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APC CASE-42800

Biopsy Oropharynx

Reported by 3 hospitals in the network.

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.

National pricing summary

Low

$1.5k

Average

$1.6k

Median

$1.5k

High

$1.8k

Hospitals reporting this code

#HospitalLocation
1Mercy Health St Ritas Medical Center LlcLima, OH$1.5k$1.5k$1.5k$1.5k—
2Mercy Health West Hospital LlcCincinnati, OH$1.8k$1.8k$1.8k$1.8k$12
3St Francis Hospital IncGreenville, SC$1.5k$1.5k$1.5k$1.5k$7

Look up this code directly

Ask Claude or any MCP client for APC CASE-42800 pricing at a specific hospital — see how to connect.

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