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CPT 86972

BB Bill RBC Pretreat Grd Sep

Reported by 64 hospitals in the network under the other 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 payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$87

Average

$239

Median

$207

High

$620

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.
1IOM Health System LPFort Wayne, IN$152$194$65—$149$741
2Bluffton Health System LLCBluffton, IN$152$188$61—$152$741
3Dukes Health System LLCPeru, IN$152$142$18—$74$401
4Warsaw Health System LLCWarsaw, IN$152$203$77—$117$741
5Lutheran Musculoskeletal Center LLCFort Wayne, IN$152$203$73—$117$741
6St. Joseph Health System, LLCWayne, IN$152$212$112—$137$741
7Dupont Hospital LLCWayne, IN$152$194$65—$152$741
8Natchez Hospital Company LLCNatchez, MS$152$178$167—$3$647
9Vicksburg Healthcare LLCVicksburg, MS$182$178$102—$3$365
10Northwest Sahurita Hospital LLCTucson, AZ$107$113$52—$2$451
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