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CPT 64628

HC TRML DSTRJ IOS BVN 1ST 2 L/S

Reported by 106 hospitals in the network under the percent of billed charges 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 percentage of total billed charges.

National pricing summary

Based on 2,436–2,688 billing samples across every hospital reporting.

Low

$1

Average

$16.1k

Median

$15.3k

High

$72.4k

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$38.6k$35.8k$21.3k1,216–1,378$7.2k$38.6k
2Northwestern Medicine Central DuPage HospitalWinfield, IL$29.5k$35.6k$24.9k660$2.7k$38.6k
3Northern Illinois Medical Center DBA Northwestern Medicine McHenry HospitalMcHenry, IL$24.8k$28.4k$15.6k550$7.1k$38.6k
4Catholic Health Initiatives ColoradoWest Jordan, UT$10.4k$11.0k$3.1k2–20$330$16.9k
5Massachusetts General HospitalBoston, MA$1.6k$1.6k$2682–20$1.1k$19.1k
6Granbury Hospital CorporationGranbury, TX$68.6k$72.4k$29.6k1–10$390$116.5k
7Catholic Health Initiatives ColoradoLayton, UT$10.0k$10.8k$2.9k1–10$330$16.9k
8St Joseph Mercy OaklandPontiac, MI$17.8k$15.1k$4.7k1–10$888$29.5k
9Medical Park Hospital LLCWinston-Salem, NC$642$642—1–10$12.5k$24.9k
10Brigham and Women's HospitalBoston, MA$1.4k$1.4k—1–10$1.1k$19.1k
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