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APR-DRG 425

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Reported by 12 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

$2.5k

Average

$12.1k

Median

$10.7k

High

$25.8k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$14.6k$17.5k$17.7k$20.6k$1.9k
2The Mercy Hospital IncSpringfield, MA$5.9k$18.5k$25.8k$47.6k$10.2k
3St Mary Mercy LivoniaLivonia, MI$4.0k$11.9k$11.7k$11.9k$368
4Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$2.4k$2.5k$2.5k$2.6k$88
5Mercy Medical Center - DubuqueDubuque, IA$8.6k$9.6k$10.1k$10.7k$617
6Mercy Health Services-Iowa Corp.Mason City, IA$9.7k$10.7k$10.7k$10.7k$119
7Catholic Health Initiatives-Iowa CorpDes Moines, IA$9.7k$10.7k$10.7k$10.7k$119
8Covenant Medical Center IncWaterloo, IA$9.7k$10.7k$10.7k$10.7k$119
9Catholic Health Initiatives-Iowa CorpWest Des Moines, IA$8.6k$10.7k$13.7k$21.0k$5.2k
10Mercy Medical Center-Clinton IncClinton, IA$19.2k$21.1k$21.1k$21.1k$234
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