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APR-DRG 519

BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC

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

$5.5k

Average

$14.4k

Median

$12.7k

High

$25.2k

Hospitals reporting this code

#HospitalLocation
1Sanford Aberdeen Medical CenterAberdeen, SD$19.5k$22.8k$23.3k$26.2k$2.3k
2The Mercy Hospital IncSpringfield, MA$8.2k$23.4k$25.2k$29.7k$5.2k
3Catholic Health Initiatives-Iowa CorpDes Moines, IA$10.8k$11.9k$11.9k$11.9k$133
4Catholic Health Initiatives-Iowa CorpWest Des Moines, IA$10.8k$12.8k$13.5k$15.1k$1.6k
5Mount Carmel Grove CityGrove City, OH$6.6k$6.8k$6.7k$6.9k$98
6Mount Carmel St Ann'sWesterville, OH$5.4k$5.5k$5.5k$5.6k$80

Look up this code directly

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