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  5. /Case rate

CDM 75000134

HC PROCTOSIGMOIDOSCOPY W/ST

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

$1.1k

Average

$2.7k

Median

$2.5k

High

$5.7k

Hospitals reporting this code

#HospitalLocation
1Vanderbilt Wilson County HospitalLebanon, TN$719$2.4k$3.9k$9.6k$2.5k
2Vanderbilt Tullahoma-Harton HospitalTullahoma, TN$632$6.0k$5.7k$9.6k$3.0k
3Vanderbilt University Medical CenterNashville, TN$1.6k$2.5k$3.9k$9.6k$2.4k
4Vanderbilt Bedford HospitalShelbyville, TN$719$6.0k$5.4k$9.6k$2.5k
5Baylor Scott & White Medical Center - TempleTemple, TX$288$3.0k$3.0k$3.0k—
6Baylor Scott & White Medical Center - BrenhamBrenham, TX$237$3.0k$3.0k$3.0k—
7Baylor Scott & White Medical Center - TaylorTaylor, TX$378$3.0k$3.0k$3.0k—
8Baylor Scott & White Medical Center - HillcrestWaco, TX$231$1.0k$1.1k$1.4k$53
9Baylor University Medical CenterDallas, TX$356$2.1k$3.9k$7.4k$2.4k
10Baylor Scott & White All Saints Medical Center - Fort WorthFort Worth, TX$335$1.9k$2.0k$2.1k$99
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