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  4. /98-4
  5. /Case rate

APR-DRG 98-4

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Reported by 3 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

$47.0k

Average

$64.7k

Median

$61.6k

High

$85.4k

Hospitals reporting this code

#HospitalLocation
1Sanford Medical Center BismarckBismarck, ND$85.4k$85.4k$85.4k$85.4k—
2Albert Einstein Medical CenterPhiladelphia, PA$40.7k$61.6k$61.6k$71.5k$9.9k
3Einstein Medical Center MontgomeryEast Norriton, PA$31.1k$47.0k$47.0k$58.5k$7.5k

Look up this code directly

Ask Claude or any MCP client for APR-DRG 98-4 pricing at a specific hospital — see how to connect.

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