New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
0101005
0101000
3701000
1624000
2801000
0701000
0501000
3801000
4720001
7002001
4652001
5501000
1427000
7001041
7002004
7002002
3535001
7000001
7001002
5123000
7001003
0601000
5120000
7002003
4429000
2238001
5263700
5263000
5401001
5155000
0901001
0824000
7003000
4401000
3421000
7003005
7003008
7003025
1001000
3301000
5925000
2625000
7001009
5001000

Agency
ADIRONDACK MEDICAL HOSP
ALB MED SO CLINICAL CAMPUS
ALBANY MEDICAL CENTER
ALBERT LINDLEY LEE
ALICE HYDE MEDICAL CTR
AMSTERDAM MEMORIAL HOSP
ARNOT OGDEN MEMORIAL
AUBURN MEMORIAL HOSPITAL
AURELIA OSBORN FOX
BASSETT HOSPITAL
BELLEVUE HOSPITAL CTR
BELLEVUE WOMAN'S HOSP
BENEDICTINE HOSPITAL
BERTRAND CHAFFEE HOSPITAL
BETH ISRAEL / KINGS HIGHWAY
BETH ISRAEL / NORTH DIVISION
BETH ISRAEL MEDICAL CTR
BON SECOURS COMM HOSP
BRONX-LEBANON HOSP CTR
BROOKDALE HOSP MED CTR
BROOKHAVEN MEMORIAL HOSP
BROOKLYN HOSPITAL CENTER
BROOKS MEMORIAL HOSPITAL
BRUNSWICK HOSPITAL CTR
CABRINI MEDICAL CENTER
CANTON-POTSDAM HOSPITAL
CARTHAGE AREA HOSPITAL
CATSKILL REGIONAL / G HERMANN
CATSKILL REGIONAL MED CTR
CAYUGA MEDICAL CENTER
CENTRAL SUFFOLK HOSPITAL
CHAMPLAIN VALLEY PHYS
CHENANGO MEMORIAL HOSP
CITY HOSPITAL CENTER
CLAXTON-HEPBURN MED CTR
CLIFTON SPRINGS HOSPITAL
CMC (MARY IMMACULATE)
CMC (ST JOHNS)
CMC (ST JOSEPHS)
COLUMBIA MEMORIAL HOSP
COMM GEN / GREATER SYRACUSE
COMM HOSP / DOBBS FERRY
COMMUNITY MEMORIAL HOSP
CONEY ISLAND HOSPITAL
CORNING HOSPITAL

Mmisid
00363213
01952712
00277716
00354105
00354114
00381420
00363199
00347553
00279098
00302429
00246039
00354132
00274020
00354150
00243105
00243105
00243105
00273905
00476022
00243572
00245529
00243614
00381439
00268295
00243132
00354196
00310852
00273978
00273978
00332729
00274328
00318814
00314723
00246075
00354072
00354641
00243861
00244124
00498531
00335915
00315004
00274066
00354229
00246066
00361739

PAS
1
$1,111.97
$1,149.24
$1,336.58
$1,134.89
$1,109.94
$1,149.24
$1,111.49
$1,084.13
$1,145.43
$1,234.82
$1,499.72
$1,149.24
$1,143.83
$1,131.08
$1,304.10
$1,304.10
$1,505.12
$1,176.65
$1,505.12
$1,505.12
$1,259.37
$1,505.12
$1,121.63
$1,252.95
$1,505.12
$1,111.97
$1,122.12
$1,143.26
$1,143.83
$1,084.13
$1,259.37
$1,110.47
$1,143.26
$1,499.72
$1,111.97
$1,151.22
$1,505.12
$1,505.12
$1,505.12
$1,135.59
$1,148.40
$1,225.70
$1,149.21
$1,499.72
$1,103.51

PAS
2
$931.52
$961.53
$1,112.45
$949.98
$929.88
$961.53
$931.13
$909.09
$958.47
$1,030.47
$1,243.85
$961.53
$957.18
$946.92
$1,086.29
$1,086.29
$1,248.20
$983.61
$1,248.20
$1,248.20
$1,050.26
$1,248.20
$939.30
$1,045.08
$1,248.20
$931.52
$939.69
$956.73
$957.18
$909.09
$1,050.26
$930.32
$956.73
$1,243.85
$931.52
$963.14
$1,248.20
$1,248.20
$1,248.20
$950.55
$960.86
$1,023.12
$961.52
$1,243.85
$924.71
Page 1 of 25

PAS
3
$1,696.82
$1,744.92
$1,986.71
$1,726.40
$1,694.21
$1,744.92
$1,696.20
$1,660.88
$1,740.00
$1,855.37
$2,197.25
$1,744.92
$1,737.95
$1,721.49
$1,944.80
$1,944.80
$2,204.22
$1,780.29
$2,204.22
$2,204.22
$1,887.06
$2,204.22
$1,709.28
$1,878.78
$2,204.22
$1,696.82
$1,709.93
$1,737.21
$1,737.95
$1,660.88
$1,887.06
$1,694.88
$1,737.21
$2,197.25
$1,696.82
$1,747.47
$2,204.22
$2,204.22
$2,204.22
$1,727.31
$1,743.83
$1,843.59
$1,744.88
$2,197.25
$1,685.90

PAS
4
$2,202.65
$2,247.60
$2,473.59
$2,230.29
$2,200.20
$2,247.60
$2,202.08
$2,169.06
$2,243.01
$2,350.85
$2,670.39
$2,247.60
$2,241.09
$2,225.70
$2,434.43
$2,434.43
$2,676.92
$2,280.68
$2,676.92
$2,676.92
$2,380.47
$2,676.92
$2,214.30
$2,372.72
$2,676.92
$2,202.65
$2,214.90
$2,240.40
$2,241.09
$2,169.06
$2,380.47
$2,200.85
$2,240.40
$2,670.39
$2,202.65
$2,250.00
$2,676.92
$2,676.92
$2,676.92
$2,231.15
$2,246.60
$2,339.84
$2,247.57
$2,670.39
$2,192.45

PAS
5
$700.22
$721.04
$825.72
$713.01
$699.08
$721.04
$699.95
$684.65
$718.91
$768.86
$916.88
$721.04
$718.02
$710.90
$807.57
$807.57
$919.89
$736.35
$919.89
$919.89
$782.58
$919.89
$705.62
$779.00
$919.89
$700.22
$705.89
$717.69
$718.02
$684.65
$782.58
$699.38
$717.69
$916.88
$700.22
$722.15
$919.89
$919.89
$919.89
$713.42
$720.57
$763.76
$721.02
$916.88
$695.49

PAS
6
$1,522.59
$1,581.32
$1,876.49
$1,558.70
$1,519.40
$1,581.32
$1,521.83
$1,478.72
$1,575.32
$1,716.15
$2,133.53
$1,581.32
$1,572.80
$1,552.71
$1,825.32
$1,825.32
$2,142.05
$1,624.50
$2,142.05
$2,142.05
$1,754.84
$2,142.05
$1,537.82
$1,744.73
$2,142.05
$1,522.59
$1,538.60
$1,571.90
$1,572.80
$1,478.72
$1,754.84
$1,520.24
$1,571.90
$2,133.53
$1,522.59
$1,584.44
$2,142.05
$2,142.05
$2,142.05
$1,559.82
$1,579.98
$1,701.78
$1,581.27
$2,133.53
$1,509.26

PAS
7
$1,427.87
$1,487.12
$1,784.94
$1,464.30
$1,424.64
$1,487.12
$1,427.10
$1,383.60
$1,481.06
$1,623.17
$2,044.28
$1,487.12
$1,478.52
$1,458.26
$1,733.31
$1,733.31
$2,052.87
$1,530.69
$2,052.87
$2,052.87
$1,662.20
$2,052.87
$1,443.23
$1,652.00
$2,052.87
$1,427.87
$1,444.01
$1,477.62
$1,478.52
$1,383.60
$1,662.20
$1,425.50
$1,477.62
$2,044.28
$1,427.87
$1,490.27
$2,052.87
$2,052.87
$2,052.87
$1,465.43
$1,485.78
$1,608.66
$1,487.07
$2,044.28
$1,414.43

PAS
8
$737.69
$752.70
$828.15
$746.91
$736.88
$752.70
$737.49
$726.47
$751.16
$787.17
$893.85
$752.70
$750.53
$745.38
$815.07
$815.07
$896.03
$763.74
$896.03
$896.03
$797.06
$896.03
$741.59
$794.48
$896.03
$737.69
$741.78
$750.29
$750.53
$726.47
$797.06
$737.09
$750.29
$893.85
$737.69
$753.50
$896.03
$896.03
$896.03
$747.20
$752.36
$783.50
$752.69
$893.85
$734.28

PAS
9
$1,030.25
$1,064.10
$1,234.28
$1,051.07
$1,028.42
$1,064.10
$1,029.81
$1,004.96
$1,060.64
$1,141.85
$1,382.46
$1,064.10
$1,059.20
$1,047.62
$1,204.77
$1,204.77
$1,387.37
$1,089.00
$1,387.37
$1,387.37
$1,164.15
$1,387.37
$1,039.02
$1,158.32
$1,387.37
$1,030.25
$1,039.47
$1,058.67
$1,059.20
$1,004.96
$1,164.15
$1,028.90
$1,058.67
$1,382.46
$1,030.25
$1,065.90
$1,387.37
$1,387.37
$1,387.37
$1,051.71
$1,063.34
$1,133.55
$1,064.07
$1,382.46
$1,022.57
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1101000
3301008
0226700
1229000
5127000
2221000
4423000
5526001
4601001
7001024
1401005
3202003
7003001
2910000
3429000
3402000
5601000
4329000
5154001
7002009
4322000
2701001
7002012
7002011
5901000
5153000
3154000
7001046
5022000
2906000
7000002
7003003
5149000
0228000
1401014
1401002
3103000
1401009
1404000
7001016
7001033
5501001
2728001
5922000
7002017

Agency
CORTLAND MEMORIAL HOSP
CROUSE HOSPITAL
CUBA MEMORIAL HOSPITAL
DELAWARE VALLEY HOSPITAL
EASTERN LONG ISLAND HOSP
EJ NOBLE / ALEXANDRIA
EJ NOBLE / GOUVERNEUR
ELLENVILLE REGIONAL HOSP
ELLIS HOSPITAL
EPISCOPAL HEALTH SERVICES
ERIE COUNTY MEDICAL CTR
FAXTON-ST LUKES HEALTHCARE
FLUSHING HOSPITAL
FRANKLIN HOSP MED CTR
FREDERICK FERRIS THOMPSON
GENEVA GENERAL HOSPITAL
GLENS FALLS HOSPITAL
GOOD SAMARITAN / SUFFERN
GOOD SAMARITAN / WEST ISLIP
HARLEM HOSPITAL CENTER
HELEN HAYES HOSPITAL
HIGHLAND HOSP / ROCHESTER
HOSP FOR SPECIAL SURGERY
HOSPITAL FOR JOINT DISEASES
HUDSON VALLEY HOSP CTR
HUNTINGTON HOSP ASSOC
INTER-COMMUNITY MEMORIAL
INTERFAITH MEDICAL CTR
IRA DAVENPORT MEMORIAL
ISLAND MEDICAL CENTER
JACOBI MEDICAL CENTER
JAMAICA HOSPITAL
JOHN T MATHER MEMORIAL
JONES MEMORIAL
KALEIDA HLTH (BUFFALO GEN)
KALEIDA HLTH (CHILD OF BUFF)
KALEIDA HLTH (DEGRAFF)
KALEIDA HLTH (MILLARD)
KENMORE MERCY HOSPITAL
KINGS COUNTY HOSPITAL
KINGSBROOK JEWISH MEDICAL
KINGSTON HOSPITAL
LAKESIDE MEMORIAL HOSP
LAWRENCE HOSPITAL
LENOX HILL HOSPITAL

Mmisid
00279176
00279396
00354238
00347571
00274337
00354265
00354256
02094860
00347562
00729382
00245863
00384309
00243843
00268328
00362529
00378712
00314998
00273941
00274346
00246108
00273950
00354307
00243370
00243389
00274153
00274355
00354325
00734336
00332816
00273285
00246048
00243852
00274364
00354403
00361968
00360614
00354247
00384643
00354343
00246117
00243669
00274048
00279543
00274093
00243421

PAS
1
$1,085.52
$1,151.39
$1,069.83
$1,143.26
$1,259.37
$1,122.12
$1,109.94
$1,143.26
$1,148.43
$1,505.12
$1,318.29
$1,126.44
$1,505.12
$1,259.37
$1,151.22
$1,151.22
$1,125.08
$1,225.70
$1,259.37
$1,499.72
$1,231.76
$1,152.86
$1,316.30
$1,316.30
$1,225.70
$1,259.37
$1,132.22
$1,316.30
$1,101.53
$1,252.95
$1,499.72
$1,505.12
$1,259.37
$1,069.83
$1,318.29
$1,132.61
$1,132.22
$1,318.29
$1,130.33
$1,499.72
$1,316.30
$1,143.83
$1,151.22
$1,225.70
$1,505.12

PAS
2
$910.22
$963.27
$897.59
$956.73
$1,050.26
$939.69
$929.88
$956.73
$960.89
$1,248.20
$1,097.70
$943.17
$1,248.20
$1,050.26
$963.14
$963.14
$942.08
$1,023.12
$1,050.26
$1,243.85
$1,028.00
$964.46
$1,096.10
$1,096.10
$1,023.12
$1,050.26
$947.82
$1,096.10
$923.10
$1,045.08
$1,243.85
$1,248.20
$1,050.26
$897.59
$1,097.70
$948.14
$947.82
$1,097.70
$946.31
$1,243.85
$1,096.10
$957.18
$963.14
$1,023.12
$1,248.20
Page 2 of 25

PAS
3
$1,662.69
$1,747.68
$1,642.44
$1,737.21
$1,887.06
$1,709.93
$1,694.21
$1,737.21
$1,743.89
$2,204.22
$1,963.10
$1,715.49
$2,204.22
$1,887.06
$1,747.47
$1,747.47
$1,713.74
$1,843.59
$1,887.06
$2,197.25
$1,851.41
$1,749.60
$1,960.52
$1,960.52
$1,843.59
$1,887.06
$1,722.95
$1,960.52
$1,683.35
$1,878.78
$2,197.25
$2,204.22
$1,887.06
$1,642.44
$1,963.10
$1,723.44
$1,722.95
$1,963.10
$1,720.50
$2,197.25
$1,960.52
$1,737.95
$1,747.47
$1,843.59
$2,204.22

PAS
4

PAS
5

PAS
6

PAS
7

PAS
8

PAS
9

$2,170.76
$2,250.20
$2,151.83
$2,240.40
$2,380.47
$2,214.90
$2,200.20
$2,240.40
$2,246.64
$2,676.92
$2,451.54
$2,220.11
$2,676.92
$2,380.47
$2,250.00
$2,250.00
$2,218.47
$2,339.84
$2,380.47
$2,670.39
$2,347.14
$2,251.98
$2,449.13
$2,449.13
$2,339.84
$2,380.47
$2,227.07
$2,449.13
$2,190.05
$2,372.72
$2,670.39
$2,676.92
$2,380.47
$2,151.83
$2,451.54
$2,227.55
$2,227.07
$2,451.54
$2,224.79
$2,670.39
$2,449.13
$2,241.09
$2,250.00
$2,339.84
$2,676.92

$685.44
$722.24
$676.67
$717.69
$782.58
$705.89
$699.08
$717.69
$720.59
$919.89
$815.51
$708.30
$919.89
$782.58
$722.15
$722.15
$707.54
$763.76
$782.58
$916.88
$767.15
$723.06
$814.38
$814.38
$763.76
$782.58
$711.53
$814.38
$694.38
$779.00
$916.88
$919.89
$782.58
$676.67
$815.51
$711.74
$711.53
$815.51
$710.46
$916.88
$814.38
$718.02
$722.15
$763.76
$919.89

$1,480.92
$1,584.69
$1,456.20
$1,571.90
$1,754.84
$1,538.60
$1,519.40
$1,571.90
$1,580.04
$2,142.05
$1,847.67
$1,545.38
$2,142.05
$1,754.84
$1,584.44
$1,584.44
$1,543.26
$1,701.78
$1,754.84
$2,133.53
$1,711.32
$1,587.03
$1,844.52
$1,844.52
$1,701.78
$1,754.84
$1,554.50
$1,844.52
$1,506.14
$1,744.73
$2,133.53
$2,142.05
$1,754.84
$1,456.20
$1,847.67
$1,555.10
$1,554.50
$1,847.67
$1,551.51
$2,133.53
$1,844.52
$1,572.80
$1,584.44
$1,701.78
$2,142.05

$1,385.82
$1,490.52
$1,360.89
$1,477.62
$1,662.20
$1,444.01
$1,424.64
$1,477.62
$1,485.84
$2,052.87
$1,755.86
$1,450.86
$2,052.87
$1,662.20
$1,490.27
$1,490.27
$1,448.72
$1,608.66
$1,662.20
$2,044.28
$1,618.29
$1,492.88
$1,752.69
$1,752.69
$1,608.66
$1,662.20
$1,460.06
$1,752.69
$1,411.26
$1,652.00
$2,044.28
$2,052.87
$1,662.20
$1,360.89
$1,755.86
$1,460.67
$1,460.06
$1,755.86
$1,457.04
$2,044.28
$1,752.69
$1,478.52
$1,490.27
$1,608.66
$2,052.87

$727.04
$753.56
$720.72
$750.29
$797.06
$741.78
$736.88
$750.29
$752.37
$896.03
$820.79
$743.51
$896.03
$797.06
$753.50
$753.50
$742.97
$783.50
$797.06
$893.85
$785.93
$754.16
$819.98
$819.98
$783.50
$797.06
$745.85
$819.98
$733.49
$794.48
$893.85
$896.03
$797.06
$720.72
$820.79
$746.00
$745.85
$820.79
$745.08
$893.85
$819.98
$750.53
$753.50
$783.50
$896.03

$1,006.23
$1,066.05
$991.98
$1,058.67
$1,164.15
$1,039.47
$1,028.42
$1,058.67
$1,063.37
$1,387.37
$1,217.66
$1,043.39
$1,387.37
$1,164.15
$1,065.90
$1,065.90
$1,042.16
$1,133.55
$1,164.15
$1,382.46
$1,139.06
$1,067.40
$1,215.84
$1,215.84
$1,133.55
$1,164.15
$1,048.64
$1,215.84
$1,020.77
$1,158.32
$1,382.46
$1,387.37
$1,164.15
$991.98
$1,217.66
$1,049.00
$1,048.64
$1,217.66
$1,046.93
$1,382.46
$1,215.84
$1,059.20
$1,065.90
$1,133.55
$1,387.37
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
2424000
7000008
2129000
3101000
2902000
7001017
7003004
7001019
7001020
7002019
1226701
3824000
5721700
4402000
3622000
0101003
7002020
1401008
2909000
7002021
7000006
1564701
7003015
7002024
3121001
5903000
2950002
1701000
2952006
3102000
2527000
7000024
7002052
7003013
2901000
2952005
2951001
1327000
5920000
7001008
7002026
7003010
7001021
7099003
7002054

Agency
LEWIS COUNTY GENERAL
LINCOLN MEDICAL & MENTAL
LITTLE FALLS HOSPITAL
LOCKPORT MEMORIAL HOSP
LONG BEACH MEDICAL CTR
LONG ISLAND COLLEGE HOSP
LONG ISLAND JEWISH
LUTHERAN MEDICAL CENTER
MAIMONIDES MEDICAL CTR
MANHATTAN EYE EAR & THROAT
MARGARETVILLE MEMORIAL
MARY IMOGENE BASSETT
MARY MCCLELLAN HOSPITAL
MASSENA MEMORIAL HOSPITAL
MEDINA MEMORIAL HOSPITAL
MEMORIAL HOSP (ALBANY)
MEMORIAL HOSP FOR CANCER
MERCY HOSPITAL OF BUFFALO
MERCY MEDICAL CENTER
METROPOLITAN HOSPITAL CTR
MONTEFIORE HOSPITAL
MOSES-LUDINGTON HOSPITAL
MOUNT SINAI / WEST QUEENS
MOUNT SINAI HOSPITAL
MOUNT ST MARYS HOSPITAL
MOUNT VERNON HOSPITAL
NASSAU HEALTH CARE CORP
NATHAN LITTAUER HOSPITAL
NEW ISLAND HOSPITAL
NIAGARA FALLS MEMORIAL**
NICHOLAS H NOYES HOSP
NORTH CENTRAL BRONX
NORTH GENERAL HOSPITAL
NORTH SHORE / FOREST HILLS
NORTH SHORE / GLEN COVE
NORTH SHORE / PLAINVIEW
NORTH SHORE UNIVERSITY
NORTHERN DUTCHESS HOSP
NORTHERN WESTCHESTER
NY COMMUNITY / BROOKLYN
NY EYE & EAR INFIRMARY
NY MEDICAL CTR OF QUEENS
NY METHODIST HOSPITAL
NY PRESBY HOSP (ALLEN)
NY PRESBY HOSP (NY PAYNE)

Mmisid
00354370
00246126
00310870
00354389
00245487
00243678
00243903
00243729
00243641
00243458
00279387
00305000
00336952
00354398
00310898
00364003
00243467
00354412
00274295
00246135
00243554
00360930
00243509
00243509
01746616
00274117
01962156
00313924
01949875
00354467
00354476
00246171
00355142
00243889
00274240
00274231
00245510
00268300
00274144
00243696
00243476
00244133
00243701
00243178
00243518

PAS
1
$1,122.12
$1,499.72
$1,127.21
$1,132.22
$1,259.37
$1,505.12
$1,505.12
$1,316.30
$1,505.12
$1,300.95
$1,143.26
$1,328.18
$1,125.89
$1,111.97
$1,139.73
$1,149.24
$1,316.30
$1,130.33
$1,259.37
$1,499.72
$1,505.12
$1,130.36
$1,304.10
$1,505.12
$1,131.45
$1,225.70
$1,453.16
$1,137.17
$1,252.95
$1,131.45
$1,151.22
$1,499.72
$1,488.69
$1,488.69
$1,259.37
$1,259.37
$1,453.16
$1,204.14
$1,225.70
$1,304.10
$1,304.10
$1,505.12
$1,505.12
$1,505.12
$1,505.12

PAS
2
$939.69
$1,243.85
$943.80
$947.82
$1,050.26
$1,248.20
$1,248.20
$1,096.10
$1,248.20
$1,083.74
$956.73
$1,105.67
$942.72
$931.52
$953.88
$961.53
$1,096.10
$946.31
$1,050.26
$1,243.85
$1,248.20
$946.34
$1,086.29
$1,248.20
$947.21
$1,023.12
$1,206.35
$951.81
$1,045.08
$947.21
$963.14
$1,243.85
$1,234.97
$1,234.97
$1,050.26
$1,050.26
$1,206.35
$1,005.77
$1,023.12
$1,086.29
$1,086.29
$1,248.20
$1,248.20
$1,248.20
$1,248.20
Page 3 of 25

PAS
3
$1,709.93
$2,197.25
$1,716.48
$1,722.95
$1,887.06
$2,204.22
$2,204.22
$1,960.52
$2,204.22
$1,940.72
$1,737.21
$1,975.86
$1,714.77
$1,696.82
$1,732.64
$1,744.92
$1,960.52
$1,720.50
$1,887.06
$2,197.25
$2,204.22
$1,720.55
$1,944.80
$2,204.22
$1,721.96
$1,843.59
$2,137.16
$1,729.34
$1,878.78
$1,721.96
$1,747.47
$2,197.25
$2,183.03
$2,183.03
$1,887.06
$1,887.06
$2,137.16
$1,815.78
$1,843.59
$1,944.80
$1,944.80
$2,204.22
$2,204.22
$2,204.22
$2,204.22

PAS
4

PAS
5

PAS
6

PAS
7

PAS
8

PAS
9

$2,214.90
$2,670.39
$2,221.04
$2,227.07
$2,380.47
$2,676.92
$2,676.92
$2,449.13
$2,676.92
$2,430.62
$2,240.40
$2,463.47
$2,219.43
$2,202.65
$2,236.14
$2,247.60
$2,449.13
$2,224.79
$2,380.47
$2,670.39
$2,676.92
$2,224.83
$2,434.43
$2,676.92
$2,226.15
$2,339.84
$2,614.23
$2,233.05
$2,372.72
$2,226.15
$2,250.00
$2,670.39
$2,657.10
$2,657.10
$2,380.47
$2,380.47
$2,614.23
$2,313.84
$2,339.84
$2,434.43
$2,434.43
$2,676.92
$2,676.92
$2,676.92
$2,676.92

$705.89
$916.88
$708.72
$711.53
$782.58
$919.89
$919.89
$814.38
$919.89
$805.80
$717.69
$821.03
$707.99
$700.22
$715.73
$721.04
$814.38
$710.46
$782.58
$916.88
$919.89
$710.49
$807.57
$919.89
$711.09
$763.76
$890.87
$714.29
$779.00
$711.09
$722.15
$916.88
$910.71
$910.71
$782.58
$782.58
$890.87
$751.71
$763.76
$807.57
$807.57
$919.89
$919.89
$919.89
$919.89

$1,538.60
$2,133.53
$1,546.61
$1,554.50
$1,754.84
$2,142.05
$2,142.05
$1,844.52
$2,142.05
$1,820.34
$1,571.90
$1,863.24
$1,544.52
$1,522.59
$1,566.33
$1,581.32
$1,844.52
$1,551.51
$1,754.84
$2,133.53
$2,142.05
$1,551.57
$1,825.32
$2,142.05
$1,553.28
$1,701.78
$2,060.18
$1,562.30
$1,744.73
$1,553.28
$1,584.44
$2,133.53
$2,116.16
$2,116.16
$1,754.84
$1,754.84
$2,060.18
$1,667.82
$1,701.78
$1,825.32
$1,825.32
$2,142.05
$2,142.05
$2,142.05
$2,142.05

$1,444.01
$2,044.28
$1,452.09
$1,460.06
$1,662.20
$2,052.87
$2,052.87
$1,752.69
$2,052.87
$1,728.29
$1,477.62
$1,771.58
$1,449.99
$1,427.87
$1,472.00
$1,487.12
$1,752.69
$1,457.04
$1,662.20
$2,044.28
$2,052.87
$1,457.10
$1,733.31
$2,052.87
$1,458.84
$1,608.66
$1,970.27
$1,467.93
$1,652.00
$1,458.84
$1,490.27
$2,044.28
$2,026.76
$2,026.76
$1,662.20
$1,662.20
$1,970.27
$1,574.40
$1,608.66
$1,733.31
$1,733.31
$2,052.87
$2,052.87
$2,052.87
$2,052.87

