|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$36,459.24
|
|
|
Service Code
|
MSDRG 982
|
| Min. Negotiated Rate |
$22,345.99 |
| Max. Negotiated Rate |
$36,459.24 |
| Rate for Payer: Aetna Medicare |
$23,522.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,402.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,402.61
|
| Rate for Payer: BCBS MAPPO |
$23,522.09
|
| Rate for Payer: BCN Medicare Advantage |
$23,522.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,522.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$23,522.09
|
| Rate for Payer: Mclaren Medicare |
$23,522.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24,698.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,050.40
|
| Rate for Payer: PACE Medicare |
$22,345.99
|
| Rate for Payer: PACE SWMI |
$23,522.09
|
| Rate for Payer: PHP Commercial |
$25,874.30
|
| Rate for Payer: PHP Medicare Advantage |
$23,522.09
|
| Rate for Payer: Priority Health Medicare |
$23,522.09
|
| Rate for Payer: Railroad Medicare Medicare |
$23,522.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,522.09
|
| Rate for Payer: UHC Exchange |
$36,459.24
|
| Rate for Payer: UHC Medicare Advantage |
$23,522.09
|
| Rate for Payer: UHCCP DNSP |
$23,522.09
|
| Rate for Payer: VA VA |
$23,522.09
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$68,347.64
|
|
|
Service Code
|
MSDRG 981
|
| Min. Negotiated Rate |
$41,890.49 |
| Max. Negotiated Rate |
$68,347.64 |
| Rate for Payer: Aetna Medicare |
$44,095.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55,119.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55,119.06
|
| Rate for Payer: BCBS MAPPO |
$44,095.25
|
| Rate for Payer: BCN Medicare Advantage |
$44,095.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44,095.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$44,095.25
|
| Rate for Payer: Mclaren Medicare |
$44,095.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46,300.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50,709.54
|
| Rate for Payer: PACE Medicare |
$41,890.49
|
| Rate for Payer: PACE SWMI |
$44,095.25
|
| Rate for Payer: PHP Commercial |
$48,504.78
|
| Rate for Payer: PHP Medicare Advantage |
$44,095.25
|
| Rate for Payer: Priority Health Medicare |
$44,095.25
|
| Rate for Payer: Railroad Medicare Medicare |
$44,095.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$44,095.25
|
| Rate for Payer: UHC Exchange |
$68,347.64
|
| Rate for Payer: UHC Medicare Advantage |
$44,095.25
|
| Rate for Payer: UHCCP DNSP |
$44,095.25
|
| Rate for Payer: VA VA |
$44,095.25
|
|
|
MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$25,669.80
|
|
|
Service Code
|
MSDRG 983
|
| Min. Negotiated Rate |
$15,733.10 |
| Max. Negotiated Rate |
$25,669.80 |
| Rate for Payer: Aetna Medicare |
$16,561.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,701.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,701.45
|
| Rate for Payer: BCBS MAPPO |
$16,561.16
|
| Rate for Payer: BCN Medicare Advantage |
$16,561.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,561.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,561.16
|
| Rate for Payer: Mclaren Medicare |
$16,561.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,389.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,045.33
|
| Rate for Payer: PACE Medicare |
$15,733.10
|
| Rate for Payer: PACE SWMI |
$16,561.16
|
| Rate for Payer: PHP Commercial |
$18,217.28
|
| Rate for Payer: PHP Medicare Advantage |
$16,561.16
|
| Rate for Payer: Priority Health Medicare |
$16,561.16
|
| Rate for Payer: Railroad Medicare Medicare |
$16,561.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,561.16
|
| Rate for Payer: UHC Exchange |
$25,669.80
|
| Rate for Payer: UHC Medicare Advantage |
$16,561.16
|
| Rate for Payer: UHCCP DNSP |
$16,561.16
|
| Rate for Payer: VA VA |
$16,561.16
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$24,882.83
|
|
|
Service Code
|
MSDRG 038
|
| Min. Negotiated Rate |
$15,250.77 |
| Max. Negotiated Rate |
$24,882.83 |
