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  5. /Case rate
CPT 80506

HC PATH CLIN CONSLTJ PROLNG SVC

Reported by 44 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

$0

Average

$280

Median

$41

High

$6.9k

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.
1The Finley HospitalDubuque, IA$173$173——$45$173
2Trinity Medical CenterRock Island, IL$173$173——$33$173
3Unity HealthcareMuscatine, IA$173$173——$42$173
4Meriter Hospital, IncMadison, WI$47$46$2—$39$114
5Florida Coast Medical and Surgical Center, Inc.Port St. Lucie, FL$0$0$0—$0$153
6Victoria of Texas LPVictoria, TX$250$250——$16$272
7Victoria of Texas LPVictoria, TX$250$250——$16$272
8Cocke County HMA, LLCNewport, TN$27$27$11—$16$573
9Campbell County HMA, LLCLaFollette, TN$27$28$12—$16$573
10Jefferson County HMA LLCJefferson City, TN$25$25$9—$16$573
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