|
Cardiac pacemaker & defibrillator device replacement
|
Facility
|
IP
|
$78,454.60
|
|
|
Service Code
|
APR-DRG 1762
|
| Min. Negotiated Rate |
$34,868.71 |
| Max. Negotiated Rate |
$78,454.60 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$78,454.60
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$78,454.60
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$34,868.71
|
| Rate for Payer: Amida Care Medicaid |
$34,868.71
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$78,454.60
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$34,868.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34,868.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41,842.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,868.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34,868.71
|
| Rate for Payer: Healthfirst Commercial |
$47,587.00
|
| Rate for Payer: Healthfirst Essential Plan |
$78,454.60
|
| Rate for Payer: Healthfirst QHP |
$43,368.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34,868.71
|
| Rate for Payer: SOMOS Essential |
$78,454.60
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$78,454.60
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$78,454.60
|
| Rate for Payer: United Healthcare Medicaid |
$34,868.71
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34,868.71
|
|
|
Cardiac pacemaker & defibrillator device replacement
|
Facility
|
IP
|
$91,191.44
|
|
|
Service Code
|
APR-DRG 1763
|
| Min. Negotiated Rate |
$40,529.53 |
| Max. Negotiated Rate |
$91,191.44 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$91,191.44
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$91,191.44
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$40,529.53
|
| Rate for Payer: Amida Care Medicaid |
$40,529.53
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$91,191.44
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$40,529.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40,529.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$48,635.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40,529.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40,529.53
|
| Rate for Payer: Healthfirst Commercial |
$52,768.00
|
| Rate for Payer: Healthfirst Essential Plan |
$91,191.44
|
| Rate for Payer: Healthfirst QHP |
$42,968.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40,529.53
|
| Rate for Payer: SOMOS Essential |
$91,191.44
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$91,191.44
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$91,191.44
|
| Rate for Payer: United Healthcare Medicaid |
$40,529.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40,529.53
|
|
|
Cardiac pacemaker & defibrillator revision except device replacement
|
Facility
|
IP
|
$79,161.62
|
|
|
Service Code
|
APR-DRG 1773
|
| Min. Negotiated Rate |
$27,716.00 |
| Max. Negotiated Rate |
$79,161.62 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$79,161.62
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$79,161.62
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$35,182.94
|
| Rate for Payer: Amida Care Medicaid |
$35,182.94
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$79,161.62
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$35,182.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35,182.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$42,219.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35,182.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35,182.94
|
| Rate for Payer: Healthfirst Commercial |
$50,471.00
|
| Rate for Payer: Healthfirst Essential Plan |
$79,161.62
|
| Rate for Payer: Healthfirst QHP |
$27,716.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$35,182.94
|
| Rate for Payer: SOMOS Essential |
$79,161.62
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$79,161.62
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$79,161.62
|
| Rate for Payer: United Healthcare Medicaid |
$35,182.94
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$35,182.94
|
|
|
Cardiac pacemaker & defibrillator revision except device replacement
|
Facility
|
IP
|
$56,537.10
|
|
|
Service Code
|
APR-DRG 1771
|
| Min. Negotiated Rate |
$14,541.00 |
| Max. Negotiated Rate |
$56,537.10 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$56,537.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$56,537.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,127.60
|
| Rate for Payer: Amida Care Medicaid |
$25,127.60
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$56,537.10
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,127.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,127.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30,153.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,127.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,127.60
|
| Rate for Payer: Healthfirst Commercial |
$26,973.00
|
| Rate for Payer: Healthfirst Essential Plan |
$56,537.10
|
| Rate for Payer: Healthfirst QHP |
$14,541.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,127.60
|
| Rate for Payer: SOMOS Essential |
$56,537.10
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$56,537.10
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$56,537.10
|
| Rate for Payer: United Healthcare Medicaid |
$25,127.60
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,127.60
|
|
|
Cardiac pacemaker & defibrillator revision except device replacement
|
Facility
|
IP
|
$62,745.48
|
|
|
Service Code
|
APR-DRG 1772
|
| Min. Negotiated Rate |
$20,523.00 |
| Max. Negotiated Rate |
$62,745.48 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$62,745.48
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$62,745.48
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$27,886.88
|
| Rate for Payer: Amida Care Medicaid |
$27,886.88
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$62,745.48