| Rate for Payer: Aetna Medicare |
$16,053.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,066.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,066.80
|
| Rate for Payer: BCBS MAPPO |
$16,053.44
|
| Rate for Payer: BCN Medicare Advantage |
$16,053.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,053.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,053.44
|
| Rate for Payer: Mclaren Medicare |
$16,053.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,856.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,461.46
|
| Rate for Payer: PACE Medicare |
$15,250.77
|
| Rate for Payer: PACE SWMI |
$16,053.44
|
| Rate for Payer: PHP Commercial |
$17,658.78
|
| Rate for Payer: PHP Medicare Advantage |
$16,053.44
|
| Rate for Payer: Priority Health Medicare |
$16,053.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16,053.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,053.44
|
| Rate for Payer: UHC Exchange |
$24,882.83
|
| Rate for Payer: UHC Medicare Advantage |
$16,053.44
|
| Rate for Payer: UHCCP DNSP |
$16,053.44
|
| Rate for Payer: VA VA |
$16,053.44
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$48,528.02
|
|
|
Service Code
|
MSDRG 037
|
| Min. Negotiated Rate |
$29,742.98 |
| Max. Negotiated Rate |
$48,528.02 |
| Rate for Payer: Aetna Medicare |
$31,308.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,135.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,135.50
|
| Rate for Payer: BCBS MAPPO |
$31,308.40
|
| Rate for Payer: BCN Medicare Advantage |
$31,308.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,308.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,308.40
|
| Rate for Payer: Mclaren Medicare |
$31,308.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,873.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,004.66
|
| Rate for Payer: PACE Medicare |
$29,742.98
|
| Rate for Payer: PACE SWMI |
$31,308.40
|
| Rate for Payer: PHP Commercial |
$34,439.24
|
| Rate for Payer: PHP Medicare Advantage |
$31,308.40
|
| Rate for Payer: Priority Health Medicare |
$31,308.40
|
| Rate for Payer: Railroad Medicare Medicare |
$31,308.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,308.40
|
| Rate for Payer: UHC Exchange |
$48,528.02
|
| Rate for Payer: UHC Medicare Advantage |
$31,308.40
|
| Rate for Payer: UHCCP DNSP |
$31,308.40
|
| Rate for Payer: VA VA |
$31,308.40
|
|
|
MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,339.46
|
|
|
Service Code
|
MSDRG 039
|
| Min. Negotiated Rate |
$11,240.31 |
| Max. Negotiated Rate |
$18,339.46 |
| Rate for Payer: Aetna Medicare |
$11,831.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,789.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,789.89
|
| Rate for Payer: BCBS MAPPO |
$11,831.91
|
| Rate for Payer: BCN Medicare Advantage |
$11,831.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,831.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,831.91
|
| Rate for Payer: Mclaren Medicare |
$11,831.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,423.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,606.70
|
| Rate for Payer: PACE Medicare |
$11,240.31
|
| Rate for Payer: PACE SWMI |
$11,831.91
|
| Rate for Payer: PHP Commercial |
$13,015.10
|
| Rate for Payer: PHP Medicare Advantage |
$11,831.91
|
| Rate for Payer: Priority Health Medicare |
$11,831.91
|
| Rate for Payer: Railroad Medicare Medicare |
$11,831.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,831.91
|
| Rate for Payer: UHC Exchange |
$18,339.46
|
| Rate for Payer: UHC Medicare Advantage |
$11,831.91
|
| Rate for Payer: UHCCP DNSP |
$11,831.91
|
| Rate for Payer: VA VA |
$11,831.91
|
|
|
MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT
|
Facility
|
IP
|
$23,772.24
|
|
|
Service Code
|
MSDRG 115
|
| Min. Negotiated Rate |
$14,570.08 |
| Max. Negotiated Rate |
$23,772.24 |
| Rate for Payer: Aetna Medicare |
$15,336.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,171.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,171.16
|
