|
MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$18,683.84
|
|
|
Service Code
|
MSDRG 476
|
| Min. Negotiated Rate |
$11,451.39 |
| Max. Negotiated Rate |
$18,683.84 |
| Rate for Payer: Aetna Medicare |
$12,054.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,067.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,067.61
|
| Rate for Payer: BCBS MAPPO |
$12,054.09
|
| Rate for Payer: BCN Medicare Advantage |
$12,054.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,054.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,054.09
|
| Rate for Payer: Mclaren Medicare |
$12,054.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,656.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,862.20
|
| Rate for Payer: PACE Medicare |
$11,451.39
|
| Rate for Payer: PACE SWMI |
$12,054.09
|
| Rate for Payer: PHP Commercial |
$13,259.50
|
| Rate for Payer: PHP Medicare Advantage |
$12,054.09
|
| Rate for Payer: Priority Health Medicare |
$12,054.09
|
| Rate for Payer: Railroad Medicare Medicare |
$12,054.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,054.09
|
| Rate for Payer: UHC Exchange |
$18,683.84
|
| Rate for Payer: UHC Medicare Advantage |
$12,054.09
|
| Rate for Payer: UHCCP DNSP |
$12,054.09
|
| Rate for Payer: VA VA |
$12,054.09
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$29,312.84
|
|
|
Service Code
|
MSDRG 617
|
| Min. Negotiated Rate |
$17,965.93 |
| Max. Negotiated Rate |
$29,312.84 |
| Rate for Payer: Aetna Medicare |
$18,911.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,639.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,639.39
|
| Rate for Payer: BCBS MAPPO |
$18,911.51
|
| Rate for Payer: BCN Medicare Advantage |
$18,911.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,911.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,911.51
|
| Rate for Payer: Mclaren Medicare |
$18,911.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,857.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,748.24
|
| Rate for Payer: PACE Medicare |
$17,965.93
|
| Rate for Payer: PACE SWMI |
$18,911.51
|
| Rate for Payer: PHP Commercial |
$20,802.66
|
| Rate for Payer: PHP Medicare Advantage |
$18,911.51
|
| Rate for Payer: Priority Health Medicare |
$18,911.51
|
| Rate for Payer: Railroad Medicare Medicare |
$18,911.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,911.51
|
| Rate for Payer: UHC Exchange |
$29,312.84
|
| Rate for Payer: UHC Medicare Advantage |
$18,911.51
|
| Rate for Payer: UHCCP DNSP |
$18,911.51
|
| Rate for Payer: VA VA |
$18,911.51
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$56,053.39
|
|
|
Service Code
|
MSDRG 616
|
| Min. Negotiated Rate |
$34,355.31 |
| Max. Negotiated Rate |
$56,053.39 |
| Rate for Payer: Aetna Medicare |
$36,163.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,204.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,204.35
|
| Rate for Payer: BCBS MAPPO |
$36,163.48
|
| Rate for Payer: BCN Medicare Advantage |
$36,163.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,163.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$36,163.48
|
| Rate for Payer: Mclaren Medicare |
$36,163.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37,971.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,588.00
|
| Rate for Payer: PACE Medicare |
$34,355.31
|
| Rate for Payer: PACE SWMI |
$36,163.48
|
| Rate for Payer: PHP Commercial |
$39,779.83
|
| Rate for Payer: PHP Medicare Advantage |
$36,163.48
|
| Rate for Payer: Priority Health Medicare |
$36,163.48
|
| Rate for Payer: Railroad Medicare Medicare |
$36,163.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,163.48
|
| Rate for Payer: UHC Exchange |
$56,053.39
|
| Rate for Payer: UHC Medicare Advantage |
$36,163.48
|
| Rate for Payer: UHCCP DNSP |
$36,163.48
|
| Rate for Payer: VA VA |
$36,163.48
|
|
|
MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$19,817.97
|
|
|
Service Code
|
MSDRG 618
|
| Min. Negotiated Rate |
$12,146.50 |
| Max. Negotiated Rate |
