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CPT 54401

INSERT SELF-CONTD PROSTHESIS

Reported by 395 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

$14.4k

Median

$14.3k

High

$42.5k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$3.6k$19.7k$16.6k$46.5k$7.0k
2Northwest Iowa Hospital CorporationSioux City, IA$2.2k$20.0k$17.7k$53.7k$6.3k
3Medical Ctiy ArgyleArgyle, TX$2.4k$9.3k$15.1k$55.0k$13.7k
4Medical City AllianceSAGINAW, TX$2.4k$8.5k$14.4k$54.1k$14.1k
5St Luke's Methodist HospitalCedar Rapids, IA$19.0k$19.3k$19.3k$50.1k$280
6Trinity Medical CenterRock Island, IL$3.6k$21.4k$18.5k$57.1k$8.4k
7Trinity Medical CenterBettendorf, IA$18.9k$19.5k$20.7k$51.7k$3.7k
8Unity HealthcareMuscatine, IA$3.6k$18.9k$17.1k$60.5k$7.4k
9Trinity Regional Medical CenterFort Dodge, IA$18.9k$19.2k$19.2k$52.8k$278
10Meriter Hospital, IncMadison, WI$613$19.4k$12.7k$19.7k$8.1k
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