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$27,886.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27,886.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33,464.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27,886.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27,886.88
|
| Rate for Payer: Healthfirst Commercial |
$34,323.00
|
| Rate for Payer: Healthfirst Essential Plan |
$62,745.48
|
| Rate for Payer: Healthfirst QHP |
$20,523.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27,886.88
|
| Rate for Payer: SOMOS Essential |
$62,745.48
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$62,745.48
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$62,745.48
|
| Rate for Payer: United Healthcare Medicaid |
$27,886.88
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$27,886.88
|
|
|
Cardiac pacemaker & defibrillator revision except device replacement
|
Facility
|
IP
|
$143,426.20
|
|
|
Service Code
|
APR-DRG 1774
|
| Min. Negotiated Rate |
$62,000.00 |
| Max. Negotiated Rate |
$143,426.20 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$143,426.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$143,426.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$63,744.98
|
| Rate for Payer: Amida Care Medicaid |
$63,744.98
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$143,426.20
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$63,744.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$63,744.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$76,493.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63,744.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$63,744.98
|
| Rate for Payer: Healthfirst Commercial |
$125,515.00
|
| Rate for Payer: Healthfirst Essential Plan |
$143,426.20
|
| Rate for Payer: Healthfirst QHP |
$62,000.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$63,744.98
|
| Rate for Payer: SOMOS Essential |
$143,426.20
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$143,426.20
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$143,426.20
|
| Rate for Payer: United Healthcare Medicaid |
$63,744.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$63,744.98
|
|
|
CARDIAC REHABILITATION
|
Facility
|
OP
|
$66.16
|
|
|
Service Code
|
EAPG 00094
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$66.16 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$48.60
|
| Rate for Payer: Healthfirst Commercial |
$66.16
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES
|
Facility
|
OP
|
$275.57
|
|
|
Service Code
|
EAPG 00600
|
| Min. Negotiated Rate |
$199.03 |
| Max. Negotiated Rate |
$275.57 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$199.03
|
| Rate for Payer: Healthfirst Commercial |
$275.57
|
|
|
Cardiac structural & valvular disorders
|
Facility
|
IP
|
$101,302.47
|
|
|
Service Code
|
APR-DRG 2004
|
| Min. Negotiated Rate |
$45,023.32 |
| Max. Negotiated Rate |
$101,302.47 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$101,302.47
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$101,302.47
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$45,023.32
|
| Rate for Payer: Amida Care Medicaid |
$45,023.32
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$101,302.47
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$45,023.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$45,023.32
|
| Rate for Payer: Fidelis Qualified Health Plan |
$54,027.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45,023.32
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$45,023.32
|
| Rate for Payer: Healthfirst Commercial |
$52,495.00
|
| Rate for Payer: Healthfirst Essential Plan |
$101,302.47
|
| Rate for Payer: Healthfirst QHP |
$48,764.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$45,023.32
|
| Rate for Payer: SOMOS Essential |
$101,302.47
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$101,302.47
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$101,302.47
|
| Rate for Payer: United Healthcare Medicaid |
$45,023.32
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$45,023.32
|
|
|
Cardiac structural & valvular disorders
|
Facility
|
IP
|
$40,938.79
|
|
|
Service Code
|
APR-DRG 2001
|
| Min. Negotiated Rate |
$5,691.00 |
| Max. Negotiated Rate |
$40,938.79 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$40,938.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$40,938.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,195.02
|
| Rate for Payer: Amida Care Medicaid |
$18,195.02
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$40,938.79
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,195.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,195.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,834.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,195.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,195.02
|
| Rate for Payer: Healthfirst Commercial |
$10,380.00
|
| Rate for Payer: Healthfirst Essential Plan |
$40,938.79
|
| Rate for Payer: Healthfirst QHP |
$5,691.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,195.02
|
| Rate for Payer: SOMOS Essential |
$40,938.79
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$40,938.79
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$40,938.79
|
| Rate for Payer: United Healthcare Medicaid |
$18,195.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,195.02
|
|
|
Cardiac structural & valvular disorders
|
Facility
|
IP
|
$54,029.14
|
|
|
Service Code
|
APR-DRG 2003
|
| Min. Negotiated Rate |
$12,216.00 |
| Max. Negotiated Rate |
$54,029.14 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$54,029.14
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$54,029.14
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24,012.95
|
| Rate for Payer: Amida Care Medicaid |
$24,012.95
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$54,029.14
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$24,012.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24,012.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,815.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,012.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24,012.95
