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APC CASE-43262

Ercp W/Sphincterotomy/Papillotomy|UNUSUAL NON-OVERLAPPING SERVICE

Reported by 18 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

$3.7k

Average

$4.3k

Median

$3.8k

High

$5.9k

Hospitals reporting this code

#HospitalLocation
1Mercy Health St Vincent Medical Center LlcToledo, OH$3.7k$5.9k$4.9k$6.0k$1.1k
2Mercy Health Youngstown LlcWarren, OH$3.6k$3.6k$3.7k$3.7k$24
3Mercy Health Youngstown LlcYoungstown, OH$3.6k$3.6k$3.7k$3.7k$26
4Mercy Health Lourdes Hospital LlcPaducah, KY$3.8k$3.9k$4.9k$6.2k$1.1k
5Jewish Hospital LlcCincinnati, OH$3.8k$3.8k$3.8k$3.8k$25
6Mercy Health St Vincent Medical Center LlcToledo, OH$5.9k$5.9k$5.9k$5.9k—
7Mercy Health Kings Mills Hospital LlcMason, OH$3.8k$3.8k$3.8k$3.8k$30
8Mercy Health St Ritas Medical Center LlcLima, OH$3.8k$3.8k$3.8k$3.8k—
9Mercy Health Fairfield Hospital LlcFairfield, OH$3.8k$3.9k$4.8k$6.0k$1.1k
10Mercy Health Clermont Hospital LlcBatavia, OH$3.8k$3.8k$3.8k$3.8k$33
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