
Service Code
|
MSDRG 275
|
| Min. Negotiated Rate |
$50,447.10 |
| Max. Negotiated Rate |
$97,963.14 |
| Rate for Payer: Aetna Medicare |
$53,102.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66,377.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66,377.76
|
| Rate for Payer: BCBS MAPPO |
$53,102.21
|
| Rate for Payer: BCN Medicare Advantage |
$53,102.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53,102.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$53,102.21
|
| Rate for Payer: Mclaren Medicare |
$53,102.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55,757.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61,067.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$58,412.43
|
| Rate for Payer: PACE Medicare |
$50,447.10
|
| Rate for Payer: PACE SWMI |
$53,102.21
|
| Rate for Payer: PHP Commercial |
$58,412.43
|
| Rate for Payer: PHP Medicare Advantage |
$53,102.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97,963.14
|
| Rate for Payer: Priority Health Medicare |
$53,102.21
|
| Rate for Payer: Priority Health Narrow Network |
$78,370.51
|
| Rate for Payer: Railroad Medicare Medicare |
$53,102.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53,102.21
|
| Rate for Payer: UHC Exchange |
$82,308.43
|
| Rate for Payer: UHCCP DNSP |
$53,102.21
|
| Rate for Payer: VA VA |
$53,102.21
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR
|
Facility
|
IP
|
$82,523.48
|
|
|
Service Code
|
MSDRG 276
|
| Min. Negotiated Rate |
$42,758.98 |
| Max. Negotiated Rate |
$82,523.48 |
| Rate for Payer: Aetna Medicare |
$45,009.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56,261.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56,261.81
|
| Rate for Payer: BCBS MAPPO |
$45,009.45
|
| Rate for Payer: BCN Medicare Advantage |
$45,009.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45,009.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$45,009.45
|
| Rate for Payer: Mclaren Medicare |
$45,009.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47,259.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51,760.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$49,510.39
|
| Rate for Payer: PACE Medicare |
$42,758.98
|
| Rate for Payer: PACE SWMI |
$45,009.45
|
| Rate for Payer: PHP Commercial |
$49,510.39
|
| Rate for Payer: PHP Medicare Advantage |
$45,009.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82,523.48
|
| Rate for Payer: Priority Health Medicare |
$45,009.45
|
| Rate for Payer: Priority Health Narrow Network |
$66,018.78
|
| Rate for Payer: Railroad Medicare Medicare |
$45,009.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45,009.45
|
| Rate for Payer: UHC Exchange |
$69,764.65
|
| Rate for Payer: UHCCP DNSP |
$45,009.45
|
| Rate for Payer: VA VA |
$45,009.45
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
|
IP
|
$63,452.65
|
|
|
Service Code
|
MSDRG 277
|
| Min. Negotiated Rate |
$33,262.73 |
| Max. Negotiated Rate |
$63,452.65 |
| Rate for Payer: Aetna Medicare |
$35,013.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43,766.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43,766.75
|
| Rate for Payer: BCBS MAPPO |
$35,013.40
|
| Rate for Payer: BCN Medicare Advantage |
$35,013.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,013.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$35,013.40
|
| Rate for Payer: Mclaren Medicare |
$35,013.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36,764.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,265.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$38,514.74
|
| Rate for Payer: PACE Medicare |
$33,262.73
|
| Rate for Payer: PACE SWMI |
$35,013.40
|
| Rate for Payer: PHP Commercial |
$38,514.74
|
| Rate for Payer: PHP Medicare Advantage |
$35,013.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63,452.65
|
| Rate for Payer: Priority Health Medicare |
$35,013.40
|
| Rate for Payer: Priority Health Narrow Network |
$50,762.12
|
| Rate for Payer: Railroad Medicare Medicare |
$35,013.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35,013.40
|
| Rate for Payer: UHC Exchange |
$54,270.77
|
| Rate for Payer: UHCCP DNSP |
$35,013.40
|
| Rate for Payer: VA VA |
$35,013.40
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$8,335.56
|
|
|
Service Code
|
APR-DRG 1771
|
| Min. Negotiated Rate |
$7,536.34 |
| Max. Negotiated Rate |
$8,335.56 |
| Rate for Payer: BCBS Complete |
$8,335.56
|
| Rate for Payer: Mclaren Medicaid |
$7,938.62
|
| Rate for Payer: Meridian Medicaid |
$8,335.56
|
| Rate for Payer: PHP Medicaid |
$7,536.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,938.62
|
| Rate for Payer: UHC Medicaid |
$7,938.62
|
| Rate for Payer: UHCCP Medicaid |
$7,938.62
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$12,254.84
