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  4. /205-3
  5. /Case rate

APR-DRG 205-3

CARDIOMYOPATHY

Reported by 32 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

$2.3k

Average

$7.6k

Median

$6.2k

High

$24.9k

Hospitals reporting this code

#HospitalLocation
1Natchez Hospital Company LLCNatchez, MS$6.1k$6.2k$6.2k$6.6k$153
2Wesley Health System LLCHattiesburg, MS$6.1k$6.1k$6.2k$6.6k$160
3Jackson HMA LLCMS 39204, MS$6.1k$6.2k$6.2k$6.6k$148
4Vicksburg Healthcare LLCVicksburg, MS$6.1k$6.1k$6.2k$6.6k$160
5Brandon HMA LLCBrandon, MS$6.1k$6.2k$6.2k$6.6k$153
6River Oaks Hospital LLCFlowood, MS$6.1k$6.2k$6.6k$9.8k$1.1k
7Mat-Su Valley Medical Center LLCAK 99645, AK$10.6k$10.6k$10.6k$10.6k—
8McAllen Hospitals, LPMcAllen, TX—$5.2k$5.3k—$44
9McAllen Hospitals, LPMcAllen, TX—$5.2k$5.3k—$44
10McAllen Hospitals, LPEdinburg, TX—$5.2k$5.3k—$44
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