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APR-DRG 137

MOUTH PROCEDURES WITH CC/MCC

Reported by 11 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

$4.1k

Average

$12.9k

Median

$13.1k

High

$32.4k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$14.5k$16.9k$17.1k$19.5k$1.6k
2The Mercy Hospital IncSpringfield, MA$8.2k$27.6k$32.4k$51.1k$8.2k
3St Joseph Mercy ChelseaChelsea, MI$825$11.7k$11.6k$11.7k$170
4Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$4.0k$4.1k$4.1k$4.4k$145
5Mercy Health Services-Iowa Corp.Mason City, IA$12.9k$14.2k$14.2k$14.2k$158
6Catholic Health Initiatives-Iowa CorpDes Moines, IA$12.9k$14.2k$14.2k$14.2k$158
7Covenant Medical Center IncWaterloo, IA$12.9k$14.2k$14.2k$14.2k$158
8Mercy Medical Center-Clinton IncClinton, IA$10.8k$12.5k$13.1k$14.3k$1.2k
9Diley Ridge Medical CenterCanal Winchester, OH$4.9k$5.2k$5.2k$5.3k$123
10Mount Carmel St Ann'sWesterville, OH$5.9k$9.6k$8.1k$10.0k$1.9k
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