|
REVISE FINGER/TOE NERVE-F6
|
Facility
|
IP
|
$16,437.00
|
|
|
Service Code
|
HCPCS 64702
|
| Hospital Charge Code |
16000526
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,465.55 |
| Max. Negotiated Rate |
$2,465.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,465.55
|
|
|
REVISE LOW BACK NERVE(S)
|
Facility
|
IP
|
$9,663.00
|
|
|
Service Code
|
HCPCS 64714
|
| Hospital Charge Code |
16001044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,449.45 |
| Max. Negotiated Rate |
$1,449.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,449.45
|
|
|
REVISE LOW BACK NERVE(S)
|
Facility
|
OP
|
$9,663.00
|
|
|
Service Code
|
HCPCS 64714
|
| Hospital Charge Code |
16001044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$274.43 |
| Max. Negotiated Rate |
$8,415.40 |
| Rate for Payer: Aetna Commercial |
$6,310.10
|
| Rate for Payer: Aetna Medicare Advantage |
$7,516.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,415.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,415.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,319.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,415.40
|
| Rate for Payer: Cigna Commercial |
$4,650.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2,319.89
|
| Rate for Payer: Clover Medicare Advantage |
$2,203.90
|
| Rate for Payer: EmblemHealth Commercial |
$6,959.67
|
| Rate for Payer: Humana Medicare Advantage |
$2,389.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,319.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,512.38
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,449.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.43
|
|
|
REVISE LOWER LEG TENDON
|
Facility
|
OP
|
$22,425.68
|
|
|
Service Code
|
HCPCS 27691
|
| Hospital Charge Code |
16000565
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$569.19 |
| Max. Negotiated Rate |
$31,271.12 |
| Rate for Payer: Aetna Commercial |
$23,447.95
|
| Rate for Payer: Aetna Medicare Advantage |
$27,930.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,620.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31,271.12
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: Cigna Medicare Advantage |
$8,620.57
|
| Rate for Payer: Clover Medicare Advantage |
$8,189.54
|
| Rate for Payer: EmblemHealth Commercial |
$25,861.71
|
| Rate for Payer: Humana Medicare Advantage |
$8,879.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,620.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,830.68
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,363.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$708.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$580.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$569.19
|
|
|
REVISE LOWER LEG TENDON
|
Facility
|
IP
|
$22,425.68
|
|
|
Service Code
|
HCPCS 27691
|
| Hospital Charge Code |
16000565
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,363.85 |
| Max. Negotiated Rate |
$3,363.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,363.85
|
|
|
REVISE RECONSTR BREAST
|
Facility
|
IP
|
$42,601.70
|
|
|
Service Code
|
HCPCS 19380
|
| Hospital Charge Code |
16000790
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,390.26 |
| Max. Negotiated Rate |
$6,390.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,390.26
|
|
|
REVISE RECONSTR BREAST
|
Facility
|
OP
|
$42,601.70
|
|
|
Service Code
|
HCPCS 19380
|
| Hospital Charge Code |
16000790
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,209.89 |
| Max. Negotiated Rate |
$28,616.22 |
| Rate for Payer: Aetna Commercial |
$21,457.24
|
| Rate for Payer: Aetna Medicare Advantage |
$25,559.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28,616.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28,616.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,888.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28,616.22
|
| Rate for Payer: Cigna Commercial |
$15,812.86
|
| Rate for Payer: Cigna Medicare Advantage |
$7,888.69
|
| Rate for Payer: Clover Medicare Advantage |
$7,494.26
|
| Rate for Payer: EmblemHealth Commercial |
$23,666.07
|
| Rate for Payer: Humana Medicare Advantage |
$8,125.35
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,888.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,076.44
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,390.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,346.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,888.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,888.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,209.89
|
|
|
REVISE/REMOVE NEUROELECTRODE
|
Facility
|
IP
|
$16,134.72
|
|
|
Service Code
|
HCPCS 64585
|
| Hospital Charge Code |
1600000694
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,420.21 |
| Max. Negotiated Rate |
$2,420.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,420.21
|
|
|
REVISE/REMOVE NEUROELECTRODE
|
Facility
|
OP
|
$16,134.72
|
|
|
Service Code
|
HCPCS 64585
|
| Hospital Charge Code |
1600000694
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$458.23 |
| Max. Negotiated Rate |
$15,066.71 |
| Rate for Payer: Aetna Commercial |
$11,297.44
|
| Rate for Payer: Aetna Medicare Advantage |
$13,457.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,066.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,066.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,153.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,066.71
|
| Rate for Payer: Cigna Commercial |
$8,325.61
|
| Rate for Payer: Cigna Medicare Advantage |
$4,153.47
|
| Rate for Payer: Clover Medicare Advantage |
$3,945.80
|
| Rate for Payer: EmblemHealth Commercial |
