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APR-DRG 470

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Reported by 6 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

$2.9k

Average

$11.6k

Median

$12.1k

High

$22.4k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$18.8k$21.9k$22.4k$25.2k$2.2k
2The Mercy Hospital IncSpringfield, MA$6.9k$13.6k$13.2k$32.9k$1.5k
3Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$2.8k$2.9k$2.9k$3.1k$102
4Catholic Health Initiatives-Iowa CorpWest Des Moines, IA$14.7k$16.1k$16.1k$16.1k$179
5Mount Carmel St Ann'sWesterville, OH$7.7k$13.1k$10.9k$13.7k$2.8k
6Mount Carmel EastColumbus, OH$4.3k$4.4k$4.4k$4.4k$46

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