| Rate for Payer: BCBS MAPPO |
$15,336.93
|
| Rate for Payer: BCN Medicare Advantage |
$15,336.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,336.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,336.93
|
| Rate for Payer: Mclaren Medicare |
$15,336.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,103.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,637.47
|
| Rate for Payer: PACE Medicare |
$14,570.08
|
| Rate for Payer: PACE SWMI |
$15,336.93
|
| Rate for Payer: PHP Commercial |
$16,870.62
|
| Rate for Payer: PHP Medicare Advantage |
$15,336.93
|
| Rate for Payer: Priority Health Medicare |
$15,336.93
|
| Rate for Payer: Railroad Medicare Medicare |
$15,336.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,336.93
|
| Rate for Payer: UHC Exchange |
$23,772.24
|
| Rate for Payer: UHC Medicare Advantage |
$15,336.93
|
| Rate for Payer: UHCCP DNSP |
$15,336.93
|
| Rate for Payer: VA VA |
$15,336.93
|
|
|
MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE
|
Facility
|
IP
|
$84,818.79
|
|
|
Service Code
|
MSDRG 790
|
| Min. Negotiated Rate |
$51,985.71 |
| Max. Negotiated Rate |
$84,818.79 |
| Rate for Payer: Aetna Medicare |
$54,721.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68,402.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68,402.25
|
| Rate for Payer: BCBS MAPPO |
$54,721.80
|
| Rate for Payer: BCN Medicare Advantage |
$54,721.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54,721.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$54,721.80
|
| Rate for Payer: Mclaren Medicare |
$54,721.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57,457.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62,930.07
|
| Rate for Payer: PACE Medicare |
$51,985.71
|
| Rate for Payer: PACE SWMI |
$54,721.80
|
| Rate for Payer: PHP Commercial |
$60,193.98
|
| Rate for Payer: PHP Medicare Advantage |
$54,721.80
|
| Rate for Payer: Priority Health Medicare |
$54,721.80
|
| Rate for Payer: Railroad Medicare Medicare |
$54,721.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$54,721.80
|
| Rate for Payer: UHC Exchange |
$84,818.79
|
| Rate for Payer: UHC Medicare Advantage |
$54,721.80
|
| Rate for Payer: UHCCP DNSP |
$54,721.80
|
| Rate for Payer: VA VA |
$54,721.80
|
|
|
MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
|
IP
|
$21,438.95
|
|
|
Service Code
|
MSDRG 748
|
| Min. Negotiated Rate |
$13,140.00 |
| Max. Negotiated Rate |
$21,438.95 |
| Rate for Payer: Aetna Medicare |
$13,831.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,289.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,289.47
|
| Rate for Payer: BCBS MAPPO |
$13,831.58
|
| Rate for Payer: BCN Medicare Advantage |
$13,831.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,831.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,831.58
|
| Rate for Payer: Mclaren Medicare |
$13,831.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,523.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,906.32
|
| Rate for Payer: PACE Medicare |
$13,140.00
|
| Rate for Payer: PACE SWMI |
$13,831.58
|
| Rate for Payer: PHP Commercial |
$15,214.74
|
| Rate for Payer: PHP Medicare Advantage |
$13,831.58
|
| Rate for Payer: Priority Health Medicare |
$13,831.58
|
| Rate for Payer: Railroad Medicare Medicare |
$13,831.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,831.58
|
| Rate for Payer: UHC Exchange |
$21,438.95
|
| Rate for Payer: UHC Medicare Advantage |
$13,831.58
|
| Rate for Payer: UHCCP DNSP |
$13,831.58
|
| Rate for Payer: VA VA |
$13,831.58
|
|
|
MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$15,017.30
|
|
|
Service Code
|
MSDRG 864
|
| Min. Negotiated Rate |
$9,204.15 |
| Max. Negotiated Rate |
$15,017.30 |
| Rate for Payer: Aetna Medicare |
$9,688.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,110.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,110.73
|
| Rate for Payer: BCBS MAPPO |
$9,688.58
|
| Rate for Payer: BCN Medicare Advantage |