$12,460.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,278.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,153.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,195.03
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,420.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$509.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$458.23
|
|
|
REVISE/REPLACE KNEE JOINT 1 CO
|
Facility
|
OP
|
$12,899.50
|
|
|
Service Code
|
HCPCS 27486
|
| Hospital Charge Code |
16000448
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$366.35 |
| Max. Negotiated Rate |
$55,329.13 |
| Rate for Payer: Aetna Commercial |
$41,487.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49,418.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55,329.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55,329.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,252.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55,329.13
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: Cigna Medicare Advantage |
$15,252.69
|
| Rate for Payer: Clover Medicare Advantage |
$14,490.06
|
| Rate for Payer: EmblemHealth Commercial |
$45,758.07
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,252.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,353.87
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,934.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$407.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$366.35
|
|
|
REVISE/REPLACE KNEE JOINT 1 CO
|
Facility
|
IP
|
$12,899.50
|
|
|
Service Code
|
HCPCS 27486
|
| Hospital Charge Code |
16000448
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,934.92 |
| Max. Negotiated Rate |
$1,934.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,934.92
|
|
|
REVISE/RMV PN/GASTR STIMUL
|
Facility
|
OP
|
$15,827.28
|
|
|
Service Code
|
HCPCS 64595
|
| Hospital Charge Code |
1600000693
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$449.49 |
| Max. Negotiated Rate |
$15,066.71 |
| Rate for Payer: Aetna Commercial |
$11,297.44
|
| Rate for Payer: Aetna Medicare Advantage |
$13,457.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,066.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,066.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,153.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,066.71
|
| Rate for Payer: Cigna Commercial |
$8,325.61
|
| Rate for Payer: Cigna Medicare Advantage |
$4,153.47
|
| Rate for Payer: Clover Medicare Advantage |
$3,945.80
|
| Rate for Payer: EmblemHealth Commercial |
$12,460.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,278.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,153.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,115.09
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,374.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$500.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$449.49
|
|
|
REVISE/RMV PN/GASTR STIMUL
|
Facility
|
IP
|
$15,827.28
|
|
|
Service Code
|
HCPCS 64595
|
| Hospital Charge Code |
1600000693
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,374.09 |
| Max. Negotiated Rate |
$2,374.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,374.09
|
|
|
REVISION ARTHROPLASTY,SHOULDER
|
Facility
|
IP
|
$16,453.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
16000421
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,467.95 |
| Max. Negotiated Rate |
$2,467.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,467.95
|
|
|
REVISION ARTHROPLASTY,SHOULDER
|
Facility
|
OP
|
$16,453.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
16000421
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$467.27 |
| Max. Negotiated Rate |
$75,563.15 |
| Rate for Payer: Aetna Commercial |
$56,659.34
|
| Rate for Payer: Aetna Medicare Advantage |
$67,491.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,563.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,563.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,830.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75,563.15
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: Cigna Medicare Advantage |
$20,830.64
|
| Rate for Payer: Clover Medicare Advantage |
$19,789.11
|
| Rate for Payer: EmblemHealth Commercial |
$62,491.92
|
| Rate for Payer: Humana Medicare Advantage |
$21,455.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,830.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,277.78
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,467.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$519.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$467.27
|
|
|
REVISION OF BLADDER/URETHRA
|
Facility
|
IP
|
$14,429.00
|
|
|
Service Code
|
HCPCS 51800
|
| Hospital Charge Code |
1600000621
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,164.35 |
| Max. Negotiated Rate |
$2,164.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,164.35
|
|
|
REVISION OF BLADDER/URETHRA
|
Facility
|
OP
|
$14,429.00
|
|
|
Service Code
|
HCPCS 51800
|
| Hospital Charge Code |
1600000621
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.78 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$5,483.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4,328.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,679.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,679.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,679.39
|
| Rate for Payer: Cigna Commercial |
$7,214.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,751.54
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,164.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$455.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$409.78
|
|
|
REVISION OF CALF TENDON
|
Facility
|