$741.78
$893.85
$743.82
$745.85
$797.06
$896.03
$896.03
$819.98
$896.03
$813.80
$750.29
$824.76
$743.30
$737.69
$748.86
$752.70
$819.98
$745.08
$797.06
$893.85
$896.03
$745.10
$815.07
$896.03
$745.53
$783.50
$875.10
$747.84
$794.48
$745.53
$753.50
$893.85
$889.41
$889.41
$797.06
$797.06
$875.10
$774.81
$783.50
$815.07
$815.07
$896.03
$896.03
$896.03
$896.03

$1,039.47
$1,382.46
$1,044.09
$1,048.64
$1,164.15
$1,387.37
$1,387.37
$1,215.84
$1,387.37
$1,201.91
$1,058.67
$1,226.64
$1,042.89
$1,030.25
$1,055.46
$1,064.10
$1,215.84
$1,046.93
$1,164.15
$1,382.46
$1,387.37
$1,046.96
$1,204.77
$1,387.37
$1,047.95
$1,133.55
$1,340.18
$1,053.14
$1,158.32
$1,047.95
$1,065.90
$1,382.46
$1,372.46
$1,372.46
$1,164.15
$1,164.15
$1,340.18
$1,113.98
$1,133.55
$1,204.77
$1,204.77
$1,387.37
$1,387.37
$1,387.37
$1,387.37
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
7002030
5906000
7002053
7000025
4324000
7002000
0401001
2601001
3523000
3501000
3702000
0301001
7000005
1402000
2754001
7003020
7003006
5932000
3950000
7003007
7004010
2221001
2701003
3201002
1401010
4102002
2201000
4501000
4823000
4102003
1401006
7004006
1401013
6120000
5904000
2950001
5126000
5154000
5902000
3529000
7000014
5157003
5149001
4601002
7002033

Agency

Mmisid

NY PRESBY HOSP (PRESBY)

NY UNITED HOSPITAL
NY UNIV MED CTR (TISCH)
NY WESTCHESTER SQUARE
NYACK HOSPITAL
NYU DOWNTOWN HOSPITAL
OLEAN GENERAL HOSPITAL
ONEIDA CITY HOSPITAL
ORANGE REGIONAL MED CTR
ORANGE REGIONAL(MIDDLETOWN)
OSWEGO HOSPITAL
OUR LADY OF LOURDES HOSP
OUR LADY OF MERCY
OUR LADY OF VICTORY HOSP
PARK RIDGE HOSPITAL
PARKWAY HOSPITAL
PENINSULA HOSPITAL CTR
PHELPS MEMORIAL HOSPITAL
PUTNAM COMMUNITY HOSPITAL
QUEENS HOSPITAL CENTER
RICHMOND UNIVERSITY MEDICAL CENTER
RIVER HOSPITAL**
ROCHESTER GENERAL HOSP
ROME HOSPITAL AND MURPHY
ROSWELL PARK MEMORIAL
SAMARITAN HOSPITAL / TROY
SAMARITAN MEDICAL CENTER
SARATOGA HOSPITAL
SCHUYLER HOSPITAL
SETON HEALTH SYSTEMS
SHEEHAN MEMORIAL EMERG
SISTERS OF CHARITY (BAYLEY)
SISTERS OF CHARITY HOSP
SOLDIERS AND SAILORS
SOUND SHORE HOSPITAL
SOUTH NASSAU COMMUNITIES
SOUTHAMPTON HOSP ASSOC
SOUTHSIDE HOSPITAL
ST AGNES HOSPITAL
ST ANTHONY COMMUNITY
ST BARNABAS HOSPITAL
ST CATHERINE OF SIENA
ST CHARLES HOSPITAL
ST CLARE'S / SCHENECTADY
ST CLARES HOSP & HEALTH

00243178
00274204
00273116
00273092
00243967
00647269
00354632
00310903
00258379
00258379
00354485
00337664
00243563
00354494
00378721
00244151
00243898
00274162
00258360
00246153
00248820
02392854
00303315
00352534
00354518
00318805
00354316
00303282
00363144
01534463
00354545
00652328
00354563
00336498
00274126
00245496
00274406
00268319
00274180
00273890
00243361
02060942
00274415
00361748
00243201

PAS
1
$1,505.12
$1,225.70
$1,505.12
$1,304.10
$1,225.70
$1,484.28
$1,121.79
$1,149.21
$1,175.84
$1,175.84
$1,134.11
$1,114.91
$1,505.12
$1,130.33
$1,153.41
$1,304.10
$1,316.30
$1,225.70
$1,207.74
$1,499.72
$1,505.12
$1,122.12
$1,338.60
$1,127.21
$1,133.10
$1,148.43
$1,122.66
$1,148.43
$1,101.53
$1,148.43
$1,131.08
$1,316.30
$1,133.10
$1,083.60
$1,419.18
$1,266.71
$1,259.37
$1,259.37
$1,232.73
$1,176.65
$1,316.30
$1,259.37
$1,259.37
$1,148.43
$1,488.69

PAS
2
$1,248.20
$1,023.12
$1,248.20
$1,086.29
$1,023.12
$1,231.41
$939.42
$961.52
$982.97
$982.97
$949.35
$933.89
$1,248.20
$946.31
$964.91
$1,086.29
$1,096.10
$1,023.12
$1,008.66
$1,243.85
$1,248.20
$939.69
$1,114.07
$943.80
$948.54
$960.89
$940.14
$960.89
$923.10
$960.89
$946.92
$1,096.10
$948.54
$908.67
$1,178.97
$1,056.17
$1,050.26
$1,050.26
$1,028.79
$983.61
$1,096.10
$1,050.26
$1,050.26
$960.89
$1,234.97
Page 4 of 25

PAS
3
$2,204.22
$1,843.59
$2,204.22
$1,944.80
$1,843.59
$2,177.33
$1,709.49
$1,744.88
$1,779.24
$1,779.24
$1,725.39
$1,700.61
$2,204.22
$1,720.50
$1,750.31
$1,944.80
$1,960.52
$1,843.59
$1,820.42
$2,197.25
$2,204.22
$1,709.93
$1,989.30
$1,716.48
$1,724.10
$1,743.89
$1,710.62
$1,743.89
$1,683.35
$1,743.89
$1,721.49
$1,960.52
$1,724.10
$1,660.22
$2,093.31
$1,896.53
$1,887.06
$1,887.06
$1,852.68
$1,780.29
$1,960.52
$1,887.06
$1,887.06
$1,743.89
$2,183.03

PAS
4

PAS
5

PAS
6

PAS
7

PAS
8

PAS
9

$2,676.92
$2,339.84
$2,676.92
$2,434.43
$2,339.84
$2,651.76
$2,214.50
$2,247.57
$2,279.69
$2,279.69
$2,229.36
$2,206.20
$2,676.92
$2,224.79
$2,252.64
$2,434.43
$2,449.13
$2,339.84
$2,318.18
$2,670.39
$2,676.92
$2,214.90
$2,476.04
$2,221.04
$2,228.15
$2,246.64
$2,215.55
$2,246.64
$2,190.05
$2,246.64
$2,225.70
$2,449.13
$2,228.15
$2,168.43
$2,573.24
$2,389.32
$2,380.47
$2,380.47
$2,348.33
$2,280.68
$2,449.13
$2,380.47
$2,380.47
$2,246.64
$2,657.10

$919.89
$763.76
$919.89
$807.57
$763.76
$908.25
$705.69
$721.02
$735.90
$735.90
$712.58
$701.85
$919.89
$710.46
$723.38
$807.57
$814.38
$763.76
$753.72
$916.88
$919.89
$705.89
$826.85
$708.72
$712.02
$720.59
$706.19
$720.59
$694.38
$720.59
$710.90
$814.38
$712.02
$684.36
$871.88
$786.68
$782.58
$782.58
$767.69
$736.35
$814.38
$782.58
$782.58
$720.59
$910.71

$2,142.05
$1,701.78
$2,142.05
$1,825.32
$1,701.78
$2,109.20
$1,538.06
$1,581.27
$1,623.21
$1,623.21
$1,557.48
$1,527.23
$2,142.05
$1,551.51
$1,587.89
$1,825.32
$1,844.52
$1,701.78
$1,673.49
$2,133.53
$2,142.05
$1,538.60
$1,879.67
$1,546.61
$1,555.89
$1,580.04
$1,539.45
$1,580.04
$1,506.14
$1,580.04
$1,552.71
$1,844.52
$1,555.89
$1,477.91
$2,006.64
$1,766.40
$1,754.84
$1,754.84
$1,712.87
$1,624.50
$1,844.52
$1,754.84
$1,754.84
$1,580.04
$2,116.16

$2,052.87
$1,608.66
$2,052.87
$1,733.31
$1,608.66
$2,019.74
$1,443.48
$1,487.07
$1,529.40
$1,529.40
$1,463.07
$1,432.55
$2,052.87
$1,457.04
$1,493.75
$1,733.31
$1,752.69
$1,608.66
$1,580.12
$2,044.28
$2,052.87
$1,444.01
$1,788.14
$1,452.09
$1,461.47
$1,485.84
$1,444.88
$1,485.84
$1,411.26
$1,485.84
$1,458.26
$1,752.69
$1,461.47
$1,382.78
$1,916.25
$1,673.87
$1,662.20
$1,662.20
$1,619.85
$1,530.69
$1,752.69
$1,662.20
$1,662.20
$1,485.84
$2,026.76

$896.03
$783.50
$896.03
$815.07
$783.50
$887.63
$741.65
$752.69
$763.41
$763.41
$746.61
$738.87
$896.03
$745.08
$754.38
$815.07
$819.98
$783.50
$776.25
$893.85
$896.03
$741.78
$828.96
$743.82
$746.21
$752.37
$741.99
$752.37
$733.49
$752.37
$745.38
$819.98
$746.21
$726.26
$861.42
$800.01
$797.06
$797.06
$786.33
$763.74
$819.98
$797.06
$797.06
$752.37
$889.41

$1,387.37
$1,133.55
$1,387.37
$1,204.77
$1,133.55
$1,368.44
$1,039.17
$1,064.07
$1,088.27
$1,088.27
$1,050.36
$1,032.92
$1,387.37
$1,046.93
$1,067.90
$1,204.77
$1,215.84
$1,133.55
$1,117.25
$1,382.46
$1,387.37
$1,039.47
$1,236.11
$1,044.09
$1,049.45
$1,063.37
$1,039.97
$1,063.37
$1,020.77
$1,063.37
$1,047.62
$1,215.84
$1,049.45
$1,004.49
$1,309.31
$1,170.81
$1,164.15
$1,164.15
$1,139.94
$1,089.00
$1,215.84
$1,164.15
$1,164.15
$1,063.37
$1,372.46
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
3202002
1302000
2953000
5002001
5907001
1455000
0701001
3301003
5907002
3502000
3522000
7002032
2801001
7001025
0101004
7002037
7001037
5151001
7004003
2701005
3301007
1227000
0427000
0303001
1801000
1302001
7001032
5820000
5957001
0632000
5902001
2908000
0602001
7001045
7001035
6027000

Agency
ST ELIZABETH MED CTR
ST FRANCIS / POUGHKEEPSIE
ST FRANCIS HOSP / ROSLYN
ST JAMES MERCY HOSPITAL
ST JOHNS RIVERSIDE
ST JOSEPH HOSPITAL
ST JOSEPHS / ELMIRA
ST JOSEPHS HOSP & HEALTH
ST JOSEPHS OF YONKERS
ST LUKES / NEWBURGH
ST LUKES CORNWALL / CORNWALL
ST LUKES ROOSEVELT
ST MARYS AT AMSTERDAM
ST MARYS OF BROOKLYN
ST PETERS HOSPITAL
ST VINCENTS HOSPITAL
STATE UNIV / DOWNSTATE
STATE UNIV / STONY BROOK
STATEN ISLAND UNIV HOSPITAL
STRONG MEMORIAL HOSPITAL
SUNY HEALTH SCIENCE CENTER
THE HOSPITAL
TLC HEALTH NETWORK
UNITED HEALTH SERVICES
UNITED MEMORIAL (GENESEE)
VASSAR BROTHERS MED CTR
VICTORY MEMORIAL HOSPITAL
WAYNE HEALTH CARE
WESTCHESTER MEDICAL CTR
WESTFIELD MEMORIAL HOSP
WHITE PLAINS HOSPITAL
WINTHROP UNIVERSITY HOSP
WOMANS CHRISTIAN ASSOC
WOODHULL MEDICAL CENTER
WYCKOFF HEIGHTS HOSPITAL
WYOMING COUNTY COMMUNITY

Mmisid
00279901
00273845
00244046
00363162
00245501
00354581
00363126
00315013
00258920
00273914
00273863
00354967
00351639
00729373
00318823
00243229
00243590
00357795
00244202
00279034
00354590
00313951
00347544
00614755
00354283
00273854
00243449
00354458
00274213
00354614
00274222
00244211
00354623
00698866
00243825
00310889

PAS
1
$1,126.44
$1,205.18
$1,266.71
$1,103.51
$1,225.70
$1,130.33
$1,111.49
$1,336.56
$1,225.70
$1,175.84
$1,176.65
$1,505.12
$1,148.43
$1,505.12
$1,336.58
$1,505.12
$1,505.12
$1,453.16
$1,505.12
$1,338.60
$1,336.56
$1,143.26
$1,121.24
$1,117.74
$1,071.71
$1,203.24
$1,304.10
$1,151.22
$1,419.18
$1,121.63
$1,225.70
$1,453.16
$1,120.86
$1,499.72
$1,316.30
$1,071.71

PAS
2
$943.17
$1,006.59
$1,056.17
$924.71
$1,023.12
$946.31
$931.13
$1,112.43
$1,023.12
$982.97
$983.61
$1,248.20
$960.89
$1,248.20
$1,112.45
$1,248.20
$1,248.20
$1,206.35
$1,248.20
$1,114.07
$1,112.43
$956.73
$938.99
$936.17
$899.09
$1,005.03
$1,086.29
$963.14
$1,178.97
$939.30
$1,023.12
$1,206.35
$938.69
$1,243.85
$1,096.10
$899.09

PAS
3
$1,715.49
$1,817.12
$1,896.53
$1,685.90
$1,843.59
$1,720.50
$1,696.20
$1,986.69
$1,843.59
$1,779.24
$1,780.29
$2,204.22
$1,743.89
$2,204.22
$1,986.71
$2,204.22
$2,204.22
$2,137.16
$2,204.22
$1,989.30
$1,986.69
$1,737.21
$1,708.79
$1,704.27
$1,644.86
$1,814.61
$1,944.80
$1,747.47
$2,093.31
$1,709.28
$1,843.59
$2,137.16
$1,708.31
$2,197.25
$1,960.52
$1,644.86

3102000 NIAGARA FALLS**

Page 5 of 25

PAS
4

PAS
5

PAS
6

PAS
7

PAS
8

PAS
9

$2,220.11
$2,315.09
$2,389.32
$2,192.45
$2,339.84
$2,224.79
$2,202.08
$2,473.58
$2,339.84
$2,279.69
$2,280.68
$2,676.92
$2,246.64
$2,676.92
$2,473.59
$2,676.92
$2,676.92
$2,614.23
$2,676.92
$2,476.04
$2,473.58
$2,240.40
$2,213.84
$2,209.61
$2,154.08
$2,312.75
$2,434.43
$2,250.00
$2,573.24
$2,214.30
$2,339.84
$2,614.23
$2,213.39
$2,670.39
$2,449.13
$2,154.08

$708.30
$752.30
$786.68
$695.49
$763.76
$710.46
$699.95
$825.71
$763.76
$735.90
$736.35
$919.89
$720.59
$919.89
$825.72
$919.89
$919.89
$890.87
$919.89
$826.85
$825.71
$717.69
$705.39
$703.44
$677.72
$751.22
$807.57
$722.15
$871.88
$705.62
$763.76
$890.87
$705.18
$916.88
$814.38
$677.72

$1,545.38
$1,669.46
$1,766.40
$1,509.26
$1,701.78
$1,551.51
$1,521.83
$1,876.47
$1,701.78
$1,623.21
$1,624.50
$2,142.05
$1,580.04
$2,142.05
$1,876.49
$2,142.05
$2,142.05
$2,060.18
$2,142.05
$1,879.67
$1,876.47
$1,571.90
$1,537.20
$1,531.68
$1,459.14
$1,666.40
$1,825.32
$1,584.44
$2,006.64
$1,537.82
$1,701.78
$2,060.18
$1,536.62
$2,133.53
$1,844.52
$1,459.14

$1,450.86
$1,576.05
$1,673.87
$1,414.43
$1,608.66
$1,457.04
$1,427.10
$1,784.91
$1,608.66
$1,529.40
$1,530.69
$2,052.87
$1,485.84
$2,052.87
$1,784.94
$2,052.87
$2,052.87
$1,970.27
$2,052.87
$1,788.14
$1,784.91
$1,477.62
$1,442.61
$1,437.05
$1,363.86
$1,572.96
$1,733.31
$1,490.27
$1,916.25
$1,443.23
$1,608.66
$1,970.27
$1,442.01
$2,044.28
$1,752.69
$1,363.86

$743.51
$775.23
$800.01
$734.28
$783.50
$745.08
$737.49
$828.14
$783.50
$763.41
$763.74
$896.03
$752.37
$896.03
$828.15
$896.03
$896.03
$875.10
$896.03
$828.96
$828.14
$750.29
$741.42
$740.01
$721.47
$774.45
$815.07
$753.50
$861.42
$741.59
$783.50
$875.10
$741.27
$893.85
$819.98
$721.47

$1,043.39
$1,114.92
$1,170.81
$1,022.57
$1,133.55
$1,046.93
$1,029.81
$1,234.26
$1,133.55
$1,088.27
$1,089.00
$1,387.37
$1,063.37
$1,387.37
$1,234.28
$1,387.37
$1,387.37
$1,340.18
$1,387.37
$1,236.11
$1,234.26
$1,058.67
$1,038.68
$1,035.50
$993.68
$1,113.15
$1,204.77
$1,065.90
$1,309.31
$1,039.02
$1,133.55
$1,340.18
$1,038.33
$1,382.46
$1,215.84
$993.68

PAS 25 (Lithotripsy Rate) Effective 02/11/2003

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
0101005
0101000
3701000
1624000
2801000
0701000
0501000
3801000
4720001
7002001
4652001
5501000
1427000
7001041
7002004
7002002
3535001
7000001
7001002
5123000
7001003
0601000
5120000
7002003
4429000
2238001
5263700
5263000
5401001
5155000
0901001
0824000
7003000
4401000
3421000
7003005
7003008
7003025
1001000
3301000
5925000
2625000
7001009
5001000

Agency
ADIRONDACK MEDICAL HOSP
ALB MED SO CLINICAL CAMPUS
ALBANY MEDICAL CENTER
ALBERT LINDLEY LEE
ALICE HYDE MEDICAL CTR
AMSTERDAM MEMORIAL HOSP
ARNOT OGDEN MEMORIAL
AUBURN MEMORIAL HOSPITAL
AURELIA OSBORN FOX
BASSETT HOSPITAL
BELLEVUE HOSPITAL CTR
BELLEVUE WOMAN'S HOSP
BENEDICTINE HOSPITAL
BERTRAND CHAFFEE HOSPITAL
BETH ISRAEL / KINGS HIGHWAY
BETH ISRAEL / NORTH DIVISION
BETH ISRAEL MEDICAL CTR
BON SECOURS COMM HOSP
BRONX-LEBANON HOSP CTR
BROOKDALE HOSP MED CTR
BROOKHAVEN MEMORIAL HOSP
BROOKLYN HOSPITAL CENTER
BROOKS MEMORIAL HOSPITAL
BRUNSWICK HOSPITAL CTR
CABRINI MEDICAL CENTER
CANTON-POTSDAM HOSPITAL
CARTHAGE AREA HOSPITAL
CATSKILL REGIONAL / G HERMANN
CATSKILL REGIONAL MED CTR
CAYUGA MEDICAL CENTER
CENTRAL SUFFOLK HOSPITAL
CHAMPLAIN VALLEY PHYS
CHENANGO MEMORIAL HOSP
CITY HOSPITAL CENTER
CLAXTON-HEPBURN MED CTR
CLIFTON SPRINGS HOSPITAL
CMC (MARY IMMACULATE)
CMC (ST JOHNS)
CMC (ST JOSEPHS)
COLUMBIA MEMORIAL HOSP
COMM GEN / GREATER SYRACUSE
COMM HOSP / DOBBS FERRY
COMMUNITY MEMORIAL HOSP
CONEY ISLAND HOSPITAL
CORNING HOSPITAL

Mmisid
00363213
01952712
00277716
00354105
00354114
00381420
00363199
00347553
00279098
00302429
00246039
00354132
00274020
00354150
00243105
00243105
00243105
00273905
00476022
00243572
00245529
00243614
00381439
00268295
00243132
00354196
00310852
00273978
00273978
00332729
00274328
00318814
00314723
00246075
00354072
00354641
00243861
00244124
00498531
00335915
00315004
00274066
00354229
00246066
00361739

PAS
10
$1,410.38
$1,465.73
$1,743.99
$1,444.41
$1,407.36
$1,465.73
$1,409.66
$1,369.02
$1,460.07
$1,592.85
$1,986.30
$1,465.73
$1,457.70
$1,438.77
$1,695.77
$1,695.77
$1,994.33
$1,506.45
$1,994.33
$1,994.33
$1,629.32
$1,994.33
$1,424.73
$1,619.79
$1,994.33
$1,410.38
$1,425.45
$1,456.86
$1,457.70
$1,369.02
$1,629.32
$1,408.16
$1,456.86
$1,986.30
$1,410.38
$1,468.68
$1,994.33
$1,994.33
$1,994.33
$1,445.48
$1,464.48
$1,579.31
$1,465.70
$1,986.30
$1,397.81

PAS
11
$872.13
$899.42
$1,036.56
$888.92
$870.66
$899.42
$871.79
$851.75
$896.63
$962.07
$1,155.98
$899.42
$895.46
$886.13
$1,012.79
$1,012.79
$1,159.94
$919.49
$1,159.94
$1,159.94
$980.04
$1,159.94
$879.21
$975.35
$1,159.94
$872.13
$879.57
$895.05
$895.46
$851.75
$980.04
$871.04
$895.05
$1,155.98
$872.13
$900.87
$1,159.94
$1,159.94
$1,159.94
$889.43
$898.80
$955.40
$899.40
$1,155.98
$865.95

PAS
12
$732.68
$760.34
$899.36
$749.69
$731.18
$760.34
$732.33
$712.02
$757.52
$823.85
$1,020.42
$760.34
$756.33
$746.87
$875.27
$875.27
$1,024.43
$780.68
$1,024.43
$1,024.43
$842.07
$1,024.43
$739.86
$837.30
$1,024.43
$732.68
$740.22
$755.91
$756.33
$712.02
$842.07
$731.58
$755.91
$1,020.42
$732.68
$761.81
$1,024.43
$1,024.43
$1,024.43
$750.21
$759.72
$817.08
$760.32
$1,020.42
$726.41

Page 6 of 25

PAS
13
$865.29
$897.92
$1,061.93
$885.35
$863.52
$897.92
$864.87
$840.92
$894.59
$972.84
$1,204.76
$897.92
$893.19
$882.02
$1,033.50
$1,033.50
$1,209.48
$921.92
$1,209.48
$1,209.48
$994.34
$1,209.48
$873.75
$988.73
$1,209.48
$865.29
$874.19
$892.68
$893.19
$840.92
$994.34
$863.99
$892.68
$1,204.76
$865.29
$899.66
$1,209.48
$1,209.48
$1,209.48
$885.98
$897.18
$964.86
$897.90
$1,204.76
$857.88

PAS
14
$2,114.90
$2,157.38
$2,370.87
$2,141.03
$2,112.60
$2,157.38
$2,114.36
$2,083.17
$2,153.04
$2,254.91
$2,556.78
$2,157.38
$2,151.21
$2,136.69
$2,333.87
$2,333.87
$2,562.95
$2,188.61
$2,562.95
$2,562.95
$2,282.88
$2,562.95
$2,125.92
$2,275.58
$2,562.95
$2,114.90
$2,126.48
$2,150.57
$2,151.21
$2,083.17
$2,282.88
$2,113.20
$2,150.57
$2,556.78
$2,114.90
$2,159.64
$2,562.95
$2,562.95
$2,562.95
$2,141.84
$2,156.42
$2,244.51
$2,157.35
$2,556.78
$2,105.27

PAS
15
$1,462.77
$1,523.40
$1,828.19
$1,500.06
$1,459.49
$1,523.40
$1,461.99
$1,417.47
$1,517.21
$1,662.63
$2,093.58
$1,523.40
$1,514.61
$1,493.88
$1,775.36
$1,775.36
$2,102.37
$1,568.00
$2,102.37
$2,102.37
$1,702.58
$2,102.37
$1,478.49
$1,692.14
$2,102.37
$1,462.77
$1,479.30
$1,513.70
$1,514.61
$1,417.47
$1,702.58
$1,460.34
$1,513.70
$2,093.58
$1,462.77
$1,526.64
$2,102.37
$2,102.37
$2,102.37
$1,501.22
$1,522.04
$1,647.80
$1,523.37
$2,093.58
$1,449.02

PAS
16
$982.05
$1,018.11
$1,199.40
$1,004.22
$980.09
$1,018.11
$981.59
$955.10
$1,014.42
$1,100.93
$1,357.28
$1,018.11
$1,012.88
$1,000.55
$1,167.98
$1,167.98
$1,362.51
$1,044.65
$1,362.51
$1,362.51
$1,124.70
$1,362.51
$991.40
$1,118.48
$1,362.51
$982.05
$991.88
$1,012.34
$1,012.88
$955.10
$1,124.70
$980.60
$1,012.34
$1,357.28
$982.05
$1,020.03
$1,362.51
$1,362.51
$1,362.51
$1,004.91
$1,017.30
$1,092.11
$1,018.08
$1,357.28
$973.86

PAS
17
$560.45
$579.89
$677.58
$572.40
$559.40
$579.89
$560.21
$545.93
$577.89
$624.51
$762.65
$579.89
$577.07
$570.42
$660.65
$660.65
$765.47
$594.18
$765.47
$765.47
$637.32
$765.47
$565.49
$633.98
$765.47
$560.45
$565.74
$576.77
$577.07
$545.93
$637.32
$559.67
$576.77
$762.65
$560.45
$580.92
$765.47
$765.47
$765.47
$572.78
$579.45
$619.76
$579.87
$762.65
$556.04

