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APC CASE-19303

Mastectomy Simple Complete|BILATERAL PROCEDURE

Reported by 16 hospitals in the network under the other 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 payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$6.3k

Average

$7.5k

Median

$6.5k

High

$11.1k

Hospitals reporting this code

#HospitalLocation
1Mercy Health Youngstown LlcWarren, OH$6.3k$6.3k$6.3k$6.4k$47
2Mercy Health Youngstown LlcYoungstown, OH$6.3k$6.3k$6.3k$6.3k—
3Mercy Health Regional Medical Center LlcLorain, OH$6.3k$6.3k$6.3k$6.4k$44
4Mercy Health St Vincent Medical Center LlcOregon, OH$6.5k$6.5k$6.5k$6.6k$41
5Mercy Health West Hospital LlcCincinnati, OH$6.6k$6.6k$6.6k$6.7k$59
6Mercy Health Anderson Hospital LlcCincinnati, OH$6.5k$6.5k$6.5k$6.6k$58
7Community Mercy Health PartnersSpringfield, OH$6.4k$6.4k$6.4k$6.5k$32
8Bon Secours St Francis Medical Center LlcMidlothian, VA$6.5k$6.5k$6.5k$6.6k$41
9Bon Secours St Marys Hospital Of Richmond LlcRichmond, VA$6.7k$10.3k$10.3k$14.1k$3.6k
10St Francis Hospital IncGreenville, SC$6.4k$13.2k$11.1k$13.3k$3.2k
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