|
|
|
Service Code
|
APR-DRG 1772
|
| Min. Negotiated Rate |
$11,079.84 |
| Max. Negotiated Rate |
$12,254.84 |
| Rate for Payer: BCBS Complete |
$12,254.84
|
| Rate for Payer: Mclaren Medicaid |
$11,671.27
|
| Rate for Payer: Meridian Medicaid |
$12,254.84
|
| Rate for Payer: PHP Medicaid |
$11,079.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,671.27
|
| Rate for Payer: UHC Medicaid |
$11,671.27
|
| Rate for Payer: UHCCP Medicaid |
$11,671.27
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$21,396.37
|
|
|
Service Code
|
APR-DRG 1774
|
| Min. Negotiated Rate |
$19,344.88 |
| Max. Negotiated Rate |
$21,396.37 |
| Rate for Payer: BCBS Complete |
$21,396.37
|
| Rate for Payer: Mclaren Medicaid |
$20,377.50
|
| Rate for Payer: Meridian Medicaid |
$21,396.37
|
| Rate for Payer: PHP Medicaid |
$19,344.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,377.50
|
| Rate for Payer: UHC Medicaid |
$20,377.50
|
| Rate for Payer: UHCCP Medicaid |
$20,377.50
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
|
IP
|
$17,745.75
|
|
|
Service Code
|
APR-DRG 1773
|
| Min. Negotiated Rate |
$16,044.28 |
| Max. Negotiated Rate |
$17,745.75 |
| Rate for Payer: BCBS Complete |
$17,745.75
|
| Rate for Payer: Mclaren Medicaid |
$16,900.72
|
| Rate for Payer: Meridian Medicaid |
$17,745.75
|
| Rate for Payer: PHP Medicaid |
$16,044.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,900.72
|
| Rate for Payer: UHC Medicaid |
$16,900.72
|
| Rate for Payer: UHCCP Medicaid |
$16,900.72
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$43,168.68
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$23,162.42 |
| Max. Negotiated Rate |
$43,168.68 |
| Rate for Payer: Aetna Medicare |
$24,381.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,476.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,476.86
|
| Rate for Payer: BCBS MAPPO |
$24,381.49
|
| Rate for Payer: BCN Medicare Advantage |
$24,381.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,381.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$24,381.49
|
| Rate for Payer: Mclaren Medicare |
$24,381.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,600.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,038.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$26,819.64
|
| Rate for Payer: PACE Medicare |
$23,162.42
|
| Rate for Payer: PACE SWMI |
$24,381.49
|
| Rate for Payer: PHP Commercial |
$26,819.64
|
| Rate for Payer: PHP Medicare Advantage |
$24,381.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43,168.68
|
| Rate for Payer: Priority Health Medicare |
$24,381.49
|
| Rate for Payer: Priority Health Narrow Network |
$34,534.95
|
| Rate for Payer: Railroad Medicare Medicare |
$24,381.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24,381.49
|
| Rate for Payer: UHC Exchange |
$37,791.31
|
| Rate for Payer: UHCCP DNSP |
$24,381.49
|
| Rate for Payer: VA VA |
$24,381.49
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$27,781.23
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$15,500.29 |
| Max. Negotiated Rate |
$27,781.23 |
| Rate for Payer: Aetna Medicare |
$16,316.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,395.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,395.11
|
| Rate for Payer: BCBS MAPPO |
$16,316.09
|
| Rate for Payer: BCN Medicare Advantage |
$16,316.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,316.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,316.09
|
| Rate for Payer: Mclaren Medicare |
$16,316.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,131.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,763.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,947.70
|
| Rate for Payer: PACE Medicare |
$15,500.29
|
| Rate for Payer: PACE SWMI |
$16,316.09
|
| Rate for Payer: PHP Commercial |
$17,947.70
|
| Rate for Payer: PHP Medicare Advantage |
$16,316.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27,781.23
|
| Rate for Payer: Priority Health Medicare |
$16,316.09
|
| Rate for Payer: Priority Health Narrow Network |
$22,224.98
|
| Rate for Payer: Railroad Medicare Medicare |
$16,316.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,316.09
|
| Rate for Payer: UHC Exchange |
$25,289.94
|
| Rate for Payer: UHCCP DNSP |
$16,316.09
|
| Rate for Payer: VA VA |
$16,316.09
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$25,973.20
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$14,600.00 |
| Max. Negotiated Rate |
$25,973.20 |
| Rate for Payer: Aetna Medicare |
$15,368.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,210.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,210.53
|
| Rate for Payer: BCBS MAPPO |
$15,368.42
|
| Rate for Payer: BCN Medicare Advantage |
