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  5. /Case rate

APR-DRG 133-4

RESPIRATORY FAILURE

Reported by 18 hospitals in the network under the case rate 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 negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$4.2k

Average

$13.1k

Median

$12.6k

High

$25.5k

Hospitals reporting this code

#HospitalLocation
1Natchez Hospital Company LLCNatchez, MS$12.2k$12.3k$12.4k$13.1k$304
2Wesley Health System LLCHattiesburg, MS$12.2k$12.2k$12.3k$13.1k$316
3Jackson HMA LLCMS 39204, MS$12.2k$12.3k$12.3k$13.1k$293
4Vicksburg Healthcare LLCVicksburg, MS$12.2k$12.2k$12.3k$13.1k$316
5Brandon HMA LLCBrandon, MS$12.2k$12.3k$12.4k$13.1k$304
6River Oaks Hospital LLCFlowood, MS$12.2k$12.3k$13.1k$19.5k$2.2k
7Mat-Su Valley Medical Center LLCAK 99645, AK$25.5k$25.5k$25.5k$25.5k—
8McAllen Hospitals, LPMcAllen, TX—$12.5k$12.6k—$105
9McAllen Hospitals, LPEdinburg, TX—$12.5k$12.6k—$105
10Northwest Texas Healthcare System, Inc.Amarillo, TX—$12.8k$13.0k—$286
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