|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$59,439.18
|
|
|
Service Code
|
MSDRG 958
|
| Min. Negotiated Rate |
$36,430.47 |
| Max. Negotiated Rate |
$59,439.18 |
| Rate for Payer: Aetna Medicare |
$38,347.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47,934.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47,934.82
|
| Rate for Payer: BCBS MAPPO |
$38,347.86
|
| Rate for Payer: BCN Medicare Advantage |
$38,347.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,347.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$38,347.86
|
| Rate for Payer: Mclaren Medicare |
$38,347.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40,265.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,100.04
|
| Rate for Payer: PACE Medicare |
$36,430.47
|
| Rate for Payer: PACE SWMI |
$38,347.86
|
| Rate for Payer: PHP Commercial |
$42,182.65
|
| Rate for Payer: PHP Medicare Advantage |
$38,347.86
|
| Rate for Payer: Priority Health Medicare |
$38,347.86
|
| Rate for Payer: Railroad Medicare Medicare |
$38,347.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$38,347.86
|
| Rate for Payer: UHC Exchange |
$59,439.18
|
| Rate for Payer: UHC Medicare Advantage |
$38,347.86
|
| Rate for Payer: UHCCP DNSP |
$38,347.86
|
| Rate for Payer: VA VA |
$38,347.86
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$105,833.36
|
|
|
Service Code
|
MSDRG 957
|
| Min. Negotiated Rate |
$64,865.61 |
| Max. Negotiated Rate |
$105,833.36 |
| Rate for Payer: Aetna Medicare |
$68,279.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85,349.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85,349.49
|
| Rate for Payer: BCBS MAPPO |
$68,279.59
|
| Rate for Payer: BCN Medicare Advantage |
$68,279.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68,279.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$68,279.59
|
| Rate for Payer: Mclaren Medicare |
$68,279.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71,693.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78,521.53
|
| Rate for Payer: PACE Medicare |
$64,865.61
|
| Rate for Payer: PACE SWMI |
$68,279.59
|
| Rate for Payer: PHP Commercial |
$75,107.55
|
| Rate for Payer: PHP Medicare Advantage |
$68,279.59
|
| Rate for Payer: Priority Health Medicare |
$68,279.59
|
| Rate for Payer: Railroad Medicare Medicare |
$68,279.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$68,279.59
|
| Rate for Payer: UHC Exchange |
$105,833.36
|
| Rate for Payer: UHC Medicare Advantage |
$68,279.59
|
| Rate for Payer: UHCCP DNSP |
$68,279.59
|
| Rate for Payer: VA VA |
$68,279.59
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$39,164.56
|
|
|
Service Code
|
MSDRG 959
|
| Min. Negotiated Rate |
$24,004.09 |
| Max. Negotiated Rate |
$39,164.56 |
| Rate for Payer: Aetna Medicare |
$25,267.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,584.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,584.33
|
| Rate for Payer: BCBS MAPPO |
$25,267.46
|
| Rate for Payer: BCN Medicare Advantage |
$25,267.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,267.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25,267.46
|
| Rate for Payer: Mclaren Medicare |
$25,267.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26,530.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,057.58
|
| Rate for Payer: PACE Medicare |
$24,004.09
|
| Rate for Payer: PACE SWMI |
$25,267.46
|
| Rate for Payer: PHP Commercial |
$27,794.21
|
| Rate for Payer: PHP Medicare Advantage |
$25,267.46
|
| Rate for Payer: Priority Health Medicare |
$25,267.46
|
| Rate for Payer: Railroad Medicare Medicare |
$25,267.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,267.46
|
| Rate for Payer: UHC Exchange |
$39,164.56
|
| Rate for Payer: UHC Medicare Advantage |
$25,267.46
|
| Rate for Payer: UHCCP DNSP |
$25,267.46
|
| Rate for Payer: VA VA |
$25,267.46
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC
|
Facility
|
IP
|
$27,216.08
|
|
|
Service Code
|
MSDRG 803
|
| Min. Negotiated Rate |
$16,680.82 |