$19,817.97 |
| Rate for Payer: Aetna Medicare |
$12,785.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,982.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,982.24
|
| Rate for Payer: BCBS MAPPO |
$12,785.79
|
| Rate for Payer: BCN Medicare Advantage |
$12,785.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,785.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,785.79
|
| Rate for Payer: Mclaren Medicare |
$12,785.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,425.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,703.66
|
| Rate for Payer: PACE Medicare |
$12,146.50
|
| Rate for Payer: PACE SWMI |
$12,785.79
|
| Rate for Payer: PHP Commercial |
$14,064.37
|
| Rate for Payer: PHP Medicare Advantage |
$12,785.79
|
| Rate for Payer: Priority Health Medicare |
$12,785.79
|
| Rate for Payer: Railroad Medicare Medicare |
$12,785.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,785.79
|
| Rate for Payer: UHC Exchange |
$19,817.97
|
| Rate for Payer: UHC Medicare Advantage |
$12,785.79
|
| Rate for Payer: UHCCP DNSP |
$12,785.79
|
| Rate for Payer: VA VA |
$12,785.79
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$20,008.86
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$12,263.49 |
| Max. Negotiated Rate |
$20,008.86 |
| Rate for Payer: Aetna Medicare |
$12,908.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,136.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,136.17
|
| Rate for Payer: BCBS MAPPO |
$12,908.94
|
| Rate for Payer: BCN Medicare Advantage |
$12,908.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,908.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,908.94
|
| Rate for Payer: Mclaren Medicare |
$12,908.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,554.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,845.28
|
| Rate for Payer: PACE Medicare |
$12,263.49
|
| Rate for Payer: PACE SWMI |
$12,908.94
|
| Rate for Payer: PHP Commercial |
$14,199.83
|
| Rate for Payer: PHP Medicare Advantage |
$12,908.94
|
| Rate for Payer: Priority Health Medicare |
$12,908.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12,908.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,908.94
|
| Rate for Payer: UHC Exchange |
$20,008.86
|
| Rate for Payer: UHC Medicare Advantage |
$12,908.94
|
| Rate for Payer: UHCCP DNSP |
$12,908.94
|
| Rate for Payer: VA VA |
$12,908.94
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$35,332.06
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$21,655.14 |
| Max. Negotiated Rate |
$35,332.06 |
| Rate for Payer: Aetna Medicare |
$22,794.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,493.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,493.60
|
| Rate for Payer: BCBS MAPPO |
$22,794.88
|
| Rate for Payer: BCN Medicare Advantage |
$22,794.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,794.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,794.88
|
| Rate for Payer: Mclaren Medicare |
$22,794.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,934.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,214.11
|
| Rate for Payer: PACE Medicare |
$21,655.14
|
| Rate for Payer: PACE SWMI |
$22,794.88
|
| Rate for Payer: PHP Commercial |
$25,074.37
|
| Rate for Payer: PHP Medicare Advantage |
$22,794.88
|
| Rate for Payer: Priority Health Medicare |
$22,794.88
|
| Rate for Payer: Railroad Medicare Medicare |
$22,794.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,794.88
|
| Rate for Payer: UHC Exchange |
$35,332.06
|
| Rate for Payer: UHC Medicare Advantage |
$22,794.88
|
| Rate for Payer: UHCCP DNSP |
$22,794.88
|
| Rate for Payer: VA VA |
$22,794.88
|
|
|
MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$14,780.78
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$9,059.19 |
| Max. Negotiated Rate |
$14,780.78 |
| Rate for Payer: Aetna Medicare |
$9,535.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,919.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,919.99