PAS
18
$680.93
$707.88
$843.35
$697.50
$679.47
$707.88
$680.58
$660.80
$705.12
$769.77
$961.32
$707.88
$703.97
$694.76
$819.87
$819.87
$965.24
$727.70
$965.24
$965.24
$787.53
$965.24
$687.92
$782.88
$965.24
$680.93
$688.28
$703.56
$703.97
$660.80
$787.53
$679.85
$703.56
$961.32
$680.93
$709.32
$965.24
$965.24
$965.24
$698.01
$707.27
$763.17
$707.87
$961.32
$674.82

PAS
19
$789.99
$815.60
$944.34
$805.74
$788.60
$815.60
$789.66
$770.85
$812.99
$874.41
$1,056.44
$815.60
$811.89
$803.13
$922.02
$922.02
$1,060.16
$834.44
$1,060.16
$1,060.16
$891.29
$1,060.16
$796.64
$886.88
$1,060.16
$789.99
$796.97
$811.50
$811.89
$770.85
$891.29
$788.96
$811.50
$1,056.44
$789.99
$816.96
$1,060.16
$1,060.16
$1,060.16
$806.22
$815.03
$868.14
$815.58
$1,056.44
$784.17
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
1101000
3301008
0226700
1229000
5127000
2221000
4423000
5526001
4601001
7001024
1401005
3202003
7003001
2910000
3429000
3402000
5601000
4329000
5154001
7002009
4322000
2701001
7002012
7002011
5901000
5153000
3154000
7001046
5022000
2906000
7000002
7003003
5149000
0228000
1401014
1401002
3103000
1401009
1404000
7001016
7001033
5501001
2728001
5922000
7002017

Agency
ADIRONDACK
MEDICAL HOSP
HOSP
CORTLAND
MEMORIAL
CROUSE HOSPITAL
CUBA MEMORIAL HOSPITAL
DELAWARE VALLEY HOSPITAL
EASTERN LONG ISLAND HOSP
EJ NOBLE / ALEXANDRIA
EJ NOBLE / GOUVERNEUR
ELLENVILLE REGIONAL HOSP
ELLIS HOSPITAL
EPISCOPAL HEALTH SERVICES
ERIE COUNTY MEDICAL CTR
FAXTON-ST LUKES HEALTHCARE
FLUSHING HOSPITAL
FRANKLIN HOSP MED CTR
FREDERICK FERRIS THOMPSON
GENEVA GENERAL HOSPITAL
GLENS FALLS HOSPITAL
GOOD SAMARITAN / SUFFERN
GOOD SAMARITAN / WEST ISLIP
HARLEM HOSPITAL CENTER
HELEN HAYES HOSPITAL
HIGHLAND HOSP / ROCHESTER
HOSP FOR SPECIAL SURGERY
HOSPITAL FOR JOINT DISEASES
HUDSON VALLEY HOSP CTR
HUNTINGTON HOSP ASSOC
INTER-COMMUNITY MEMORIAL
INTERFAITH MEDICAL CTR
IRA DAVENPORT MEMORIAL
ISLAND MEDICAL CENTER
JACOBI MEDICAL CENTER
JAMAICA HOSPITAL
JOHN T MATHER MEMORIAL
JONES MEMORIAL
KALEIDA HLTH (BUFFALO GEN)
KALEIDA HLTH (CHILD OF BUFF)
KALEIDA HLTH (DEGRAFF)
KALEIDA HLTH (MILLARD)
KENMORE MERCY HOSPITAL
KINGS COUNTY HOSPITAL
KINGSBROOK JEWISH MEDICAL
KINGSTON HOSPITAL
LAKESIDE MEMORIAL HOSP
LAWRENCE HOSPITAL
LENOX HILL HOSPITAL

Mmisid
00363213
00279176
00279396
00354238
00347571
00274337
00354265
00354256
02094860
00347562
00729382
00245863
00384309
00243843
00268328
00362529
00378712
00314998
00273941
00274346
00246108
00273950
00354307
00243370
00243389
00274153
00274355
00354325
00734336
00332816
00273285
00246048
00243852
00274364
00354403
00361968
00360614
00354247
00384643
00354343
00246117
00243669
00274048
00279543
00274093
00243421

PAS
10

PAS
11

PAS
12

PAS
13

PAS
14

PAS
15

PAS
16

PAS
17

PAS
18

PAS
19

$1,371.11
$1,468.92
$1,347.80
$1,456.86
$1,629.32
$1,425.45
$1,407.36
$1,456.86
$1,464.54
$1,994.33
$1,716.83
$1,431.86
$1,994.33
$1,629.32
$1,468.68
$1,468.68
$1,429.86
$1,579.31
$1,629.32
$1,986.30
$1,588.29
$1,471.11
$1,713.86
$1,713.86
$1,579.31
$1,629.32
$1,440.45
$1,713.86
$1,394.87
$1,619.79
$1,986.30
$1,994.33
$1,629.32
$1,347.80
$1,716.83
$1,441.02
$1,440.45
$1,716.83
$1,437.63
$1,986.30
$1,713.86
$1,457.70
$1,468.68
$1,579.31
$1,994.33

$852.78
$900.99
$841.29
$895.05
$980.04
$879.57
$870.66
$895.05
$898.83
$1,159.94
$1,023.17
$882.72
$1,159.94
$980.04
$900.87
$900.87
$881.73
$955.40
$980.04
$1,155.98
$959.82
$902.07
$1,021.71
$1,021.71
$955.40
$980.04
$886.95
$1,021.71
$864.50
$975.35
$1,155.98
$1,159.94
$980.04
$841.29
$1,023.17
$887.24
$886.95
$1,023.17
$885.57
$1,155.98
$1,021.71
$895.46
$900.87
$955.40
$1,159.94

$713.06
$761.93
$701.42
$755.91
$842.07
$740.22
$731.18
$755.91
$759.75
$1,024.43
$885.80
$743.42
$1,024.43
$842.07
$761.81
$761.81
$742.41
$817.08
$842.07
$1,020.42
$821.57
$763.04
$884.31
$884.31
$817.08
$842.07
$747.71
$884.31
$724.94
$837.30
$1,020.42
$1,024.43
$842.07
$701.42
$885.80
$747.99
$747.71
$885.80
$746.30
$1,020.42
$884.31
$756.33
$761.81
$817.08
$1,024.43

$842.13
$899.79
$828.41
$892.68
$994.34
$874.19
$863.52
$892.68
$897.21
$1,209.48
$1,045.92
$877.95
$1,209.48
$994.34
$899.66
$899.66
$876.77
$964.86
$994.34
$1,204.76
$970.16
$901.10
$1,044.17
$1,044.17
$964.86
$994.34
$883.02
$1,044.17
$856.14
$988.73
$1,204.76
$1,209.48
$994.34
$828.41
$1,045.92
$883.35
$883.02
$1,045.92
$881.36
$1,204.76
$1,044.17
$893.19
$899.66
$964.86
$1,209.48

$2,084.76
$2,159.82
$2,066.88
$2,150.57
$2,282.88
$2,126.48
$2,112.60
$2,150.57
$2,156.46
$2,562.95
$2,350.02
$2,131.40
$2,562.95
$2,282.88
$2,159.64
$2,159.64
$2,129.85
$2,244.51
$2,282.88
$2,556.78
$2,251.41
$2,161.50
$2,347.76
$2,347.76
$2,244.51
$2,282.88
$2,137.98
$2,347.76
$2,103.00
$2,275.58
$2,556.78
$2,562.95
$2,282.88
$2,066.88
$2,350.02
$2,138.42
$2,137.98
$2,350.02
$2,135.82
$2,556.78
$2,347.76
$2,151.21
$2,159.64
$2,244.51
$2,562.95

$1,419.75
$1,526.90
$1,394.24
$1,513.70
$1,702.58
$1,479.30
$1,459.49
$1,513.70
$1,522.10
$2,102.37
$1,798.43
$1,486.31
$2,102.37
$1,702.58
$1,526.64
$1,526.64
$1,484.12
$1,647.80
$1,702.58
$2,093.58
$1,657.64
$1,529.31
$1,795.19
$1,795.19
$1,647.80
$1,702.58
$1,495.71
$1,795.19
$1,445.79
$1,692.14
$2,093.58
$2,102.37
$1,702.58
$1,394.24
$1,798.43
$1,496.34
$1,495.71
$1,798.43
$1,492.64
$2,093.58
$1,795.19
$1,514.61
$1,526.64
$1,647.80
$2,102.37

$956.46
$1,020.20
$941.28
$1,012.34
$1,124.70
$991.88
$980.09
$1,012.34
$1,017.33
$1,362.51
$1,181.70
$996.05
$1,362.51
$1,124.70
$1,020.03
$1,020.03
$994.74
$1,092.11
$1,124.70
$1,357.28
$1,097.96
$1,021.62
$1,179.78
$1,179.78
$1,092.11
$1,124.70
$1,001.64
$1,179.78
$971.94
$1,118.48
$1,357.28
$1,362.51
$1,124.70
$941.28
$1,181.70
$1,002.02
$1,001.64
$1,181.70
$999.81
$1,357.28
$1,179.78
$1,012.88
$1,020.03
$1,092.11
$1,362.51

$546.66
$581.00
$538.47
$576.77
$637.32
$565.74
$559.40
$576.77
$579.47
$765.47
$668.04
$567.99
$765.47
$637.32
$580.92
$580.92
$567.29
$619.76
$637.32
$762.65
$622.91
$581.78
$666.99
$666.99
$619.76
$637.32
$571.01
$666.99
$555.00
$633.98
$762.65
$765.47
$637.32
$538.47
$668.04
$571.22
$571.01
$668.04
$570.02
$762.65
$666.99
$577.07
$580.92
$619.76
$765.47

$661.80
$709.43
$650.46
$703.56
$787.53
$688.28
$679.47
$703.56
$707.30
$965.24
$830.13
$691.40
$965.24
$787.53
$709.32
$709.32
$690.42
$763.17
$787.53
$961.32
$767.55
$710.51
$828.68
$828.68
$763.17
$787.53
$695.57
$828.68
$673.38
$782.88
$961.32
$965.24
$787.53
$650.46
$830.13
$695.85
$695.57
$830.13
$694.20
$961.32
$828.68
$703.97
$709.32
$763.17
$965.24

$771.83
$817.08
$761.04
$811.50
$891.29
$796.97
$788.60
$811.50
$815.06
$1,060.16
$931.77
$799.94
$1,060.16
$891.29
$816.96
$816.96
$799.01
$868.14
$891.29
$1,056.44
$872.30
$818.09
$930.39
$930.39
$868.14
$891.29
$803.90
$930.39
$782.82
$886.88
$1,056.44
$1,060.16
$891.29
$761.04
$931.77
$804.17
$803.90
$931.77
$802.61
$1,056.44
$930.39
$811.89
$816.96
$868.14
$1,060.16

Page 7 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
2424000
7000008
2129000
3101000
2902000
7001017
7003004
7001019
7001020
7002019
1226701
3824000
5721700
4402000
3622000
0101003
7002020
1401008
2909000
7002021
7000006
1564701
7003015
7002024
3121001
5903000
2950002
1701000
2952006
3102000
2527000
7000024
7002052
7003013
2901000
2952005
2951001
1327000
5920000
7001008
7002026
7003010
7001021
7099003
7002054

Agency
ADIRONDACK
MEDICAL
HOSP
LEWIS
COUNTY
GENERAL
LINCOLN MEDICAL & MENTAL
LITTLE FALLS HOSPITAL
LOCKPORT MEMORIAL HOSP
LONG BEACH MEDICAL CTR
LONG ISLAND COLLEGE HOSP
LONG ISLAND JEWISH
LUTHERAN MEDICAL CENTER
MAIMONIDES MEDICAL CTR
MANHATTAN EYE EAR & THROAT
MARGARETVILLE MEMORIAL
MARY IMOGENE BASSETT
MARY MCCLELLAN HOSPITAL
MASSENA MEMORIAL HOSPITAL
MEDINA MEMORIAL HOSPITAL
MEMORIAL HOSP (ALBANY)
MEMORIAL HOSP FOR CANCER
MERCY HOSPITAL OF BUFFALO
MERCY MEDICAL CENTER
METROPOLITAN HOSPITAL CTR
MONTEFIORE HOSPITAL
MOSES-LUDINGTON HOSPITAL
MOUNT SINAI / WEST QUEENS
MOUNT SINAI HOSPITAL
MOUNT ST MARYS HOSPITAL
MOUNT VERNON HOSPITAL
NASSAU HEALTH CARE CORP
NATHAN LITTAUER HOSPITAL
NEW ISLAND HOSPITAL
NIAGARA FALLS MEMORIAL**
NICHOLAS H NOYES HOSP
NORTH CENTRAL BRONX
NORTH GENERAL HOSPITAL
NORTH SHORE / FOREST HILLS
NORTH SHORE / GLEN COVE
NORTH SHORE / PLAINVIEW
NORTH SHORE UNIVERSITY
NORTHERN DUTCHESS HOSP
NORTHERN WESTCHESTER
NY COMMUNITY / BROOKLYN
NY EYE & EAR INFIRMARY
NY MEDICAL CTR OF QUEENS
NY METHODIST HOSPITAL
NY PRESBY HOSP (ALLEN)
NY PRESBY HOSP (NY PAYNE)

Mmisid
00363213
00354370
00246126
00310870
00354389
00245487
00243678
00243903
00243729
00243641
00243458
00279387
00305000
00336952
00354398
00310898
00364003
00243467
00354412
00274295
00246135
00243554
00360930
00243509
00243509
01746616
00274117
01962156
00313924
01949875
00354467
00354476
00246171
00355142
00243889
00274240
00274231
00245510
00268300
00274144
00243696
00243476
00244133
00243701
00243178
00243518

PAS
10

PAS
11

PAS
12

PAS
13

PAS
14

PAS
15

PAS
16

PAS
17

PAS
18

PAS
19

$1,425.45
$1,986.30
$1,433.01
$1,440.45
$1,629.32
$1,994.33
$1,994.33
$1,713.86
$1,994.33
$1,691.06
$1,456.86
$1,731.51
$1,431.05
$1,410.38
$1,451.61
$1,465.73
$1,713.86
$1,437.63
$1,629.32
$1,986.30
$1,994.33
$1,437.69
$1,695.77
$1,994.33
$1,439.31
$1,579.31
$1,917.15
$1,447.80
$1,619.79
$1,439.31
$1,468.68
$1,986.30
$1,969.94
$1,969.94
$1,629.32
$1,629.32
$1,917.15
$1,547.28
$1,579.31
$1,695.77
$1,695.77
$1,994.33
$1,994.33
$1,994.33
$1,994.33

$879.57
$1,155.98
$883.29
$886.95
$980.04
$1,159.94
$1,159.94
$1,021.71
$1,159.94
$1,010.48
$895.05
$1,030.41
$882.33
$872.13
$892.46
$899.42
$1,021.71
$885.57
$980.04
$1,155.98
$1,159.94
$885.60
$1,012.79
$1,159.94
$886.40
$955.40
$1,121.90
$890.58
$975.35
$886.40
$900.87
$1,155.98
$1,147.91
$1,147.91
$980.04
$980.04
$1,121.90
$939.62
$955.40
$1,012.79
$1,012.79
$1,159.94
$1,159.94
$1,159.94
$1,159.94

$740.22
$1,020.42
$744.00
$747.71
$842.07
$1,024.43
$1,024.43
$884.31
$1,024.43
$872.91
$755.91
$893.13
$743.01
$732.68
$753.29
$760.34
$884.31
$746.30
$842.07
$1,020.42
$1,024.43
$746.33
$875.27
$1,024.43
$747.14
$817.08
$985.88
$751.38
$837.30
$747.14
$761.81
$1,020.42
$1,012.25
$1,012.25
$842.07
$842.07
$985.88
$801.09
$817.08
$875.27
$875.27
$1,024.43
$1,024.43
$1,024.43
$1,024.43

$874.19
$1,204.76
$878.63
$883.02
$994.34
$1,209.48
$1,209.48
$1,044.17
$1,209.48
$1,030.74
$892.68
$1,054.58
$877.47
$865.29
$889.59
$897.92
$1,044.17
$881.36
$994.34
$1,204.76
$1,209.48
$881.39
$1,033.50
$1,209.48
$882.35
$964.86
$1,164.00
$887.36
$988.73
$882.35
$899.66
$1,204.76
$1,195.11
$1,195.11
$994.34
$994.34
$1,164.00
$945.99
$964.86
$1,033.50
$1,033.50
$1,209.48
$1,209.48
$1,209.48
$1,209.48

$2,126.48
$2,556.78
$2,132.28
$2,137.98
$2,282.88
$2,562.95
$2,562.95
$2,347.76
$2,562.95
$2,330.27
$2,150.57
$2,361.29
$2,130.77
$2,114.90
$2,146.53
$2,157.38
$2,347.76
$2,135.82
$2,282.88
$2,556.78
$2,562.95
$2,135.87
$2,333.87
$2,562.95
$2,137.11
$2,244.51
$2,503.73
$2,143.62
$2,275.58
$2,137.11
$2,159.64
$2,556.78
$2,544.23
$2,544.23
$2,282.88
$2,282.88
$2,503.73
$2,219.94
$2,244.51
$2,333.87
$2,333.87
$2,562.95
$2,562.95
$2,562.95
$2,562.95

$1,479.30
$2,093.58
$1,487.58
$1,495.71
$1,702.58
$2,102.37
$2,102.37
$1,795.19
$2,102.37
$1,770.21
$1,513.70
$1,814.51
$1,485.42
$1,462.77
$1,507.94
$1,523.40
$1,795.19
$1,492.64
$1,702.58
$2,093.58
$2,102.37
$1,492.70
$1,775.36
$2,102.37
$1,494.48
$1,647.80
$2,017.85
$1,503.77
$1,692.14
$1,494.48
$1,526.64
$2,093.58
$2,075.66
$2,075.66
$1,702.58
$1,702.58
$2,017.85
$1,612.73
$1,647.80
$1,775.36
$1,775.36
$2,102.37
$2,102.37
$2,102.37
$2,102.37

$991.88
$1,357.28
$996.80
$1,001.64
$1,124.70
$1,362.51
$1,362.51
$1,179.78
$1,362.51
$1,164.92
$1,012.34
$1,191.27
$995.52
$982.05
$1,008.92
$1,018.11
$1,179.78
$999.81
$1,124.70
$1,357.28
$1,362.51
$999.84
$1,167.98
$1,362.51
$1,000.91
$1,092.11
$1,312.23
$1,006.43
$1,118.48
$1,000.91
$1,020.03
$1,357.28
$1,346.61
$1,346.61
$1,124.70
$1,124.70
$1,312.23
$1,071.24
$1,092.11
$1,167.98
$1,167.98
$1,362.51
$1,362.51
$1,362.51
$1,362.51

$565.74
$762.65
$568.40
$571.01
$637.32
$765.47
$765.47
$666.99
$765.47
$659.00
$576.77
$673.20
$567.71
$560.45
$574.92
$579.89
$666.99
$570.02
$637.32
$762.65
$765.47
$570.05
$660.65
$765.47
$570.62
$619.76
$738.38
$573.59
$633.98
$570.62
$580.92
$762.65
$756.90
$756.90
$637.32
$637.32
$738.38
$608.52
$619.76
$660.65
$660.65
$765.47
$765.47
$765.47
$765.47

$688.28
$961.32
$691.95
$695.57
$787.53
$965.24
$965.24
$828.68
$965.24
$817.59
$703.56
$837.27
$690.99
$680.93
$701.00
$707.88
$828.68
$694.20
$787.53
$961.32
$965.24
$694.23
$819.87
$965.24
$695.03
$763.17
$927.66
$699.15
$782.88
$695.03
$709.32
$961.32
$953.36
$953.36
$787.53
$787.53
$927.66
$747.59
$763.17
$819.87
$819.87
$965.24
$965.24
$965.24
$965.24

$796.97
$1,056.44
$800.46
$803.90
$891.29
$1,060.16
$1,060.16
$930.39
$1,060.16
$919.85
$811.50
$938.57
$799.55
$789.99
$809.07
$815.60
$930.39
$802.61
$891.29
$1,056.44
$1,060.16
$802.62
$922.02
$1,060.16
$803.37
$868.14
$1,024.44
$807.30
$886.88
$803.37
$816.96
$1,056.44
$1,048.86
$1,048.86
$891.29
$891.29
$1,024.44
$853.34
$868.14
$922.02
$922.02
$1,060.16
$1,060.16
$1,060.16
$1,060.16

Page 8 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
7002030
5906000
7002053
7000025
4324000
7002000
0401001
2601001
3523000
3501000
3702000
0301001
7000005
1402000
2754001
7003020
7003006
5932000
3950000
7003007
7004010
2221001
2701003
3201002
1401010
4102002
2201000
4501000
4823000
4102003
1401006
7004006
1401013
6120000
5904000
2950001
5126000
5154000
5902000
3529000
7000014
5157003
5149001
4601002
7002033

Agency
ADIRONDACK
MEDICAL
HOSP
NY
PRESBY HOSP
(PRESBY)
NY UNITED HOSPITAL
NY UNIV MED CTR (TISCH)
NY WESTCHESTER SQUARE
NYACK HOSPITAL
NYU DOWNTOWN HOSPITAL
OLEAN GENERAL HOSPITAL
ONEIDA CITY HOSPITAL
ORANGE REGIONAL MED CTR
ORANGE REGIONAL(MIDDLETOWN)
OSWEGO HOSPITAL
OUR LADY OF LOURDES HOSP
OUR LADY OF MERCY
OUR LADY OF VICTORY HOSP
PARK RIDGE HOSPITAL
PARKWAY HOSPITAL
PENINSULA HOSPITAL CTR
PHELPS MEMORIAL HOSPITAL
PUTNAM COMMUNITY HOSPITAL
QUEENS HOSPITAL CENTER
RICHMOND UNIVERSITY MEDICAL CENTER
RIVER HOSPITAL**
ROCHESTER GENERAL HOSP
ROME HOSPITAL AND MURPHY
ROSWELL PARK MEMORIAL
SAMARITAN HOSPITAL / TROY
SAMARITAN MEDICAL CENTER
SARATOGA HOSPITAL
SCHUYLER HOSPITAL
SETON HEALTH SYSTEMS
SHEEHAN MEMORIAL EMERG
SISTERS OF CHARITY (BAYLEY)
SISTERS OF CHARITY HOSP
SOLDIERS AND SAILORS
SOUND SHORE HOSPITAL
SOUTH NASSAU COMMUNITIES
SOUTHAMPTON HOSP ASSOC
SOUTHSIDE HOSPITAL
ST AGNES HOSPITAL
ST ANTHONY COMMUNITY
ST BARNABAS HOSPITAL
ST CATHERINE OF SIENA
ST CHARLES HOSPITAL
ST CLARE'S / SCHENECTADY
ST CLARES HOSP & HEALTH

Mmisid
00363213
00243178
00274204
00273116
00273092
00243967
00647269
00354632
00310903
00258379
00258379
00354485
00337664
00243563
00354494
00378721
00244151
00243898
00274162
00258360
00246153
00248820
02392854
00303315
00352534
00354518
00318805
00354316
00303282
00363144
01534463
00354545
00652328
00354563
00336498
00274126
00245496
00274406
00268319
00274180
00273890
00243361
02060942
00274415
00361748
00243201

PAS
10

PAS
11

PAS
12

PAS
13

PAS
14

PAS
15

PAS
16

PAS
17

PAS
18

PAS
19

$1,994.33
$1,579.31
$1,994.33
$1,695.77
$1,579.31
$1,963.37
$1,424.96
$1,465.70
$1,505.24
$1,505.24
$1,443.26
$1,414.74
$1,994.33
$1,437.63
$1,471.94
$1,695.77
$1,713.86
$1,579.31
$1,552.62
$1,986.30
$1,994.33
$1,425.45
$1,746.99
$1,433.01
$1,441.77
$1,464.54
$1,426.26
$1,464.54
$1,394.87
$1,464.54
$1,438.77
$1,713.86
$1,441.77
$1,368.24
$1,866.69
$1,640.22
$1,629.32
$1,629.32
$1,589.75
$1,506.45
$1,713.86
$1,629.32
$1,629.32
$1,464.54
$1,969.94

$1,159.94
$955.40
$1,159.94
$1,012.79
$955.40
$1,144.68
$879.33
$899.40
$918.89
$918.89
$888.35
$874.29
$1,159.94
$885.57
$902.48
$1,012.79
$1,021.71
$955.40
$942.24
$1,155.98
$1,159.94
$879.57
$1,038.03
$883.29
$887.61
$898.83
$879.96
$898.83
$864.50
$898.83
$886.13
$1,021.71
$887.61
$851.37
$1,097.03
$985.41
$980.04
$980.04
$960.54
$919.49
$1,021.71
$980.04
$980.04
$898.83
$1,147.91

$1,024.43
$817.08
$1,024.43
$875.27
$817.08
$1,008.96
$739.97
$760.32
$780.08
$780.08
$749.12
$734.87
$1,024.43
$746.30
$763.44
$875.27
$884.31
$817.08
$803.75
$1,020.42
$1,024.43
$740.22
$900.86
$744.00
$748.37
$759.75
$740.63
$759.75
$724.94
$759.75
$746.87
$884.31
$748.37
$711.63
$960.66
$847.52
$842.07
$842.07
$822.30
$780.68
$884.31
$842.07
$842.07
$759.75
$1,012.25

$1,209.48
$964.86
$1,209.48
$1,033.50
$964.86
$1,191.24
$873.89
$897.90
$921.20
$921.20
$884.67
$867.86
$1,209.48
$881.36
$901.58
$1,033.50
$1,044.17
$964.86
$949.14
$1,204.76
$1,209.48
$874.19
$1,063.70
$878.63
$883.80
$897.21
$874.65
$897.21
$856.14
$897.21
$882.02
$1,044.17
$883.80
$840.45
$1,134.26
$1,000.77
$994.34
$994.34
$971.01
$921.92
$1,044.17
$994.34
$994.34
$897.21
$1,195.11

