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  5. /Case rate

APR-DRG 385

INFLAMMATORY BOWEL DISEASE WITH MCC

Reported by 7 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

$4.0k

Average

$10.0k

Median

$7.2k

High

$18.7k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$15.4k$18.4k$18.7k$21.6k$2.0k
2The Mercy Hospital IncSpringfield, MA$5.5k$11.0k$16.1k$22.4k$5.9k
3St Joseph Mercy Ann ArborYpsilanti, MI$825$7.5k$7.2k$7.5k$509
4Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$4.3k$4.4k$4.4k$4.7k$157
5Catholic Health Initiatives-Iowa CorpDes Moines, IA$11.8k$13.0k$12.9k$13.0k$144
6Mount Carmel St Ann'sWesterville, OH$6.8k$7.0k$6.9k$7.0k$74
7Mount Carmel EastColumbus, OH$3.4k$4.3k$4.0k$4.5k$463

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