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APR-DRG 466

REVISION OF HIP OR KNEE REPLACEMENT WITH MCC

Reported by 10 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

$3.7k

Average

$17.9k

Median

$11.3k

High

$60.4k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$50.7k$59.1k$60.4k$68.0k$6.0k
2Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$2.8k$3.7k$3.7k$4.8k$833
3Mercy Health Services-Iowa Corp.Mason City, IA$30.6k$33.6k$33.6k$33.6k$373
4Catholic Health Initiatives-Iowa CorpDes Moines, IA$8.8k$9.7k$9.7k$9.7k$107
5Covenant Medical Center IncWaterloo, IA$14.5k$16.0k$16.0k$16.0k$178
6Catholic Health Initiatives-Iowa CorpWest Des Moines, IA$14.5k$23.3k$24.8k$33.6k$8.8k
7Mercy Medical Center-Clinton IncClinton, IA$8.8k$12.2k$12.9k$16.1k$3.2k
8Mount Carmel Grove CityGrove City, OH$4.1k$6.1k$6.6k$9.6k$2.1k
9Mount Carmel St Ann'sWesterville, OH$4.2k$6.3k$6.8k$9.9k$2.2k
10Mount Carmel EastColumbus, OH$4.1k$4.3k$5.0k$6.1k$916

Look up this code directly

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