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CPT 31257

NSL/SINS NDSC TOT W/SPHENDT

Reported by 364 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

$10

Average

$9.4k

Median

$7.7k

High

$72.4k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$2.2k$6.9k$6.2k$16.0k$2.0k
2Northwest Iowa Hospital CorporationSioux City, IA$6.1k$7.0k$7.0k$18.5k$101
3Medical Ctiy ArgyleArgyle, TX$1.6k$7.6k$8.1k$17.0k$3.9k
4Medical City AllianceSAGINAW, TX$1.6k$7.3k$7.4k$15.3k$3.2k
5St Luke's Methodist HospitalCedar Rapids, IA$6.1k$6.6k$6.6k$17.2k$96
6Trinity Medical CenterRock Island, IL$2.2k$7.4k$6.6k$19.6k$2.5k
7Trinity Medical CenterBettendorf, IA$6.0k$6.7k$7.1k$17.8k$1.3k
8University of Iowa Health Care Medical Center DowntownIowa City, IA$5.0k$7.9k$7.9k$10.2k$2.0k
9Unity HealthcareMuscatine, IA$2.2k$6.5k$6.1k$20.8k$2.2k
10Trinity Regional Medical CenterFort Dodge, IA$5.9k$6.6k$6.6k$18.2k$96
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