$15,368.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,368.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,368.42
|
| Rate for Payer: Mclaren Medicare |
$15,368.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,136.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,673.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,905.26
|
| Rate for Payer: PACE Medicare |
$14,600.00
|
| Rate for Payer: PACE SWMI |
$15,368.42
|
| Rate for Payer: PHP Commercial |
$16,905.26
|
| Rate for Payer: PHP Medicare Advantage |
$15,368.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25,973.20
|
| Rate for Payer: Priority Health Medicare |
$15,368.42
|
| Rate for Payer: Priority Health Narrow Network |
$20,778.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15,368.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15,368.42
|
| Rate for Payer: UHC Exchange |
$23,821.05
|
| Rate for Payer: UHCCP DNSP |
$15,368.42
|
| Rate for Payer: VA VA |
$15,368.42
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$44,689.57
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$23,919.73 |
| Max. Negotiated Rate |
$44,689.57 |
| Rate for Payer: Aetna Medicare |
$25,178.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,473.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,473.33
|
| Rate for Payer: BCBS MAPPO |
$25,178.66
|
| Rate for Payer: BCN Medicare Advantage |
$25,178.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,178.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,178.66
|
| Rate for Payer: Mclaren Medicare |
$25,178.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,437.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,955.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$27,696.53
|
| Rate for Payer: PACE Medicare |
$23,919.73
|
| Rate for Payer: PACE SWMI |
$25,178.66
|
| Rate for Payer: PHP Commercial |
$27,696.53
|
| Rate for Payer: PHP Medicare Advantage |
$25,178.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44,689.57
|
| Rate for Payer: Priority Health Medicare |
$25,178.66
|
| Rate for Payer: Priority Health Narrow Network |
$35,751.65
|
| Rate for Payer: Railroad Medicare Medicare |
$25,178.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,178.66
|
| Rate for Payer: UHC Exchange |
$39,026.92
|
| Rate for Payer: UHCCP DNSP |
$25,178.66
|
| Rate for Payer: VA VA |
$25,178.66
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$22,392.87
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$12,817.17 |
| Max. Negotiated Rate |
$22,392.87 |
| Rate for Payer: Aetna Medicare |
$13,491.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,864.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,864.70
|
| Rate for Payer: BCBS MAPPO |
$13,491.76
|
| Rate for Payer: BCN Medicare Advantage |
$13,491.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,491.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,491.76
|
| Rate for Payer: Mclaren Medicare |
$13,491.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,166.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,515.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,840.94
|
| Rate for Payer: PACE Medicare |
$12,817.17
|
| Rate for Payer: PACE SWMI |
$13,491.76
|
| Rate for Payer: PHP Commercial |
$14,840.94
|
| Rate for Payer: PHP Medicare Advantage |
$13,491.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22,392.87
|
| Rate for Payer: Priority Health Medicare |
$13,491.76
|
| Rate for Payer: Priority Health Narrow Network |
$17,914.30
|
| Rate for Payer: Railroad Medicare Medicare |
$13,491.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,491.76
|
| Rate for Payer: UHC Exchange |
$20,912.23
|
| Rate for Payer: UHCCP DNSP |
$13,491.76
|
| Rate for Payer: VA VA |
$13,491.76
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$21,539.69
|
|
|
Service Code
|
APR-DRG 2004
|
| Min. Negotiated Rate |
$19,474.46 |
| Max. Negotiated Rate |
$21,539.69 |
| Rate for Payer: BCBS Complete |
$21,539.69
|
| Rate for Payer: Mclaren Medicaid |
$20,513.99
|
| Rate for Payer: Meridian Medicaid |
$21,539.69
|
| Rate for Payer: PHP Medicaid |
$19,474.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,513.99
|
| Rate for Payer: UHC Medicaid |
$20,513.99
|
| Rate for Payer: UHCCP Medicaid |
$20,513.99
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$3,847.35
|
|
|
Service Code
|
APR-DRG 2001
|
| Min. Negotiated Rate |
$3,478.46 |
| Max. Negotiated Rate |
$3,847.35 |
| Rate for Payer: BCBS Complete |
$3,847.35
|
| Rate for Payer: Mclaren Medicaid |
$3,664.14
|
| Rate for Payer: Meridian Medicaid |
$3,847.35
|
| Rate for Payer: PHP Medicaid |
$3,478.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,664.14
|
| Rate for Payer: UHC Medicaid |
$3,664.14
|
| Rate for Payer: UHCCP Medicaid |
$3,664.14