$9,688.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,688.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,688.58
|
| Rate for Payer: Mclaren Medicare |
$9,688.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,173.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,141.87
|
| Rate for Payer: PACE Medicare |
$9,204.15
|
| Rate for Payer: PACE SWMI |
$9,688.58
|
| Rate for Payer: PHP Commercial |
$10,657.44
|
| Rate for Payer: PHP Medicare Advantage |
$9,688.58
|
| Rate for Payer: Priority Health Medicare |
$9,688.58
|
| Rate for Payer: Railroad Medicare Medicare |
$9,688.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,688.58
|
| Rate for Payer: UHC Exchange |
$15,017.30
|
| Rate for Payer: UHC Medicare Advantage |
$9,688.58
|
| Rate for Payer: UHCCP DNSP |
$9,688.58
|
| Rate for Payer: VA VA |
$9,688.58
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH CC
|
Facility
|
IP
|
$26,870.32
|
|
|
Service Code
|
MSDRG 504
|
| Min. Negotiated Rate |
$16,468.91 |
| Max. Negotiated Rate |
$26,870.32 |
| Rate for Payer: Aetna Medicare |
$17,335.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,669.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,669.61
|
| Rate for Payer: BCBS MAPPO |
$17,335.69
|
| Rate for Payer: BCN Medicare Advantage |
$17,335.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,335.69
|
| Rate for Payer: Mclaren Medicare |
$17,335.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,202.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,936.04
|
| Rate for Payer: PACE Medicare |
$16,468.91
|
| Rate for Payer: PACE SWMI |
$17,335.69
|
| Rate for Payer: PHP Commercial |
$19,069.26
|
| Rate for Payer: PHP Medicare Advantage |
$17,335.69
|
| Rate for Payer: Priority Health Medicare |
$17,335.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17,335.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,335.69
|
| Rate for Payer: UHC Exchange |
$26,870.32
|
| Rate for Payer: UHC Medicare Advantage |
$17,335.69
|
| Rate for Payer: UHCCP DNSP |
$17,335.69
|
| Rate for Payer: VA VA |
$17,335.69
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITH MCC
|
Facility
|
IP
|
$39,201.90
|
|
|
Service Code
|
MSDRG 503
|
| Min. Negotiated Rate |
$24,026.97 |
| Max. Negotiated Rate |
$39,201.90 |
| Rate for Payer: Aetna Medicare |
$25,291.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,614.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,614.44
|
| Rate for Payer: BCBS MAPPO |
$25,291.55
|
| Rate for Payer: BCN Medicare Advantage |
$25,291.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,291.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,291.55
|
| Rate for Payer: Mclaren Medicare |
$25,291.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,556.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,085.28
|
| Rate for Payer: PACE Medicare |
$24,026.97
|
| Rate for Payer: PACE SWMI |
$25,291.55
|
| Rate for Payer: PHP Commercial |
$27,820.71
|
| Rate for Payer: PHP Medicare Advantage |
$25,291.55
|
| Rate for Payer: Priority Health Medicare |
$25,291.55
|
| Rate for Payer: Railroad Medicare Medicare |
$25,291.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,291.55
|
| Rate for Payer: UHC Exchange |
$39,201.90
|
| Rate for Payer: UHC Medicare Advantage |
$25,291.55
|
| Rate for Payer: UHCCP DNSP |
$25,291.55
|
| Rate for Payer: VA VA |
$25,291.55
|
|
|
MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,870.32
|
|
|
Service Code
|
MSDRG 505
|
| Min. Negotiated Rate |
$16,468.91 |
| Max. Negotiated Rate |
$26,870.32 |
| Rate for Payer: Aetna Medicare |
$17,335.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,669.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,669.61
|
| Rate for Payer: BCBS MAPPO |
$17,335.69
|
| Rate for Payer: BCN Medicare Advantage |
$17,335.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,335.69
|
| Rate for Payer: Mclaren Medicare |
$17,335.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,202.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,936.04
|
| Rate for Payer: PACE Medicare |