| Max. Negotiated Rate |
$27,216.08 |
| Rate for Payer: Aetna Medicare |
$17,558.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,948.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,948.45
|
| Rate for Payer: BCBS MAPPO |
$17,558.76
|
| Rate for Payer: BCN Medicare Advantage |
$17,558.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,558.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,558.76
|
| Rate for Payer: Mclaren Medicare |
$17,558.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,436.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,192.57
|
| Rate for Payer: PACE Medicare |
$16,680.82
|
| Rate for Payer: PACE SWMI |
$17,558.76
|
| Rate for Payer: PHP Commercial |
$19,314.64
|
| Rate for Payer: PHP Medicare Advantage |
$17,558.76
|
| Rate for Payer: Priority Health Medicare |
$17,558.76
|
| Rate for Payer: Railroad Medicare Medicare |
$17,558.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,558.76
|
| Rate for Payer: UHC Exchange |
$27,216.08
|
| Rate for Payer: UHC Medicare Advantage |
$17,558.76
|
| Rate for Payer: UHCCP DNSP |
$17,558.76
|
| Rate for Payer: VA VA |
$17,558.76
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC
|
Facility
|
IP
|
$52,178.01
|
|
|
Service Code
|
MSDRG 802
|
| Min. Negotiated Rate |
$31,980.07 |
| Max. Negotiated Rate |
$52,178.01 |
| Rate for Payer: Aetna Medicare |
$33,663.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42,079.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42,079.04
|
| Rate for Payer: BCBS MAPPO |
$33,663.23
|
| Rate for Payer: BCN Medicare Advantage |
$33,663.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33,663.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$33,663.23
|
| Rate for Payer: Mclaren Medicare |
$33,663.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35,346.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38,712.71
|
| Rate for Payer: PACE Medicare |
$31,980.07
|
| Rate for Payer: PACE SWMI |
$33,663.23
|
| Rate for Payer: PHP Commercial |
$37,029.55
|
| Rate for Payer: PHP Medicare Advantage |
$33,663.23
|
| Rate for Payer: Priority Health Medicare |
$33,663.23
|
| Rate for Payer: Railroad Medicare Medicare |
$33,663.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$33,663.23
|
| Rate for Payer: UHC Exchange |
$52,178.01
|
| Rate for Payer: UHC Medicare Advantage |
$33,663.23
|
| Rate for Payer: UHCCP DNSP |
$33,663.23
|
| Rate for Payer: VA VA |
$33,663.23
|
|
|
MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC
|
Facility
|
IP
|
$17,888.60
|
|
|
Service Code
|
MSDRG 804
|
| Min. Negotiated Rate |
$10,963.98 |
| Max. Negotiated Rate |
$17,888.60 |
| Rate for Payer: Aetna Medicare |
$11,541.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,426.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,426.29
|
| Rate for Payer: BCBS MAPPO |
$11,541.03
|
| Rate for Payer: BCN Medicare Advantage |
$11,541.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,541.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,541.03
|
| Rate for Payer: Mclaren Medicare |
$11,541.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,118.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,272.18
|
| Rate for Payer: PACE Medicare |
$10,963.98
|
| Rate for Payer: PACE SWMI |
$11,541.03
|
| Rate for Payer: PHP Commercial |
$12,695.13
|
| Rate for Payer: PHP Medicare Advantage |
$11,541.03
|
| Rate for Payer: Priority Health Medicare |
$11,541.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11,541.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,541.03
|
| Rate for Payer: UHC Exchange |
$17,888.60
|
| Rate for Payer: UHC Medicare Advantage |
$11,541.03
|
| Rate for Payer: UHCCP DNSP |
$11,541.03
|
| Rate for Payer: VA VA |
$11,541.03
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$28,707.05
|
|
|
Service Code
|
MSDRG 205
|
| Min. Negotiated Rate |
$17,594.65 |
| Max. Negotiated Rate |
$28,707.05 |
| Rate for Payer: Aetna Medicare |
