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CPT 875T

Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional

Reported by 35 hospitals in the network under the fee schedule 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 negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$0

Average

$126

Median

$144

High

$228

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.
1VHS Harper-Hutzel Hospital IncDetroit, MI$1$1——$1$16
2VHS Huron Valley-Sinai Hospital IncCommerce Charter Twp, MI$1$1——$1$16
3Santa Rosa Hospital - Westover HillsSan Antonio, TX$109$111$14—$88$128
4Southeast Texas Orthopedic Specialty CenterPort Arthur, TX$146$152$15—$131$173
5Christus Health Southeast TexasPort Arthur, TX$146$152$15—$131$173
6Christus Health Southeast TexasBeaumont, TX$146$152$15—$131$173
7CHRISTUS Hospital - OrangeOrange, TX$146$152$15—$131$173
8CHRISTUS West BeaumontBeaumont, TX$146$152$15—$131$173
9Santa Rosa Hospital - Alamo HeightsSan Antonio, TX$109$111$13—$89$128
10Santa Rosa Emergency Center - AlonSan Antonio, TX$109$111$14—$88$128
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