$16,468.91
|
| Rate for Payer: PACE SWMI |
$17,335.69
|
| Rate for Payer: PHP Commercial |
$19,069.26
|
| Rate for Payer: PHP Medicare Advantage |
$17,335.69
|
| Rate for Payer: Priority Health Medicare |
$17,335.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17,335.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,335.69
|
| Rate for Payer: UHC Exchange |
$26,870.32
|
| Rate for Payer: UHC Medicare Advantage |
$17,335.69
|
| Rate for Payer: UHCCP DNSP |
$17,335.69
|
| Rate for Payer: VA VA |
$17,335.69
|
|
|
MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC
|
Facility
|
IP
|
$23,687.86
|
|
|
Service Code
|
MSDRG 533
|
| Min. Negotiated Rate |
$14,518.37 |
| Max. Negotiated Rate |
$23,687.86 |
| Rate for Payer: Aetna Medicare |
$15,282.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,103.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,103.11
|
| Rate for Payer: BCBS MAPPO |
$15,282.49
|
| Rate for Payer: BCN Medicare Advantage |
$15,282.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,282.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$15,282.49
|
| Rate for Payer: Mclaren Medicare |
$15,282.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,046.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,574.86
|
| Rate for Payer: PACE Medicare |
$14,518.37
|
| Rate for Payer: PACE SWMI |
$15,282.49
|
| Rate for Payer: PHP Commercial |
$16,810.74
|
| Rate for Payer: PHP Medicare Advantage |
$15,282.49
|
| Rate for Payer: Priority Health Medicare |
$15,282.49
|
| Rate for Payer: Railroad Medicare Medicare |
$15,282.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,282.49
|
| Rate for Payer: UHC Exchange |
$23,687.86
|
| Rate for Payer: UHC Medicare Advantage |
$15,282.49
|
| Rate for Payer: UHCCP DNSP |
$15,282.49
|
| Rate for Payer: VA VA |
$15,282.49
|
|
|
MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
|
IP
|
$13,855.51
|
|
|
Service Code
|
MSDRG 534
|
| Min. Negotiated Rate |
$8,492.09 |
| Max. Negotiated Rate |
$13,855.51 |
| Rate for Payer: Aetna Medicare |
$8,939.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,173.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,173.80
|
| Rate for Payer: BCBS MAPPO |
$8,939.04
|
| Rate for Payer: BCN Medicare Advantage |
$8,939.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,939.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,939.04
|
| Rate for Payer: Mclaren Medicare |
$8,939.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,385.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,279.90
|
| Rate for Payer: PACE Medicare |
$8,492.09
|
| Rate for Payer: PACE SWMI |
$8,939.04
|
| Rate for Payer: PHP Commercial |
$9,832.94
|
| Rate for Payer: PHP Medicare Advantage |
$8,939.04
|
| Rate for Payer: Priority Health Medicare |
$8,939.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8,939.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,939.04
|
| Rate for Payer: UHC Exchange |
$13,855.51
|
| Rate for Payer: UHC Medicare Advantage |
$8,939.04
|
| Rate for Payer: UHCCP DNSP |
$8,939.04
|
| Rate for Payer: VA VA |
$8,939.04
|
|
|
MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
|
IP
|
$20,990.84
|
|
|
Service Code
|
MSDRG 535
|
| Min. Negotiated Rate |
$12,865.36 |
| Max. Negotiated Rate |
$20,990.84 |
| Rate for Payer: Aetna Medicare |
$13,542.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,928.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,928.10
|
| Rate for Payer: BCBS MAPPO |
$13,542.48
|
| Rate for Payer: BCN Medicare Advantage |
$13,542.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,542.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,542.48
|
| Rate for Payer: Mclaren Medicare |
$13,542.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,219.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,573.85
|
| Rate for Payer: PACE Medicare |
$12,865.36
|
| Rate for Payer: PACE SWMI |
$13,542.48
|
| Rate for Payer: PHP Commercial |
$14,896.73
|
| Rate for Payer: PHP Medicare Advantage |