$18,520.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,150.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,150.85
|
| Rate for Payer: BCBS MAPPO |
$18,520.68
|
| Rate for Payer: BCN Medicare Advantage |
$18,520.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,520.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,520.68
|
| Rate for Payer: Mclaren Medicare |
$18,520.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,446.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,298.78
|
| Rate for Payer: PACE Medicare |
$17,594.65
|
| Rate for Payer: PACE SWMI |
$18,520.68
|
| Rate for Payer: PHP Commercial |
$20,372.75
|
| Rate for Payer: PHP Medicare Advantage |
$18,520.68
|
| Rate for Payer: Priority Health Medicare |
$18,520.68
|
| Rate for Payer: Railroad Medicare Medicare |
$18,520.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,520.68
|
| Rate for Payer: UHC Exchange |
$28,707.05
|
| Rate for Payer: UHC Medicare Advantage |
$18,520.68
|
| Rate for Payer: UHCCP DNSP |
$18,520.68
|
| Rate for Payer: VA VA |
$18,520.68
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$15,125.19
|
|
|
Service Code
|
MSDRG 206
|
| Min. Negotiated Rate |
$9,270.28 |
| Max. Negotiated Rate |
$15,125.19 |
| Rate for Payer: Aetna Medicare |
$9,758.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,197.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,197.74
|
| Rate for Payer: BCBS MAPPO |
$9,758.19
|
| Rate for Payer: BCN Medicare Advantage |
$9,758.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,758.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,758.19
|
| Rate for Payer: Mclaren Medicare |
$9,758.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,246.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,221.92
|
| Rate for Payer: PACE Medicare |
$9,270.28
|
| Rate for Payer: PACE SWMI |
$9,758.19
|
| Rate for Payer: PHP Commercial |
$10,734.01
|
| Rate for Payer: PHP Medicare Advantage |
$9,758.19
|
| Rate for Payer: Priority Health Medicare |
$9,758.19
|
| Rate for Payer: Railroad Medicare Medicare |
$9,758.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,758.19
|
| Rate for Payer: UHC Exchange |
$15,125.19
|
| Rate for Payer: UHC Medicare Advantage |
$9,758.19
|
| Rate for Payer: UHCCP DNSP |
$9,758.19
|
| Rate for Payer: VA VA |
$9,758.19
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$27,868.92
|
|
|
Service Code
|
MSDRG 167
|
| Min. Negotiated Rate |
$17,080.95 |
| Max. Negotiated Rate |
$27,868.92 |
| Rate for Payer: Aetna Medicare |
$17,979.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,474.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,474.94
|
| Rate for Payer: BCBS MAPPO |
$17,979.95
|
| Rate for Payer: BCN Medicare Advantage |
$17,979.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,979.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,979.95
|
| Rate for Payer: Mclaren Medicare |
$17,979.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,878.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,676.94
|
| Rate for Payer: PACE Medicare |
$17,080.95
|
| Rate for Payer: PACE SWMI |
$17,979.95
|
| Rate for Payer: PHP Commercial |
$19,777.94
|
| Rate for Payer: PHP Medicare Advantage |
$17,979.95
|
| Rate for Payer: Priority Health Medicare |
$17,979.95
|
| Rate for Payer: Railroad Medicare Medicare |
$17,979.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,979.95
|
| Rate for Payer: UHC Exchange |
$27,868.92
|
| Rate for Payer: UHC Medicare Advantage |
$17,979.95
|
| Rate for Payer: UHCCP DNSP |
$17,979.95
|
| Rate for Payer: VA VA |
$17,979.95
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$55,850.08
|
|
|
Service Code
|
MSDRG 166
|
| Min. Negotiated Rate |
$34,230.69 |
| Max. Negotiated Rate |
$55,850.08 |
| Rate for Payer: Aetna Medicare |
$36,032.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45,040.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45,040.39
|
| Rate for Payer: BCBS MAPPO |
$36,032.31
|
| Rate for Payer: BCN Medicare Advantage |