$2,562.95
$2,244.51
$2,562.95
$2,333.87
$2,244.51
$2,539.19
$2,126.09
$2,157.35
$2,187.69
$2,187.69
$2,140.14
$2,118.26
$2,562.95
$2,135.82
$2,162.13
$2,333.87
$2,347.76
$2,244.51
$2,224.04
$2,556.78
$2,562.95
$2,126.48
$2,373.17
$2,132.28
$2,138.99
$2,156.46
$2,127.09
$2,156.46
$2,103.00
$2,156.46
$2,136.69
$2,347.76
$2,138.99
$2,082.59
$2,465.01
$2,291.25
$2,282.88
$2,282.88
$2,252.52
$2,188.61
$2,347.76
$2,282.88
$2,282.88
$2,156.46
$2,544.23

$2,102.37
$1,647.80
$2,102.37
$1,775.36
$1,647.80
$2,068.47
$1,478.75
$1,523.37
$1,566.68
$1,566.68
$1,498.80
$1,467.56
$2,102.37
$1,492.64
$1,530.20
$1,775.36
$1,795.19
$1,647.80
$1,618.58
$2,093.58
$2,102.37
$1,479.30
$1,831.47
$1,487.58
$1,497.17
$1,522.10
$1,480.19
$1,522.10
$1,445.79
$1,522.10
$1,493.88
$1,795.19
$1,497.17
$1,416.63
$1,962.57
$1,714.52
$1,702.58
$1,702.58
$1,659.24
$1,568.00
$1,795.19
$1,702.58
$1,702.58
$1,522.10
$2,075.66

$1,362.51
$1,092.11
$1,362.51
$1,167.98
$1,092.11
$1,342.34
$991.55
$1,018.08
$1,043.85
$1,043.85
$1,003.47
$984.89
$1,362.51
$999.81
$1,022.16
$1,167.98
$1,179.78
$1,092.11
$1,074.72
$1,357.28
$1,362.51
$991.88
$1,201.35
$996.80
$1,002.50
$1,017.33
$992.40
$1,017.33
$971.94
$1,017.33
$1,000.55
$1,179.78
$1,002.50
$954.60
$1,279.34
$1,131.80
$1,124.70
$1,124.70
$1,098.92
$1,044.65
$1,179.78
$1,124.70
$1,124.70
$1,017.33
$1,346.61

$765.47
$619.76
$765.47
$660.65
$619.76
$754.59
$565.58
$579.87
$593.75
$593.75
$572.00
$561.98
$765.47
$570.02
$582.06
$660.65
$666.99
$619.76
$610.40
$762.65
$765.47
$565.74
$678.63
$568.40
$571.47
$579.47
$566.03
$579.47
$555.00
$579.47
$570.42
$666.99
$571.47
$545.66
$720.65
$641.15
$637.32
$637.32
$623.43
$594.18
$666.99
$637.32
$637.32
$579.47
$756.90

$965.24
$763.17
$965.24
$819.87
$763.17
$950.16
$688.04
$707.87
$727.11
$727.11
$696.95
$683.06
$965.24
$694.20
$710.90
$819.87
$828.68
$763.17
$750.18
$961.32
$965.24
$688.28
$844.82
$691.95
$696.21
$707.30
$688.67
$707.30
$673.38
$707.30
$694.76
$828.68
$696.21
$660.42
$903.09
$792.83
$787.53
$787.53
$768.26
$727.70
$828.68
$787.53
$787.53
$707.30
$953.36

$1,060.16
$868.14
$1,060.16
$922.02
$868.14
$1,045.83
$796.74
$815.58
$833.88
$833.88
$805.20
$792.02
$1,060.16
$802.61
$818.48
$922.02
$930.39
$868.14
$855.80
$1,056.44
$1,060.16
$796.97
$945.72
$800.46
$804.51
$815.06
$797.34
$815.06
$782.82
$815.06
$803.13
$930.39
$804.51
$770.51
$1,001.10
$896.33
$891.29
$891.29
$872.97
$834.44
$930.39
$891.29
$891.29
$815.06
$1,048.86

Page 9 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
3202002
1302000
2953000
5002001
5907001
1455000
0701001
3301003
5907002
3502000
3522000
7002032
2801001
7001025
0101004
7002037
7001037
5151001
7004003
2701005
3301007
1227000
0427000
0303001
1801000
1302001
7001032
5820000
5957001
0632000
5902001
2908000
0602001
7001045
7001035
6027000

Agency
ADIRONDACK
ST
ELIZABETHMEDICAL
MED CTRHOSP
ST FRANCIS / POUGHKEEPSIE
ST FRANCIS HOSP / ROSLYN
ST JAMES MERCY HOSPITAL
ST JOHNS RIVERSIDE
ST JOSEPH HOSPITAL
ST JOSEPHS / ELMIRA
ST JOSEPHS HOSP & HEALTH
ST JOSEPHS OF YONKERS
ST LUKES / NEWBURGH
ST LUKES CORNWALL / CORNWALL
ST LUKES ROOSEVELT
ST MARYS AT AMSTERDAM
ST MARYS OF BROOKLYN
ST PETERS HOSPITAL
ST VINCENTS HOSPITAL
STATE UNIV / DOWNSTATE
STATE UNIV / STONY BROOK
STATEN ISLAND UNIV HOSPITAL
STRONG MEMORIAL HOSPITAL
SUNY HEALTH SCIENCE CENTER
THE HOSPITAL
TLC HEALTH NETWORK
UNITED HEALTH SERVICES
UNITED MEMORIAL (GENESEE)
VASSAR BROTHERS MED CTR
VICTORY MEMORIAL HOSPITAL
WAYNE HEALTH CARE
WESTCHESTER MEDICAL CTR
WESTFIELD MEMORIAL HOSP
WHITE PLAINS HOSPITAL
WINTHROP UNIVERSITY HOSP
WOMANS CHRISTIAN ASSOC
WOODHULL MEDICAL CENTER
WYCKOFF HEIGHTS HOSPITAL
WYOMING COUNTY COMMUNITY

Mmisid
00363213
00279901
00273845
00244046
00363162
00245501
00354581
00363126
00315013
00258920
00273914
00273863
00354967
00351639
00729373
00318823
00243229
00243590
00357795
00244202
00279034
00354590
00313951
00347544
00614755
00354283
00273854
00243449
00354458
00274213
00354614
00274222
00244211
00354623
00698866
00243825
00310889

PAS
10

PAS
11

PAS
12

PAS
13

PAS
14

PAS
15

PAS
16

PAS
17

PAS
18

PAS
19

$1,431.86
$1,548.83
$1,640.22
$1,397.81
$1,579.31
$1,437.63
$1,409.66
$1,743.98
$1,579.31
$1,505.24
$1,506.45
$1,994.33
$1,464.54
$1,994.33
$1,743.99
$1,994.33
$1,994.33
$1,917.15
$1,994.33
$1,746.99
$1,743.98
$1,456.86
$1,424.15
$1,418.94
$1,350.57
$1,545.95
$1,695.77
$1,468.68
$1,866.69
$1,424.73
$1,579.31
$1,917.15
$1,423.59
$1,986.30
$1,713.86
$1,350.57

$882.72
$940.37
$985.41
$865.95
$955.40
$885.57
$871.79
$1,036.55
$955.40
$918.89
$919.49
$1,159.94
$898.83
$1,159.94
$1,036.56
$1,159.94
$1,159.94
$1,121.90
$1,159.94
$1,038.03
$1,036.55
$895.05
$878.93
$876.36
$842.66
$938.96
$1,012.79
$900.87
$1,097.03
$879.21
$955.40
$1,121.90
$878.66
$1,155.98
$1,021.71
$842.66

$743.42
$801.86
$847.52
$726.41
$817.08
$746.30
$732.33
$899.36
$817.08
$780.08
$780.68
$1,024.43
$759.75
$1,024.43
$899.36
$1,024.43
$1,024.43
$985.88
$1,024.43
$900.86
$899.36
$755.91
$739.56
$736.97
$702.80
$800.42
$875.27
$761.81
$960.66
$739.86
$817.08
$985.88
$739.29
$1,020.42
$884.31
$702.80

$877.95
$946.89
$1,000.77
$857.88
$964.86
$881.36
$864.87
$1,061.93
$964.86
$921.20
$921.92
$1,209.48
$897.21
$1,209.48
$1,061.93
$1,209.48
$1,209.48
$1,164.00
$1,209.48
$1,063.70
$1,061.93
$892.68
$873.41
$870.35
$830.04
$945.20
$1,033.50
$899.66
$1,134.26
$873.75
$964.86
$1,164.00
$873.08
$1,204.76
$1,044.17
$830.04

$2,131.40
$2,221.13
$2,291.25
$2,105.27
$2,244.51
$2,135.82
$2,114.36
$2,370.86
$2,244.51
$2,187.69
$2,188.61
$2,562.95
$2,156.46
$2,562.95
$2,370.87
$2,562.95
$2,562.95
$2,503.73
$2,562.95
$2,373.17
$2,370.86
$2,150.57
$2,125.47
$2,121.48
$2,069.01
$2,218.92
$2,333.87
$2,159.64
$2,465.01
$2,125.92
$2,244.51
$2,503.73
$2,125.05
$2,556.78
$2,347.76
$2,069.01

$1,486.31
$1,614.42
$1,714.52
$1,449.02
$1,647.80
$1,492.64
$1,461.99
$1,828.16
$1,647.80
$1,566.68
$1,568.00
$2,102.37
$1,522.10
$2,102.37
$1,828.19
$2,102.37
$2,102.37
$2,017.85
$2,102.37
$1,831.47
$1,828.16
$1,513.70
$1,477.86
$1,472.16
$1,397.27
$1,611.26
$1,775.36
$1,526.64
$1,962.57
$1,478.49
$1,647.80
$2,017.85
$1,477.26
$2,093.58
$1,795.19
$1,397.27

$996.05
$1,072.25
$1,131.80
$973.86
$1,092.11
$999.81
$981.59
$1,199.40
$1,092.11
$1,043.85
$1,044.65
$1,362.51
$1,017.33
$1,362.51
$1,199.40
$1,362.51
$1,362.51
$1,312.23
$1,362.51
$1,201.35
$1,199.40
$1,012.34
$991.02
$987.63
$943.08
$1,070.37
$1,167.98
$1,020.03
$1,279.34
$991.40
$1,092.11
$1,312.23
$990.66
$1,357.28
$1,179.78
$943.08

$567.99
$609.06
$641.15
$556.04
$619.76
$570.02
$560.21
$677.57
$619.76
$593.75
$594.18
$765.47
$579.47
$765.47
$677.58
$765.47
$765.47
$738.38
$765.47
$678.63
$677.57
$576.77
$565.29
$563.46
$539.45
$608.04
$660.65
$580.92
$720.65
$565.49
$619.76
$738.38
$565.10
$762.65
$666.99
$539.45

$691.40
$748.34
$792.83
$674.82
$763.17
$694.20
$680.58
$843.35
$763.17
$727.11
$727.70
$965.24
$707.30
$965.24
$843.35
$965.24
$965.24
$927.66
$965.24
$844.82
$843.35
$703.56
$687.63
$685.11
$651.81
$746.93
$819.87
$709.32
$903.09
$687.92
$763.17
$927.66
$687.36
$961.32
$828.68
$651.81

$799.94
$854.04
$896.33
$784.17
$868.14
$802.61
$789.66
$944.33
$868.14
$833.88
$834.44
$1,060.16
$815.06
$1,060.16
$944.34
$1,060.16
$1,060.16
$1,024.44
$1,060.16
$945.72
$944.33
$811.50
$796.37
$793.95
$762.32
$852.71
$922.02
$816.96
$1,001.10
$796.64
$868.14
$1,024.44
$796.11
$1,056.44
$930.39
$762.32

Page 10 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
0101005
0101000
3701000
1624000
2801000
0701000
0501000
3801000
4720001
7002001
4652001
5501000
1427000
7001041
7002004
7002002
3535001
7000001
7001002
5123000
7001003
0601000
5120000
7002003
4429000
2238001
5263700
5263000
5401001
5155000
0901001
0824000
7003000
4401000
3421000
7003005
7003008
7003025
1001000
3301000
5925000
2625000
7001009
5001000

Agency
ADIRONDACK MEDICAL HOSP
ALB MED SO CLINICAL CAMPUS
ALBANY MEDICAL CENTER
ALBERT LINDLEY LEE
ALICE HYDE MEDICAL CTR
AMSTERDAM MEMORIAL HOSP
ARNOT OGDEN MEMORIAL
AUBURN MEMORIAL HOSPITAL
AURELIA OSBORN FOX
BASSETT HOSPITAL
BELLEVUE HOSPITAL CTR
BELLEVUE WOMAN'S HOSP
BENEDICTINE HOSPITAL
BERTRAND CHAFFEE HOSPITAL
BETH ISRAEL / KINGS HIGHWAY
BETH ISRAEL / NORTH DIVISION
BETH ISRAEL MEDICAL CTR
BON SECOURS COMM HOSP
BRONX-LEBANON HOSP CTR
BROOKDALE HOSP MED CTR
BROOKHAVEN MEMORIAL HOSP
BROOKLYN HOSPITAL CENTER
BROOKS MEMORIAL HOSPITAL
BRUNSWICK HOSPITAL CTR
CABRINI MEDICAL CENTER
CANTON-POTSDAM HOSPITAL
CARTHAGE AREA HOSPITAL
CATSKILL REGIONAL / G HERMANN
CATSKILL REGIONAL MED CTR
CAYUGA MEDICAL CENTER
CENTRAL SUFFOLK HOSPITAL
CHAMPLAIN VALLEY PHYS
CHENANGO MEMORIAL HOSP
CITY HOSPITAL CENTER
CLAXTON-HEPBURN MED CTR
CLIFTON SPRINGS HOSPITAL
CMC (MARY IMMACULATE)
CMC (ST JOHNS)
CMC (ST JOSEPHS)
COLUMBIA MEMORIAL HOSP
COMM GEN / GREATER SYRACUSE
COMM HOSP / DOBBS FERRY
COMMUNITY MEMORIAL HOSP
CONEY ISLAND HOSPITAL
CORNING HOSPITAL

Mmisid
00363213
01952712
00277716
00354105
00354114
00381420
00363199
00347553
00279098
00302429
00246039
00354132
00274020
00354150
00243105
00243105
00243105
00273905
00476022
00243572
00245529
00243614
00381439
00268295
00243132
00354196
00310852
00273978
00273978
00332729
00274328
00318814
00314723
00246075
00354072
00354641
00243861
00244124
00498531
00335915
00315004
00274066
00354229
00246066
00361739

PAS
20
$603.63
$627.20
$745.65
$618.12
$602.36
$627.20
$603.33
$586.04
$624.80
$681.32
$848.79
$627.20
$623.78
$615.72
$725.12
$725.12
$852.21
$644.54
$852.21
$852.21
$696.84
$852.21
$609.75
$692.78
$852.21
$603.63
$610.05
$623.42
$623.78
$586.04
$696.84
$602.69
$623.42
$848.79
$603.63
$628.46
$852.21
$852.21
$852.21
$618.57
$626.67
$675.54
$627.18
$848.79
$598.29

PAS
21
$1,504.26
$1,539.51
$1,716.63
$1,525.94
$1,502.36
$1,539.51
$1,503.81
$1,477.94
$1,535.91
$1,620.42
$1,870.88
$1,539.51
$1,534.40
$1,522.34
$1,685.93
$1,685.93
$1,875.99
$1,565.42
$1,875.99
$1,875.99
$1,643.64
$1,875.99
$1,513.41
$1,637.57
$1,875.99
$1,504.26
$1,513.88
$1,533.86
$1,534.40
$1,477.94
$1,643.64
$1,502.85
$1,533.86
$1,870.88
$1,504.26
$1,541.39
$1,875.99
$1,875.99
$1,875.99
$1,526.61
$1,538.72
$1,611.80
$1,539.48
$1,870.88
$1,496.27

PAS
22
$1,194.15
$1,238.18
$1,459.46
$1,221.21
$1,191.75
$1,238.18
$1,193.58
$1,161.26
$1,233.68
$1,339.26
$1,652.15
$1,238.18
$1,231.79
$1,216.73
$1,421.10
$1,421.10
$1,658.54
$1,270.55
$1,658.54
$1,658.54
$1,368.26
$1,658.54
$1,205.57
$1,360.68
$1,658.54
$1,194.15
$1,206.15
$1,231.11
$1,231.79
$1,161.26
$1,368.26
$1,192.38
$1,231.11
$1,652.15
$1,194.15
$1,240.52
$1,658.54
$1,658.54
$1,658.54
$1,222.05
$1,237.17
$1,328.49
$1,238.15
$1,652.15
$1,184.16

Page 11 of 25

PAS
23
$610.13
$628.88
$723.09
$621.65
$609.11
$628.88
$609.89
$596.12
$626.96
$671.91
$805.13
$628.88
$626.15
$619.74
$706.76
$706.76
$807.84
$642.66
$807.84
$807.84
$684.26
$807.84
$614.99
$681.03
$807.84
$610.13
$615.24
$625.86
$626.15
$596.12
$684.26
$609.38
$625.86
$805.13
$610.13
$629.87
$807.84
$807.84
$807.84
$622.01
$628.44
$667.32
$628.86
$805.13
$605.87

PAS
24
$652.58
$672.86
$774.80
$665.06
$651.48
$672.86
$652.32
$637.43
$670.79
$719.43
$863.55
$672.86
$669.92
$662.99
$757.13
$757.13
$866.49
$687.78
$866.49
$866.49
$732.78
$866.49
$657.84
$729.29
$866.49
$652.58
$658.11
$669.62
$669.92
$637.43
$732.78
$651.77
$669.62
$863.55
$652.58
$673.94
$866.49
$866.49
$866.49
$665.45
$672.41
$714.47
$672.84
$863.55
$647.99

PAS
25
$4,128.27
$0.00
$0.00
$0.00
$4,125.05
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4,752.98
$0.00
$0.00
$4,752.98
$4,128.27
$0.00
$0.00
$0.00
$0.00
$0.00
$4,125.90
$0.00
$4,744.38
$4,128.27
$0.00
$4,752.98
$4,752.98
$4,752.98
$0.00
$0.00
$0.00
$0.00
$4,744.38
$0.00

PAS
26
$672.39
$692.99
$796.55
$685.05
$671.27
$692.99
$672.12
$656.99
$690.89
$740.30
$886.73
$692.99
$690.00
$682.95
$778.59
$778.59
$889.71
$708.14
$889.71
$889.71
$753.87
$889.71
$677.73
$750.32
$889.71
$672.39
$678.00
$689.69
$690.00
$656.99
$753.87
$671.55
$689.69
$886.73
$672.39
$694.08
$889.71
$889.71
$889.71
$685.44
$692.52
$735.26
$692.97
$886.73
$667.71

PAS
27
$1,436.64
$1,495.07
$1,788.75
$1,472.57
$1,433.46
$1,495.07
$1,435.89
$1,392.99
$1,489.10
$1,629.23
$2,044.50
$1,495.07
$1,486.59
$1,466.61
$1,737.84
$1,737.84
$2,052.98
$1,538.04
$2,052.98
$2,052.98
$1,667.72
$2,052.98
$1,451.79
$1,657.67
$2,052.98
$1,436.64
$1,452.56
$1,485.71
$1,486.59
$1,392.99
$1,667.72
$1,434.30
$1,485.71
$2,044.50
$1,436.64
$1,498.17
$2,052.98
$2,052.98
$2,052.98
$1,473.68
$1,493.75
$1,614.93
$1,495.02
$2,044.50
$1,423.38

PAS
28
$894.12
$926.04
$1,086.54
$913.76
$892.38
$926.04
$893.70
$870.26
$922.79
$999.36
$1,226.31
$926.04
$921.42
$910.49
$1,058.73
$1,058.73
$1,230.95
$949.53
$1,230.95
$1,230.95
$1,020.41
$1,230.95
$902.40
$1,014.90
$1,230.95
$894.12
$902.82
$920.93
$921.42
$870.26
$1,020.41
$892.83
$920.93
$1,226.31
$894.12
$927.75
$1,230.95
$1,230.95
$1,230.95
$914.36
$925.32
$991.55
$926.03
$1,226.31
$886.88

PAS
29
$1,038.60
$1,073.60
$1,249.50
$1,060.13
$1,036.71
$1,073.60
$1,038.15
$1,012.46
$1,070.03
$1,153.95
$1,402.67
$1,073.60
$1,068.53
$1,056.56
$1,219.01
$1,219.01
$1,407.74
$1,099.34
$1,407.74
$1,407.74
$1,177.01
$1,407.74
$1,047.68
$1,170.98
$1,407.74
$1,038.60
$1,048.14
$1,067.99
$1,068.53
$1,012.46
$1,177.01
$1,037.21
$1,067.99
$1,402.67
$1,038.60
$1,075.46
$1,407.74
$1,407.74
$1,407.74
$1,060.79
$1,072.82
$1,145.39
$1,073.58
$1,402.67
$1,030.67
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
1101000
3301008
0226700
1229000
5127000
2221000
4423000
5526001
4601001
7001024
1401005
3202003
7003001
2910000
3429000
3402000
5601000
4329000
5154001
7002009
4322000
2701001
7002012
7002011
5901000
5153000
3154000
7001046
5022000
2906000
7000002
7003003
5149000
0228000
1401014
1401002
3103000
1401009
1404000
7001016
7001033
5501001
2728001
5922000
7002017

Agency
ADIRONDACK
MEDICAL HOSP
HOSP
CORTLAND
MEMORIAL
CROUSE HOSPITAL
CUBA MEMORIAL HOSPITAL
DELAWARE VALLEY HOSPITAL
EASTERN LONG ISLAND HOSP
EJ NOBLE / ALEXANDRIA
EJ NOBLE / GOUVERNEUR
ELLENVILLE REGIONAL HOSP
ELLIS HOSPITAL
EPISCOPAL HEALTH SERVICES
ERIE COUNTY MEDICAL CTR
FAXTON-ST LUKES HEALTHCARE
FLUSHING HOSPITAL
FRANKLIN HOSP MED CTR
FREDERICK FERRIS THOMPSON
GENEVA GENERAL HOSPITAL
GLENS FALLS HOSPITAL
GOOD SAMARITAN / SUFFERN
GOOD SAMARITAN / WEST ISLIP
HARLEM HOSPITAL CENTER
HELEN HAYES HOSPITAL
HIGHLAND HOSP / ROCHESTER
HOSP FOR SPECIAL SURGERY
HOSPITAL FOR JOINT DISEASES
HUDSON VALLEY HOSP CTR
HUNTINGTON HOSP ASSOC
INTER-COMMUNITY MEMORIAL
INTERFAITH MEDICAL CTR
IRA DAVENPORT MEMORIAL
ISLAND MEDICAL CENTER
JACOBI MEDICAL CENTER
JAMAICA HOSPITAL
JOHN T MATHER MEMORIAL
JONES MEMORIAL
KALEIDA HLTH (BUFFALO GEN)
KALEIDA HLTH (CHILD OF BUFF)
KALEIDA HLTH (DEGRAFF)
KALEIDA HLTH (MILLARD)
KENMORE MERCY HOSPITAL
KINGS COUNTY HOSPITAL
KINGSBROOK JEWISH MEDICAL
KINGSTON HOSPITAL
LAKESIDE MEMORIAL HOSP
LAWRENCE HOSPITAL
LENOX HILL HOSPITAL

Mmisid
00363213
00279176
00279396
00354238
00347571
00274337
00354265
00354256
02094860
00347562
00729382
00245863
00384309
00243843
00268328
00362529
00378712
00314998
00273941
00274346
00246108
00273950
00354307
00243370
00243389
00274153
00274355
00354325
00734336
00332816
00273285
00246048
00243852
00274364
00354403
00361968
00360614
00354247
00384643
00354343
00246117
00243669
00274048
00279543
00274093
00243421

PAS
20

PAS
21

PAS
22

PAS
23

PAS
24

PAS
25

PAS
26

PAS
27

PAS
28

PAS
29

$586.92
$628.56
$576.99
$623.42
$696.84
$610.05
$602.36
$623.42
$626.69
$852.21
$734.09
$612.78
$852.21
$696.84
$628.46
$628.46
$611.93
$675.54
$696.84
$848.79
$679.37
$629.49
$732.83
$732.83
$675.54
$696.84
$616.44
$732.83
$597.03
$692.78
$848.79
$852.21
$696.84
$576.99
$734.09
$616.68
$616.44
$734.09
$615.24
$848.79
$732.83
$623.78
$628.46
$675.54
$852.21

$1,479.27
$1,541.54
$1,464.44
$1,533.86
$1,643.64
$1,513.88
$1,502.36
$1,533.86
$1,538.75
$1,875.99
$1,699.34
$1,517.94
$1,875.99
$1,643.64
$1,541.39
$1,541.39
$1,516.67
$1,611.80
$1,643.64
$1,870.88
$1,617.53
$1,542.93
$1,697.45
$1,697.45
$1,611.80
$1,643.64
$1,523.42
$1,697.45
$1,494.39
$1,637.57
$1,870.88
$1,875.99
$1,643.64
$1,464.44
$1,699.34
$1,523.78
$1,523.42
$1,699.34
$1,521.62
$1,870.88
$1,697.45
$1,534.40
$1,541.39
$1,611.80
$1,875.99

$1,162.92
$1,240.71
$1,144.38
$1,231.11
$1,368.26
$1,206.15
$1,191.75
$1,231.11
$1,237.22
$1,658.54
$1,437.86
$1,211.24
$1,658.54
$1,368.26
$1,240.52
$1,240.52
$1,209.65
$1,328.49
$1,368.26
$1,652.15
$1,335.63
$1,242.45
$1,435.49
$1,435.49
$1,328.49
$1,368.26
$1,218.06
$1,435.49
$1,181.82
$1,360.68
$1,652.15
$1,658.54
$1,368.26
$1,144.38
$1,437.86
$1,218.53
$1,218.06
$1,437.86
$1,215.83
$1,652.15
$1,435.49
$1,231.79
$1,240.52
$1,328.49
$1,658.54

$596.82
$629.96
$588.93
$625.86
$684.26
$615.24
$609.11
$625.86
$628.47
$807.84
$713.88
$617.40
$807.84
$684.26
$629.87
$629.87
$616.73
$667.32
$684.26
$805.13
$670.37
$630.69
$712.88
$712.88
$667.32
$684.26
$620.31
$712.88
$604.88
$681.03
$805.13
$807.84
$684.26
$588.93
$713.88
$620.51
$620.31
$713.88
$619.35
$805.13
$712.88
$626.15
$629.87
$667.32
$807.84