|
| Rate for Payer: BCBS MAPPO |
$9,535.99
|
| Rate for Payer: BCN Medicare Advantage |
$9,535.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,535.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,535.99
|
| Rate for Payer: Mclaren Medicare |
$9,535.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,012.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,966.39
|
| Rate for Payer: PACE Medicare |
$9,059.19
|
| Rate for Payer: PACE SWMI |
$9,535.99
|
| Rate for Payer: PHP Commercial |
$10,489.59
|
| Rate for Payer: PHP Medicare Advantage |
$9,535.99
|
| Rate for Payer: Priority Health Medicare |
$9,535.99
|
| Rate for Payer: Railroad Medicare Medicare |
$9,535.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,535.99
|
| Rate for Payer: UHC Exchange |
$14,780.78
|
| Rate for Payer: UHC Medicare Advantage |
$9,535.99
|
| Rate for Payer: UHCCP DNSP |
$9,535.99
|
| Rate for Payer: VA VA |
$9,535.99
|
|
|
MS-DRG 42.00: ANGINA PECTORIS
|
Facility
|
IP
|
$12,255.28
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$7,511.30 |
| Max. Negotiated Rate |
$12,255.28 |
| Rate for Payer: Aetna Medicare |
$7,906.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,883.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,883.29
|
| Rate for Payer: BCBS MAPPO |
$7,906.63
|
| Rate for Payer: BCN Medicare Advantage |
$7,906.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,906.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,906.63
|
| Rate for Payer: Mclaren Medicare |
$7,906.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,301.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,092.62
|
| Rate for Payer: PACE Medicare |
$7,511.30
|
| Rate for Payer: PACE SWMI |
$7,906.63
|
| Rate for Payer: PHP Commercial |
$8,697.29
|
| Rate for Payer: PHP Medicare Advantage |
$7,906.63
|
| Rate for Payer: Priority Health Medicare |
$7,906.63
|
| Rate for Payer: Railroad Medicare Medicare |
$7,906.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,906.63
|
| Rate for Payer: UHC Exchange |
$12,255.28
|
| Rate for Payer: UHC Medicare Advantage |
$7,906.63
|
| Rate for Payer: UHCCP DNSP |
$7,906.63
|
| Rate for Payer: VA VA |
$7,906.63
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
|
IP
|
$94,815.72
|
|
|
Service Code
|
MSDRG 268
|
| Min. Negotiated Rate |
$58,112.86 |
| Max. Negotiated Rate |
$94,815.72 |
| Rate for Payer: Aetna Medicare |
$61,171.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76,464.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76,464.29
|
| Rate for Payer: BCBS MAPPO |
$61,171.43
|
| Rate for Payer: BCN Medicare Advantage |
$61,171.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61,171.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$61,171.43
|
| Rate for Payer: Mclaren Medicare |
$61,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64,230.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70,347.14
|
| Rate for Payer: PACE Medicare |
$58,112.86
|
| Rate for Payer: PACE SWMI |
$61,171.43
|
| Rate for Payer: PHP Commercial |
$67,288.57
|
| Rate for Payer: PHP Medicare Advantage |
$61,171.43
|
| Rate for Payer: Priority Health Medicare |
$61,171.43
|
| Rate for Payer: Railroad Medicare Medicare |
$61,171.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$61,171.43
|
| Rate for Payer: UHC Exchange |
$94,815.72
|
| Rate for Payer: UHC Medicare Advantage |
$61,171.43
|
| Rate for Payer: UHCCP DNSP |
$61,171.43
|
| Rate for Payer: VA VA |
$61,171.43
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$60,143.18
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$36,861.95 |
| Max. Negotiated Rate |
$60,143.18 |
| Rate for Payer: Aetna Medicare |
$38,802.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48,502.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48,502.56
|
| Rate for Payer: BCBS MAPPO |
$38,802.05
|
| Rate for Payer: BCN Medicare Advantage |
$38,802.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,802.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$38,802.05