$36,032.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36,032.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$36,032.31
|
| Rate for Payer: Mclaren Medicare |
$36,032.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37,833.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41,437.16
|
| Rate for Payer: PACE Medicare |
$34,230.69
|
| Rate for Payer: PACE SWMI |
$36,032.31
|
| Rate for Payer: PHP Commercial |
$39,635.54
|
| Rate for Payer: PHP Medicare Advantage |
$36,032.31
|
| Rate for Payer: Priority Health Medicare |
$36,032.31
|
| Rate for Payer: Railroad Medicare Medicare |
$36,032.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$36,032.31
|
| Rate for Payer: UHC Exchange |
$55,850.08
|
| Rate for Payer: UHC Medicare Advantage |
$36,032.31
|
| Rate for Payer: UHCCP DNSP |
$36,032.31
|
| Rate for Payer: VA VA |
$36,032.31
|
|
|
MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$21,322.78
|
|
|
Service Code
|
MSDRG 168
|
| Min. Negotiated Rate |
$13,068.80 |
| Max. Negotiated Rate |
$21,322.78 |
| Rate for Payer: Aetna Medicare |
$13,756.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,195.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,195.79
|
| Rate for Payer: BCBS MAPPO |
$13,756.63
|
| Rate for Payer: BCN Medicare Advantage |
$13,756.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,756.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,756.63
|
| Rate for Payer: Mclaren Medicare |
$13,756.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,444.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,820.12
|
| Rate for Payer: PACE Medicare |
$13,068.80
|
| Rate for Payer: PACE SWMI |
$13,756.63
|
| Rate for Payer: PHP Commercial |
$15,132.29
|
| Rate for Payer: PHP Medicare Advantage |
$13,756.63
|
| Rate for Payer: Priority Health Medicare |
$13,756.63
|
| Rate for Payer: Railroad Medicare Medicare |
$13,756.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,756.63
|
| Rate for Payer: UHC Exchange |
$21,322.78
|
| Rate for Payer: UHC Medicare Advantage |
$13,756.63
|
| Rate for Payer: UHCCP DNSP |
$13,756.63
|
| Rate for Payer: VA VA |
$13,756.63
|
|
|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$27,119.26
|
|
|
Service Code
|
MSDRG 580
|
| Min. Negotiated Rate |
$16,621.49 |
| Max. Negotiated Rate |
$27,119.26 |
| Rate for Payer: Aetna Medicare |
$17,496.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,870.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,870.38
|
| Rate for Payer: BCBS MAPPO |
$17,496.30
|
| Rate for Payer: BCN Medicare Advantage |
$17,496.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,496.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,496.30
|
| Rate for Payer: Mclaren Medicare |
$17,496.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,371.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,120.74
|
| Rate for Payer: PACE Medicare |
$16,621.49
|
| Rate for Payer: PACE SWMI |
$17,496.30
|
| Rate for Payer: PHP Commercial |
$19,245.93
|
| Rate for Payer: PHP Medicare Advantage |
$17,496.30
|
| Rate for Payer: Priority Health Medicare |
$17,496.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17,496.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,496.30
|
| Rate for Payer: UHC Exchange |
$27,119.26
|
| Rate for Payer: UHC Medicare Advantage |
$17,496.30
|
| Rate for Payer: UHCCP DNSP |
$17,496.30
|
| Rate for Payer: VA VA |
$17,496.30
|
|
|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$47,677.44
|
|
|
Service Code
|
MSDRG 579
|
| Min. Negotiated Rate |
$29,221.66 |
| Max. Negotiated Rate |
$47,677.44 |
| Rate for Payer: Aetna Medicare |
$30,759.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,449.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,449.55
|
| Rate for Payer: BCBS MAPPO |
$30,759.64
|
| Rate for Payer: BCN Medicare Advantage |
$30,759.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,759.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$30,759.64
|
| Rate for Payer: Mclaren Medicare |
