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CPT 99211

OFF/OP EST MAY X REQ PHY/QHP

Reported by 133 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

$2.8k

Median

$104

High

$21.7k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$29$29$29$29—
2Trinity Medical CenterRock Island, IL$29$29$29$29—
3Unity HealthcareMuscatine, IA$29$29$29$29—
4Meriter Hospital, IncMadison, WI$8$20$19$188$3
5Hca Florida Twin Cities HospitalNICEVILLE, FL$25$15k$15k$15k—
6Hca Florida Lake Monroe HospitalSANFORD, FL$18$15k$15k$15k—
7Hca Florida Ocala HospitalSUMMERFIELD, FL$9$15k$15k$15k—
8Hca Florida West Marion HospitalOCALA, FL$25$15k$15k$15k—
9Hca Florida Orange Park HospitalMIDDLEBURG, FL$19$15k$15k$15k—
10Hca Florida Gulf Coast HospitalPANAMA CITY, FL$24$15k$15k$15k—
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