|
| Rate for Payer: Mclaren Medicare |
$38,802.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40,742.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,622.36
|
| Rate for Payer: PACE Medicare |
$36,861.95
|
| Rate for Payer: PACE SWMI |
$38,802.05
|
| Rate for Payer: PHP Commercial |
$42,682.25
|
| Rate for Payer: PHP Medicare Advantage |
$38,802.05
|
| Rate for Payer: Priority Health Medicare |
$38,802.05
|
| Rate for Payer: Railroad Medicare Medicare |
$38,802.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$38,802.05
|
| Rate for Payer: UHC Exchange |
$60,143.18
|
| Rate for Payer: UHC Medicare Advantage |
$38,802.05
|
| Rate for Payer: UHCCP DNSP |
$38,802.05
|
| Rate for Payer: VA VA |
$38,802.05
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$23,526.04
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$14,419.19 |
| Max. Negotiated Rate |
$23,526.04 |
| Rate for Payer: Aetna Medicare |
$15,178.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,972.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,972.61
|
| Rate for Payer: BCBS MAPPO |
$15,178.09
|
| Rate for Payer: BCN Medicare Advantage |
$15,178.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,178.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,178.09
|
| Rate for Payer: Mclaren Medicare |
$15,178.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,936.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,454.80
|
| Rate for Payer: PACE Medicare |
$14,419.19
|
| Rate for Payer: PACE SWMI |
$15,178.09
|
| Rate for Payer: PHP Commercial |
$16,695.90
|
| Rate for Payer: PHP Medicare Advantage |
$15,178.09
|
| Rate for Payer: Priority Health Medicare |
$15,178.09
|
| Rate for Payer: Railroad Medicare Medicare |
$15,178.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,178.09
|
| Rate for Payer: UHC Exchange |
$23,526.04
|
| Rate for Payer: UHC Medicare Advantage |
$15,178.09
|
| Rate for Payer: UHCCP DNSP |
$15,178.09
|
| Rate for Payer: VA VA |
$15,178.09
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$36,867.26
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$22,596.06 |
| Max. Negotiated Rate |
$36,867.26 |
| Rate for Payer: Aetna Medicare |
$23,785.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,731.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,731.66
|
| Rate for Payer: BCBS MAPPO |
$23,785.33
|
| Rate for Payer: BCN Medicare Advantage |
$23,785.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,785.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,785.33
|
| Rate for Payer: Mclaren Medicare |
$23,785.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,974.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,353.13
|
| Rate for Payer: PACE Medicare |
$22,596.06
|
| Rate for Payer: PACE SWMI |
$23,785.33
|
| Rate for Payer: PHP Commercial |
$26,163.86
|
| Rate for Payer: PHP Medicare Advantage |
$23,785.33
|
| Rate for Payer: Priority Health Medicare |
$23,785.33
|
| Rate for Payer: Railroad Medicare Medicare |
$23,785.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,785.33
|
| Rate for Payer: UHC Exchange |
$36,867.26
|
| Rate for Payer: UHC Medicare Advantage |
$23,785.33
|
| Rate for Payer: UHCCP DNSP |
$23,785.33
|
| Rate for Payer: VA VA |
$23,785.33
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,140.29
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$11,118.24 |
| Max. Negotiated Rate |
$18,140.29 |
| Rate for Payer: Aetna Medicare |
$11,703.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,629.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,629.26
|
| Rate for Payer: BCBS MAPPO |
$11,703.41
|
| Rate for Payer: BCN Medicare Advantage |
$11,703.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,703.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,703.41
|
| Rate for Payer: Mclaren Medicare |
$11,703.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,288.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,458.92