$13,542.48
|
| Rate for Payer: Priority Health Medicare |
$13,542.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13,542.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,542.48
|
| Rate for Payer: UHC Exchange |
$20,990.84
|
| Rate for Payer: UHC Medicare Advantage |
$13,542.48
|
| Rate for Payer: UHCCP DNSP |
$13,542.48
|
| Rate for Payer: VA VA |
$13,542.48
|
|
|
MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
|
IP
|
$13,812.64
|
|
|
Service Code
|
MSDRG 536
|
| Min. Negotiated Rate |
$8,465.81 |
| Max. Negotiated Rate |
$13,812.64 |
| Rate for Payer: Aetna Medicare |
$8,911.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,139.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,139.23
|
| Rate for Payer: BCBS MAPPO |
$8,911.38
|
| Rate for Payer: BCN Medicare Advantage |
$8,911.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,911.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,911.38
|
| Rate for Payer: Mclaren Medicare |
$8,911.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,356.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,248.09
|
| Rate for Payer: PACE Medicare |
$8,465.81
|
| Rate for Payer: PACE SWMI |
$8,911.38
|
| Rate for Payer: PHP Commercial |
$9,802.52
|
| Rate for Payer: PHP Medicare Advantage |
$8,911.38
|
| Rate for Payer: Priority Health Medicare |
$8,911.38
|
| Rate for Payer: Railroad Medicare Medicare |
$8,911.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,911.38
|
| Rate for Payer: UHC Exchange |
$13,812.64
|
| Rate for Payer: UHC Medicare Advantage |
$8,911.38
|
| Rate for Payer: UHCCP DNSP |
$8,911.38
|
| Rate for Payer: VA VA |
$8,911.38
|
|
|
MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC
|
Facility
|
IP
|
$22,838.63
|
|
|
Service Code
|
MSDRG 562
|
| Min. Negotiated Rate |
$13,997.87 |
| Max. Negotiated Rate |
$22,838.63 |
| Rate for Payer: Aetna Medicare |
$14,734.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,418.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,418.25
|
| Rate for Payer: BCBS MAPPO |
$14,734.60
|
| Rate for Payer: BCN Medicare Advantage |
$14,734.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,734.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,734.60
|
| Rate for Payer: Mclaren Medicare |
$14,734.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,471.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,944.79
|
| Rate for Payer: PACE Medicare |
$13,997.87
|
| Rate for Payer: PACE SWMI |
$14,734.60
|
| Rate for Payer: PHP Commercial |
$16,208.06
|
| Rate for Payer: PHP Medicare Advantage |
$14,734.60
|
| Rate for Payer: Priority Health Medicare |
$14,734.60
|
| Rate for Payer: Railroad Medicare Medicare |
$14,734.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,734.60
|
| Rate for Payer: UHC Exchange |
$22,838.63
|
| Rate for Payer: UHC Medicare Advantage |
$14,734.60
|
| Rate for Payer: UHCCP DNSP |
$14,734.60
|
| Rate for Payer: VA VA |
$14,734.60
|
|
|
MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC
|
Facility
|
IP
|
$14,959.20
|
|
|
Service Code
|
MSDRG 563
|
| Min. Negotiated Rate |
$9,168.55 |
| Max. Negotiated Rate |
$14,959.20 |
| Rate for Payer: Aetna Medicare |
$9,651.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,063.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,063.88
|
| Rate for Payer: BCBS MAPPO |
$9,651.10
|
| Rate for Payer: BCN Medicare Advantage |
$9,651.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,651.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,651.10
|
| Rate for Payer: Mclaren Medicare |
$9,651.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,133.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,098.76
|
| Rate for Payer: PACE Medicare |
$9,168.55
|
| Rate for Payer: PACE SWMI |
$9,651.10
|
| Rate for Payer: PHP Commercial |
$10,616.21
|
| Rate for Payer: PHP Medicare Advantage |
$9,651.10
|
| Rate for Payer: Priority Health Medicare |
$9,651.10
|
| Rate for Payer: Railroad Medicare Medicare |