$638.19
$674.03
$629.66
$669.62
$732.78
$658.11
$651.48
$669.62
$672.42
$866.49
$764.84
$660.45
$866.49
$732.78
$673.94
$673.94
$659.72
$714.47
$732.78
$863.55
$717.75
$674.84
$763.76
$763.76
$714.47
$732.78
$663.60
$763.76
$646.91
$729.29
$863.55
$866.49
$732.78
$629.66
$764.84
$663.81
$663.60
$764.84
$662.57
$863.55
$763.76
$669.92
$673.94
$714.47
$866.49

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4,186.22
$0.00
$0.00
$0.00
$4,752.98
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4,744.38
$0.00
$0.00
$0.00
$4,456.11
$0.00
$0.00
$0.00
$0.00
$4,744.38
$0.00
$0.00
$0.00
$0.00
$0.00

$657.77
$694.17
$649.10
$689.69
$753.87
$678.00
$671.27
$689.69
$692.54
$889.71
$786.44
$680.39
$889.71
$753.87
$694.08
$694.08
$679.64
$735.26
$753.87
$886.73
$738.60
$695.00
$785.33
$785.33
$735.26
$753.87
$683.58
$785.33
$666.62
$750.32
$886.73
$889.71
$753.87
$649.10
$786.44
$683.79
$683.58
$786.44
$682.53
$886.73
$785.33
$690.00
$694.08
$735.26
$889.71

$1,395.18
$1,498.43
$1,370.58
$1,485.71
$1,667.72
$1,452.56
$1,433.46
$1,485.71
$1,493.81
$2,052.98
$1,760.09
$1,459.32
$2,052.98
$1,667.72
$1,498.17
$1,498.17
$1,457.21
$1,614.93
$1,667.72
$2,044.50
$1,624.41
$1,500.75
$1,756.95
$1,756.95
$1,614.93
$1,667.72
$1,468.38
$1,756.95
$1,420.26
$1,657.67
$2,044.50
$2,052.98
$1,667.72
$1,370.58
$1,760.09
$1,468.98
$1,468.38
$1,760.09
$1,465.41
$2,044.50
$1,756.95
$1,486.59
$1,498.17
$1,614.93
$2,052.98

$871.46
$927.89
$858.02
$920.93
$1,020.41
$902.82
$892.38
$920.93
$925.35
$1,230.95
$1,070.88
$906.51
$1,230.95
$1,020.41
$927.75
$927.75
$905.36
$991.55
$1,020.41
$1,226.31
$996.74
$929.15
$1,069.17
$1,069.17
$991.55
$1,020.41
$911.46
$1,069.17
$885.17
$1,014.90
$1,226.31
$1,230.95
$1,020.41
$858.02
$1,070.88
$911.79
$911.46
$1,070.88
$909.84
$1,226.31
$1,069.17
$921.42
$927.75
$991.55
$1,230.95

$1,013.78
$1,075.62
$999.05
$1,067.99
$1,177.01
$1,048.14
$1,036.71
$1,067.99
$1,072.85
$1,407.74
$1,232.33
$1,052.19
$1,407.74
$1,177.01
$1,075.46
$1,075.46
$1,050.92
$1,145.39
$1,177.01
$1,402.67
$1,151.07
$1,077.00
$1,230.45
$1,230.45
$1,145.39
$1,177.01
$1,057.62
$1,230.45
$1,028.81
$1,170.98
$1,402.67
$1,407.74
$1,177.01
$999.05
$1,232.33
$1,057.98
$1,057.62
$1,232.33
$1,055.84
$1,402.67
$1,230.45
$1,068.53
$1,075.46
$1,145.39
$1,407.74

Page 12 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
2424000
7000008
2129000
3101000
2902000
7001017
7003004
7001019
7001020
7002019
1226701
3824000
5721700
4402000
3622000
0101003
7002020
1401008
2909000
7002021
7000006
1564701
7003015
7002024
3121001
5903000
2950002
1701000
2952006
3102000
2527000
7000024
7002052
7003013
2901000
2952005
2951001
1327000
5920000
7001008
7002026
7003010
7001021
7099003
7002054

Agency
ADIRONDACK
MEDICAL
HOSP
LEWIS
COUNTY
GENERAL
LINCOLN MEDICAL & MENTAL
LITTLE FALLS HOSPITAL
LOCKPORT MEMORIAL HOSP
LONG BEACH MEDICAL CTR
LONG ISLAND COLLEGE HOSP
LONG ISLAND JEWISH
LUTHERAN MEDICAL CENTER
MAIMONIDES MEDICAL CTR
MANHATTAN EYE EAR & THROAT
MARGARETVILLE MEMORIAL
MARY IMOGENE BASSETT
MARY MCCLELLAN HOSPITAL
MASSENA MEMORIAL HOSPITAL
MEDINA MEMORIAL HOSPITAL
MEMORIAL HOSP (ALBANY)
MEMORIAL HOSP FOR CANCER
MERCY HOSPITAL OF BUFFALO
MERCY MEDICAL CENTER
METROPOLITAN HOSPITAL CTR
MONTEFIORE HOSPITAL
MOSES-LUDINGTON HOSPITAL
MOUNT SINAI / WEST QUEENS
MOUNT SINAI HOSPITAL
MOUNT ST MARYS HOSPITAL
MOUNT VERNON HOSPITAL
NASSAU HEALTH CARE CORP
NATHAN LITTAUER HOSPITAL
NEW ISLAND HOSPITAL
NIAGARA FALLS MEMORIAL**
NICHOLAS H NOYES HOSP
NORTH CENTRAL BRONX
NORTH GENERAL HOSPITAL
NORTH SHORE / FOREST HILLS
NORTH SHORE / GLEN COVE
NORTH SHORE / PLAINVIEW
NORTH SHORE UNIVERSITY
NORTHERN DUTCHESS HOSP
NORTHERN WESTCHESTER
NY COMMUNITY / BROOKLYN
NY EYE & EAR INFIRMARY
NY MEDICAL CTR OF QUEENS
NY METHODIST HOSPITAL
NY PRESBY HOSP (ALLEN)
NY PRESBY HOSP (NY PAYNE)

Mmisid
00363213
00354370
00246126
00310870
00354389
00245487
00243678
00243903
00243729
00243641
00243458
00279387
00305000
00336952
00354398
00310898
00364003
00243467
00354412
00274295
00246135
00243554
00360930
00243509
00243509
01746616
00274117
01962156
00313924
01949875
00354467
00354476
00246171
00355142
00243889
00274240
00274231
00245510
00268300
00274144
00243696
00243476
00244133
00243701
00243178
00243518

PAS
20

PAS
21

PAS
22

PAS
23

PAS
24

PAS
25

PAS
26

PAS
27

PAS
28

PAS
29

$610.05
$848.79
$613.28
$616.44
$696.84
$852.21
$852.21
$732.83
$852.21
$723.12
$623.42
$740.34
$612.44
$603.63
$621.18
$627.20
$732.83
$615.24
$696.84
$848.79
$852.21
$615.27
$725.12
$852.21
$615.96
$675.54
$819.36
$619.56
$692.78
$615.96
$628.46
$848.79
$841.82
$841.82
$696.84
$696.84
$819.36
$661.92
$675.54
$725.12
$725.12
$852.21
$852.21
$852.21
$852.21

$1,513.88
$1,870.88
$1,518.68
$1,523.42
$1,643.64
$1,875.99
$1,875.99
$1,697.45
$1,875.99
$1,682.94
$1,533.86
$1,708.68
$1,517.43
$1,504.26
$1,530.51
$1,539.51
$1,697.45
$1,521.62
$1,643.64
$1,870.88
$1,875.99
$1,521.66
$1,685.93
$1,875.99
$1,522.70
$1,611.80
$1,826.87
$1,528.10
$1,637.57
$1,522.70
$1,541.39
$1,870.88
$1,860.45
$1,860.45
$1,643.64
$1,643.64
$1,826.87
$1,591.43
$1,611.80
$1,685.93
$1,685.93
$1,875.99
$1,875.99
$1,875.99
$1,875.99

$1,206.15
$1,652.15
$1,212.15
$1,218.06
$1,368.26
$1,658.54
$1,658.54
$1,435.49
$1,658.54
$1,417.37
$1,231.11
$1,449.53
$1,210.59
$1,194.15
$1,226.94
$1,238.18
$1,435.49
$1,215.83
$1,368.26
$1,652.15
$1,658.54
$1,215.87
$1,421.10
$1,658.54
$1,217.16
$1,328.49
$1,597.16
$1,223.91
$1,360.68
$1,217.16
$1,240.52
$1,652.15
$1,639.13
$1,639.13
$1,368.26
$1,368.26
$1,597.16
$1,303.02
$1,328.49
$1,421.10
$1,421.10
$1,658.54
$1,658.54
$1,658.54
$1,658.54

$615.24
$805.13
$617.79
$620.31
$684.26
$807.84
$807.84
$712.88
$807.84
$705.17
$625.86
$718.86
$617.13
$610.13
$624.09
$628.88
$712.88
$619.35
$684.26
$805.13
$807.84
$619.38
$706.76
$807.84
$619.92
$667.32
$781.71
$622.80
$681.03
$619.92
$629.87
$805.13
$799.58
$799.58
$684.26
$684.26
$781.71
$656.48
$667.32
$706.76
$706.76
$807.84
$807.84
$807.84
$807.84

$658.11
$863.55
$660.87
$663.60
$732.78
$866.49
$866.49
$763.76
$866.49
$755.40
$669.62
$770.22
$660.15
$652.58
$667.68
$672.86
$763.76
$662.57
$732.78
$863.55
$866.49
$662.60
$757.13
$866.49
$663.18
$714.47
$838.22
$666.29
$729.29
$663.18
$673.94
$863.55
$857.55
$857.55
$732.78
$732.78
$838.22
$702.74
$714.47
$757.13
$757.13
$866.49
$866.49
$866.49
$866.49

$0.00
$0.00
$0.00
$0.00
$0.00
$4,752.98
$4,752.98
$4,452.93
$0.00
$0.00
$0.00
$0.00
$0.00
$4,128.27
$0.00
$4,187.49
$0.00
$0.00
$4,362.50
$0.00
$4,752.98
$0.00
$0.00
$4,752.98
$0.00
$0.00
$0.00
$0.00
$0.00
$4,159.23
$0.00
$0.00
$4,726.86
$0.00
$0.00
$0.00
$4,670.42
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4,752.98

$678.00
$886.73
$680.81
$683.58
$753.87
$889.71
$889.71
$785.33
$889.71
$776.85
$689.69
$791.90
$680.07
$672.39
$687.74
$692.99
$785.33
$682.53
$753.87
$886.73
$889.71
$682.55
$778.59
$889.71
$683.16
$735.26
$860.99
$686.31
$750.32
$683.16
$694.08
$886.73
$880.64
$880.64
$753.87
$753.87
$860.99
$723.33
$735.26
$778.59
$778.59
$889.71
$889.71
$889.71
$889.71

$1,452.56
$2,044.50
$1,460.54
$1,468.38
$1,667.72
$2,052.98
$2,052.98
$1,756.95
$2,052.98
$1,732.89
$1,485.71
$1,775.58
$1,458.45
$1,436.64
$1,480.16
$1,495.07
$1,756.95
$1,465.41
$1,667.72
$2,044.50
$2,052.98
$1,465.47
$1,737.84
$2,052.98
$1,467.18
$1,614.93
$1,971.53
$1,476.14
$1,657.67
$1,467.18
$1,498.17
$2,044.50
$2,027.22
$2,027.22
$1,667.72
$1,667.72
$1,971.53
$1,581.14
$1,614.93
$1,737.84
$1,737.84
$2,052.98
$2,052.98
$2,052.98
$2,052.98

$902.82
$1,226.31
$907.17
$911.46
$1,020.41
$1,230.95
$1,230.95
$1,069.17
$1,230.95
$1,056.02
$920.93
$1,079.34
$906.05
$894.12
$917.90
$926.04
$1,069.17
$909.84
$1,020.41
$1,226.31
$1,230.95
$909.87
$1,058.73
$1,230.95
$910.80
$991.55
$1,186.43
$915.71
$1,014.90
$910.80
$927.75
$1,226.31
$1,216.86
$1,216.86
$1,020.41
$1,020.41
$1,186.43
$973.08
$991.55
$1,058.73
$1,058.73
$1,230.95
$1,230.95
$1,230.95
$1,230.95

$1,048.14
$1,402.67
$1,052.93
$1,057.62
$1,177.01
$1,407.74
$1,407.74
$1,230.45
$1,407.74
$1,216.04
$1,067.99
$1,241.61
$1,051.68
$1,038.60
$1,064.67
$1,073.60
$1,230.45
$1,055.84
$1,177.01
$1,402.67
$1,407.74
$1,055.88
$1,219.01
$1,407.74
$1,056.90
$1,145.39
$1,358.96
$1,062.27
$1,170.98
$1,056.90
$1,075.46
$1,402.67
$1,392.32
$1,392.32
$1,177.01
$1,177.01
$1,358.96
$1,125.15
$1,145.39
$1,219.01
$1,219.01
$1,407.74
$1,407.74
$1,407.74
$1,407.74

Page 13 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
7002030
5906000
7002053
7000025
4324000
7002000
0401001
2601001
3523000
3501000
3702000
0301001
7000005
1402000
2754001
7003020
7003006
5932000
3950000
7003007
7004010
2221001
2701003
3201002
1401010
4102002
2201000
4501000
4823000
4102003
1401006
7004006
1401013
6120000
5904000
2950001
5126000
5154000
5902000
3529000
7000014
5157003
5149001
4601002
7002033

Agency
ADIRONDACK
MEDICAL
HOSP
NY
PRESBY HOSP
(PRESBY)
NY UNITED HOSPITAL
NY UNIV MED CTR (TISCH)
NY WESTCHESTER SQUARE
NYACK HOSPITAL
NYU DOWNTOWN HOSPITAL
OLEAN GENERAL HOSPITAL
ONEIDA CITY HOSPITAL
ORANGE REGIONAL MED CTR
ORANGE REGIONAL(MIDDLETOWN)
OSWEGO HOSPITAL
OUR LADY OF LOURDES HOSP
OUR LADY OF MERCY
OUR LADY OF VICTORY HOSP
PARK RIDGE HOSPITAL
PARKWAY HOSPITAL
PENINSULA HOSPITAL CTR
PHELPS MEMORIAL HOSPITAL
PUTNAM COMMUNITY HOSPITAL
QUEENS HOSPITAL CENTER
RICHMOND UNIVERSITY MEDICAL CENTER
RIVER HOSPITAL**
ROCHESTER GENERAL HOSP
ROME HOSPITAL AND MURPHY
ROSWELL PARK MEMORIAL
SAMARITAN HOSPITAL / TROY
SAMARITAN MEDICAL CENTER
SARATOGA HOSPITAL
SCHUYLER HOSPITAL
SETON HEALTH SYSTEMS
SHEEHAN MEMORIAL EMERG
SISTERS OF CHARITY (BAYLEY)
SISTERS OF CHARITY HOSP
SOLDIERS AND SAILORS
SOUND SHORE HOSPITAL
SOUTH NASSAU COMMUNITIES
SOUTHAMPTON HOSP ASSOC
SOUTHSIDE HOSPITAL
ST AGNES HOSPITAL
ST ANTHONY COMMUNITY
ST BARNABAS HOSPITAL
ST CATHERINE OF SIENA
ST CHARLES HOSPITAL
ST CLARE'S / SCHENECTADY
ST CLARES HOSP & HEALTH

Mmisid
00363213
00243178
00274204
00273116
00273092
00243967
00647269
00354632
00310903
00258379
00258379
00354485
00337664
00243563
00354494
00378721
00244151
00243898
00274162
00258360
00246153
00248820
02392854
00303315
00352534
00354518
00318805
00354316
00303282
00363144
01534463
00354545
00652328
00354563
00336498
00274126
00245496
00274406
00268319
00274180
00273890
00243361
02060942
00274415
00361748
00243201

PAS
20

PAS
21

PAS
22

PAS
23

PAS
24

PAS
25

PAS
26

PAS
27

PAS
28

PAS
29

$852.21
$675.54
$852.21
$725.12
$675.54
$839.03
$609.84
$627.18
$644.01
$644.01
$617.64
$605.49
$852.21
$615.24
$629.84
$725.12
$732.83
$675.54
$664.19
$848.79
$852.21
$610.05
$746.93
$613.28
$617.00
$626.69
$610.40
$626.69
$597.03
$626.69
$615.72
$732.83
$617.00
$585.71
$797.87
$701.48
$696.84
$696.84
$680.00
$644.54
$732.83
$696.84
$696.84
$626.69
$841.82

$1,875.99
$1,611.80
$1,875.99
$1,685.93
$1,611.80
$1,856.28
$1,513.55
$1,539.48
$1,564.65
$1,564.65
$1,525.20
$1,507.05
$1,875.99
$1,521.62
$1,543.46
$1,685.93
$1,697.45
$1,611.80
$1,594.82
$1,870.88
$1,875.99
$1,513.88
$1,718.54
$1,518.68
$1,524.26
$1,538.75
$1,514.39
$1,538.75
$1,494.39
$1,538.75
$1,522.34
$1,697.45
$1,524.26
$1,477.46
$1,794.74
$1,650.57
$1,643.64
$1,643.64
$1,618.46
$1,565.42
$1,697.45
$1,643.64
$1,643.64
$1,538.75
$1,860.45

$1,658.54
$1,328.49
$1,658.54
$1,421.10
$1,328.49
$1,633.91
$1,205.75
$1,238.15
$1,269.59
$1,269.59
$1,220.30
$1,197.62
$1,658.54
$1,215.83
$1,243.10
$1,421.10
$1,435.49
$1,328.49
$1,307.27
$1,652.15
$1,658.54
$1,206.15
$1,461.84
$1,212.15
$1,219.11
$1,237.22
$1,206.78
$1,237.22
$1,181.82
$1,237.22
$1,216.73
$1,435.49
$1,219.11
$1,160.64
$1,557.02
$1,376.93
$1,368.26
$1,368.26
$1,336.79
$1,270.55
$1,435.49
$1,368.26
$1,368.26
$1,237.22
$1,639.13

$807.84
$667.32
$807.84
$706.76
$667.32
$797.36
$615.06
$628.86
$642.24
$642.24
$621.26
$611.61
$807.84
$619.35
$630.98
$706.76
$712.88
$667.32
$658.29
$805.13
$807.84
$615.24
$724.10
$617.79
$620.76
$628.47
$615.51
$628.47
$604.88
$628.47
$619.74
$712.88
$620.76
$595.86
$764.63
$687.95
$684.26
$684.26
$670.86
$642.66
$712.88
$684.26
$684.26
$628.47
$799.58

$866.49
$714.47
$866.49
$757.13
$714.47
$855.15
$657.93
$672.84
$687.33
$687.33
$664.64
$654.18
$866.49
$662.57
$675.14
$757.13
$763.76
$714.47
$704.69
$863.55
$866.49
$658.11
$775.89
$660.87
$664.08
$672.42
$658.41
$672.42
$646.91
$672.42
$662.99
$763.76
$664.08
$637.16
$819.74
$736.77
$732.78
$732.78
$718.29
$687.78
$763.76
$732.78
$732.78
$672.42
$857.55

$4,752.98
$0.00
$0.00
$0.00
$0.00
$0.00
$4,143.87
$0.00
$0.00
$4,229.75
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4,145.27
$0.00
$0.00
$4,186.22
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

$889.71
$735.26
$889.71
$778.59
$735.26
$878.19
$677.81
$692.97
$707.69
$707.69
$684.63
$674.01
$889.71
$682.53
$695.30
$778.59
$785.33
$735.26
$725.33
$886.73
$889.71
$678.00
$797.66
$680.81
$684.08
$692.54
$678.30
$692.54
$666.62
$692.54
$682.95
$785.33
$684.08
$656.70
$842.21
$757.92
$753.87
$753.87
$739.14
$708.14
$785.33
$753.87
$753.87
$692.54
$880.64

$2,052.98
$1,614.93
$2,052.98
$1,737.84
$1,614.93
$2,020.31
$1,452.03
$1,495.02
$1,536.77
$1,536.77
$1,471.35
$1,441.25
$2,052.98
$1,465.41
$1,501.61
$1,737.84
$1,756.95
$1,614.93
$1,586.78
$2,044.50
$2,052.98
$1,452.56
$1,791.92
$1,460.54
$1,469.78
$1,493.81
$1,453.41
$1,493.81
$1,420.26
$1,493.81
$1,466.61
$1,756.95
$1,469.78
$1,392.17
$1,918.25
$1,679.22
$1,667.72
$1,667.72
$1,625.96
$1,538.04
$1,756.95
$1,667.72
$1,667.72
$1,493.81
$2,027.22

$1,230.95
$991.55
$1,230.95
$1,058.73
$991.55
$1,213.08
$902.52
$926.03
$948.83
$948.83
$913.08
$896.64
$1,230.95
$909.84
$929.63
$1,058.73
$1,069.17
$991.55
$976.17
$1,226.31
$1,230.95
$902.82
$1,088.28
$907.17
$912.23
$925.35
$903.29
$925.35
$885.17
$925.35
$910.49
$1,069.17
$912.23
$869.82
$1,157.31
$1,026.69
$1,020.41
$1,020.41
$997.58
$949.53
$1,069.17
$1,020.41
$1,020.41
$925.35
$1,216.86

$1,407.74
$1,145.39
$1,407.74
$1,219.01
$1,145.39
$1,388.18
$1,047.83
$1,073.58
$1,098.57
$1,098.57
$1,059.39
$1,041.36
$1,407.74
$1,055.84
$1,077.53
$1,219.01
$1,230.45
$1,145.39
$1,128.53
$1,402.67
$1,407.74
$1,048.14
$1,251.39
$1,052.93
$1,058.46
$1,072.85
$1,048.65
$1,072.85
$1,028.81
$1,072.85
$1,056.56
$1,230.45
$1,058.46
$1,011.98
$1,327.05
$1,183.89
$1,177.01
$1,177.01
$1,152.00
$1,099.34
$1,230.45
$1,177.01
$1,177.01
$1,072.85
$1,392.32

Page 14 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
3202002
1302000
2953000
5002001
5907001
1455000
0701001
3301003
5907002
3502000
3522000
7002032
2801001
7001025
0101004
7002037
7001037
5151001
7004003
2701005
3301007
1227000
0427000
0303001
1801000
1302001
7001032
5820000
5957001
0632000
5902001
2908000
0602001
7001045
7001035
6027000

Agency
ADIRONDACK
ST
ELIZABETHMEDICAL
MED CTRHOSP
ST FRANCIS / POUGHKEEPSIE
ST FRANCIS HOSP / ROSLYN
ST JAMES MERCY HOSPITAL
ST JOHNS RIVERSIDE
ST JOSEPH HOSPITAL
ST JOSEPHS / ELMIRA
ST JOSEPHS HOSP & HEALTH
ST JOSEPHS OF YONKERS
ST LUKES / NEWBURGH
ST LUKES CORNWALL / CORNWALL
ST LUKES ROOSEVELT
ST MARYS AT AMSTERDAM
ST MARYS OF BROOKLYN
ST PETERS HOSPITAL
ST VINCENTS HOSPITAL
STATE UNIV / DOWNSTATE
STATE UNIV / STONY BROOK
STATEN ISLAND UNIV HOSPITAL
STRONG MEMORIAL HOSPITAL
SUNY HEALTH SCIENCE CENTER
THE HOSPITAL
TLC HEALTH NETWORK
UNITED HEALTH SERVICES
UNITED MEMORIAL (GENESEE)
VASSAR BROTHERS MED CTR
VICTORY MEMORIAL HOSPITAL
WAYNE HEALTH CARE
WESTCHESTER MEDICAL CTR
WESTFIELD MEMORIAL HOSP
WHITE PLAINS HOSPITAL
WINTHROP UNIVERSITY HOSP
WOMANS CHRISTIAN ASSOC
WOODHULL MEDICAL CENTER
WYCKOFF HEIGHTS HOSPITAL
WYOMING COUNTY COMMUNITY

Mmisid
00363213
00279901
00273845
00244046
00363162
00245501
00354581
00363126
00315013
00258920
00273914
00273863
00354967
00351639
00729373
00318823
00243229
00243590
00357795
00244202
00279034
00354590
00313951
00347544
00614755
00354283
00273854
00243449
00354458
00274213
00354614
00274222
00244211
00354623
00698866
00243825
00310889

PAS
20

PAS
21

PAS
22

PAS
23

PAS
24

PAS
25

PAS
26

PAS
27

PAS
28

PAS
29

$612.78
$662.57
$701.48
$598.29
$675.54
$615.24
$603.33
$745.64
$675.54
$644.01
$644.54
$852.21
$626.69
$852.21
$745.65
$852.21
$852.21
$819.36
$852.21
$746.93
$745.64
$623.42
$609.50
$607.29
$578.18
$661.34
$725.12
$628.46
$797.87
$609.75
$675.54
$819.36
$609.27
$848.79
$732.83
$578.18

$1,517.94
$1,592.40
$1,650.57
$1,496.27
$1,611.80
$1,521.62
$1,503.81
$1,716.62
$1,611.80
$1,564.65
$1,565.42
$1,875.99
$1,538.75
$1,875.99
$1,716.63
$1,875.99
$1,875.99
$1,826.87
$1,875.99
$1,718.54
$1,716.62
$1,533.86
$1,513.04
$1,509.72
$1,466.21
$1,590.56
$1,685.93
$1,541.39
$1,794.74
$1,513.41
$1,611.80
$1,826.87
$1,512.69
$1,870.88
$1,697.45
$1,466.21

$1,211.24
$1,304.25
$1,376.93
$1,184.16
$1,328.49
$1,215.83
$1,193.58
$1,459.44
$1,328.49
$1,269.59
$1,270.55
$1,658.54
$1,237.22
$1,658.54
$1,459.46
$1,658.54
$1,658.54
$1,597.16
$1,658.54
$1,461.84
$1,459.44
$1,231.11
$1,205.10
$1,200.96
$1,146.59
$1,301.96
$1,421.10
$1,240.52
$1,557.02
$1,205.57
$1,328.49
$1,597.16
$1,204.67
$1,652.15
$1,435.49
$1,146.59

$617.40
$657.00
$687.95
$605.87
$667.32
$619.35
$609.89
$723.08
$667.32
$642.24
$642.66
$807.84
$628.47
$807.84
$723.09
$807.84
$807.84
$781.71
$807.84
$724.10
$723.08
$625.86
$614.79
$613.04
$589.88
$656.03
$706.76
$629.87
$764.63
$614.99
$667.32
$781.71
$614.60
$805.13
$712.88
$589.88