|
| Rate for Payer: PACE Medicare |
$11,118.24
|
| Rate for Payer: PACE SWMI |
$11,703.41
|
| Rate for Payer: PHP Commercial |
$12,873.75
|
| Rate for Payer: PHP Medicare Advantage |
$11,703.41
|
| Rate for Payer: Priority Health Medicare |
$11,703.41
|
| Rate for Payer: Railroad Medicare Medicare |
$11,703.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,703.41
|
| Rate for Payer: UHC Exchange |
$18,140.29
|
| Rate for Payer: UHC Medicare Advantage |
$11,703.41
|
| Rate for Payer: UHCCP DNSP |
$11,703.41
|
| Rate for Payer: VA VA |
$11,703.41
|
|
|
MS-DRG 42.00: ARTHROSCOPY
|
Facility
|
IP
|
$26,893.83
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$16,483.32 |
| Max. Negotiated Rate |
$26,893.83 |
| Rate for Payer: Aetna Medicare |
$17,350.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,688.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,688.58
|
| Rate for Payer: BCBS MAPPO |
$17,350.86
|
| Rate for Payer: BCN Medicare Advantage |
$17,350.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,350.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,350.86
|
| Rate for Payer: Mclaren Medicare |
$17,350.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,218.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,953.49
|
| Rate for Payer: PACE Medicare |
$16,483.32
|
| Rate for Payer: PACE SWMI |
$17,350.86
|
| Rate for Payer: PHP Commercial |
$19,085.95
|
| Rate for Payer: PHP Medicare Advantage |
$17,350.86
|
| Rate for Payer: Priority Health Medicare |
$17,350.86
|
| Rate for Payer: Railroad Medicare Medicare |
$17,350.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,350.86
|
| Rate for Payer: UHC Exchange |
$26,893.83
|
| Rate for Payer: UHC Medicare Advantage |
$17,350.86
|
| Rate for Payer: UHCCP DNSP |
$17,350.86
|
| Rate for Payer: VA VA |
$17,350.86
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC
|
Facility
|
IP
|
$18,686.61
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$11,453.09 |
| Max. Negotiated Rate |
$18,686.61 |
| Rate for Payer: Aetna Medicare |
$12,055.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,069.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,069.85
|
| Rate for Payer: BCBS MAPPO |
$12,055.88
|
| Rate for Payer: BCN Medicare Advantage |
$12,055.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,055.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$12,055.88
|
| Rate for Payer: Mclaren Medicare |
$12,055.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,658.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,864.26
|
| Rate for Payer: PACE Medicare |
$11,453.09
|
| Rate for Payer: PACE SWMI |
$12,055.88
|
| Rate for Payer: PHP Commercial |
$13,261.47
|
| Rate for Payer: PHP Medicare Advantage |
$12,055.88
|
| Rate for Payer: Priority Health Medicare |
$12,055.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12,055.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,055.88
|
| Rate for Payer: UHC Exchange |
$18,686.61
|
| Rate for Payer: UHC Medicare Advantage |
$12,055.88
|
| Rate for Payer: UHCCP DNSP |
$12,055.88
|
| Rate for Payer: VA VA |
$12,055.88
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
|
IP
|
$11,897.04
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$7,291.73 |
| Max. Negotiated Rate |
$11,897.04 |
| Rate for Payer: Aetna Medicare |
$7,675.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,594.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,594.39
|
| Rate for Payer: BCBS MAPPO |
$7,675.51
|
| Rate for Payer: BCN Medicare Advantage |
$7,675.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,675.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,675.51
|
| Rate for Payer: Mclaren Medicare |
$7,675.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,059.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,826.84
|
| Rate for Payer: PACE Medicare |
$7,291.73
|
| Rate for Payer: PACE SWMI |
$7,675.51
|
| Rate for Payer: PHP Commercial |
$8,443.06