IP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 27687
|
| Hospital Charge Code |
16000304
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,587.14 |
| Max. Negotiated Rate |
$1,587.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
|
|
REVISION OF CALF TENDON
|
Facility
|
OP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 27687
|
| Hospital Charge Code |
16000304
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$300.50 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,751.04
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$334.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$300.50
|
|
|
REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
|
IP
|
$130,882.44
|
|
|
Service Code
|
MSDRG 467
|
| Min. Negotiated Rate |
$39,852.03 |
| Max. Negotiated Rate |
$130,882.44 |
| Rate for Payer: Aetna Commercial |
$95,074.51
|
| Rate for Payer: Aetna Medicare Advantage |
$130,882.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$96,690.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$96,690.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$41,949.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$96,690.45
|
| Rate for Payer: Cigna Commercial |
$78,618.49
|
| Rate for Payer: Cigna Medicare Advantage |
$41,949.50
|
| Rate for Payer: Clover Medicare Advantage |
$39,852.03
|
| Rate for Payer: EmblemHealth Commercial |
$125,848.50
|
| Rate for Payer: Humana Medicare Advantage |
$43,207.99
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$41,949.50
|
| Rate for Payer: Oxford Commercial |
$62,138.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$83,174.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$41,949.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$41,949.50
|
|
|
REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$183,921.78
|
|
|
Service Code
|
MSDRG 466
|
| Min. Negotiated Rate |
$56,001.83 |
| Max. Negotiated Rate |
$183,921.78 |
| Rate for Payer: Aetna Commercial |
$132,849.71
|
| Rate for Payer: Aetna Medicare Advantage |
$183,921.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$143,788.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$143,788.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$58,949.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$143,788.95
|
| Rate for Payer: Cigna Commercial |
$116,043.98
|
| Rate for Payer: Cigna Medicare Advantage |
$58,949.29
|
| Rate for Payer: Clover Medicare Advantage |
$56,001.83
|
| Rate for Payer: EmblemHealth Commercial |
$176,847.87
|
| Rate for Payer: Humana Medicare Advantage |
$60,717.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$58,949.29
|
| Rate for Payer: Oxford Commercial |
$91,719.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$122,769.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$58,949.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$58,949.29
|
|
|
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$106,283.74
|
|
|
Service Code
|
MSDRG 468
|
| Min. Negotiated Rate |
$32,362.03 |
| Max. Negotiated Rate |
$106,283.74 |
| Rate for Payer: Aetna Commercial |
$77,554.99
|
| Rate for Payer: Aetna Medicare Advantage |
$106,283.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73,972.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73,972.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$34,065.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73,972.35
|
| Rate for Payer: Cigna Commercial |
$61,261.16
|
| Rate for Payer: Cigna Medicare Advantage |
$34,065.30
|
| Rate for Payer: Clover Medicare Advantage |
$32,362.03
|
| Rate for Payer: EmblemHealth Commercial |
$102,195.90
|
| Rate for Payer: Humana Medicare Advantage |
$35,087.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$34,065.30
|
| Rate for Payer: Oxford Commercial |
$48,419.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$64,811.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$34,065.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$34,065.30
|
|
|
REVISION OF TOTAL KNEE ARTH
|
Facility
|
OP
|
$21,142.50
|
|
|
Service Code
|
HCPCS 27487
|
| Hospital Charge Code |
16000449
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$600.45 |
| Max. Negotiated Rate |
$75,563.15 |
| Rate for Payer: Aetna Commercial |
$56,659.34
|
| Rate for Payer: Aetna Medicare Advantage |
$67,491.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,563.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,563.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,830.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75,563.15
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: Cigna Medicare Advantage |
$20,830.64
|
| Rate for Payer: Clover Medicare Advantage |
$19,789.11
|
| Rate for Payer: EmblemHealth Commercial |
$62,491.92
|
| Rate for Payer: Humana Medicare Advantage |
$21,455.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,830.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,497.05
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,171.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$668.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$600.45
|
|
|
REVISION OF TOTAL KNEE ARTH
|
Facility
|
IP
|
$21,142.50
|
|
|
Service Code
|
HCPCS 27487
|
| Hospital Charge Code |
16000449
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,171.38 |
| Max. Negotiated Rate |
$3,171.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,171.38
|
|
|
REVISION OF UPPER EYELID
|
Facility
|
IP
|
$7,356.39
|
|
|
Service Code
|
HCPCS 15822
|
| Hospital Charge Code |
16000661
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,103.46 |
| Max. Negotiated Rate |
$1,103.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,103.46
|
|
