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CDM 43400003

HC OT EVAL MOD COMPLEX 45 MIN

Reported by 32 hospitals in the network under the fee schedule 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 negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$90

Average

$264

Median

$255

High

$337

Hospitals reporting this code

#HospitalLocation
1Vanderbilt Wilson County HospitalLebanon, TN$95$103$107$418$87
2Vanderbilt Tullahoma-Harton HospitalTullahoma, TN$95$108$125$418$102
3Vanderbilt University Medical CenterNashville, TN$95$96$90$418$79
4Vanderbilt Bedford HospitalShelbyville, TN$95$108$125$418$102
5Baylor Scott & White Medical Center - TempleTemple, TX$80$285$251$477$92
6Baylor Scott & White Medical Center - BrenhamBrenham, TX$65$285$251$477$92
7Baylor Scott & White Medical Center - TaylorTaylor, TX$86$285$251$363$92
8Baylor Scott & White Medical Center - HillcrestWaco, TX$64$294$274$451$77
9Baylor University Medical CenterDallas, TX$76$295$333$603$206
10Baylor Scott & White All Saints Medical Center - Fort WorthFort Worth, TX$72$295$333$603$206
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