$30,759.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,297.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,373.59
|
| Rate for Payer: PACE Medicare |
$29,221.66
|
| Rate for Payer: PACE SWMI |
$30,759.64
|
| Rate for Payer: PHP Commercial |
$33,835.60
|
| Rate for Payer: PHP Medicare Advantage |
$30,759.64
|
| Rate for Payer: Priority Health Medicare |
$30,759.64
|
| Rate for Payer: Railroad Medicare Medicare |
$30,759.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$30,759.64
|
| Rate for Payer: UHC Exchange |
$47,677.44
|
| Rate for Payer: UHC Medicare Advantage |
$30,759.64
|
| Rate for Payer: UHCCP DNSP |
$30,759.64
|
| Rate for Payer: VA VA |
$30,759.64
|
|
|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,502.53
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$13,791.87 |
| Max. Negotiated Rate |
$22,502.53 |
| Rate for Payer: Aetna Medicare |
$14,517.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,147.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,147.20
|
| Rate for Payer: BCBS MAPPO |
$14,517.76
|
| Rate for Payer: BCN Medicare Advantage |
$14,517.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,517.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,517.76
|
| Rate for Payer: Mclaren Medicare |
$14,517.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,243.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,695.42
|
| Rate for Payer: PACE Medicare |
$13,791.87
|
| Rate for Payer: PACE SWMI |
$14,517.76
|
| Rate for Payer: PHP Commercial |
$15,969.54
|
| Rate for Payer: PHP Medicare Advantage |
$14,517.76
|
| Rate for Payer: Priority Health Medicare |
$14,517.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14,517.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,517.76
|
| Rate for Payer: UHC Exchange |
$22,502.53
|
| Rate for Payer: UHC Medicare Advantage |
$14,517.76
|
| Rate for Payer: UHCCP DNSP |
$14,517.76
|
| Rate for Payer: VA VA |
$14,517.76
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$37,907.34
|
|
|
Service Code
|
MSDRG 253
|
| Min. Negotiated Rate |
$23,233.53 |
| Max. Negotiated Rate |
$37,907.34 |
| Rate for Payer: Aetna Medicare |
$24,456.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,570.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,570.44
|
| Rate for Payer: BCBS MAPPO |
$24,456.35
|
| Rate for Payer: BCN Medicare Advantage |
$24,456.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,456.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$24,456.35
|
| Rate for Payer: Mclaren Medicare |
$24,456.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,679.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,124.80
|
| Rate for Payer: PACE Medicare |
$23,233.53
|
| Rate for Payer: PACE SWMI |
$24,456.35
|
| Rate for Payer: PHP Commercial |
$26,901.99
|
| Rate for Payer: PHP Medicare Advantage |
$24,456.35
|
| Rate for Payer: Priority Health Medicare |
$24,456.35
|
| Rate for Payer: Railroad Medicare Medicare |
$24,456.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,456.35
|
| Rate for Payer: UHC Exchange |
$37,907.34
|
| Rate for Payer: UHC Medicare Advantage |
$24,456.35
|
| Rate for Payer: UHCCP DNSP |
$24,456.35
|
| Rate for Payer: VA VA |
$24,456.35
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$50,042.53
|
|
|
Service Code
|
MSDRG 252
|
| Min. Negotiated Rate |
$30,671.22 |
| Max. Negotiated Rate |
$50,042.53 |
| Rate for Payer: Aetna Medicare |
$32,285.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,356.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,356.88
|
| Rate for Payer: BCBS MAPPO |
$32,285.50
|
| Rate for Payer: BCN Medicare Advantage |
$32,285.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,285.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$32,285.50
|
| Rate for Payer: Mclaren Medicare |
$32,285.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,899.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,128.32
|
| Rate for Payer: PACE Medicare |
$30,671.22
|
| Rate for Payer: PACE SWMI |