$9,651.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,651.10
|
| Rate for Payer: UHC Exchange |
$14,959.20
|
| Rate for Payer: UHC Medicare Advantage |
$9,651.10
|
| Rate for Payer: UHCCP DNSP |
$9,651.10
|
| Rate for Payer: VA VA |
$9,651.10
|
|
|
MS-DRG 42.00: FULL TERM NEONATE WITH MAJOR PROBLEMS
|
Facility
|
IP
|
$60,278.71
|
|
|
Service Code
|
MSDRG 793
|
| Min. Negotiated Rate |
$36,945.02 |
| Max. Negotiated Rate |
$60,278.71 |
| Rate for Payer: Aetna Medicare |
$38,889.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48,611.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48,611.86
|
| Rate for Payer: BCBS MAPPO |
$38,889.49
|
| Rate for Payer: BCN Medicare Advantage |
$38,889.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,889.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$38,889.49
|
| Rate for Payer: Mclaren Medicare |
$38,889.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40,833.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,722.91
|
| Rate for Payer: PACE Medicare |
$36,945.02
|
| Rate for Payer: PACE SWMI |
$38,889.49
|
| Rate for Payer: PHP Commercial |
$42,778.44
|
| Rate for Payer: PHP Medicare Advantage |
$38,889.49
|
| Rate for Payer: Priority Health Medicare |
$38,889.49
|
| Rate for Payer: Railroad Medicare Medicare |
$38,889.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$38,889.49
|
| Rate for Payer: UHC Exchange |
$60,278.71
|
| Rate for Payer: UHC Medicare Advantage |
$38,889.49
|
| Rate for Payer: UHCCP DNSP |
$38,889.49
|
| Rate for Payer: VA VA |
$38,889.49
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY
|
Facility
|
IP
|
$32,275.43
|
|
|
Service Code
|
MSDRG 934
|
| Min. Negotiated Rate |
$19,781.72 |
| Max. Negotiated Rate |
$32,275.43 |
| Rate for Payer: Aetna Medicare |
$20,822.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,028.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,028.58
|
| Rate for Payer: BCBS MAPPO |
$20,822.86
|
| Rate for Payer: BCN Medicare Advantage |
$20,822.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,822.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,822.86
|
| Rate for Payer: Mclaren Medicare |
$20,822.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,864.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,946.29
|
| Rate for Payer: PACE Medicare |
$19,781.72
|
| Rate for Payer: PACE SWMI |
$20,822.86
|
| Rate for Payer: PHP Commercial |
$22,905.15
|
| Rate for Payer: PHP Medicare Advantage |
$20,822.86
|
| Rate for Payer: Priority Health Medicare |
$20,822.86
|
| Rate for Payer: Railroad Medicare Medicare |
$20,822.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,822.86
|
| Rate for Payer: UHC Exchange |
$32,275.43
|
| Rate for Payer: UHC Medicare Advantage |
$20,822.86
|
| Rate for Payer: UHCCP DNSP |
$20,822.86
|
| Rate for Payer: VA VA |
$20,822.86
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC
|
Facility
|
IP
|
$94,972.00
|
|
|
Service Code
|
MSDRG 928
|
| Min. Negotiated Rate |
$58,208.65 |
| Max. Negotiated Rate |
$94,972.00 |
| Rate for Payer: Aetna Medicare |
$61,272.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76,590.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76,590.32
|
| Rate for Payer: BCBS MAPPO |
$61,272.26
|
| Rate for Payer: BCN Medicare Advantage |
$61,272.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61,272.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$61,272.26
|
| Rate for Payer: Mclaren Medicare |
$61,272.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64,335.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70,463.10
|
| Rate for Payer: PACE Medicare |
$58,208.65
|
| Rate for Payer: PACE SWMI |
$61,272.26
|
| Rate for Payer: PHP Commercial |
$67,399.49
|
| Rate for Payer: PHP Medicare Advantage |
$61,272.26
|
| Rate for Payer: Priority Health Medicare |
$61,272.26
|
| Rate for Payer: Railroad Medicare Medicare |
$61,272.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$61,272.26
|
| Rate for Payer: UHC Exchange |
$94,972.00
|
| Rate for Payer: UHC Medicare Advantage |
