1015 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
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| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 12 | — | — | $9,358.56 | $12,272 | $12,857 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 12 | — | — | $3,937 | $16,878 | $17,682 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 12 | — | — | $2,932 | $9,374.22 | $9,820.61 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 12 | — | — | $2,206 | $6,930.5 | $7,260.53 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 12 | — | — | $10,470 | $13,516 | $14,160 |
| COPD w MCC | MS-DRG | 190 | 12 | — | — | $7,421.59 | $10,105 | $10,586 |
| COPD w CC | MS-DRG | 191 | 12 | — | — | $5,648.1 | $8,119.74 | $8,506.4 |
| COPD w/o CC/MCC | MS-DRG | 192 | 12 | — | — | $4,301.4 | $6,612.57 | $6,927.46 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 12 | — | — | $5,399.53 | $7,841.56 | $8,214.96 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 12 | — | — | $4,210.95 | $6,511.34 | $6,821.41 |
| AMI discharged alive w MCC | MS-DRG | 280 | 12 | — | — | $10,747 | $13,827 | $14,485 |
| AMI discharged alive w CC | MS-DRG | 281 | 12 | — | — | $6,157.97 | $8,690.38 | $9,104.2 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 12 | — | — | $4,844.77 | $7,220.69 | $7,564.54 |
| Heart failure & shock w MCC | MS-DRG | 291 | 12 | — | — | $8,601.46 | $11,425 | $11,969 |
| Heart failure & shock w CC | MS-DRG | 292 | 12 | — | — | $5,688.3 | $8,164.74 | $8,553.53 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 12 | — | — | $3,792.2 | $6,042.7 | $6,330.45 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 12 | — | — | $8,066.8 | $10,827 | $11,342 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 12 | — | — | $4,929.19 | $7,315.17 | $7,663.51 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 12 | — | — | $3,792.87 | $6,043.44 | $6,331.23 |
| GI hemorrhage w CC | MS-DRG | 378 | 12 | — | — | $6,570.69 | $9,152.27 | $9,588.1 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 12 | — | — | $4,223.68 | $6,525.59 | $6,836.34 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 12 | — | — | $5,223.32 | $7,644.35 | $8,008.36 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 12 | — | — | $10,504 | $13,554 | $14,199 |
| Kidney/UTI w MCC | MS-DRG | 689 | 12 | — | — | $7,774.01 | $10,499 | $10,999 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 12 | — | — | $5,423.65 | $7,868.55 | $8,243.25 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 12 | — | — | $13,015 | $16,364 | $17,143 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 12 | — | — | $6,856.11 | $9,471.7 | $9,922.74 |
| surgery | ||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 12 | — | — | $30,797 | $36,265 | $37,992 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 12 | — | — | $16,061 | $19,774 | $20,715 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 12 | — | — | $11,275 | $14,418 | $15,104 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 12 | — | — | $11,334 | $14,483 | $15,173 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 12 | — | — | $9,150.86 | $12,040 | $12,613 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 12 | — | — | $22,828 | $27,346 | $28,649 |
| Major joint replacement w MCC | MS-DRG | 469 | 12 | — | — | $20,322 | $24,543 | $25,711 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 12 | — | — | $12,924 | $16,262 | $17,037 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 12 | — | — | $19,512 | $23,636 | $24,762 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 12 | — | — | $14,033 | $17,504 | $18,337 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 12 | — | — | $10,928 | $14,028 | $14,696 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 12 | — | — | $19,346 | $23,449 | $24,566 |
| OR procedure for obesity w CC | MS-DRG | 620 | 12 | — | — | $10,722 | $13,798 | $14,455 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 12 | — | — | $10,106 | $13,109 | $13,733 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 12 | — | — | $8,312.69 | $11,102 | $11,631 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 12 | — | — | $13,729 | $17,164 | $17,981 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 43 | $11,207 |
| amerigroup | 43 | $11,425 |
| Blue Cross Blue Shield | 43 | $9,699.06 |
| Centene | 43 | $11,800 |
| Cigna | 43 | $11,425 |
| devoted healthcare | 43 | $11,425 |
| fidelis | 43 | $11,969 |
| healthspring | 43 | $11,425 |
| Humana | 43 | $10,881 |
| select health | 43 | $11,643 |
| southern care | 43 | $10,881 |
| UnitedHealthcare | 43 | $10,288 |
