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CPT 42802

PR BIOPSY HYPOPHARYNX

Reported by 18 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

$422

Average

$14.3k

Median

$554

High

$50k

Hospitals reporting this code

#HospitalLocation
1University of Iowa Health Care Medical Center DowntownIowa City, IA$0$598$624$797$161
2University of Iowa Health Care Medical CenterIowa City, IA$0$598$624$797$161
3Northside Hospital, Inc.Lawrenceville, GA$1.5k$50k$50k$50k—
4Northside Hospital, Inc.Canton, GA$1.5k$50k$50k$50k—
5Northside Hospital, Inc.Atlanta, GA$1.5k$50k$50k$50k—
6Northside Hospital, Inc.Duluth, GA$1.5k$50k$50k$50k—
7Northside Hospital, Inc.Cumming, GA$1.5k$50k$50k$50k—
8Mary Hitchcock Memorial HospitalLebanon, NH$439$859$708$859$195
9Cheshire Medical CenterKeene, NH$492$854$800$876$138
10Fairview Health ServicesMinneapolis, MN$139$524$485$655$162
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