$32,285.50
|
| Rate for Payer: PHP Commercial |
$35,514.05
|
| Rate for Payer: PHP Medicare Advantage |
$32,285.50
|
| Rate for Payer: Priority Health Medicare |
$32,285.50
|
| Rate for Payer: Railroad Medicare Medicare |
$32,285.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,285.50
|
| Rate for Payer: UHC Exchange |
$50,042.53
|
| Rate for Payer: UHC Medicare Advantage |
$32,285.50
|
| Rate for Payer: UHCCP DNSP |
$32,285.50
|
| Rate for Payer: VA VA |
$32,285.50
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$26,792.85
|
|
|
Service Code
|
MSDRG 254
|
| Min. Negotiated Rate |
$16,421.42 |
| Max. Negotiated Rate |
$26,792.85 |
| Rate for Payer: Aetna Medicare |
$17,285.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,607.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,607.14
|
| Rate for Payer: BCBS MAPPO |
$17,285.71
|
| Rate for Payer: BCN Medicare Advantage |
$17,285.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,285.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,285.71
|
| Rate for Payer: Mclaren Medicare |
$17,285.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,150.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,878.57
|
| Rate for Payer: PACE Medicare |
$16,421.42
|
| Rate for Payer: PACE SWMI |
$17,285.71
|
| Rate for Payer: PHP Commercial |
$19,014.28
|
| Rate for Payer: PHP Medicare Advantage |
$17,285.71
|
| Rate for Payer: Priority Health Medicare |
$17,285.71
|
| Rate for Payer: Railroad Medicare Medicare |
$17,285.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,285.71
|
| Rate for Payer: UHC Exchange |
$26,792.85
|
| Rate for Payer: UHC Medicare Advantage |
$17,285.71
|
| Rate for Payer: UHCCP DNSP |
$17,285.71
|
| Rate for Payer: VA VA |
$17,285.71
|
|
|
MS-DRG 42.00: OTITIS MEDIA AND URI WITH MCC
|
Facility
|
IP
|
$18,292.45
|
|
|
Service Code
|
MSDRG 152
|
| Min. Negotiated Rate |
$11,211.50 |
| Max. Negotiated Rate |
$18,292.45 |
| Rate for Payer: Aetna Medicare |
$11,801.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,751.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,751.98
|
| Rate for Payer: BCBS MAPPO |
$11,801.58
|
| Rate for Payer: BCN Medicare Advantage |
$11,801.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,801.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,801.58
|
| Rate for Payer: Mclaren Medicare |
$11,801.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,391.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,571.82
|
| Rate for Payer: PACE Medicare |
$11,211.50
|
| Rate for Payer: PACE SWMI |
$11,801.58
|
| Rate for Payer: PHP Commercial |
$12,981.74
|
| Rate for Payer: PHP Medicare Advantage |
$11,801.58
|
| Rate for Payer: Priority Health Medicare |
$11,801.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11,801.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,801.58
|
| Rate for Payer: UHC Exchange |
$18,292.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,801.58
|
| Rate for Payer: UHCCP DNSP |
$11,801.58
|
| Rate for Payer: VA VA |
$11,801.58
|
|
|
MS-DRG 42.00: OTITIS MEDIA AND URI WITHOUT MCC
|
Facility
|
IP
|
$12,440.61
|
|
|
Service Code
|
MSDRG 153
|
| Min. Negotiated Rate |
$7,624.89 |
| Max. Negotiated Rate |
$12,440.61 |
| Rate for Payer: Aetna Medicare |
$8,026.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,032.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,032.75
|
| Rate for Payer: BCBS MAPPO |
$8,026.20
|
| Rate for Payer: BCN Medicare Advantage |
$8,026.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,026.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,026.20
|
| Rate for Payer: Mclaren Medicare |
$8,026.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,427.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,230.13
|
| Rate for Payer: PACE Medicare |
$7,624.89
|
| Rate for Payer: PACE SWMI |
$8,026.20
|
| Rate for Payer: PHP Commercial |
$8,828.82
|
| Rate for Payer: PHP Medicare Advantage |
$8,026.20
|
| Rate for Payer: Priority Health Medicare |
