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APC CASE-19380

Revision of Reconstructed Breast|SEPARATE STRUCTURE|LEFT SIDE

Reported by 12 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

$6.5k

Average

$7.0k

Median

$7.2k

High

$7.4k

Hospitals reporting this code

#HospitalLocation
1Mercy Health St Vincent Medical Center LlcToledo, OH$6.5k$7.2k$7.3k$7.9k$643
2Mercy Health Youngstown LlcWarren, OH$6.3k$6.3k$6.8k$7.7k$670
3Mercy Health Lourdes Hospital LlcPaducah, KY$6.6k$6.6k$6.6k$6.7k$57
4Jewish Hospital LlcCincinnati, OH$6.5k$6.5k$6.5k$6.5k—
5Mercy Health Fairfield Hospital LlcFairfield, OH$6.6k$6.6k$6.6k$6.7k$44
6Bon Secours St Francis Medical Center LlcMidlothian, VA$6.5k$7.3k$7.3k$8.1k$741
7Bon Secours St Marys Hospital Of Richmond LlcRichmond, VA$6.7k$6.8k$7.4k$8.4k$773
8St Francis Hospital IncGreenville, SC$6.4k$7.0k$7.2k$7.9k$557
9Bon Secours Memorial Regional Medical Center LlcMechanicsville, VA$6.7k$7.3k$7.2k$7.4k$284
10St Francis Hospital IncGreenville, SC$6.4k$6.4k$6.9k$7.8k$705
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