|
| Rate for Payer: Healthfirst Commercial |
$19,515.00
|
| Rate for Payer: Healthfirst Essential Plan |
$54,029.14
|
| Rate for Payer: Healthfirst QHP |
$12,216.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24,012.95
|
| Rate for Payer: SOMOS Essential |
$54,029.14
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$54,029.14
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$54,029.14
|
| Rate for Payer: United Healthcare Medicaid |
$24,012.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$24,012.95
|
|
|
Cardiac structural & valvular disorders
|
Facility
|
IP
|
$44,257.54
|
|
|
Service Code
|
APR-DRG 2002
|
| Min. Negotiated Rate |
$7,658.00 |
| Max. Negotiated Rate |
$44,257.54 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,257.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,257.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,670.02
|
| Rate for Payer: Amida Care Medicaid |
$19,670.02
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,257.54
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,670.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,670.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,604.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,670.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,670.02
|
| Rate for Payer: Healthfirst Commercial |
$13,382.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,257.54
|
| Rate for Payer: Healthfirst QHP |
$7,658.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,670.02
|
| Rate for Payer: SOMOS Essential |
$44,257.54
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,257.54
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,257.54
|
| Rate for Payer: United Healthcare Medicaid |
$19,670.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,670.02
|
|
|
Cardiac valve procedures w AMI or complex PDX
|
Facility
|
IP
|
$92,906.21
|
|
|
Service Code
|
APR-DRG 1621
|
| Min. Negotiated Rate |
$41,291.65 |
| Max. Negotiated Rate |
$92,906.21 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$92,906.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$92,906.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$41,291.65
|
| Rate for Payer: Amida Care Medicaid |
$41,291.65
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$92,906.21
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$41,291.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41,291.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49,549.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41,291.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$41,291.65
|
| Rate for Payer: Healthfirst Commercial |
$64,101.00
|
| Rate for Payer: Healthfirst Essential Plan |
$92,906.21
|
| Rate for Payer: Healthfirst QHP |
$43,037.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$41,291.65
|
| Rate for Payer: SOMOS Essential |
$92,906.21
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$92,906.21
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$92,906.21
|
| Rate for Payer: United Healthcare Medicaid |
$41,291.65
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$41,291.65
|
|
|
Cardiac valve procedures w AMI or complex PDX
|
Facility
|
IP
|
$110,845.44
|
|
|
Service Code
|
APR-DRG 1622
|
| Min. Negotiated Rate |
$49,264.64 |
| Max. Negotiated Rate |
$110,845.44 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$110,845.44
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$110,845.44
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$49,264.64
|
| Rate for Payer: Amida Care Medicaid |
$49,264.64
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$110,845.44
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$49,264.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$49,264.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59,117.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$49,264.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$49,264.64
|
| Rate for Payer: Healthfirst Commercial |
$74,697.00
|
| Rate for Payer: Healthfirst Essential Plan |
$110,845.44
|
| Rate for Payer: Healthfirst QHP |
$49,665.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$49,264.64
|
| Rate for Payer: SOMOS Essential |
$110,845.44
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$110,845.44
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$110,845.44
|
| Rate for Payer: United Healthcare Medicaid |
$49,264.64
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$49,264.64
|
|
|
Cardiac valve procedures w AMI or complex PDX
|
Facility
|
IP
|
$197,069.74
|
|
|
Service Code
|
APR-DRG 1624
|
| Min. Negotiated Rate |
$87,586.55 |
| Max. Negotiated Rate |
$197,069.74 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$197,069.74
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$197,069.74
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$87,586.55
|
| Rate for Payer: Amida Care Medicaid |
$87,586.55
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$197,069.74
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$87,586.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$87,586.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$105,103.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87,586.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$87,586.55
|
| Rate for Payer: Healthfirst Commercial |
$193,480.00
|
| Rate for Payer: Healthfirst Essential Plan |
$197,069.74
|
| Rate for Payer: Healthfirst QHP |
$101,280.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$87,586.55
|
| Rate for Payer: SOMOS Essential |
$197,069.74
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$197,069.74
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$197,069.74
|
| Rate for Payer: United Healthcare Medicaid |
$87,586.55
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$87,586.55
|
|
|
Cardiac valve procedures w AMI or complex PDX
|
Facility
|
IP
|
$132,910.67
|
