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  5. /Percent of billed charges
CPT 99251

PRO-IP CONSULT LV 1

Reported by 14 hospitals in the network under the percent of billed charges 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 percentage of total billed charges.

National pricing summary

Low

$77

Average

$97

Median

$85

High

$168

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.
1Lafayette Regional Health CenterLexington, MO$145$162$70—$57$305
2IOM Health System LPFort Wayne, IN$70$78$30—$33$164
3Bluffton Health System LLCBluffton, IN$92$92$32—$32$148
4Dukes Health System LLCPeru, IN$84$87$27—$25$262
5Warsaw Health System LLCWarsaw, IN$87$87$31—$28$164
6Lutheran Musculoskeletal Center LLCFort Wayne, IN$72$77$28—$32$164
7St. Joseph Health System, LLCWayne, IN$90$92$35—$32$164
8Dupont Hospital LLCWayne, IN$74$82$31—$33$148
9La Porte Hospital Company LLCLa Porte, IN$105$98$24—$31$129
10Vanderbilt Wilson County HospitalLebanon, TN$78$83$17—$31$125
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