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$5,247.87
|
|
|
Service Code
|
APR-DRG 2002
|
| Min. Negotiated Rate |
$4,744.70 |
| Max. Negotiated Rate |
$5,247.87 |
| Rate for Payer: BCBS Complete |
$5,247.87
|
| Rate for Payer: Mclaren Medicaid |
$4,997.97
|
| Rate for Payer: Meridian Medicaid |
$5,247.87
|
| Rate for Payer: PHP Medicaid |
$4,744.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,997.97
|
| Rate for Payer: UHC Medicaid |
$4,997.97
|
| Rate for Payer: UHCCP Medicaid |
$4,997.97
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
|
IP
|
$11,471.20
|
|
|
Service Code
|
APR-DRG 2003
|
| Min. Negotiated Rate |
$10,371.33 |
| Max. Negotiated Rate |
$11,471.20 |
| Rate for Payer: BCBS Complete |
$11,471.20
|
| Rate for Payer: Mclaren Medicaid |
$10,924.95
|
| Rate for Payer: Meridian Medicaid |
$11,471.20
|
| Rate for Payer: PHP Medicaid |
$10,371.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,924.95
|
| Rate for Payer: UHC Medicaid |
$10,924.95
|
| Rate for Payer: UHCCP Medicaid |
$10,924.95
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$90,336.73
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$46,649.56 |
| Max. Negotiated Rate |
$90,336.73 |
| Rate for Payer: Aetna Medicare |
$49,104.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61,381.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61,381.00
|
| Rate for Payer: BCBS MAPPO |
$49,104.80
|
| Rate for Payer: BCN Medicare Advantage |
$49,104.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,104.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$49,104.80
|
| Rate for Payer: Mclaren Medicare |
$49,104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51,560.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56,470.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$54,015.28
|
| Rate for Payer: PACE Medicare |
$46,649.56
|
| Rate for Payer: PACE SWMI |
$49,104.80
|
| Rate for Payer: PHP Commercial |
$54,015.28
|
| Rate for Payer: PHP Medicare Advantage |
$49,104.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90,336.73
|
| Rate for Payer: Priority Health Medicare |
$49,104.80
|
| Rate for Payer: Priority Health Narrow Network |
$72,269.39
|
| Rate for Payer: Railroad Medicare Medicare |
$49,104.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49,104.80
|
| Rate for Payer: UHC Exchange |
$76,112.44
|
| Rate for Payer: UHCCP DNSP |
$49,104.80
|
| Rate for Payer: VA VA |
$49,104.80
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$134,403.93
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$68,592.64 |
| Max. Negotiated Rate |
$134,403.93 |
| Rate for Payer: Aetna Medicare |
$72,202.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90,253.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90,253.48
|
| Rate for Payer: BCBS MAPPO |
$72,202.78
|
| Rate for Payer: BCN Medicare Advantage |
$72,202.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72,202.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$72,202.78
|
| Rate for Payer: Mclaren Medicare |
$72,202.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75,812.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83,033.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$79,423.06
|
| Rate for Payer: PACE Medicare |
$68,592.64
|
| Rate for Payer: PACE SWMI |
$72,202.78
|
| Rate for Payer: PHP Commercial |
$79,423.06
|
| Rate for Payer: PHP Medicare Advantage |
$72,202.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$134,403.93
|
| Rate for Payer: Priority Health Medicare |
$72,202.78
|
| Rate for Payer: Priority Health Narrow Network |
$107,523.15
|
| Rate for Payer: Railroad Medicare Medicare |
$72,202.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72,202.78
|
| Rate for Payer: UHC Exchange |
$111,914.31
|
| Rate for Payer: UHCCP DNSP |
$72,202.78
|
| Rate for Payer: VA VA |
$72,202.78
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$90,336.73
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$46,649.56 |
| Max. Negotiated Rate |
$90,336.73 |
| Rate for Payer: Aetna Medicare |
$49,104.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61,381.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61,381.00
|
| Rate for Payer: BCBS MAPPO |
$49,104.80
|
| Rate for Payer: BCN Medicare Advantage |
$49,104.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49,104.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$49,104.80
|
| Rate for Payer: Mclaren Medicare |
$49,104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51,560.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56,470.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$54,015.28
|
| Rate for Payer: PACE Medicare |
$46,649.56
|
| Rate for Payer: PACE SWMI |
$49,104.80
|
