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APC 0856

Outpatient Services

Reported by 2 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$34.2k

Average

$34.6k

Median

$34.6k

High

$35.1k

Hospitals reporting this code

#HospitalLocation
1Sanford Fargo Medical CenterFargo, ND$30.1k$34.9k$35.1k$40.4k$3.7k
2Sanford USD Medical CenterSioux Falls, SD$29.3k$34.0k$34.2k$39.4k$3.6k

Look up this code directly

Ask Claude or any MCP client for APC 0856 pricing at a specific hospital — see how to connect.

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