5700 E. HIGHWAY 90, SIERRA VISTA, AZ, 85635
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| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 6 | $34,154 | $13,662 | $1,928.34 | $6,585.57 | $19,895 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | $46,131 | $18,452 | $10,432 | $17,291 | $24,490 |
| COPD w MCC | MS-DRG | 190 | 1 | $31,668 | $12,667 | $11,345 | $11,345 | $11,345 |
| COPD w/o CC/MCC | MS-DRG | 192 | 2 | $21,615 | $8,646.15 | $5,368.97 | $6,777.27 | $8,185.57 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 4 | $26,956 | $10,782 | $8,144.13 | $8,394.74 | $12,067 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 1 | $22,591 | $9,036.45 | $6,208 | $6,208 | $6,208 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | $50,346 | $20,138 | $15,754 | $16,741 | $25,897 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | $32,776 | $13,110 | $9,164.48 | $9,568.16 | $18,613 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 4 | $25,270 | $10,108 | $6,908.41 | $7,531.56 | $47,015 |
| Heart failure & shock w MCC | MS-DRG | 291 | 6 | $39,458 | $15,783 | $13,120 | $15,390 | $17,238 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | $26,719 | $10,687 | $5,782.25 | $7,132.02 | $8,481.78 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 1 | $43,422 | $17,369 | $4,515.79 | $4,515.79 | $4,515.79 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 4 | $48,950 | $19,580 | $11,356 | $12,307 | $13,833 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | $24,754 | $9,901.58 | $7,789.99 | $8,890.25 | $10,506 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 2 | $27,270 | $10,908 | $5,826.43 | $5,891.46 | $5,956.49 |
| GI hemorrhage w CC | MS-DRG | 378 | 3 | $60,127 | $24,051 | $10,034 | $10,410 | $28,202 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 6 | $30,783 | $12,313 | $7,332.03 | $8,259.62 | $9,950.18 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 1 | $51,459 | $20,584 | $7,150.11 | $7,150.11 | $7,150.11 |
| Kidney/UTI w MCC | MS-DRG | 689 | 3 | $44,461 | $17,785 | $11,490 | $11,821 | $12,421 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 4 | $38,981 | $15,592 | $7,762.7 | $8,155.34 | $10,628 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | $62,362 | $24,945 | $13,876 | $19,799 | $44,677 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 6 | $46,872 | $18,749 | $9,283.26 | $10,720 | $18,065 |
| surgery | ||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 2 | $162,023 | $64,809 | $3,430 | $25,283 | $47,135 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 3 | $191,937 | $76,775 | $17,375 | $24,575 | $36,052 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | $166,688 | $66,675 | $16,603 | $16,869 | $17,136 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 1 | $152,139 | $60,855 | $17,975 | $17,975 | $17,975 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 1 | $108,679 | $43,471 | $16,269 | $16,269 | $16,269 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | $491,352 | $196,541 | $28,106 | $28,106 | $28,106 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | $168,133 | $67,253 | $33,924 | $34,141 | $34,358 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 5 | $149,927 | $59,971 | $18,135 | $19,987 | $63,374 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 3 | $160,211 | $64,084 | $20,544 | $30,092 | $30,729 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 5 | $169,548 | $67,819 | $19,520 | $21,826 | $28,497 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 6 | $105,471 | $42,189 | $14,928 | $15,889 | $24,117 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 3 | $108,066 | $43,226 | $13,331 | $15,561 | $37,502 |
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 26 | $15,754 |
| WellCare | 23 | $9,830.63 |
| Humana | 18 | $12,885 |
| Blue Cross Blue Shield | 16 | $16,722 |
| Ambetter | 11 | $12,706 |
| Aetna | 7 | $15,131 |
| ameriben solutions | 6 | $20,838 |
| arizona physicians ipa inc | 5 | $15,272 |
| Cigna | 3 | $19,067 |
| ucare | 1 | $19,546 |
| azch-complete care plan | 1 | $7,150.11 |
