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APC CASE-19342

Insj/Rplcmt Breast Implant Sep Day Mastectomy|LEFT SIDE

Reported by 13 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

$7.3k

Average

$7.9k

Median

$8.0k

High

$8.2k

Hospitals reporting this code

#HospitalLocation
1Mercy Health Youngstown LlcWarren, OH$6.9k$7.7k$7.5k$7.7k$376
2Mercy Health Youngstown LlcYoungstown, OH$7.7k$7.7k$7.7k$7.7k—
3Mercy Health Lourdes Hospital LlcPaducah, KY$8.1k$8.3k$8.2k$8.3k$77
4Mercy Health Regional Medical Center LlcLorain, OH$6.9k$7.3k$7.3k$7.9k$456
5Mercy Health Kings Mills Hospital LlcMason, OH$8.0k$8.0k$8.0k$8.1k$59
6Mercy Health Youngstown LlcYoungstown, OH$7.9k$7.9k$7.9k$7.9k—
7Bon Secours St Francis Medical Center LlcMidlothian, VA$8.0k$8.0k$8.0k$8.1k$56
8Bon Secours St Marys Hospital Of Richmond LlcRichmond, VA$8.2k$8.2k$8.2k$8.4k$73
9St Francis Hospital IncGreenville, SC$7.8k$7.8k$7.9k$7.9k$37
10Bon Secours Memorial Regional Medical Center LlcMechanicsville, VA$8.2k$8.2k$8.2k$8.4k$49
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