$660.45
$703.29
$736.77
$647.99
$714.47
$662.57
$652.32
$774.78
$714.47
$687.33
$687.78
$866.49
$672.42
$866.49
$774.80
$866.49
$866.49
$838.22
$866.49
$775.89
$774.78
$669.62
$657.63
$655.73
$630.68
$702.24
$757.13
$673.94
$819.74
$657.84
$714.47
$838.22
$657.42
$863.55
$763.76
$630.68

$0.00
$4,276.38
$0.00
$0.00
$0.00
$0.00
$4,127.51
$0.00
$4,308.98
$4,229.75
$4,231.05
$0.00
$0.00
$0.00
$4,485.17
$0.00
$4,752.98
$4,670.42
$0.00
$4,488.38
$4,485.15
$0.00
$0.00
$0.00
$0.00
$0.00
$4,433.57
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

$680.39
$723.92
$757.92
$667.71
$735.26
$682.53
$672.12
$796.55
$735.26
$707.69
$708.14
$889.71
$692.54
$889.71
$796.55
$889.71
$889.71
$860.99
$889.71
$797.66
$796.55
$689.69
$677.51
$675.57
$650.13
$722.84
$778.59
$694.08
$842.21
$677.73
$735.26
$860.99
$677.31
$886.73
$785.33
$650.13

$1,459.32
$1,582.76
$1,679.22
$1,423.38
$1,614.93
$1,465.41
$1,435.89
$1,788.74
$1,614.93
$1,536.77
$1,538.04
$2,052.98
$1,493.81
$2,052.98
$1,788.75
$2,052.98
$2,052.98
$1,971.53
$2,052.98
$1,791.92
$1,788.74
$1,485.71
$1,451.18
$1,445.69
$1,373.52
$1,579.73
$1,737.84
$1,498.17
$1,918.25
$1,451.79
$1,614.93
$1,971.53
$1,450.59
$2,044.50
$1,756.95
$1,373.52

$906.51
$973.97
$1,026.69
$886.88
$991.55
$909.84
$893.70
$1,086.54
$991.55
$948.83
$949.53
$1,230.95
$925.35
$1,230.95
$1,086.54
$1,230.95
$1,230.95
$1,186.43
$1,230.95
$1,088.28
$1,086.54
$920.93
$902.06
$899.06
$859.62
$972.32
$1,058.73
$927.75
$1,157.31
$902.40
$991.55
$1,186.43
$901.74
$1,226.31
$1,069.17
$859.62

$1,052.19
$1,126.13
$1,183.89
$1,030.67
$1,145.39
$1,055.84
$1,038.15
$1,249.49
$1,145.39
$1,098.57
$1,099.34
$1,407.74
$1,072.85
$1,407.74
$1,249.50
$1,407.74
$1,407.74
$1,358.96
$1,407.74
$1,251.39
$1,249.49
$1,067.99
$1,047.32
$1,044.03
$1,000.80
$1,124.30
$1,219.01
$1,075.46
$1,327.05
$1,047.68
$1,145.39
$1,358.96
$1,046.97
$1,402.67
$1,230.45
$1,000.80

Page 15 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
0101005
0101000
3701000
1624000
2801000
0701000
0501000
3801000
4720001
7002001
4652001
5501000
1427000
7001041
7002004
7002002
3535001
7000001
7001002
5123000
7001003
0601000
5120000
7002003
4429000
2238001
5263700
5263000
5401001
5155000
0901001
0824000
7003000
4401000
3421000
7003005
7003008
7003025
1001000
3301000
5925000
2625000
7001009
5001000

Agency
ADIRONDACK MEDICAL HOSP
ALB MED SO CLINICAL CAMPUS
ALBANY MEDICAL CENTER
ALBERT LINDLEY LEE
ALICE HYDE MEDICAL CTR
AMSTERDAM MEMORIAL HOSP
ARNOT OGDEN MEMORIAL
AUBURN MEMORIAL HOSPITAL
AURELIA OSBORN FOX
BASSETT HOSPITAL
BELLEVUE HOSPITAL CTR
BELLEVUE WOMAN'S HOSP
BENEDICTINE HOSPITAL
BERTRAND CHAFFEE HOSPITAL
BETH ISRAEL / KINGS HIGHWAY
BETH ISRAEL / NORTH DIVISION
BETH ISRAEL MEDICAL CTR
BON SECOURS COMM HOSP
BRONX-LEBANON HOSP CTR
BROOKDALE HOSP MED CTR
BROOKHAVEN MEMORIAL HOSP
BROOKLYN HOSPITAL CENTER
BROOKS MEMORIAL HOSPITAL
BRUNSWICK HOSPITAL CTR
CABRINI MEDICAL CENTER
CANTON-POTSDAM HOSPITAL
CARTHAGE AREA HOSPITAL
CATSKILL REGIONAL / G HERMANN
CATSKILL REGIONAL MED CTR
CAYUGA MEDICAL CENTER
CENTRAL SUFFOLK HOSPITAL
CHAMPLAIN VALLEY PHYS
CHENANGO MEMORIAL HOSP
CITY HOSPITAL CENTER
CLAXTON-HEPBURN MED CTR
CLIFTON SPRINGS HOSPITAL
CMC (MARY IMMACULATE)
CMC (ST JOHNS)
CMC (ST JOSEPHS)
COLUMBIA MEMORIAL HOSP
COMM GEN / GREATER SYRACUSE
COMM HOSP / DOBBS FERRY
COMMUNITY MEMORIAL HOSP
CONEY ISLAND HOSPITAL
CORNING HOSPITAL

Mmisid
00363213
01952712
00277716
00354105
00354114
00381420
00363199
00347553
00279098
00302429
00246039
00354132
00274020
00354150
00243105
00243105
00243105
00273905
00476022
00243572
00245529
00243614
00381439
00268295
00243132
00354196
00310852
00273978
00273978
00332729
00274328
00318814
00314723
00246075
00354072
00354641
00243861
00244124
00498531
00335915
00315004
00274066
00354229
00246066
00361739

PAS
30
$1,085.04
$1,123.56
$1,317.14
$1,108.73
$1,082.96
$1,123.56
$1,084.55
$1,056.27
$1,119.62
$1,211.99
$1,485.69
$1,123.56
$1,117.97
$1,104.80
$1,283.58
$1,283.58
$1,491.27
$1,151.88
$1,491.27
$1,491.27
$1,237.35
$1,491.27
$1,095.03
$1,230.72
$1,491.27
$1,085.04
$1,095.54
$1,117.38
$1,117.97
$1,056.27
$1,237.35
$1,083.50
$1,117.38
$1,485.69
$1,085.04
$1,125.60
$1,491.27
$1,491.27
$1,491.27
$1,109.46
$1,122.69
$1,202.57
$1,123.53
$1,485.69
$1,076.31

PAS
31
$787.04
$813.89
$948.81
$803.55
$785.58
$813.89
$786.69
$766.98
$811.14
$875.52
$1,066.31
$813.89
$809.99
$800.81
$925.43
$925.43
$1,070.21
$833.63
$1,070.21
$1,070.21
$893.21
$1,070.21
$794.00
$888.59
$1,070.21
$787.04
$794.36
$809.58
$809.99
$766.98
$893.21
$785.96
$809.58
$1,066.31
$787.04
$815.31
$1,070.21
$1,070.21
$1,070.21
$804.06
$813.27
$868.95
$813.86
$1,066.31
$780.95

PAS
32
$709.61
$729.24
$827.96
$721.68
$708.54
$729.24
$709.35
$694.94
$727.25
$774.35
$913.91
$729.24
$726.41
$719.69
$810.84
$810.84
$916.76
$743.69
$916.76
$916.76
$787.28
$916.76
$714.71
$783.89
$916.76
$709.61
$714.96
$726.11
$726.41
$694.94
$787.28
$708.83
$726.11
$913.91
$709.61
$730.29
$916.76
$916.76
$916.76
$722.06
$728.81
$769.53
$729.23
$913.91
$705.15

Page 16 of 25

PAS
33
$1,385.91
$1,440.50
$1,714.88
$1,419.47
$1,382.94
$1,440.50
$1,385.21
$1,345.13
$1,434.92
$1,565.84
$1,953.81
$1,440.50
$1,432.58
$1,413.90
$1,667.31
$1,667.31
$1,961.73
$1,480.64
$1,961.73
$1,961.73
$1,601.81
$1,961.73
$1,400.06
$1,592.40
$1,961.73
$1,385.91
$1,400.78
$1,431.74
$1,432.58
$1,345.13
$1,601.81
$1,383.72
$1,431.74
$1,953.81
$1,385.91
$1,443.41
$1,961.73
$1,961.73
$1,961.73
$1,420.52
$1,439.27
$1,552.49
$1,440.45
$1,953.81
$1,373.52

PAS
34
$1,100.67
$1,136.27
$1,315.25
$1,122.56
$1,098.74
$1,136.27
$1,100.21
$1,074.06
$1,132.64
$1,218.03
$1,471.10
$1,136.27
$1,131.11
$1,118.93
$1,284.23
$1,284.23
$1,476.26
$1,162.46
$1,476.26
$1,476.26
$1,241.49
$1,476.26
$1,109.90
$1,235.36
$1,476.26
$1,100.67
$1,110.36
$1,130.57
$1,131.11
$1,074.06
$1,241.49
$1,099.23
$1,130.57
$1,471.10
$1,100.67
$1,138.17
$1,476.26
$1,476.26
$1,476.26
$1,123.23
$1,135.47
$1,209.32
$1,136.25
$1,471.10
$1,092.59

PAS
35
$1,452.59
$1,504.25
$1,763.97
$1,484.36
$1,449.78
$1,504.25
$1,451.93
$1,413.98
$1,498.97
$1,622.90
$1,990.13
$1,504.25
$1,496.76
$1,479.09
$1,718.96
$1,718.96
$1,997.63
$1,542.26
$1,997.63
$1,997.63
$1,656.93
$1,997.63
$1,465.98
$1,648.04
$1,997.63
$1,452.59
$1,466.66
$1,495.97
$1,496.76
$1,413.98
$1,656.93
$1,450.52
$1,495.97
$1,990.13
$1,452.59
$1,507.01
$1,997.63
$1,997.63
$1,997.63
$1,485.35
$1,503.09
$1,610.25
$1,504.22
$1,990.13
$1,440.86

PAS
36
$1,515.77
$1,566.81
$1,823.45
$1,547.16
$1,512.99
$1,566.81
$1,515.11
$1,477.62
$1,561.61
$1,684.05
$2,046.93
$1,566.81
$1,559.42
$1,541.94
$1,778.97
$1,778.97
$2,054.34
$1,604.37
$2,054.34
$2,054.34
$1,717.70
$2,054.34
$1,529.00
$1,708.89
$2,054.34
$1,515.77
$1,529.67
$1,558.64
$1,559.42
$1,477.62
$1,717.70
$1,513.71
$1,558.64
$2,046.93
$1,515.77
$1,569.54
$2,054.34
$2,054.34
$2,054.34
$1,548.14
$1,565.67
$1,671.56
$1,566.78
$2,046.93
$1,504.17

PAS
37
$974.70
$1,009.47
$1,184.25
$996.09
$972.81
$1,009.47
$974.27
$948.74
$1,005.92
$1,089.32
$1,336.44
$1,009.47
$1,004.43
$992.54
$1,153.95
$1,153.95
$1,341.48
$1,035.05
$1,341.48
$1,341.48
$1,112.22
$1,341.48
$983.72
$1,106.24
$1,341.48
$974.70
$984.18
$1,003.91
$1,004.43
$948.74
$1,112.22
$973.31
$1,003.91
$1,336.44
$974.70
$1,011.33
$1,341.48
$1,341.48
$1,341.48
$996.75
$1,008.69
$1,080.81
$1,009.46
$1,336.44
$966.81

PAS
38
$999.47
$1,032.87
$1,200.80
$1,020.00
$997.65
$1,032.87
$999.03
$974.51
$1,029.47
$1,109.58
$1,347.03
$1,032.87
$1,028.03
$1,016.60
$1,171.70
$1,171.70
$1,351.88
$1,057.44
$1,351.88
$1,351.88
$1,131.60
$1,351.88
$1,008.12
$1,125.84
$1,351.88
$999.47
$1,008.57
$1,027.52
$1,028.03
$974.51
$1,131.60
$998.13
$1,027.52
$1,347.03
$999.47
$1,034.66
$1,351.88
$1,351.88
$1,351.88
$1,020.65
$1,032.12
$1,101.41
$1,032.86
$1,347.03
$991.89

PAS
39
$1,680.14
$1,748.21
$2,090.37
$1,722.00
$1,676.45
$1,748.21
$1,679.27
$1,629.29
$1,741.26
$1,904.52
$2,388.32
$1,748.21
$1,738.34
$1,715.06
$2,031.06
$2,031.06
$2,398.19
$1,798.28
$2,398.19
$2,398.19
$1,949.36
$2,398.19
$1,697.79
$1,937.64
$2,398.19
$1,680.14
$1,698.69
$1,737.30
$1,738.34
$1,629.29
$1,949.36
$1,677.41
$1,737.30
$2,388.32
$1,680.14
$1,751.84
$2,398.19
$2,398.19
$2,398.19
$1,723.29
$1,746.68
$1,887.86
$1,748.16
$2,388.32
$1,664.70
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
1101000
3301008
0226700
1229000
5127000
2221000
4423000
5526001
4601001
7001024
1401005
3202003
7003001
2910000
3429000
3402000
5601000
4329000
5154001
7002009
4322000
2701001
7002012
7002011
5901000
5153000
3154000
7001046
5022000
2906000
7000002
7003003
5149000
0228000
1401014
1401002
3103000
1401009
1404000
7001016
7001033
5501001
2728001
5922000
7002017

Agency
ADIRONDACK
MEDICAL HOSP
HOSP
CORTLAND
MEMORIAL
CROUSE HOSPITAL
CUBA MEMORIAL HOSPITAL
DELAWARE VALLEY HOSPITAL
EASTERN LONG ISLAND HOSP
EJ NOBLE / ALEXANDRIA
EJ NOBLE / GOUVERNEUR
ELLENVILLE REGIONAL HOSP
ELLIS HOSPITAL
EPISCOPAL HEALTH SERVICES
ERIE COUNTY MEDICAL CTR
FAXTON-ST LUKES HEALTHCARE
FLUSHING HOSPITAL
FRANKLIN HOSP MED CTR
FREDERICK FERRIS THOMPSON
GENEVA GENERAL HOSPITAL
GLENS FALLS HOSPITAL
GOOD SAMARITAN / SUFFERN
GOOD SAMARITAN / WEST ISLIP
HARLEM HOSPITAL CENTER
HELEN HAYES HOSPITAL
HIGHLAND HOSP / ROCHESTER
HOSP FOR SPECIAL SURGERY
HOSPITAL FOR JOINT DISEASES
HUDSON VALLEY HOSP CTR
HUNTINGTON HOSP ASSOC
INTER-COMMUNITY MEMORIAL
INTERFAITH MEDICAL CTR
IRA DAVENPORT MEMORIAL
ISLAND MEDICAL CENTER
JACOBI MEDICAL CENTER
JAMAICA HOSPITAL
JOHN T MATHER MEMORIAL
JONES MEMORIAL
KALEIDA HLTH (BUFFALO GEN)
KALEIDA HLTH (CHILD OF BUFF)
KALEIDA HLTH (DEGRAFF)
KALEIDA HLTH (MILLARD)
KENMORE MERCY HOSPITAL
KINGS COUNTY HOSPITAL
KINGSBROOK JEWISH MEDICAL
KINGSTON HOSPITAL
LAKESIDE MEMORIAL HOSP
LAWRENCE HOSPITAL
LENOX HILL HOSPITAL

Mmisid
00363213
00279176
00279396
00354238
00347571
00274337
00354265
00354256
02094860
00347562
00729382
00245863
00384309
00243843
00268328
00362529
00378712
00314998
00273941
00274346
00246108
00273950
00354307
00243370
00243389
00274153
00274355
00354325
00734336
00332816
00273285
00246048
00243852
00274364
00354403
00361968
00360614
00354247
00384643
00354343
00246117
00243669
00274048
00279543
00274093
00243421

PAS
30

PAS
31

PAS
32

PAS
33

PAS
34

PAS
35

PAS
36

PAS
37

PAS
38

PAS
39

$1,057.73
$1,125.77
$1,041.51
$1,117.38
$1,237.35
$1,095.54
$1,082.96
$1,117.38
$1,122.72
$1,491.27
$1,298.24
$1,100.00
$1,491.27
$1,237.35
$1,125.60
$1,125.60
$1,098.60
$1,202.57
$1,237.35
$1,485.69
$1,208.81
$1,127.30
$1,296.17
$1,296.17
$1,202.57
$1,237.35
$1,105.97
$1,296.17
$1,074.26
$1,230.72
$1,485.69
$1,491.27
$1,237.35
$1,041.51
$1,298.24
$1,106.37
$1,105.97
$1,298.24
$1,104.02
$1,485.69
$1,296.17
$1,117.97
$1,125.60
$1,202.57
$1,491.27

$768.00
$815.43
$756.69
$809.58
$893.21
$794.36
$785.58
$809.58
$813.30
$1,070.21
$935.64
$797.46
$1,070.21
$893.21
$815.31
$815.31
$796.49
$868.95
$893.21
$1,066.31
$873.32
$816.50
$934.20
$934.20
$868.95
$893.21
$801.62
$934.20
$779.52
$888.59
$1,066.31
$1,070.21
$893.21
$756.69
$935.64
$801.90
$801.62
$935.64
$800.25
$1,066.31
$934.20
$809.99
$815.31
$868.95
$1,070.21

$695.67
$730.38
$687.41
$726.11
$787.28
$714.96
$708.54
$726.11
$728.82
$916.76
$818.31
$717.23
$916.76
$787.28
$730.29
$730.29
$716.52
$769.53
$787.28
$913.91
$772.73
$731.16
$817.26
$817.26
$769.53
$787.28
$720.27
$817.26
$704.12
$783.89
$913.91
$916.76
$787.28
$687.41
$818.31
$720.48
$720.27
$818.31
$719.28
$913.91
$817.26
$726.41
$730.29
$769.53
$916.76

$1,347.18
$1,443.63
$1,324.20
$1,431.74
$1,601.81
$1,400.78
$1,382.94
$1,431.74
$1,439.31
$1,961.73
$1,688.09
$1,407.09
$1,961.73
$1,601.81
$1,443.41
$1,443.41
$1,405.11
$1,552.49
$1,601.81
$1,953.81
$1,561.34
$1,445.81
$1,685.16
$1,685.16
$1,552.49
$1,601.81
$1,415.57
$1,685.16
$1,370.61
$1,592.40
$1,953.81
$1,961.73
$1,601.81
$1,324.20
$1,688.09
$1,416.14
$1,415.57
$1,688.09
$1,412.79
$1,953.81
$1,685.16
$1,432.58
$1,443.41
$1,552.49
$1,961.73

$1,075.40
$1,138.32
$1,060.41
$1,130.57
$1,241.49
$1,110.36
$1,098.74
$1,130.57
$1,135.50
$1,476.26
$1,297.77
$1,114.49
$1,476.26
$1,241.49
$1,138.17
$1,138.17
$1,113.20
$1,209.32
$1,241.49
$1,471.10
$1,215.09
$1,139.73
$1,295.87
$1,295.87
$1,209.32
$1,241.49
$1,120.01
$1,295.87
$1,090.70
$1,235.36
$1,471.10
$1,476.26
$1,241.49
$1,060.41
$1,297.77
$1,120.38
$1,120.01
$1,297.77
$1,118.19
$1,471.10
$1,295.87
$1,131.11
$1,138.17
$1,209.32
$1,476.26

$1,415.93
$1,507.23
$1,394.18
$1,495.97
$1,656.93
$1,466.66
$1,449.78
$1,495.97
$1,503.14
$1,997.63
$1,738.61
$1,472.64
$1,997.63
$1,656.93
$1,507.01
$1,507.01
$1,470.77
$1,610.25
$1,656.93
$1,990.13
$1,618.64
$1,509.29
$1,735.85
$1,735.85
$1,610.25
$1,656.93
$1,480.65
$1,735.85
$1,438.11
$1,648.04
$1,990.13
$1,997.63
$1,656.93
$1,394.18
$1,738.61
$1,481.19
$1,480.65
$1,738.61
$1,478.03
$1,990.13
$1,735.85
$1,496.76
$1,507.01
$1,610.25
$1,997.63

$1,479.54
$1,569.75
$1,458.05
$1,558.64
$1,717.70
$1,529.67
$1,512.99
$1,558.64
$1,565.72
$2,054.34
$1,798.40
$1,535.58
$2,054.34
$1,717.70
$1,569.54
$1,569.54
$1,533.74
$1,671.56
$1,717.70
$2,046.93
$1,679.85
$1,571.79
$1,795.67
$1,795.67
$1,671.56
$1,717.70
$1,543.50
$1,795.67
$1,501.46
$1,708.89
$2,046.93
$2,054.34
$1,717.70
$1,458.05
$1,798.40
$1,544.03
$1,543.50
$1,798.40
$1,540.91
$2,046.93
$1,795.67
$1,559.42
$1,569.54
$1,671.56
$2,054.34

$950.04
$1,011.48
$935.40
$1,003.91
$1,112.22
$984.18
$972.81
$1,003.91
$1,008.72
$1,341.48
$1,167.18
$988.20
$1,341.48
$1,112.22
$1,011.33
$1,011.33
$986.94
$1,080.81
$1,112.22
$1,336.44
$1,086.45
$1,012.86
$1,165.32
$1,165.32
$1,080.81
$1,112.22
$993.60
$1,165.32
$964.97
$1,106.24
$1,336.44
$1,341.48
$1,112.22
$935.40
$1,167.18
$993.96
$993.60
$1,167.18
$991.83
$1,336.44
$1,165.32
$1,004.43
$1,011.33
$1,080.81
$1,341.48

$975.77
$1,034.79
$961.70
$1,027.52
$1,131.60
$1,008.57
$997.65
$1,027.52
$1,032.15
$1,351.88
$1,184.40
$1,012.44
$1,351.88
$1,131.60
$1,034.66
$1,034.66
$1,011.23
$1,101.41
$1,131.60
$1,347.03
$1,106.84
$1,036.13
$1,182.62
$1,182.62
$1,101.41
$1,131.60
$1,017.62
$1,182.62
$990.11
$1,125.84
$1,347.03
$1,351.88
$1,131.60
$961.70
$1,184.40
$1,017.96
$1,017.62
$1,184.40
$1,015.92
$1,347.03
$1,182.62
$1,028.03
$1,034.66
$1,101.41
$1,351.88

$1,631.85
$1,752.14
$1,603.19
$1,737.30
$1,949.36
$1,698.69
$1,676.45
$1,737.30
$1,746.75
$2,398.19
$2,056.97
$1,706.57
$2,398.19
$1,949.36
$1,751.84
$1,751.84
$1,704.09
$1,887.86
$1,949.36
$2,388.32
$1,898.91
$1,754.84
$2,053.32
$2,053.32
$1,887.86
$1,949.36
$1,717.13
$2,053.32
$1,661.07
$1,937.64
$2,388.32
$2,398.19
$1,949.36
$1,603.19
$2,056.97
$1,717.83
$1,717.13
$2,056.97
$1,713.66
$2,388.32
$2,053.32
$1,738.34
$1,751.84
$1,887.86
$2,398.19

Page 17 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
2424000
7000008
2129000
3101000
2902000
7001017
7003004
7001019
7001020
7002019
1226701
3824000
5721700
4402000
3622000
0101003
7002020
1401008
2909000
7002021
7000006
1564701
7003015
7002024
3121001
5903000
2950002
1701000
2952006
3102000
2527000
7000024
7002052
7003013
2901000
2952005
2951001
1327000
5920000
7001008
7002026
7003010
7001021
7099003
7002054

Agency
ADIRONDACK
MEDICAL
HOSP
LEWIS
COUNTY
GENERAL
LINCOLN MEDICAL & MENTAL
LITTLE FALLS HOSPITAL
LOCKPORT MEMORIAL HOSP
LONG BEACH MEDICAL CTR
LONG ISLAND COLLEGE HOSP
LONG ISLAND JEWISH
LUTHERAN MEDICAL CENTER
MAIMONIDES MEDICAL CTR
MANHATTAN EYE EAR & THROAT
MARGARETVILLE MEMORIAL
MARY IMOGENE BASSETT
MARY MCCLELLAN HOSPITAL
MASSENA MEMORIAL HOSPITAL
MEDINA MEMORIAL HOSPITAL
MEMORIAL HOSP (ALBANY)
MEMORIAL HOSP FOR CANCER
MERCY HOSPITAL OF BUFFALO
MERCY MEDICAL CENTER
METROPOLITAN HOSPITAL CTR
MONTEFIORE HOSPITAL
MOSES-LUDINGTON HOSPITAL
MOUNT SINAI / WEST QUEENS
MOUNT SINAI HOSPITAL
MOUNT ST MARYS HOSPITAL
MOUNT VERNON HOSPITAL
NASSAU HEALTH CARE CORP
NATHAN LITTAUER HOSPITAL
NEW ISLAND HOSPITAL
NIAGARA FALLS MEMORIAL**
NICHOLAS H NOYES HOSP
NORTH CENTRAL BRONX
NORTH GENERAL HOSPITAL
NORTH SHORE / FOREST HILLS
NORTH SHORE / GLEN COVE
NORTH SHORE / PLAINVIEW
NORTH SHORE UNIVERSITY
NORTHERN DUTCHESS HOSP
NORTHERN WESTCHESTER
NY COMMUNITY / BROOKLYN
NY EYE & EAR INFIRMARY
NY MEDICAL CTR OF QUEENS
NY METHODIST HOSPITAL
NY PRESBY HOSP (ALLEN)
NY PRESBY HOSP (NY PAYNE)

Mmisid
00363213
00354370
00246126
00310870
00354389
00245487
00243678
00243903
00243729
00243641
00243458
00279387
00305000
00336952
00354398
00310898
00364003
00243467
00354412
00274295
00246135
00243554
00360930
00243509
00243509
01746616
00274117
01962156
00313924
01949875
00354467
00354476
00246171
00355142
00243889
00274240
00274231
00245510
00268300
00274144
00243696
00243476
00244133
00243701
00243178
00243518

