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APR-DRG 165

MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Reported by 5 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

$20.7k

Average

$54.4k

Median

$68.7k

High

$90.1k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$18.7k$21.7k$22.2k$25.0k$2.2k
2Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$20.0k$20.6k$20.7k$22.0k$733
3Mercy Medical Center - DubuqueDubuque, IA$82.1k$90.3k$90.1k$90.3k$1.0k
4Mercy Health Services-Iowa Corp.Mason City, IA$46.1k$66.4k$70.4k$90.3k$19.8k
5Catholic Health Initiatives-Iowa CorpDes Moines, IA$46.1k$63.7k$68.7k$90.3k$15.3k

Look up this code directly

Ask Claude or any MCP client for APR-DRG 165 pricing at a specific hospital — see how to connect.

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