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  5. /Case rate
CPT 35538

ART BYP GRFT AORTOBI-ILIAC

Reported by 338 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

Average

$8.4k

Median

$6.8k

High

$26.5k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$10.2k$10.2k$10.2k$10.2k—
2Medical Ctiy ArgyleArgyle, TX$948$10.9k$12.0k$82.0k$8.6k
3Medical City AllianceSAGINAW, TX$2.1k$12.0k$12.9k$43.1k$6.3k
4Trinity Medical CenterRock Island, IL$10.2k$10.2k$10.2k$10.2k—
5Unity HealthcareMuscatine, IA$10.2k$10.2k$10.2k$10.2k—
6Meriter Hospital, IncMadison, WI$1.9k$6.5k$6.1k$14.2k$661
7Medical City MckinneyMcKinney, TX$948$10.9k$12.1k$58.2k$8.6k
8Medical City Las ColinasIrving, TX$948$10.9k$11.2k$43.1k$7.2k
9Med City Heart HospitalDallas, TX$948$12.1k$12.1k$49.6k$7.7k
10Medical City DentonArgyle, TX$948$10.9k$12.0k$82.0k$8.6k
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