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CPT 64628

HC TRML DSTRJ IOS BVN 1ST 2 L/S

Reported by 430 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 47–74 billing samples across every hospital reporting.

Low

$10

Average

$10.6k

Median

$10.1k

High

$41.5k

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.
1Northern Illinois Medical Center DBA Northwestern Medicine McHenry HospitalMcHenry, IL$7.4k$7.4k$39244$7.1k$7.8k
2Northwestern Memorial HospitalChicago, IL$8.4k$8.4k$4412–20$7.9k$8.8k
3MedStar Washington Hospital CenterNW, WA$8.8k$10.3k$4.2k1–10$6.6k$30.3k
4The Finley HospitalDubuque, IA$12.6k$11.9k$2.0k—$7.7k$29.7k
5Northwest Iowa Hospital CorporationSioux City, IA$13.0k$13.0k$188—$12.8k$34.3k
6Medical Ctiy ArgyleArgyle, TX$10.8k$12.2k$9.1k—$948$39.4k
7Medical City AllianceSAGINAW, TX$17.2k$13.1k$7.0k—$2.1k$35.5k
8St Luke's Methodist HospitalCedar Rapids, IA$12.3k$12.3k$179—$12.2k$32.0k
9Trinity Medical CenterRock Island, IL$13.7k$11.8k$5.4k—$2.2k$36.5k
10Trinity Medical CenterBettendorf, IA$12.5k$13.2k$2.4k—$12.1k$33.0k
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