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  5. /Case rate

APR-DRG 23.2

Spinal Procedures, Moderate

Reported by 35 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

$10.4k

Average

$17.5k

Median

$11.3k

High

$48.2k

Hospitals reporting this code

#HospitalLocation
1Santa Rosa Hospital - Westover HillsSan Antonio, TX$10.2k$10.2k$10.4k$10.7k$215
2Southeast Texas Orthopedic Specialty CenterPort Arthur, TX$10.6k$11.1k$11.0k$11.4k$294
3Christus Health Southeast TexasPort Arthur, TX$10.6k$11.1k$11.0k$11.4k$294
4Christus Health Southeast TexasBeaumont, TX$10.6k$11.1k$11.0k$11.4k$294
5CHRISTUS Hospital - OrangeOrange, TX$10.6k$11.1k$11.0k$11.4k$294
6CHRISTUS West BeaumontBeaumont, TX$10.6k$11.1k$11.0k$11.4k$294
7Santa Rosa Hospital - Alamo HeightsSan Antonio, TX$10.2k$10.2k$10.4k$10.7k$215
8Santa Rosa Emergency Center - AlonSan Antonio, TX$10.2k$10.2k$10.4k$10.7k$215
9Southeast Texas - Jasper MemorialJasper, TX$37.1k$38.9k$38.7k$40.0k$1.0k
10St. Michael Hospital - AtlantaAtlanta, TX$10.3k$10.3k$10.5k$10.9k$245
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