|
| Rate for Payer: PHP Medicare Advantage |
$7,675.51
|
| Rate for Payer: Priority Health Medicare |
$7,675.51
|
| Rate for Payer: Railroad Medicare Medicare |
$7,675.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,675.51
|
| Rate for Payer: UHC Exchange |
$11,897.04
|
| Rate for Payer: UHC Medicare Advantage |
$7,675.51
|
| Rate for Payer: UHCCP DNSP |
$7,675.51
|
| Rate for Payer: VA VA |
$7,675.51
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
|
Facility
|
IP
|
$86,078.79
|
|
|
Service Code
|
MSDRG 016
|
| Min. Negotiated Rate |
$52,757.96 |
| Max. Negotiated Rate |
$86,078.79 |
| Rate for Payer: Aetna Medicare |
$55,534.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,418.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,418.38
|
| Rate for Payer: BCBS MAPPO |
$55,534.70
|
| Rate for Payer: BCN Medicare Advantage |
$55,534.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,534.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$55,534.70
|
| Rate for Payer: Mclaren Medicare |
$55,534.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,311.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63,864.90
|
| Rate for Payer: PACE Medicare |
$52,757.96
|
| Rate for Payer: PACE SWMI |
$55,534.70
|
| Rate for Payer: PHP Commercial |
$61,088.17
|
| Rate for Payer: PHP Medicare Advantage |
$55,534.70
|
| Rate for Payer: Priority Health Medicare |
$55,534.70
|
| Rate for Payer: Railroad Medicare Medicare |
$55,534.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$55,534.70
|
| Rate for Payer: UHC Exchange |
$86,078.79
|
| Rate for Payer: UHC Medicare Advantage |
$55,534.70
|
| Rate for Payer: UHCCP DNSP |
$55,534.70
|
| Rate for Payer: VA VA |
$55,534.70
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$86,078.79
|
|
|
Service Code
|
MSDRG 017
|
| Min. Negotiated Rate |
$52,757.96 |
| Max. Negotiated Rate |
$86,078.79 |
| Rate for Payer: Aetna Medicare |
$55,534.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,418.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,418.38
|
| Rate for Payer: BCBS MAPPO |
$55,534.70
|
| Rate for Payer: BCN Medicare Advantage |
$55,534.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,534.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$55,534.70
|
| Rate for Payer: Mclaren Medicare |
$55,534.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,311.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63,864.90
|
| Rate for Payer: PACE Medicare |
$52,757.96
|
| Rate for Payer: PACE SWMI |
$55,534.70
|
| Rate for Payer: PHP Commercial |
$61,088.17
|
| Rate for Payer: PHP Medicare Advantage |
$55,534.70
|
| Rate for Payer: Priority Health Medicare |
$55,534.70
|
| Rate for Payer: Railroad Medicare Medicare |
$55,534.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$55,534.70
|
| Rate for Payer: UHC Exchange |
$86,078.79
|
| Rate for Payer: UHC Medicare Advantage |
$55,534.70
|
| Rate for Payer: UHCCP DNSP |
$55,534.70
|
| Rate for Payer: VA VA |
$55,534.70
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
|
IP
|
$29,870.22
|
|
|
Service Code
|
MSDRG 519
|
| Min. Negotiated Rate |
$18,307.55 |
| Max. Negotiated Rate |
$29,870.22 |
| Rate for Payer: Aetna Medicare |
$19,271.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,088.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,088.89
|
| Rate for Payer: BCBS MAPPO |
$19,271.11
|
| Rate for Payer: BCN Medicare Advantage |
$19,271.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,271.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$19,271.11
|
| Rate for Payer: Mclaren Medicare |
$19,271.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,234.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,161.78
|
| Rate for Payer: PACE Medicare |
$18,307.55
|
| Rate for Payer: PACE SWMI |
$19,271.11
|
| Rate for Payer: PHP Commercial |
$21,198.22
|
| Rate for Payer: PHP Medicare Advantage |
$19,271.11
|
| Rate for Payer: Priority Health Medicare |
$19,271.11
|