PAS
30

PAS
31

PAS
32

PAS
33

PAS
34

PAS
35

PAS
36

PAS
37

PAS
38

PAS
39

$1,095.54
$1,485.69
$1,100.79
$1,105.97
$1,237.35
$1,491.27
$1,491.27
$1,296.17
$1,491.27
$1,280.31
$1,117.38
$1,308.45
$1,099.43
$1,085.04
$1,113.74
$1,123.56
$1,296.17
$1,104.02
$1,237.35
$1,485.69
$1,491.27
$1,104.05
$1,283.58
$1,491.27
$1,105.19
$1,202.57
$1,437.59
$1,111.08
$1,230.72
$1,105.19
$1,125.60
$1,485.69
$1,474.31
$1,474.31
$1,237.35
$1,237.35
$1,437.59
$1,180.29
$1,202.57
$1,283.58
$1,283.58
$1,491.27
$1,491.27
$1,491.27
$1,491.27

$794.36
$1,066.31
$798.02
$801.62
$893.21
$1,070.21
$1,070.21
$934.20
$1,070.21
$923.15
$809.58
$942.75
$797.06
$787.04
$807.03
$813.89
$934.20
$800.25
$893.21
$1,066.31
$1,070.21
$800.28
$925.43
$1,070.21
$801.08
$868.95
$1,032.78
$805.19
$888.59
$801.08
$815.31
$1,066.31
$1,058.37
$1,058.37
$893.21
$893.21
$1,032.78
$853.43
$868.95
$925.43
$925.43
$1,070.21
$1,070.21
$1,070.21
$1,070.21

$714.96
$913.91
$717.65
$720.27
$787.28
$916.76
$916.76
$817.26
$916.76
$809.18
$726.11
$823.53
$716.94
$709.61
$724.23
$729.24
$817.26
$719.28
$787.28
$913.91
$916.76
$719.30
$810.84
$916.76
$719.88
$769.53
$889.38
$722.88
$783.89
$719.88
$730.29
$913.91
$908.10
$908.10
$787.28
$787.28
$889.38
$758.18
$769.53
$810.84
$810.84
$916.76
$916.76
$916.76
$916.76

$1,400.78
$1,953.81
$1,408.23
$1,415.57
$1,601.81
$1,961.73
$1,961.73
$1,685.16
$1,961.73
$1,662.69
$1,431.74
$1,702.56
$1,406.30
$1,385.91
$1,426.56
$1,440.50
$1,685.16
$1,412.79
$1,601.81
$1,953.81
$1,961.73
$1,412.84
$1,667.31
$1,961.73
$1,414.44
$1,552.49
$1,885.62
$1,422.81
$1,592.40
$1,414.44
$1,443.41
$1,953.81
$1,937.67
$1,937.67
$1,601.81
$1,601.81
$1,885.62
$1,520.91
$1,552.49
$1,667.31
$1,667.31
$1,961.73
$1,961.73
$1,961.73
$1,961.73

$1,110.36
$1,471.10
$1,115.22
$1,120.01
$1,241.49
$1,476.26
$1,476.26
$1,295.87
$1,476.26
$1,281.20
$1,130.57
$1,307.22
$1,113.96
$1,100.67
$1,127.19
$1,136.27
$1,295.87
$1,118.19
$1,241.49
$1,471.10
$1,476.26
$1,118.24
$1,284.23
$1,476.26
$1,119.29
$1,209.32
$1,426.62
$1,124.75
$1,235.36
$1,119.29
$1,138.17
$1,471.10
$1,460.57
$1,460.57
$1,241.49
$1,241.49
$1,426.62
$1,188.72
$1,209.32
$1,284.23
$1,284.23
$1,476.26
$1,476.26
$1,476.26
$1,476.26

$1,466.66
$1,990.13
$1,473.72
$1,480.65
$1,656.93
$1,997.63
$1,997.63
$1,735.85
$1,997.63
$1,714.56
$1,495.97
$1,752.32
$1,471.88
$1,452.59
$1,491.06
$1,504.25
$1,735.85
$1,478.03
$1,656.93
$1,990.13
$1,997.63
$1,478.09
$1,718.96
$1,997.63
$1,479.60
$1,610.25
$1,925.58
$1,487.52
$1,648.04
$1,479.60
$1,507.01
$1,990.13
$1,974.84
$1,974.84
$1,656.93
$1,656.93
$1,925.58
$1,580.37
$1,610.25
$1,718.96
$1,718.96
$1,997.63
$1,997.63
$1,997.63
$1,997.63

$1,529.67
$2,046.93
$1,536.65
$1,543.50
$1,717.70
$2,054.34
$2,054.34
$1,795.67
$2,054.34
$1,774.64
$1,558.64
$1,811.94
$1,534.83
$1,515.77
$1,553.79
$1,566.81
$1,795.67
$1,540.91
$1,717.70
$2,046.93
$2,054.34
$1,540.95
$1,778.97
$2,054.34
$1,542.45
$1,671.56
$1,983.15
$1,550.28
$1,708.89
$1,542.45
$1,569.54
$2,046.93
$2,031.83
$2,031.83
$1,717.70
$1,717.70
$1,983.15
$1,642.04
$1,671.56
$1,778.97
$1,778.97
$2,054.34
$2,054.34
$2,054.34
$2,054.34

$984.18
$1,336.44
$988.92
$993.60
$1,112.22
$1,341.48
$1,341.48
$1,165.32
$1,341.48
$1,151.01
$1,003.91
$1,176.41
$987.69
$974.70
$1,000.61
$1,009.47
$1,165.32
$991.83
$1,112.22
$1,336.44
$1,341.48
$991.86
$1,153.95
$1,341.48
$992.88
$1,080.81
$1,293.02
$998.22
$1,106.24
$992.88
$1,011.33
$1,336.44
$1,326.15
$1,326.15
$1,112.22
$1,112.22
$1,293.02
$1,060.70
$1,080.81
$1,153.95
$1,153.95
$1,341.48
$1,341.48
$1,341.48
$1,341.48

$1,008.57
$1,347.03
$1,013.13
$1,017.62
$1,131.60
$1,351.88
$1,351.88
$1,182.62
$1,351.88
$1,168.86
$1,027.52
$1,193.27
$1,011.95
$999.47
$1,024.35
$1,032.87
$1,182.62
$1,015.92
$1,131.60
$1,347.03
$1,351.88
$1,015.95
$1,171.70
$1,351.88
$1,016.93
$1,101.41
$1,305.30
$1,022.06
$1,125.84
$1,016.93
$1,034.66
$1,347.03
$1,337.15
$1,337.15
$1,131.60
$1,131.60
$1,305.30
$1,082.09
$1,101.41
$1,171.70
$1,171.70
$1,351.88
$1,351.88
$1,351.88
$1,351.88

$1,698.69
$2,388.32
$1,707.98
$1,717.13
$1,949.36
$2,398.19
$2,398.19
$2,053.32
$2,398.19
$2,025.29
$1,737.30
$2,075.01
$1,705.56
$1,680.14
$1,730.84
$1,748.21
$2,053.32
$1,713.66
$1,949.36
$2,388.32
$2,398.19
$1,713.74
$2,031.06
$2,398.19
$1,715.73
$1,887.86
$2,303.30
$1,726.17
$1,937.64
$1,715.73
$1,751.84
$2,388.32
$2,368.19
$2,368.19
$1,949.36
$1,949.36
$2,303.30
$1,848.50
$1,887.86
$2,031.06
$2,031.06
$2,398.19
$2,398.19
$2,398.19
$2,398.19

Page 18 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
7002030
5906000
7002053
7000025
4324000
7002000
0401001
2601001
3523000
3501000
3702000
0301001
7000005
1402000
2754001
7003020
7003006
5932000
3950000
7003007
7004010
2221001
2701003
3201002
1401010
4102002
2201000
4501000
4823000
4102003
1401006
7004006
1401013
6120000
5904000
2950001
5126000
5154000
5902000
3529000
7000014
5157003
5149001
4601002
7002033

Agency
ADIRONDACK
MEDICAL
HOSP
NY
PRESBY HOSP
(PRESBY)
NY UNITED HOSPITAL
NY UNIV MED CTR (TISCH)
NY WESTCHESTER SQUARE
NYACK HOSPITAL
NYU DOWNTOWN HOSPITAL
OLEAN GENERAL HOSPITAL
ONEIDA CITY HOSPITAL
ORANGE REGIONAL MED CTR
ORANGE REGIONAL(MIDDLETOWN)
OSWEGO HOSPITAL
OUR LADY OF LOURDES HOSP
OUR LADY OF MERCY
OUR LADY OF VICTORY HOSP
PARK RIDGE HOSPITAL
PARKWAY HOSPITAL
PENINSULA HOSPITAL CTR
PHELPS MEMORIAL HOSPITAL
PUTNAM COMMUNITY HOSPITAL
QUEENS HOSPITAL CENTER
RICHMOND UNIVERSITY MEDICAL CENTER
RIVER HOSPITAL**
ROCHESTER GENERAL HOSP
ROME HOSPITAL AND MURPHY
ROSWELL PARK MEMORIAL
SAMARITAN HOSPITAL / TROY
SAMARITAN MEDICAL CENTER
SARATOGA HOSPITAL
SCHUYLER HOSPITAL
SETON HEALTH SYSTEMS
SHEEHAN MEMORIAL EMERG
SISTERS OF CHARITY (BAYLEY)
SISTERS OF CHARITY HOSP
SOLDIERS AND SAILORS
SOUND SHORE HOSPITAL
SOUTH NASSAU COMMUNITIES
SOUTHAMPTON HOSP ASSOC
SOUTHSIDE HOSPITAL
ST AGNES HOSPITAL
ST ANTHONY COMMUNITY
ST BARNABAS HOSPITAL
ST CATHERINE OF SIENA
ST CHARLES HOSPITAL
ST CLARE'S / SCHENECTADY
ST CLARES HOSP & HEALTH

Mmisid
00363213
00243178
00274204
00273116
00273092
00243967
00647269
00354632
00310903
00258379
00258379
00354485
00337664
00243563
00354494
00378721
00244151
00243898
00274162
00258360
00246153
00248820
02392854
00303315
00352534
00354518
00318805
00354316
00303282
00363144
01534463
00354545
00652328
00354563
00336498
00274126
00245496
00274406
00268319
00274180
00273890
00243361
02060942
00274415
00361748
00243201

PAS
30

PAS
31

PAS
32

PAS
33

PAS
34

PAS
35

PAS
36

PAS
37

PAS
38

PAS
39

$1,491.27
$1,202.57
$1,491.27
$1,283.58
$1,202.57
$1,469.75
$1,095.20
$1,123.53
$1,151.04
$1,151.04
$1,107.93
$1,088.09
$1,491.27
$1,104.02
$1,127.87
$1,283.58
$1,296.17
$1,202.57
$1,184.00
$1,485.69
$1,491.27
$1,095.54
$1,319.21
$1,100.79
$1,106.90
$1,122.72
$1,096.10
$1,122.72
$1,074.26
$1,122.72
$1,104.80
$1,296.17
$1,106.90
$1,055.75
$1,402.49
$1,244.94
$1,237.35
$1,237.35
$1,209.83
$1,151.88
$1,296.17
$1,237.35
$1,237.35
$1,122.72
$1,474.31

$1,070.21
$868.95
$1,070.21
$925.43
$868.95
$1,055.19
$794.12
$813.86
$833.04
$833.04
$802.98
$789.15
$1,070.21
$800.25
$816.89
$925.43
$934.20
$868.95
$856.02
$1,066.31
$1,070.21
$794.36
$950.27
$798.02
$802.26
$813.30
$794.75
$813.30
$779.52
$813.30
$800.81
$934.20
$802.26
$766.61
$1,008.30
$898.49
$893.21
$893.21
$874.02
$833.63
$934.20
$893.21
$893.21
$813.30
$1,058.37

$916.76
$769.53
$916.76
$810.84
$769.53
$905.78
$714.78
$729.23
$743.27
$743.27
$721.28
$711.17
$916.76
$719.28
$731.45
$810.84
$817.26
$769.53
$760.07
$913.91
$916.76
$714.96
$829.02
$717.65
$720.75
$728.82
$715.25
$728.82
$704.12
$728.82
$719.69
$817.26
$720.75
$694.67
$871.47
$791.15
$787.28
$787.28
$773.24
$743.69
$817.26
$787.28
$787.28
$728.82
$908.10

$1,961.73
$1,552.49
$1,961.73
$1,667.31
$1,552.49
$1,931.21
$1,400.28
$1,440.45
$1,479.45
$1,479.45
$1,418.34
$1,390.22
$1,961.73
$1,412.79
$1,446.62
$1,667.31
$1,685.16
$1,552.49
$1,526.18
$1,953.81
$1,961.73
$1,400.78
$1,717.83
$1,408.23
$1,416.87
$1,439.31
$1,401.57
$1,439.31
$1,370.61
$1,439.31
$1,413.90
$1,685.16
$1,416.87
$1,344.36
$1,835.87
$1,612.55
$1,601.81
$1,601.81
$1,562.78
$1,480.64
$1,685.16
$1,601.81
$1,601.81
$1,439.31
$1,937.67

$1,476.26
$1,209.32
$1,476.26
$1,284.23
$1,209.32
$1,456.35
$1,110.05
$1,136.25
$1,161.68
$1,161.68
$1,121.82
$1,103.48
$1,476.26
$1,118.19
$1,140.26
$1,284.23
$1,295.87
$1,209.32
$1,192.16
$1,471.10
$1,476.26
$1,110.36
$1,317.17
$1,115.22
$1,120.86
$1,135.50
$1,110.89
$1,135.50
$1,090.70
$1,135.50
$1,118.93
$1,295.87
$1,120.86
$1,073.57
$1,394.16
$1,248.50
$1,241.49
$1,241.49
$1,216.04
$1,162.46
$1,295.87
$1,241.49
$1,241.49
$1,135.50
$1,460.57

$1,997.63
$1,610.25
$1,997.63
$1,718.96
$1,610.25
$1,968.72
$1,466.19
$1,504.22
$1,541.13
$1,541.13
$1,483.28
$1,456.67
$1,997.63
$1,478.03
$1,510.04
$1,718.96
$1,735.85
$1,610.25
$1,585.35
$1,990.13
$1,997.63
$1,466.66
$1,766.76
$1,473.72
$1,481.90
$1,503.14
$1,467.42
$1,503.14
$1,438.11
$1,503.14
$1,479.09
$1,735.85
$1,481.90
$1,413.27
$1,878.48
$1,667.12
$1,656.93
$1,656.93
$1,620.00
$1,542.26
$1,735.85
$1,656.93
$1,656.93
$1,503.14
$1,974.84

$2,054.34
$1,671.56
$2,054.34
$1,778.97
$1,671.56
$2,025.78
$1,529.21
$1,566.78
$1,603.25
$1,603.25
$1,546.10
$1,519.79
$2,054.34
$1,540.91
$1,572.54
$1,778.97
$1,795.67
$1,671.56
$1,646.96
$2,046.93
$2,054.34
$1,529.67
$1,826.22
$1,536.65
$1,544.72
$1,565.72
$1,530.42
$1,565.72
$1,501.46
$1,565.72
$1,541.94
$1,795.67
$1,544.72
$1,476.90
$1,936.61
$1,727.75
$1,717.70
$1,717.70
$1,681.20
$1,604.37
$1,795.67
$1,717.70
$1,717.70
$1,565.72
$2,031.83

$1,341.48
$1,080.81
$1,341.48
$1,153.95
$1,080.81
$1,322.04
$983.87
$1,009.46
$1,034.28
$1,034.28
$995.36
$977.45
$1,341.48
$991.83
$1,013.37
$1,153.95
$1,165.32
$1,080.81
$1,064.06
$1,336.44
$1,341.48
$984.18
$1,186.13
$988.92
$994.43
$1,008.72
$984.69
$1,008.72
$964.97
$1,008.72
$992.54
$1,165.32
$994.43
$948.24
$1,261.31
$1,119.08
$1,112.22
$1,112.22
$1,087.37
$1,035.05
$1,165.32
$1,112.22
$1,112.22
$1,008.72
$1,326.15

$1,351.88
$1,101.41
$1,351.88
$1,171.70
$1,101.41
$1,333.19
$1,008.27
$1,032.86
$1,056.72
$1,056.72
$1,019.31
$1,002.11
$1,351.88
$1,015.92
$1,036.62
$1,171.70
$1,182.62
$1,101.41
$1,085.31
$1,347.03
$1,351.88
$1,008.57
$1,202.61
$1,013.13
$1,018.41
$1,032.15
$1,009.05
$1,032.15
$990.11
$1,032.15
$1,016.60
$1,182.62
$1,018.41
$974.04
$1,274.84
$1,138.17
$1,131.60
$1,131.60
$1,107.72
$1,057.44
$1,182.62
$1,131.60
$1,131.60
$1,032.15
$1,337.15

$2,398.19
$1,887.86
$2,398.19
$2,031.06
$1,887.86
$2,360.12
$1,698.08
$1,748.16
$1,796.79
$1,796.79
$1,720.58
$1,685.51
$2,398.19
$1,713.66
$1,755.84
$2,031.06
$2,053.32
$1,887.86
$1,855.05
$2,388.32
$2,398.19
$1,698.69
$2,094.05
$1,707.98
$1,718.75
$1,746.75
$1,699.68
$1,746.75
$1,661.07
$1,746.75
$1,715.06
$2,053.32
$1,718.75
$1,628.34
$2,241.23
$1,962.77
$1,949.36
$1,949.36
$1,900.70
$1,798.28
$2,053.32
$1,949.36
$1,949.36
$1,746.75
$2,368.19

Page 19 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
3202002
1302000
2953000
5002001
5907001
1455000
0701001
3301003
5907002
3502000
3522000
7002032
2801001
7001025
0101004
7002037
7001037
5151001
7004003
2701005
3301007
1227000
0427000
0303001
1801000
1302001
7001032
5820000
5957001
0632000
5902001
2908000
0602001
7001045
7001035
6027000

Agency
ADIRONDACK
ST
ELIZABETHMEDICAL
MED CTRHOSP
ST FRANCIS / POUGHKEEPSIE
ST FRANCIS HOSP / ROSLYN
ST JAMES MERCY HOSPITAL
ST JOHNS RIVERSIDE
ST JOSEPH HOSPITAL
ST JOSEPHS / ELMIRA
ST JOSEPHS HOSP & HEALTH
ST JOSEPHS OF YONKERS
ST LUKES / NEWBURGH
ST LUKES CORNWALL / CORNWALL
ST LUKES ROOSEVELT
ST MARYS AT AMSTERDAM
ST MARYS OF BROOKLYN
ST PETERS HOSPITAL
ST VINCENTS HOSPITAL
STATE UNIV / DOWNSTATE
STATE UNIV / STONY BROOK
STATEN ISLAND UNIV HOSPITAL
STRONG MEMORIAL HOSPITAL
SUNY HEALTH SCIENCE CENTER
THE HOSPITAL
TLC HEALTH NETWORK
UNITED HEALTH SERVICES
UNITED MEMORIAL (GENESEE)
VASSAR BROTHERS MED CTR
VICTORY MEMORIAL HOSPITAL
WAYNE HEALTH CARE
WESTCHESTER MEDICAL CTR
WESTFIELD MEMORIAL HOSP
WHITE PLAINS HOSPITAL
WINTHROP UNIVERSITY HOSP
WOMANS CHRISTIAN ASSOC
WOODHULL MEDICAL CENTER
WYCKOFF HEIGHTS HOSPITAL
WYOMING COUNTY COMMUNITY

Mmisid
00363213
00279901
00273845
00244046
00363162
00245501
00354581
00363126
00315013
00258920
00273914
00273863
00354967
00351639
00729373
00318823
00243229
00243590
00357795
00244202
00279034
00354590
00313951
00347544
00614755
00354283
00273854
00243449
00354458
00274213
00354614
00274222
00244211
00354623
00698866
00243825
00310889

PAS
30

PAS
31

PAS
32

PAS
33

PAS
34

PAS
35

PAS
36

PAS
37

PAS
38

PAS
39

$1,100.00
$1,181.36
$1,244.94
$1,076.31
$1,202.57
$1,104.02
$1,084.55
$1,317.12
$1,202.57
$1,151.04
$1,151.88
$1,491.27
$1,122.72
$1,491.27
$1,317.14
$1,491.27
$1,491.27
$1,437.59
$1,491.27
$1,319.21
$1,317.12
$1,117.38
$1,094.63
$1,091.01
$1,043.45
$1,179.36
$1,283.58
$1,125.60
$1,402.49
$1,095.03
$1,202.57
$1,437.59
$1,094.25
$1,485.69
$1,296.17
$1,043.45

$797.46
$854.18
$898.49
$780.95
$868.95
$800.25
$786.69
$948.80
$868.95
$833.04
$833.63
$1,070.21
$813.30
$1,070.21
$948.81
$1,070.21
$1,070.21
$1,032.78
$1,070.21
$950.27
$948.80
$809.58
$793.73
$791.19
$758.04
$852.78
$925.43
$815.31
$1,008.30
$794.00
$868.95
$1,032.78
$793.46
$1,066.31
$934.20
$758.04

$717.23
$758.72
$791.15
$705.15
$769.53
$719.28
$709.35
$827.94
$769.53
$743.27
$743.69
$916.76
$728.82
$916.76
$827.96
$916.76
$916.76
$889.38
$916.76
$829.02
$827.94
$726.11
$714.50
$712.65
$688.40
$757.70
$810.84
$730.29
$871.47
$714.71
$769.53
$889.38
$714.30
$913.91
$817.26
$688.40

$1,407.09
$1,522.43
$1,612.55
$1,373.52
$1,552.49
$1,412.79
$1,385.21
$1,714.86
$1,552.49
$1,479.45
$1,480.64
$1,961.73
$1,439.31
$1,961.73
$1,714.88
$1,961.73
$1,961.73
$1,885.62
$1,961.73
$1,717.83
$1,714.86
$1,431.74
$1,399.49
$1,394.36
$1,326.93
$1,519.59
$1,667.31
$1,443.41
$1,835.87
$1,400.06
$1,552.49
$1,885.62
$1,398.95
$1,953.81
$1,685.16
$1,326.93

$1,114.49
$1,189.71
$1,248.50
$1,092.59
$1,209.32
$1,118.19
$1,100.21
$1,315.23
$1,209.32
$1,161.68
$1,162.46
$1,476.26
$1,135.50
$1,476.26
$1,315.25
$1,476.26
$1,476.26
$1,426.62
$1,476.26
$1,317.17
$1,315.23
$1,130.57
$1,109.52
$1,106.18
$1,062.20
$1,187.87
$1,284.23
$1,138.17
$1,394.16
$1,109.90
$1,209.32
$1,426.62
$1,109.16
$1,471.10
$1,295.87
$1,062.20

$1,472.64
$1,581.81
$1,667.12
$1,440.86
$1,610.25
$1,478.03
$1,451.93
$1,763.96
$1,610.25
$1,541.13
$1,542.26
$1,997.63
$1,503.14
$1,997.63
$1,763.97
$1,997.63
$1,997.63
$1,925.58
$1,997.63
$1,766.76
$1,763.96
$1,495.97
$1,465.44
$1,460.58
$1,396.77
$1,579.11
$1,718.96
$1,507.01
$1,878.48
$1,465.98
$1,610.25
$1,925.58
$1,464.93
$1,990.13
$1,735.85
$1,396.77

$1,535.58
$1,643.45
$1,727.75
$1,504.17
$1,671.56
$1,540.91
$1,515.11
$1,823.43
$1,671.56
$1,603.25
$1,604.37
$2,054.34
$1,565.72
$2,054.34
$1,823.45
$2,054.34
$2,054.34
$1,983.15
$2,054.34
$1,826.22
$1,823.43
$1,558.64
$1,528.47
$1,523.67
$1,460.61
$1,640.79
$1,778.97
$1,569.54
$1,936.61
$1,529.00
$1,671.56
$1,983.15
$1,527.96
$2,046.93
$1,795.67
$1,460.61

$988.20
$1,061.67
$1,119.08
$966.81
$1,080.81
$991.83
$974.27
$1,184.24
$1,080.81
$1,034.28
$1,035.05
$1,341.48
$1,008.72
$1,341.48
$1,184.25
$1,341.48
$1,341.48
$1,293.02
$1,341.48
$1,186.13
$1,184.24
$1,003.91
$983.36
$980.09
$937.14
$1,059.86
$1,153.95
$1,011.33
$1,261.31
$983.72
$1,080.81
$1,293.02
$983.01
$1,336.44
$1,165.32
$937.14

$1,012.44
$1,083.02
$1,138.17
$991.89
$1,101.41
$1,015.92
$999.03
$1,200.80
$1,101.41
$1,056.72
$1,057.44
$1,351.88
$1,032.15
$1,351.88
$1,200.80
$1,351.88
$1,351.88
$1,305.30
$1,351.88
$1,202.61
$1,200.80
$1,027.52
$1,007.78
$1,004.64
$963.38
$1,081.28
$1,171.70
$1,034.66
$1,274.84
$1,008.12
$1,101.41
$1,305.30
$1,007.45
$1,347.03
$1,182.62
$963.38

$1,706.57
$1,850.39
$1,962.77
$1,664.70
$1,887.86
$1,713.66
$1,679.27
$2,090.34
$1,887.86
$1,796.79
$1,798.28
$2,398.19
$1,746.75
$2,398.19
$2,090.37
$2,398.19
$2,398.19
$2,303.30
$2,398.19
$2,094.05
$2,090.34
$1,737.30
$1,697.09
$1,690.68
$1,606.61
$1,846.83
$2,031.06
$1,751.84
$2,241.23
$1,697.79
$1,887.86
$2,303.30
$1,696.40
$2,388.32
$2,053.32
$1,606.61

Page 20 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
0101005
0101000
3701000
1624000
2801000
0701000
0501000
3801000
4720001
7002001
4652001
5501000
1427000
7001041
7002004
7002002
3535001
7000001
7001002
5123000
7001003
0601000
5120000
7002003
4429000
2238001
5263700
5263000
5401001
5155000
0901001
0824000
7003000
4401000
3421000
7003005
7003008
7003025
1001000
3301000
5925000
2625000
7001009
5001000