| Rate for Payer: PHP Commercial |
$54,015.28
|
| Rate for Payer: PHP Medicare Advantage |
$49,104.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90,336.73
|
| Rate for Payer: Priority Health Medicare |
$49,104.80
|
| Rate for Payer: Priority Health Narrow Network |
$72,269.39
|
| Rate for Payer: Railroad Medicare Medicare |
$49,104.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49,104.80
|
| Rate for Payer: UHC Exchange |
$76,112.44
|
| Rate for Payer: UHCCP DNSP |
$49,104.80
|
| Rate for Payer: VA VA |
$49,104.80
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$73,266.27
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$38,149.39 |
| Max. Negotiated Rate |
$73,266.27 |
| Rate for Payer: Aetna Medicare |
$40,157.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50,196.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50,196.56
|
| Rate for Payer: BCBS MAPPO |
$40,157.25
|
| Rate for Payer: BCN Medicare Advantage |
$40,157.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40,157.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$40,157.25
|
| Rate for Payer: Mclaren Medicare |
$40,157.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42,165.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46,180.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$44,172.97
|
| Rate for Payer: PACE Medicare |
$38,149.39
|
| Rate for Payer: PACE SWMI |
$40,157.25
|
| Rate for Payer: PHP Commercial |
$44,172.97
|
| Rate for Payer: PHP Medicare Advantage |
$40,157.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$73,266.27
|
| Rate for Payer: Priority Health Medicare |
$40,157.25
|
| Rate for Payer: Priority Health Narrow Network |
$58,613.02
|
| Rate for Payer: Railroad Medicare Medicare |
$40,157.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40,157.25
|
| Rate for Payer: UHC Exchange |
$62,243.74
|
| Rate for Payer: UHCCP DNSP |
$40,157.25
|
| Rate for Payer: VA VA |
$40,157.25
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$105,490.63
|
|
|
Service Code
|
MSDRG 219
|
| Min. Negotiated Rate |
$54,195.38 |
| Max. Negotiated Rate |
$105,490.63 |
| Rate for Payer: Aetna Medicare |
$57,047.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71,309.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71,309.71
|
| Rate for Payer: BCBS MAPPO |
$57,047.77
|
| Rate for Payer: BCN Medicare Advantage |
$57,047.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57,047.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$57,047.77
|
| Rate for Payer: Mclaren Medicare |
$57,047.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,900.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,604.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$62,752.55
|
| Rate for Payer: PACE Medicare |
$54,195.38
|
| Rate for Payer: PACE SWMI |
$57,047.77
|
| Rate for Payer: PHP Commercial |
$62,752.55
|
| Rate for Payer: PHP Medicare Advantage |
$57,047.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$105,490.63
|
| Rate for Payer: Priority Health Medicare |
$57,047.77
|
| Rate for Payer: Priority Health Narrow Network |
$84,392.50
|
| Rate for Payer: Railroad Medicare Medicare |
$57,047.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57,047.77
|
| Rate for Payer: UHC Exchange |
$88,424.04
|
| Rate for Payer: UHCCP DNSP |
$57,047.77
|
| Rate for Payer: VA VA |
$57,047.77
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$69,246.30
|
|
|
Service Code
|
MSDRG 221
|
| Min. Negotiated Rate |
$36,147.66 |
| Max. Negotiated Rate |
$69,246.30 |
| Rate for Payer: Aetna Medicare |
$38,050.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47,562.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47,562.71
|
| Rate for Payer: BCBS MAPPO |
$38,050.17
|
| Rate for Payer: BCN Medicare Advantage |
$38,050.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,050.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$38,050.17
|
| Rate for Payer: Mclaren Medicare |
$38,050.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39,952.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43,757.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$41,855.19
|
| Rate for Payer: PACE Medicare |
$36,147.66
|
| Rate for Payer: PACE SWMI |
$38,050.17
|
| Rate for Payer: PHP Commercial |
$41,855.19
|
| Rate for Payer: PHP Medicare Advantage |
$38,050.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69,246.30
|
| Rate for Payer: Priority Health Medicare |
$38,050.17
|
| Rate for Payer: Priority Health Narrow Network |
$55,397.04
|
| Rate for Payer: Railroad Medicare Medicare |
$38,050.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38,050.17
|
| Rate for Payer: UHC Exchange |
$58,977.76
|
| Rate for Payer: UHCCP DNSP |
$38,050.17
|
| Rate for Payer: VA VA |
$38,050.17
|
|
