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  5. /Case rate
CPT 97169

ATHLETIC TRN EVAL LOW CMPLX

Reported by 7 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

$79

Median

$79

High

$312

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.
1Florida Coast Medical and Surgical Center, Inc.Port St. Lucie, FL$0$0$0—$0$192
2Novant Health New Hanover Regional Medical Center LLCWilmington, NC$312$312——$312$312
3Santa Rosa Emergency Center - CreeksideNew Braunfels, TX$79$79——$79$641
4Santa Rosa Hospital - New BraunfelsNew Braunfels, TX$79$79——$79$641
5Santa Rosa Hospital - San MarcosSan Marcos, TX$79$79——$73$411
6Arthur G James Cancer Hospital And Research InstituteColumbus, OH$1$1——$1$208
7Ohio State University HospitalsColumbus, OH$1$1——$1$218

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