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  5. /Case rate
CPT 93621

COMP EP EVL L PAC&REC C SINS

Reported by 398 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

$1

Average

$13.9k

Median

$13.6k

High

$53.2k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$232$232$232$232—
2Medical Ctiy ArgyleArgyle, TX$268$26.8k$26.4k$43.9k$11.0k
3Medical City AllianceSAGINAW, TX$268$26.8k$26.5k$43.9k$10.8k
4Trinity Medical CenterRock Island, IL$1.6k$21.9k$21.2k$21.9k$1.1k
5Unity HealthcareMuscatine, IA$2.1k$20.8k$20.8k$21.9k$1.1k
6Meriter Hospital, IncMadison, WI$70$789$8.1k$39.3k$13.9k
7University of Iowa Health Care Medical CenterIowa City, IA$18.5k$22.0k$22.8k$27.8k$3.2k
8Medical City MckinneyMcKinney, TX$268$27.8k$26.5k$43.9k$11.0k
9Medical City Las ColinasIrving, TX$268$26.8k$26.5k$43.9k$10.8k
10Med City Heart HospitalDallas, TX$268$25.3k$25.5k$43.9k$11.7k
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