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  5. /Case rate

APR-DRG 420-1

DIABETES

Reported by 31 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

$1.2k

Average

$3.6k

Median

$3.0k

High

$9.5k

Hospitals reporting this code

#HospitalLocation
1Natchez Hospital Company LLCNatchez, MS$2.9k$3.0k$3.0k$3.2k$73
2Wesley Health System LLCHattiesburg, MS$2.9k$2.9k$3.0k$3.2k$76
3Jackson HMA LLCMS 39204, MS$2.9k$3.0k$3.0k$3.2k$70
4Vicksburg Healthcare LLCVicksburg, MS$2.9k$2.9k$3.0k$3.2k$76
5Brandon HMA LLCBrandon, MS$2.9k$3.0k$3.0k$3.2k$73
6River Oaks Hospital LLCFlowood, MS$2.9k$3.0k$3.2k$4.7k$541
7Mat-Su Valley Medical Center LLCAK 99645, AK$6.1k$6.1k$6.1k$6.1k—
8McAllen Hospitals, LPMcAllen, TX—$2.5k$2.5k—$21
9McAllen Hospitals, LPEdinburg, TX—$2.5k$2.5k—$21
10Northwest Texas Healthcare System, Inc.Amarillo, TX—$2.6k$2.6k—$58
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