Agency
ADIRONDACK MEDICAL HOSP
ALB MED SO CLINICAL CAMPUS
ALBANY MEDICAL CENTER
ALBERT LINDLEY LEE
ALICE HYDE MEDICAL CTR
AMSTERDAM MEMORIAL HOSP
ARNOT OGDEN MEMORIAL
AUBURN MEMORIAL HOSPITAL
AURELIA OSBORN FOX
BASSETT HOSPITAL
BELLEVUE HOSPITAL CTR
BELLEVUE WOMAN'S HOSP
BENEDICTINE HOSPITAL
BERTRAND CHAFFEE HOSPITAL
BETH ISRAEL / KINGS HIGHWAY
BETH ISRAEL / NORTH DIVISION
BETH ISRAEL MEDICAL CTR
BON SECOURS COMM HOSP
BRONX-LEBANON HOSP CTR
BROOKDALE HOSP MED CTR
BROOKHAVEN MEMORIAL HOSP
BROOKLYN HOSPITAL CENTER
BROOKS MEMORIAL HOSPITAL
BRUNSWICK HOSPITAL CTR
CABRINI MEDICAL CENTER
CANTON-POTSDAM HOSPITAL
CARTHAGE AREA HOSPITAL
CATSKILL REGIONAL / G HERMANN
CATSKILL REGIONAL MED CTR
CAYUGA MEDICAL CENTER
CENTRAL SUFFOLK HOSPITAL
CHAMPLAIN VALLEY PHYS
CHENANGO MEMORIAL HOSP
CITY HOSPITAL CENTER
CLAXTON-HEPBURN MED CTR
CLIFTON SPRINGS HOSPITAL
CMC (MARY IMMACULATE)
CMC (ST JOHNS)
CMC (ST JOSEPHS)
COLUMBIA MEMORIAL HOSP
COMM GEN / GREATER SYRACUSE
COMM HOSP / DOBBS FERRY
COMMUNITY MEMORIAL HOSP
CONEY ISLAND HOSPITAL
CORNING HOSPITAL

Mmisid
00363213
01952712
00277716
00354105
00354114
00381420
00363199
00347553
00279098
00302429
00246039
00354132
00274020
00354150
00243105
00243105
00243105
00273905
00476022
00243572
00245529
00243614
00381439
00268295
00243132
00354196
00310852
00273978
00273978
00332729
00274328
00318814
00314723
00246075
00354072
00354641
00243861
00244124
00498531
00335915
00315004
00274066
00354229
00246066
00361739

PAS
40
$768.51
$796.61
$937.83
$785.78
$766.98
$796.61
$768.14
$747.51
$793.73
$861.12
$1,060.82
$796.61
$792.53
$782.91
$913.35
$913.35
$1,064.90
$817.26
$1,064.90
$1,064.90
$879.63
$1,064.90
$775.79
$874.79
$1,064.90
$768.51
$776.16
$792.09
$792.53
$747.51
$879.63
$767.37
$792.09
$1,060.82
$768.51
$798.09
$1,064.90
$1,064.90
$1,064.90
$786.32
$795.96
$854.24
$796.58
$1,060.82
$762.14

PAS
41
$1,218.00
$1,269.33
$1,527.35
$1,249.56
$1,215.21
$1,269.33
$1,217.34
$1,179.65
$1,264.08
$1,387.20
$1,752.02
$1,269.33
$1,261.88
$1,244.33
$1,482.62
$1,482.62
$1,759.46
$1,307.09
$1,759.46
$1,759.46
$1,421.01
$1,759.46
$1,231.31
$1,412.18
$1,759.46
$1,218.00
$1,231.98
$1,261.10
$1,261.88
$1,179.65
$1,421.01
$1,215.95
$1,261.10
$1,752.02
$1,218.00
$1,272.06
$1,759.46
$1,759.46
$1,759.46
$1,250.54
$1,268.18
$1,374.63
$1,269.29
$1,752.02
$1,206.35

PAS
42
$906.21
$932.69
$1,065.72
$922.49
$904.77
$932.69
$905.87
$886.44
$929.97
$993.47
$1,181.58
$932.69
$928.85
$919.79
$1,042.67
$1,042.67
$1,185.42
$952.14
$1,185.42
$1,185.42
$1,010.90
$1,185.42
$913.08
$1,006.34
$1,185.42
$906.21
$913.43
$928.44
$928.85
$886.44
$1,010.90
$905.15
$928.44
$1,181.58
$906.21
$934.10
$1,185.42
$1,185.42
$1,185.42
$923.00
$932.09
$986.99
$932.66
$1,181.58
$900.21

Page 21 of 25

PAS
45
$7,696.82
$7,744.92
$7,986.71
$7,726.40
$7,694.21
$7,744.92
$7,696.20
$7,660.88
$7,740.00
$7,855.37
$8,197.25
$7,744.92
$7,737.95
$7,721.49
$7,944.80
$7,944.80
$8,204.22
$7,780.29
$8,204.22
$8,204.22
$7,887.06
$8,204.22
$7,709.28
$7,878.78
$8,204.22
$7,696.82
$7,709.93
$7,737.21
$7,737.95
$7,660.88
$7,887.06
$7,694.88
$7,737.21
$8,197.25
$7,696.82
$7,747.47
$8,204.22
$8,204.22
$8,204.22
$7,727.31
$7,743.83
$7,843.59
$7,744.88
$8,197.25
$7,685.90
3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
1101000
3301008
0226700
1229000
5127000
2221000
4423000
5526001
4601001
7001024
1401005
3202003
7003001
2910000
3429000
3402000
5601000
4329000
5154001
7002009
4322000
2701001
7002012
7002011
5901000
5153000
3154000
7001046
5022000
2906000
7000002
7003003
5149000
0228000
1401014
1401002
3103000
1401009
1404000
7001016
7001033
5501001
2728001
5922000
7002017

Agency
ADIRONDACK
MEDICAL HOSP
HOSP
CORTLAND
MEMORIAL
CROUSE HOSPITAL
CUBA MEMORIAL HOSPITAL
DELAWARE VALLEY HOSPITAL
EASTERN LONG ISLAND HOSP
EJ NOBLE / ALEXANDRIA
EJ NOBLE / GOUVERNEUR
ELLENVILLE REGIONAL HOSP
ELLIS HOSPITAL
EPISCOPAL HEALTH SERVICES
ERIE COUNTY MEDICAL CTR
FAXTON-ST LUKES HEALTHCARE
FLUSHING HOSPITAL
FRANKLIN HOSP MED CTR
FREDERICK FERRIS THOMPSON
GENEVA GENERAL HOSPITAL
GLENS FALLS HOSPITAL
GOOD SAMARITAN / SUFFERN
GOOD SAMARITAN / WEST ISLIP
HARLEM HOSPITAL CENTER
HELEN HAYES HOSPITAL
HIGHLAND HOSP / ROCHESTER
HOSP FOR SPECIAL SURGERY
HOSPITAL FOR JOINT DISEASES
HUDSON VALLEY HOSP CTR
HUNTINGTON HOSP ASSOC
INTER-COMMUNITY MEMORIAL
INTERFAITH MEDICAL CTR
IRA DAVENPORT MEMORIAL
ISLAND MEDICAL CENTER
JACOBI MEDICAL CENTER
JAMAICA HOSPITAL
JOHN T MATHER MEMORIAL
JONES MEMORIAL
KALEIDA HLTH (BUFFALO GEN)
KALEIDA HLTH (CHILD OF BUFF)
KALEIDA HLTH (DEGRAFF)
KALEIDA HLTH (MILLARD)
KENMORE MERCY HOSPITAL
KINGS COUNTY HOSPITAL
KINGSBROOK JEWISH MEDICAL
KINGSTON HOSPITAL
LAKESIDE MEMORIAL HOSP
LAWRENCE HOSPITAL
LENOX HILL HOSPITAL

Mmisid
00363213
00279176
00279396
00354238
00347571
00274337
00354265
00354256
02094860
00347562
00729382
00245863
00384309
00243843
00268328
00362529
00378712
00314998
00273941
00274346
00246108
00273950
00354307
00243370
00243389
00274153
00274355
00354325
00734336
00332816
00273285
00246048
00243852
00274364
00354403
00361968
00360614
00354247
00384643
00354343
00246117
00243669
00274048
00279543
00274093
00243421

PAS
40

PAS
41

PAS
42

PAS
45

$748.58
$798.23
$736.74
$792.09
$879.63
$776.16
$766.98
$792.09
$795.99
$1,064.90
$924.05
$779.42
$1,064.90
$879.63
$798.09
$798.09
$778.40
$854.24
$879.63
$1,060.82
$858.81
$799.34
$922.53
$922.53
$854.24
$879.63
$783.77
$922.53
$760.64
$874.79
$1,060.82
$1,064.90
$879.63
$736.74
$924.05
$784.07
$783.77
$924.05
$782.34
$1,060.82
$922.53
$792.53
$798.09
$854.24
$1,064.90

$1,181.58
$1,272.29
$1,159.97
$1,261.10
$1,421.01
$1,231.98
$1,215.21
$1,261.10
$1,268.22
$1,759.46
$1,502.15
$1,237.92
$1,759.46
$1,421.01
$1,272.06
$1,272.06
$1,236.06
$1,374.63
$1,421.01
$1,752.02
$1,382.97
$1,274.33
$1,499.40
$1,499.40
$1,374.63
$1,421.01
$1,245.89
$1,499.40
$1,203.62
$1,412.18
$1,752.02
$1,759.46
$1,421.01
$1,159.97
$1,502.15
$1,246.41
$1,245.89
$1,502.15
$1,243.28
$1,752.02
$1,499.40
$1,261.88
$1,272.06
$1,374.63
$1,759.46

$887.43
$934.20
$876.29
$928.44
$1,010.90
$913.43
$904.77
$928.44
$932.12
$1,185.42
$1,052.73
$916.49
$1,185.42
$1,010.90
$934.10
$934.10
$915.53
$986.99
$1,010.90
$1,181.58
$991.28
$935.25
$1,051.32
$1,051.32
$986.99
$1,010.90
$920.60
$1,051.32
$898.80
$1,006.34
$1,181.58
$1,185.42
$1,010.90
$876.29
$1,052.73
$920.87
$920.60
$1,052.73
$919.25
$1,181.58
$1,051.32
$928.85
$934.10
$986.99
$1,185.42

$7,662.69
$7,747.68
$7,642.44
$7,737.21
$7,887.06
$7,709.93
$7,694.21
$7,737.21
$7,743.89
$8,204.22
$7,963.10
$7,715.49
$8,204.22
$7,887.06
$7,747.47
$7,747.47
$7,713.74
$7,843.59
$7,887.06
$8,197.25
$7,851.41
$7,749.60
$7,960.52
$7,960.52
$7,843.59
$7,887.06
$7,722.95
$7,960.52
$7,683.35
$7,878.78
$8,197.25
$8,204.22
$7,887.06
$7,642.44
$7,963.10
$7,723.44
$7,722.95
$7,963.10
$7,720.50
$8,197.25
$7,960.52
$7,737.95
$7,747.47
$7,843.59
$8,204.22

Page 22 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
2424000
7000008
2129000
3101000
2902000
7001017
7003004
7001019
7001020
7002019
1226701
3824000
5721700
4402000
3622000
0101003
7002020
1401008
2909000
7002021
7000006
1564701
7003015
7002024
3121001
5903000
2950002
1701000
2952006
3102000
2527000
7000024
7002052
7003013
2901000
2952005
2951001
1327000
5920000
7001008
7002026
7003010
7001021
7099003
7002054

Agency
ADIRONDACK
MEDICAL
HOSP
LEWIS
COUNTY
GENERAL
LINCOLN MEDICAL & MENTAL
LITTLE FALLS HOSPITAL
LOCKPORT MEMORIAL HOSP
LONG BEACH MEDICAL CTR
LONG ISLAND COLLEGE HOSP
LONG ISLAND JEWISH
LUTHERAN MEDICAL CENTER
MAIMONIDES MEDICAL CTR
MANHATTAN EYE EAR & THROAT
MARGARETVILLE MEMORIAL
MARY IMOGENE BASSETT
MARY MCCLELLAN HOSPITAL
MASSENA MEMORIAL HOSPITAL
MEDINA MEMORIAL HOSPITAL
MEMORIAL HOSP (ALBANY)
MEMORIAL HOSP FOR CANCER
MERCY HOSPITAL OF BUFFALO
MERCY MEDICAL CENTER
METROPOLITAN HOSPITAL CTR
MONTEFIORE HOSPITAL
MOSES-LUDINGTON HOSPITAL
MOUNT SINAI / WEST QUEENS
MOUNT SINAI HOSPITAL
MOUNT ST MARYS HOSPITAL
MOUNT VERNON HOSPITAL
NASSAU HEALTH CARE CORP
NATHAN LITTAUER HOSPITAL
NEW ISLAND HOSPITAL
NIAGARA FALLS MEMORIAL**
NICHOLAS H NOYES HOSP
NORTH CENTRAL BRONX
NORTH GENERAL HOSPITAL
NORTH SHORE / FOREST HILLS
NORTH SHORE / GLEN COVE
NORTH SHORE / PLAINVIEW
NORTH SHORE UNIVERSITY
NORTHERN DUTCHESS HOSP
NORTHERN WESTCHESTER
NY COMMUNITY / BROOKLYN
NY EYE & EAR INFIRMARY
NY MEDICAL CTR OF QUEENS
NY METHODIST HOSPITAL
NY PRESBY HOSP (ALLEN)
NY PRESBY HOSP (NY PAYNE)

Mmisid
00363213
00354370
00246126
00310870
00354389
00245487
00243678
00243903
00243729
00243641
00243458
00279387
00305000
00336952
00354398
00310898
00364003
00243467
00354412
00274295
00246135
00243554
00360930
00243509
00243509
01746616
00274117
01962156
00313924
01949875
00354467
00354476
00246171
00355142
00243889
00274240
00274231
00245510
00268300
00274144
00243696
00243476
00244133
00243701
00243178
00243518

PAS
40

PAS
41

PAS
42

PAS
45

$776.16
$1,060.82
$780.00
$783.77
$879.63
$1,064.90
$1,064.90
$922.53
$1,064.90
$910.97
$792.09
$931.50
$779.00
$768.51
$789.44
$796.61
$922.53
$782.34
$879.63
$1,060.82
$1,064.90
$782.37
$913.35
$1,064.90
$783.20
$854.24
$1,025.72
$787.50
$874.79
$783.20
$798.09
$1,060.82
$1,052.51
$1,052.51
$879.63
$879.63
$1,025.72
$837.99
$854.24
$913.35
$913.35
$1,064.90
$1,064.90
$1,064.90
$1,064.90

$1,231.98
$1,752.02
$1,238.99
$1,245.89
$1,421.01
$1,759.46
$1,759.46
$1,499.40
$1,759.46
$1,478.27
$1,261.10
$1,515.77
$1,237.17
$1,218.00
$1,256.24
$1,269.33
$1,499.40
$1,243.28
$1,421.01
$1,752.02
$1,759.46
$1,243.32
$1,482.62
$1,759.46
$1,244.84
$1,374.63
$1,687.91
$1,252.70
$1,412.18
$1,244.84
$1,272.06
$1,752.02
$1,736.84
$1,736.84
$1,421.01
$1,421.01
$1,687.91
$1,344.95
$1,374.63
$1,482.62
$1,482.62
$1,759.46
$1,759.46
$1,759.46
$1,759.46

$913.43
$1,181.58
$917.04
$920.60
$1,010.90
$1,185.42
$1,185.42
$1,051.32
$1,185.42
$1,040.42
$928.44
$1,059.75
$916.10
$906.21
$925.92
$932.69
$1,051.32
$919.25
$1,010.90
$1,181.58
$1,185.42
$919.28
$1,042.67
$1,185.42
$920.06
$986.99
$1,148.52
$924.11
$1,006.34
$920.06
$934.10
$1,181.58
$1,173.75
$1,173.75
$1,010.90
$1,010.90
$1,148.52
$971.67
$986.99
$1,042.67
$1,042.67
$1,185.42
$1,185.42
$1,185.42
$1,185.42

$7,709.93
$8,197.25
$7,716.48
$7,722.95
$7,887.06
$8,204.22
$8,204.22
$7,960.52
$8,204.22
$7,940.72
$7,737.21
$7,975.86
$7,714.77
$7,696.82
$7,732.64
$7,744.92
$7,960.52
$7,720.50
$7,887.06
$8,197.25
$8,204.22
$7,720.55
$7,944.80
$8,204.22
$7,721.96
$7,843.59
$8,137.16
$7,729.34
$7,878.78
$7,721.96
$7,747.47
$8,197.25
$8,183.03
$8,183.03
$7,887.06
$7,887.06
$8,137.16
$7,815.78
$7,843.59
$7,944.80
$7,944.80
$8,204.22
$8,204.22
$8,204.22
$8,204.22

Page 23 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
7002030
5906000
7002053
7000025
4324000
7002000
0401001
2601001
3523000
3501000
3702000
0301001
7000005
1402000
2754001
7003020
7003006
5932000
3950000
7003007
7004010
2221001
2701003
3201002
1401010
4102002
2201000
4501000
4823000
4102003
1401006
7004006
1401013
6120000
5904000
2950001
5126000
5154000
5902000
3529000
7000014
5157003
5149001
4601002
7002033

Agency
ADIRONDACK
MEDICAL
HOSP
NY
PRESBY HOSP
(PRESBY)
NY UNITED HOSPITAL
NY UNIV MED CTR (TISCH)
NY WESTCHESTER SQUARE
NYACK HOSPITAL
NYU DOWNTOWN HOSPITAL
OLEAN GENERAL HOSPITAL
ONEIDA CITY HOSPITAL
ORANGE REGIONAL MED CTR
ORANGE REGIONAL(MIDDLETOWN)
OSWEGO HOSPITAL
OUR LADY OF LOURDES HOSP
OUR LADY OF MERCY
OUR LADY OF VICTORY HOSP
PARK RIDGE HOSPITAL
PARKWAY HOSPITAL
PENINSULA HOSPITAL CTR
PHELPS MEMORIAL HOSPITAL
PUTNAM COMMUNITY HOSPITAL
QUEENS HOSPITAL CENTER
RICHMOND UNIVERSITY MEDICAL CENTER
RIVER HOSPITAL**
ROCHESTER GENERAL HOSP
ROME HOSPITAL AND MURPHY
ROSWELL PARK MEMORIAL
SAMARITAN HOSPITAL / TROY
SAMARITAN MEDICAL CENTER
SARATOGA HOSPITAL
SCHUYLER HOSPITAL
SETON HEALTH SYSTEMS
SHEEHAN MEMORIAL EMERG
SISTERS OF CHARITY (BAYLEY)
SISTERS OF CHARITY HOSP
SOLDIERS AND SAILORS
SOUND SHORE HOSPITAL
SOUTH NASSAU COMMUNITIES
SOUTHAMPTON HOSP ASSOC
SOUTHSIDE HOSPITAL
ST AGNES HOSPITAL
ST ANTHONY COMMUNITY
ST BARNABAS HOSPITAL
ST CATHERINE OF SIENA
ST CHARLES HOSPITAL
ST CLARE'S / SCHENECTADY
ST CLARES HOSP & HEALTH

Mmisid
00363213
00243178
00274204
00273116
00273092
00243967
00647269
00354632
00310903
00258379
00258379
00354485
00337664
00243563
00354494
00378721
00244151
00243898
00274162
00258360
00246153
00248820
02392854
00303315
00352534
00354518
00318805
00354316
00303282
00363144
01534463
00354545
00652328
00354563
00336498
00274126
00245496
00274406
00268319
00274180
00273890
00243361
02060942
00274415
00361748
00243201

PAS
40

PAS
41

PAS
42

PAS
45

$1,064.90
$854.24
$1,064.90
$913.35
$854.24
$1,049.18
$775.91
$796.58
$816.65
$816.65
$785.19
$770.72
$1,064.90
$782.34
$799.76
$913.35
$922.53
$854.24
$840.71
$1,060.82
$1,064.90
$776.16
$939.35
$780.00
$784.44
$795.99
$776.57
$795.99
$760.64
$795.99
$782.91
$922.53
$784.44
$747.12
$1,000.11
$885.17
$879.63
$879.63
$859.55
$817.26
$922.53
$879.63
$879.63
$795.99
$1,052.51

$1,759.46
$1,374.63
$1,759.46
$1,482.62
$1,374.63
$1,730.76
$1,231.52
$1,269.29
$1,305.96
$1,305.96
$1,248.50
$1,222.05
$1,759.46
$1,243.28
$1,275.08
$1,482.62
$1,499.40
$1,374.63
$1,349.90
$1,752.02
$1,759.46
$1,231.98
$1,530.12
$1,238.99
$1,247.12
$1,268.22
$1,232.73
$1,268.22
$1,203.62
$1,268.22
$1,244.33
$1,499.40
$1,247.12
$1,178.94
$1,641.11
$1,431.12
$1,421.01
$1,421.01
$1,384.32
$1,307.09
$1,499.40
$1,421.01
$1,421.01
$1,268.22
$1,736.84

$1,185.42
$986.99
$1,185.42
$1,042.67
$986.99
$1,170.62
$913.19
$932.66
$951.57
$951.57
$921.93
$908.30
$1,185.42
$919.25
$935.64
$1,042.67
$1,051.32
$986.99
$974.22
$1,181.58
$1,185.42
$913.43
$1,067.16
$917.04
$921.23
$932.12
$913.82
$932.12
$898.80
$932.12
$919.79
$1,051.32
$921.23
$886.07
$1,124.39
$1,016.10
$1,010.90
$1,010.90
$991.98
$952.14
$1,051.32
$1,010.90
$1,010.90
$932.12
$1,173.75

$8,204.22
$7,843.59
$8,204.22
$7,944.80
$7,843.59
$8,177.33
$7,709.49
$7,744.88
$7,779.24
$7,779.24
$7,725.39
$7,700.61
$8,204.22
$7,720.50
$7,750.31
$7,944.80
$7,960.52
$7,843.59
$7,820.42
$8,197.25
$8,204.22
$7,709.93
$7,989.30
$7,716.48
$7,724.10
$7,743.89
$7,710.62
$7,743.89
$7,683.35
$7,743.89
$7,721.49
$7,960.52
$7,724.10
$7,660.22
$8,093.31
$7,896.53
$7,887.06
$7,887.06
$7,852.68
$7,780.29
$7,960.52
$7,887.06
$7,887.06
$7,743.89
$8,183.03

Page 24 of 25

3/10/2013

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert
1623001
3202002
1302000
2953000
5002001
5907001
1455000
0701001
3301003
5907002
3502000
3522000
7002032
2801001
7001025
0101004
7002037
7001037
5151001
7004003
2701005
3301007
1227000
0427000
0303001
1801000
1302001
7001032
5820000
5957001
0632000
5902001
2908000
0602001
7001045
7001035
6027000

Agency
ADIRONDACK
ST
ELIZABETHMEDICAL
MED CTRHOSP
ST FRANCIS / POUGHKEEPSIE
ST FRANCIS HOSP / ROSLYN
ST JAMES MERCY HOSPITAL
ST JOHNS RIVERSIDE
ST JOSEPH HOSPITAL
ST JOSEPHS / ELMIRA
ST JOSEPHS HOSP & HEALTH
ST JOSEPHS OF YONKERS
ST LUKES / NEWBURGH
ST LUKES CORNWALL / CORNWALL
ST LUKES ROOSEVELT
ST MARYS AT AMSTERDAM
ST MARYS OF BROOKLYN
ST PETERS HOSPITAL
ST VINCENTS HOSPITAL
STATE UNIV / DOWNSTATE
STATE UNIV / STONY BROOK
STATEN ISLAND UNIV HOSPITAL
STRONG MEMORIAL HOSPITAL
SUNY HEALTH SCIENCE CENTER
THE HOSPITAL
TLC HEALTH NETWORK
UNITED HEALTH SERVICES
UNITED MEMORIAL (GENESEE)
VASSAR BROTHERS MED CTR
VICTORY MEMORIAL HOSPITAL
WAYNE HEALTH CARE
WESTCHESTER MEDICAL CTR
WESTFIELD MEMORIAL HOSP
WHITE PLAINS HOSPITAL
WINTHROP UNIVERSITY HOSP
WOMANS CHRISTIAN ASSOC
WOODHULL MEDICAL CENTER
WYCKOFF HEIGHTS HOSPITAL
WYOMING COUNTY COMMUNITY

Mmisid
00363213
00279901
00273845
00244046
00363162
00245501
00354581
00363126
00315013
00258920
00273914
00273863
00354967
00351639
00729373
00318823
00243229
00243590
00357795
00244202
00279034
00354590
00313951
00347544
00614755
00354283
00273854
00243449
00354458
00274213
00354614
00274222
00244211
00354623
00698866
00243825
00310889

PAS
40

PAS
41

PAS
42

PAS
45

$779.42
$838.77
$885.17
$762.14
$854.24
$782.34
$768.14
$937.82
$854.24
$816.65
$817.26
$1,064.90
$795.99
$1,064.90
$937.83
$1,064.90
$1,064.90
$1,025.72
$1,064.90
$939.35
$937.82
$792.09
$775.50
$772.86
$738.15
$837.32
$913.35
$798.09
$1,000.11
$775.79
$854.24
$1,025.72
$775.22
$1,060.82
$922.53
$738.15

$1,237.92
$1,346.37
$1,431.12
$1,206.35
$1,374.63
$1,243.28
$1,217.34
$1,527.32
$1,374.63
$1,305.96
$1,307.09
$1,759.46
$1,268.22
$1,759.46
$1,527.35
$1,759.46
$1,759.46
$1,687.91
$1,759.46
$1,530.12
$1,527.32
$1,261.10
$1,230.78
$1,225.95
$1,162.55
$1,343.70
$1,482.62
$1,272.06
$1,641.11
$1,231.31
$1,374.63
$1,687.91
$1,230.26
$1,752.02
$1,499.40
$1,162.55

$916.49
$972.41
$1,016.10
$900.21
$986.99
$919.25
$905.87
$1,065.72
$986.99
$951.57
$952.14
$1,185.42
$932.12
$1,185.42
$1,065.72
$1,185.42
$1,185.42
$1,148.52
$1,185.42
$1,067.16
$1,065.72
$928.44
$912.80
$910.31
$877.62
$971.03
$1,042.67
$934.10
$1,124.39
$913.08
$986.99
$1,148.52
$912.54
$1,181.58
$1,051.32
$877.62

$7,715.49
$7,817.12
$7,896.53
$7,685.90
$7,843.59
$7,720.50
$7,696.20
$7,986.69
$7,843.59
$7,779.24
$7,780.29
$8,204.22
$7,743.89
$8,204.22
$7,986.71
$8,204.22
$8,204.22
$8,137.16
$8,204.22
$7,989.30
$7,986.69
$7,737.21
$7,708.79
$7,704.27
$7,644.86
$7,814.61
$7,944.80
$7,747.47
$8,093.31
$7,709.28
$7,843.59
$8,137.16
$7,708.31
$8,197.25
$7,960.52
$7,644.86

Page 25 of 25

3/10/2013