$8,026.20
|
| Rate for Payer: Railroad Medicare Medicare |
$8,026.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,026.20
|
| Rate for Payer: UHC Exchange |
$12,440.61
|
| Rate for Payer: UHC Medicare Advantage |
$8,026.20
|
| Rate for Payer: UHCCP DNSP |
$8,026.20
|
| Rate for Payer: VA VA |
$8,026.20
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$41,439.73
|
|
|
Service Code
|
MSDRG 406
|
| Min. Negotiated Rate |
$25,398.54 |
| Max. Negotiated Rate |
$41,439.73 |
| Rate for Payer: Aetna Medicare |
$26,735.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,419.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,419.14
|
| Rate for Payer: BCBS MAPPO |
$26,735.31
|
| Rate for Payer: BCN Medicare Advantage |
$26,735.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,735.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,735.31
|
| Rate for Payer: Mclaren Medicare |
$26,735.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,072.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,745.61
|
| Rate for Payer: PACE Medicare |
$25,398.54
|
| Rate for Payer: PACE SWMI |
$26,735.31
|
| Rate for Payer: PHP Commercial |
$29,408.84
|
| Rate for Payer: PHP Medicare Advantage |
$26,735.31
|
| Rate for Payer: Priority Health Medicare |
$26,735.31
|
| Rate for Payer: Railroad Medicare Medicare |
$26,735.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,735.31
|
| Rate for Payer: UHC Exchange |
$41,439.73
|
| Rate for Payer: UHC Medicare Advantage |
$26,735.31
|
| Rate for Payer: UHCCP DNSP |
$26,735.31
|
| Rate for Payer: VA VA |
$26,735.31
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$77,680.70
|
|
|
Service Code
|
MSDRG 405
|
| Min. Negotiated Rate |
$47,610.75 |
| Max. Negotiated Rate |
$77,680.70 |
| Rate for Payer: Aetna Medicare |
$50,116.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62,645.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62,645.72
|
| Rate for Payer: BCBS MAPPO |
$50,116.58
|
| Rate for Payer: BCN Medicare Advantage |
$50,116.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50,116.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$50,116.58
|
| Rate for Payer: Mclaren Medicare |
$50,116.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52,622.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57,634.07
|
| Rate for Payer: PACE Medicare |
$47,610.75
|
| Rate for Payer: PACE SWMI |
$50,116.58
|
| Rate for Payer: PHP Commercial |
$55,128.24
|
| Rate for Payer: PHP Medicare Advantage |
$50,116.58
|
| Rate for Payer: Priority Health Medicare |
$50,116.58
|
| Rate for Payer: Railroad Medicare Medicare |
$50,116.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$50,116.58
|
| Rate for Payer: UHC Exchange |
$77,680.70
|
| Rate for Payer: UHC Medicare Advantage |
$50,116.58
|
| Rate for Payer: UHCCP DNSP |
$50,116.58
|
| Rate for Payer: VA VA |
$50,116.58
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,137.13
|
|
|
Service Code
|
MSDRG 407
|
| Min. Negotiated Rate |
$19,696.95 |
| Max. Negotiated Rate |
$32,137.13 |
| Rate for Payer: Aetna Medicare |
$20,733.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,917.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,917.04
|
| Rate for Payer: BCBS MAPPO |
$20,733.63
|
| Rate for Payer: BCN Medicare Advantage |
$20,733.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,733.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$20,733.63
|
| Rate for Payer: Mclaren Medicare |
$20,733.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,770.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,843.67
|
| Rate for Payer: PACE Medicare |
$19,696.95
|
| Rate for Payer: PACE SWMI |
$20,733.63
|
| Rate for Payer: PHP Commercial |
$22,806.99
|
| Rate for Payer: PHP Medicare Advantage |
$20,733.63
|
| Rate for Payer: Priority Health Medicare |
$20,733.63
|
| Rate for Payer: Railroad Medicare Medicare |
$20,733.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,733.63
|
| Rate for Payer: UHC Exchange |
$32,137.13
