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  5. /Case rate
CPT 61891

REV/RPLCMT SK-MNT CRNL NSTM

Reported by 354 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

Based on 2–20 billing samples across every hospital reporting.

Low

$10

Average

$13.7k

Median

$11.2k

High

$64.4k

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1Northwestern Memorial HospitalChicago, IL$12.3k$12.3k$6472–20$425$12.9k
2The Finley HospitalDubuque, IA$21.6k$21.6k$942—$18.9k$49.5k
3Northwest Iowa Hospital CorporationSioux City, IA$21.6k$21.6k$313—$19.0k$57.2k
4Medical Ctiy ArgyleArgyle, TX$16.2k$13.0k$9.7k—$948$65.2k
5Medical City AllianceSAGINAW, TX$17.9k$15.4k$8.3k—$2.1k$58.8k
6St Luke's Methodist HospitalCedar Rapids, IA$20.6k$20.6k$298—$18.9k$53.4k
7Trinity Medical CenterRock Island, IL$22.8k$24.0k$3.8k—$16.7k$60.8k
8Trinity Medical CenterBettendorf, IA$20.8k$22.1k$3.9k—$18.5k$55.1k
9Unity HealthcareMuscatine, IA$20.5k$21.8k$3.7k—$18.5k$64.5k
10Trinity Regional Medical CenterFort Dodge, IA$20.5k$20.5k$297—$18.3k$56.3k
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