|
|
Service Code
|
APR-DRG 1623
|
| Min. Negotiated Rate |
$59,071.41 |
| Max. Negotiated Rate |
$132,910.67 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$132,910.67
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$132,910.67
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$59,071.41
|
| Rate for Payer: Amida Care Medicaid |
$59,071.41
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$132,910.67
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$59,071.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$59,071.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$70,885.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59,071.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$59,071.41
|
| Rate for Payer: Healthfirst Commercial |
$100,406.00
|
| Rate for Payer: Healthfirst Essential Plan |
$132,910.67
|
| Rate for Payer: Healthfirst QHP |
$62,895.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$59,071.41
|
| Rate for Payer: SOMOS Essential |
$132,910.67
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$132,910.67
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$132,910.67
|
| Rate for Payer: United Healthcare Medicaid |
$59,071.41
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$59,071.41
|
|
|
Cardiac valve procedures w/o AMI or complex PDX
|
Facility
|
IP
|
$85,213.46
|
|
|
Service Code
|
APR-DRG 1631
|
| Min. Negotiated Rate |
$35,205.00 |
| Max. Negotiated Rate |
$85,213.46 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$85,213.46
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$85,213.46
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$37,872.65
|
| Rate for Payer: Amida Care Medicaid |
$37,872.65
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$85,213.46
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$37,872.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37,872.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45,447.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37,872.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37,872.65
|
| Rate for Payer: Healthfirst Commercial |
$52,883.00
|
| Rate for Payer: Healthfirst Essential Plan |
$85,213.46
|
| Rate for Payer: Healthfirst QHP |
$35,205.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$37,872.65
|
| Rate for Payer: SOMOS Essential |
$85,213.46
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$85,213.46
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$85,213.46
|
| Rate for Payer: United Healthcare Medicaid |
$37,872.65
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$37,872.65
|
|
|
Cardiac valve procedures w/o AMI or complex PDX
|
Facility
|
IP
|
$180,050.00
|
|
|
Service Code
|
APR-DRG 1634
|
| Min. Negotiated Rate |
$69,313.56 |
| Max. Negotiated Rate |
$180,050.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$155,955.51
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$155,955.51
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$69,313.56
|
| Rate for Payer: Amida Care Medicaid |
$69,313.56
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$155,955.51
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$69,313.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$69,313.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$83,176.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$69,313.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$69,313.56
|
| Rate for Payer: Healthfirst Commercial |
$180,050.00
|
| Rate for Payer: Healthfirst Essential Plan |
$155,955.51
|
| Rate for Payer: Healthfirst QHP |
$91,720.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69,313.56
|
| Rate for Payer: SOMOS Essential |
$155,955.51
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$155,955.51
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$155,955.51
|
| Rate for Payer: United Healthcare Medicaid |
$69,313.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$69,313.56
|
|
|
Cardiac valve procedures w/o AMI or complex PDX
|
Facility
|
IP
|
$111,962.23
|
|
|
Service Code
|
APR-DRG 1633
|
| Min. Negotiated Rate |
$49,760.99 |
| Max. Negotiated Rate |
$111,962.23 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$111,962.23
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$111,962.23
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$49,760.99
|
| Rate for Payer: Amida Care Medicaid |
$49,760.99
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$111,962.23
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$49,760.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$49,760.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59,713.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$49,760.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$49,760.99
|
| Rate for Payer: Healthfirst Commercial |
$86,061.00
|
| Rate for Payer: Healthfirst Essential Plan |
$111,962.23
|
| Rate for Payer: Healthfirst QHP |
$51,786.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$49,760.99
|
| Rate for Payer: SOMOS Essential |
$111,962.23
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$111,962.23
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$111,962.23
|
| Rate for Payer: United Healthcare Medicaid |
$49,760.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$49,760.99
|
|
|
Cardiac valve procedures w/o AMI or complex PDX
|
Facility
|
IP
|
$97,092.04
|
|
|
Service Code
|
APR-DRG 1632
|
| Min. Negotiated Rate |
$42,236.00 |
| Max. Negotiated Rate |
$97,092.04 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$97,092.04
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$97,092.04
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$43,152.02
|
| Rate for Payer: Amida Care Medicaid |
$43,152.02
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$97,092.04
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$43,152.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$43,152.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$51,782.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43,152.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$43,152.02