| Rate for Payer: Railroad Medicare Medicare |
$19,271.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,271.11
|
| Rate for Payer: UHC Exchange |
$29,870.22
|
| Rate for Payer: UHC Medicare Advantage |
$19,271.11
|
| Rate for Payer: UHCCP DNSP |
$19,271.11
|
| Rate for Payer: VA VA |
$19,271.11
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
|
IP
|
$52,166.92
|
|
|
Service Code
|
MSDRG 518
|
| Min. Negotiated Rate |
$31,973.28 |
| Max. Negotiated Rate |
$52,166.92 |
| Rate for Payer: Aetna Medicare |
$33,656.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,070.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,070.10
|
| Rate for Payer: BCBS MAPPO |
$33,656.08
|
| Rate for Payer: BCN Medicare Advantage |
$33,656.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,656.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$33,656.08
|
| Rate for Payer: Mclaren Medicare |
$33,656.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,338.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,704.49
|
| Rate for Payer: PACE Medicare |
$31,973.28
|
| Rate for Payer: PACE SWMI |
$33,656.08
|
| Rate for Payer: PHP Commercial |
$37,021.69
|
| Rate for Payer: PHP Medicare Advantage |
$33,656.08
|
| Rate for Payer: Priority Health Medicare |
$33,656.08
|
| Rate for Payer: Railroad Medicare Medicare |
$33,656.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$33,656.08
|
| Rate for Payer: UHC Exchange |
$52,166.92
|
| Rate for Payer: UHC Medicare Advantage |
$33,656.08
|
| Rate for Payer: UHCCP DNSP |
$33,656.08
|
| Rate for Payer: VA VA |
$33,656.08
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$22,419.57
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$13,741.03 |
| Max. Negotiated Rate |
$22,419.57 |
| Rate for Payer: Aetna Medicare |
$14,464.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,080.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,080.30
|
| Rate for Payer: BCBS MAPPO |
$14,464.24
|
| Rate for Payer: BCN Medicare Advantage |
$14,464.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,464.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,464.24
|
| Rate for Payer: Mclaren Medicare |
$14,464.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,187.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,633.88
|
| Rate for Payer: PACE Medicare |
$13,741.03
|
| Rate for Payer: PACE SWMI |
$14,464.24
|
| Rate for Payer: PHP Commercial |
$15,910.66
|
| Rate for Payer: PHP Medicare Advantage |
$14,464.24
|
| Rate for Payer: Priority Health Medicare |
$14,464.24
|
| Rate for Payer: Railroad Medicare Medicare |
$14,464.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,464.24
|
| Rate for Payer: UHC Exchange |
$22,419.57
|
| Rate for Payer: UHC Medicare Advantage |
$14,464.24
|
| Rate for Payer: UHCCP DNSP |
$14,464.24
|
| Rate for Payer: VA VA |
$14,464.24
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$35,752.47
|
|
|
Service Code
|
MSDRG 095
|
| Min. Negotiated Rate |
$21,912.80 |
| Max. Negotiated Rate |
$35,752.47 |
| Rate for Payer: Aetna Medicare |
$23,066.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,832.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,832.64
|
| Rate for Payer: BCBS MAPPO |
$23,066.11
|
| Rate for Payer: BCN Medicare Advantage |
$23,066.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,066.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,066.11
|
| Rate for Payer: Mclaren Medicare |
$23,066.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,219.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,526.03
|
| Rate for Payer: PACE Medicare |
$21,912.80
|
| Rate for Payer: PACE SWMI |
$23,066.11
|
| Rate for Payer: PHP Commercial |
$25,372.72
|
| Rate for Payer: PHP Medicare Advantage |
$23,066.11
|
| Rate for Payer: Priority Health Medicare |
$23,066.11
|
| Rate for Payer: Railroad Medicare Medicare |
$23,066.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,066.11
|
| Rate for Payer: UHC Exchange |
$35,752.47
|