$61,272.26
|
| Rate for Payer: UHCCP DNSP |
$61,272.26
|
| Rate for Payer: VA VA |
$61,272.26
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC
|
Facility
|
IP
|
$46,584.80
|
|
|
Service Code
|
MSDRG 929
|
| Min. Negotiated Rate |
$28,551.97 |
| Max. Negotiated Rate |
$46,584.80 |
| Rate for Payer: Aetna Medicare |
$30,054.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37,568.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37,568.39
|
| Rate for Payer: BCBS MAPPO |
$30,054.71
|
| Rate for Payer: BCN Medicare Advantage |
$30,054.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,054.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$30,054.71
|
| Rate for Payer: Mclaren Medicare |
$30,054.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,557.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,562.92
|
| Rate for Payer: PACE Medicare |
$28,551.97
|
| Rate for Payer: PACE SWMI |
$30,054.71
|
| Rate for Payer: PHP Commercial |
$33,060.18
|
| Rate for Payer: PHP Medicare Advantage |
$30,054.71
|
| Rate for Payer: Priority Health Medicare |
$30,054.71
|
| Rate for Payer: Railroad Medicare Medicare |
$30,054.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,054.71
|
| Rate for Payer: UHC Exchange |
$46,584.80
|
| Rate for Payer: UHC Medicare Advantage |
$30,054.71
|
| Rate for Payer: UHCCP DNSP |
$30,054.71
|
| Rate for Payer: VA VA |
$30,054.71
|
|
|
MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH CC
|
Facility
|
IP
|
$16,233.04
|
|
|
Service Code
|
MSDRG 378
|
| Min. Negotiated Rate |
$9,949.28 |
| Max. Negotiated Rate |
$16,233.04 |
| Rate for Payer: Aetna Medicare |
$10,472.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,091.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,091.16
|
| Rate for Payer: BCBS MAPPO |
$10,472.93
|
| Rate for Payer: BCN Medicare Advantage |
$10,472.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,472.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,472.93
|
| Rate for Payer: Mclaren Medicare |
$10,472.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,996.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,043.87
|
| Rate for Payer: PACE Medicare |
$9,949.28
|
| Rate for Payer: PACE SWMI |
$10,472.93
|
| Rate for Payer: PHP Commercial |
$11,520.22
|
| Rate for Payer: PHP Medicare Advantage |
$10,472.93
|
| Rate for Payer: Priority Health Medicare |
$10,472.93
|
| Rate for Payer: Railroad Medicare Medicare |
$10,472.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,472.93
|
| Rate for Payer: UHC Exchange |
$16,233.04
|
| Rate for Payer: UHC Medicare Advantage |
$10,472.93
|
| Rate for Payer: UHCCP DNSP |
$10,472.93
|
| Rate for Payer: VA VA |
$10,472.93
|
|
|
MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH MCC
|
Facility
|
IP
|
$27,744.44
|
|
|
Service Code
|
MSDRG 377
|
| Min. Negotiated Rate |
$17,004.66 |
| Max. Negotiated Rate |
$27,744.44 |
| Rate for Payer: Aetna Medicare |
$17,899.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,374.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,374.55
|
| Rate for Payer: BCBS MAPPO |
$17,899.64
|
| Rate for Payer: BCN Medicare Advantage |
$17,899.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,899.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,899.64
|
| Rate for Payer: Mclaren Medicare |
$17,899.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,794.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,584.59
|
| Rate for Payer: PACE Medicare |
$17,004.66
|
| Rate for Payer: PACE SWMI |
$17,899.64
|
| Rate for Payer: PHP Commercial |
$19,689.60
|
| Rate for Payer: PHP Medicare Advantage |
$17,899.64
|
| Rate for Payer: Priority Health Medicare |
$17,899.64
|
| Rate for Payer: Railroad Medicare Medicare |
$17,899.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,899.64
|
| Rate for Payer: UHC Exchange |
$27,744.44
|
| Rate for Payer: UHC Medicare Advantage |
$17,899.64
|
| Rate for Payer: UHCCP DNSP |
$17,899.64
|
| Rate for Payer: VA VA |
$17,899.64
|
|
