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  5. /Case rate

CDM 36000153

HC INJ SNG/MLT TRIGGR PTS 1-2MUSC

Reported by 32 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

$1.8k

Average

$4.0k

Median

$4.0k

High

$4.9k

Hospitals reporting this code

#HospitalLocation
1UPMC LititzLititz, PA$39$3.4k$3.4k$3.4k—
2UPMC MemorialYork, PA$39$1.3k$1.8k$3.4k$904
3UPMC HanoverHanover, PA$39$3.4k$3.4k$3.4k—
4UPMC CarlisleCarlisle, PA$39$3.4k$3.4k$3.4k—
5UPMC Pinnacle HospitalsHarrisburg, PA$41$1.7k$1.8k$2.1k$240
6Baylor Scott & White Medical Center - TempleTemple, TX$2.4k$2.9k$4.0k$51.8k$1.9k
7Baylor Scott & White Medical Center - BrenhamBrenham, TX$2.4k$2.8k$3.6k$51.8k$1.5k
8Baylor Scott & White Medical Center - TaylorTaylor, TX$2.4k$2.9k$4.0k$46.1k$1.9k
9Baylor Scott & White Medical Center - HillcrestWaco, TX$2.4k$3.1k$3.9k$48.9k$1.7k
10Baylor Scott & White All Saints Medical Center - Fort WorthFort Worth, TX$2.5k$4.3k$4.5k$55.5k$1.9k
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