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  5. /Case rate

APR-DRG 134-3

PULMONARY EMBOLISM

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

$2.7k

Average

$7.8k

Median

$7.4k

High

$15.9k

Hospitals reporting this code

#HospitalLocation
1Natchez Hospital Company LLCNatchez, MS$7.3k$7.3k$7.4k$7.8k$181
2Wesley Health System LLCHattiesburg, MS$7.3k$7.3k$7.4k$7.8k$189
3Jackson HMA LLCMS 39204, MS$7.3k$7.3k$7.4k$7.8k$175
4Vicksburg Healthcare LLCVicksburg, MS$7.3k$7.3k$7.4k$7.8k$189
5Brandon HMA LLCBrandon, MS$7.3k$7.3k$7.4k$7.8k$181
6River Oaks Hospital LLCFlowood, MS$7.3k$7.3k$7.9k$11.6k$1.3k
7Mat-Su Valley Medical Center LLCAK 99645, AK$15.9k$15.9k$15.9k$15.9k—
8McAllen Hospitals, LPMcAllen, TX—$6.8k$6.8k—$57
9McAllen Hospitals, LPEdinburg, TX—$6.8k$6.8k—$57
10Northwest Texas Healthcare System, Inc.Amarillo, TX—$6.9k$7.0k—$155
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