| Rate for Payer: UHC Medicare Advantage |
$23,066.11
|
| Rate for Payer: UHCCP DNSP |
$23,066.11
|
| Rate for Payer: VA VA |
$23,066.11
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$53,061.82
|
|
|
Service Code
|
MSDRG 094
|
| Min. Negotiated Rate |
$32,521.76 |
| Max. Negotiated Rate |
$53,061.82 |
| Rate for Payer: Aetna Medicare |
$34,233.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,791.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,791.79
|
| Rate for Payer: BCBS MAPPO |
$34,233.43
|
| Rate for Payer: BCN Medicare Advantage |
$34,233.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34,233.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$34,233.43
|
| Rate for Payer: Mclaren Medicare |
$34,233.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,945.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39,368.44
|
| Rate for Payer: PACE Medicare |
$32,521.76
|
| Rate for Payer: PACE SWMI |
$34,233.43
|
| Rate for Payer: PHP Commercial |
$37,656.77
|
| Rate for Payer: PHP Medicare Advantage |
$34,233.43
|
| Rate for Payer: Priority Health Medicare |
$34,233.43
|
| Rate for Payer: Railroad Medicare Medicare |
$34,233.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34,233.43
|
| Rate for Payer: UHC Exchange |
$53,061.82
|
| Rate for Payer: UHC Medicare Advantage |
$34,233.43
|
| Rate for Payer: UHCCP DNSP |
$34,233.43
|
| Rate for Payer: VA VA |
$34,233.43
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$35,752.47
|
|
|
Service Code
|
MSDRG 096
|
| Min. Negotiated Rate |
$21,912.80 |
| Max. Negotiated Rate |
$35,752.47 |
| Rate for Payer: Aetna Medicare |
$23,066.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,832.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,832.64
|
| Rate for Payer: BCBS MAPPO |
$23,066.11
|
| Rate for Payer: BCN Medicare Advantage |
$23,066.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,066.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,066.11
|
| Rate for Payer: Mclaren Medicare |
$23,066.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,219.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,526.03
|
| Rate for Payer: PACE Medicare |
$21,912.80
|
| Rate for Payer: PACE SWMI |
$23,066.11
|
| Rate for Payer: PHP Commercial |
$25,372.72
|
| Rate for Payer: PHP Medicare Advantage |
$23,066.11
|
| Rate for Payer: Priority Health Medicare |
$23,066.11
|
| Rate for Payer: Railroad Medicare Medicare |
$23,066.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,066.11
|
| Rate for Payer: UHC Exchange |
$35,752.47
|
| Rate for Payer: UHC Medicare Advantage |
$23,066.11
|
| Rate for Payer: UHCCP DNSP |
$23,066.11
|
| Rate for Payer: VA VA |
$23,066.11
|
|
|
MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS
|
Facility
|
IP
|
$27,444.30
|
|
|
Service Code
|
MSDRG 886
|
| Min. Negotiated Rate |
$16,820.70 |
| Max. Negotiated Rate |
$27,444.30 |
| Rate for Payer: Aetna Medicare |
$17,706.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,132.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,132.50
|
| Rate for Payer: BCBS MAPPO |
$17,706.00
|
| Rate for Payer: BCN Medicare Advantage |
$17,706.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,706.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,706.00
|
| Rate for Payer: Mclaren Medicare |
$17,706.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,591.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,361.90
|
| Rate for Payer: PACE Medicare |
$16,820.70
|
| Rate for Payer: PACE SWMI |
$17,706.00
|
| Rate for Payer: PHP Commercial |
$19,476.60
|
| Rate for Payer: PHP Medicare Advantage |
$17,706.00
|
| Rate for Payer: Priority Health Medicare |
$17,706.00
|
| Rate for Payer: Railroad Medicare Medicare |
$17,706.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,706.00
|
| Rate for Payer: UHC Exchange |
$27,444.30
|
| Rate for Payer: UHC Medicare Advantage |
$17,706.00
|
| Rate for Payer: UHCCP DNSP |
$17,706.00
|
| Rate for Payer: VA VA |
$17,706.00
|
|