|
| Rate for Payer: UHC Medicare Advantage |
$20,733.63
|
| Rate for Payer: UHCCP DNSP |
$20,733.63
|
| Rate for Payer: VA VA |
$20,733.63
|
|
|
MS-DRG 42.00: PANCREAS TRANSPLANT
|
Facility
|
IP
|
$112,870.50
|
|
|
Service Code
|
MSDRG 010
|
| Min. Negotiated Rate |
$69,178.70 |
| Max. Negotiated Rate |
$112,870.50 |
| Rate for Payer: Aetna Medicare |
$72,819.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91,024.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91,024.60
|
| Rate for Payer: BCBS MAPPO |
$72,819.68
|
| Rate for Payer: BCN Medicare Advantage |
$72,819.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72,819.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$72,819.68
|
| Rate for Payer: Mclaren Medicare |
$72,819.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76,460.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83,742.63
|
| Rate for Payer: PACE Medicare |
$69,178.70
|
| Rate for Payer: PACE SWMI |
$72,819.68
|
| Rate for Payer: PHP Commercial |
$80,101.65
|
| Rate for Payer: PHP Medicare Advantage |
$72,819.68
|
| Rate for Payer: Priority Health Medicare |
$72,819.68
|
| Rate for Payer: Railroad Medicare Medicare |
$72,819.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$72,819.68
|
| Rate for Payer: UHC Exchange |
$112,870.50
|
| Rate for Payer: UHC Medicare Advantage |
$72,819.68
|
| Rate for Payer: UHCCP DNSP |
$72,819.68
|
| Rate for Payer: VA VA |
$72,819.68
|
|
|
MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
|
IP
|
$17,270.35
|
|
|
Service Code
|
MSDRG 543
|
| Min. Negotiated Rate |
$10,585.05 |
| Max. Negotiated Rate |
$17,270.35 |
| Rate for Payer: Aetna Medicare |
$11,142.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,927.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,927.70
|
| Rate for Payer: BCBS MAPPO |
$11,142.16
|
| Rate for Payer: BCN Medicare Advantage |
$11,142.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,142.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,142.16
|
| Rate for Payer: Mclaren Medicare |
$11,142.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,699.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,813.48
|
| Rate for Payer: PACE Medicare |
$10,585.05
|
| Rate for Payer: PACE SWMI |
$11,142.16
|
| Rate for Payer: PHP Commercial |
$12,256.38
|
| Rate for Payer: PHP Medicare Advantage |
$11,142.16
|
| Rate for Payer: Priority Health Medicare |
$11,142.16
|
| Rate for Payer: Railroad Medicare Medicare |
$11,142.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,142.16
|
| Rate for Payer: UHC Exchange |
$17,270.35
|
| Rate for Payer: UHC Medicare Advantage |
$11,142.16
|
| Rate for Payer: UHCCP DNSP |
$11,142.16
|
| Rate for Payer: VA VA |
$11,142.16
|
|
|
MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$28,393.10
|
|
|
Service Code
|
MSDRG 542
|
| Min. Negotiated Rate |
$17,402.22 |
| Max. Negotiated Rate |
$28,393.10 |
| Rate for Payer: Aetna Medicare |
$18,318.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,897.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,897.66
|
| Rate for Payer: BCBS MAPPO |
$18,318.13
|
| Rate for Payer: BCN Medicare Advantage |
$18,318.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,318.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,318.13
|
| Rate for Payer: Mclaren Medicare |
$18,318.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,234.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,065.85
|
| Rate for Payer: PACE Medicare |
$17,402.22
|
| Rate for Payer: PACE SWMI |
$18,318.13
|
| Rate for Payer: PHP Commercial |
$20,149.94
|
| Rate for Payer: PHP Medicare Advantage |
$18,318.13
|
| Rate for Payer: Priority Health Medicare |
$18,318.13
|
| Rate for Payer: Railroad Medicare Medicare |
$18,318.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,318.13
|
| Rate for Payer: UHC Exchange |
$28,393.10
|
| Rate for Payer: UHC Medicare Advantage |
$18,318.13
|
| Rate for Payer: UHCCP DNSP |
$18,318.13
|
| Rate for Payer: VA VA |
$18,318.13
|
|