|
| Rate for Payer: Healthfirst Commercial |
$65,920.00
|
| Rate for Payer: Healthfirst Essential Plan |
$97,092.04
|
| Rate for Payer: Healthfirst QHP |
$42,236.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$43,152.02
|
| Rate for Payer: SOMOS Essential |
$97,092.04
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$97,092.04
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$97,092.04
|
| Rate for Payer: United Healthcare Medicaid |
$43,152.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43,152.02
|
|
|
CARDIOGRAM
|
Facility
|
OP
|
$72.98
|
|
|
Service Code
|
EAPG 00413
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$72.98 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$53.23
|
| Rate for Payer: Healthfirst Commercial |
$72.98
|
|
|
Cardiomyopathy
|
Facility
|
IP
|
$42,351.05
|
|
|
Service Code
|
APR-DRG 2051
|
| Min. Negotiated Rate |
$6,012.00 |
| Max. Negotiated Rate |
$42,351.05 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$42,351.05
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$42,351.05
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,822.69
|
| Rate for Payer: Amida Care Medicaid |
$18,822.69
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$42,351.05
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,822.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,822.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,587.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,822.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,822.69
|
| Rate for Payer: Healthfirst Commercial |
$10,662.00
|
| Rate for Payer: Healthfirst Essential Plan |
$42,351.05
|
| Rate for Payer: Healthfirst QHP |
$6,012.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,822.69
|
| Rate for Payer: SOMOS Essential |
$42,351.05
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$42,351.05
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$42,351.05
|
| Rate for Payer: United Healthcare Medicaid |
$18,822.69
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,822.69
|
|
|
Cardiomyopathy
|
Facility
|
IP
|
$63,183.42
|
|
|
Service Code
|
APR-DRG 2054
|
| Min. Negotiated Rate |
$12,581.00 |
| Max. Negotiated Rate |
$63,183.42 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$63,183.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$63,183.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28,081.52
|
| Rate for Payer: Amida Care Medicaid |
$28,081.52
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$63,183.42
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$28,081.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28,081.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33,697.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28,081.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28,081.52
|
| Rate for Payer: Healthfirst Commercial |
$24,651.00
|
| Rate for Payer: Healthfirst Essential Plan |
$63,183.42
|
| Rate for Payer: Healthfirst QHP |
$12,581.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28,081.52
|
| Rate for Payer: SOMOS Essential |
$63,183.42
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$63,183.42
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$63,183.42
|
| Rate for Payer: United Healthcare Medicaid |
$28,081.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28,081.52
|
|
|
Cardiomyopathy
|
Facility
|
IP
|
$57,578.29
|
|
|
Service Code
|
APR-DRG 2053
|
| Min. Negotiated Rate |
$10,887.00 |
| Max. Negotiated Rate |
$57,578.29 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$57,578.29
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$57,578.29
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,590.35
|
| Rate for Payer: Amida Care Medicaid |
$25,590.35
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$57,578.29
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,590.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,590.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30,708.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,590.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,590.35
|
| Rate for Payer: Healthfirst Commercial |
$20,065.00
|
| Rate for Payer: Healthfirst Essential Plan |
$57,578.29
|
| Rate for Payer: Healthfirst QHP |
$10,887.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,590.35
|
| Rate for Payer: SOMOS Essential |
$57,578.29
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$57,578.29
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$57,578.29
|
| Rate for Payer: United Healthcare Medicaid |
$25,590.35
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,590.35
|
|
|
Cardiomyopathy
|
Facility
|
IP
|
$45,142.20
|
|
|
Service Code
|
APR-DRG 2052
|
| Min. Negotiated Rate |
$7,524.00 |
| Max. Negotiated Rate |
$45,142.20 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,142.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,142.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,063.20
|
| Rate for Payer: Amida Care Medicaid |
$20,063.20
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,142.20
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,063.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,063.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,075.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,063.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,063.20
|
| Rate for Payer: Healthfirst Commercial |
$12,591.00
|
| Rate for Payer: Healthfirst Essential Plan |
$45,142.20
|
| Rate for Payer: Healthfirst QHP |
$7,524.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,063.20
|
| Rate for Payer: SOMOS Essential |
$45,142.20
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,142.20
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,142.20
|
| Rate for Payer: United Healthcare Medicaid |
$20,063.20
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,063.20
|
|
