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  5. /Case rate
CPT 99345

HOME/RES VST NEW HIGH MDM 75

Reported by 35 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

$377

Median

$194

High

$4.7k

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.
1The Finley HospitalDubuque, IA$764$764——$764$764
2Trinity Medical CenterRock Island, IL$764$764——$764$764
3Unity HealthcareMuscatine, IA$764$764——$764$764
4Meriter Hospital, IncMadison, WI$459$437$58—$68$700
5Florida Coast Medical and Surgical Center, Inc.Port St. Lucie, FL$0$0$0—$0$734
6IOM Health System LPFort Wayne, IN$201$201——$105$402
7Dukes Health System LLCPeru, IN$201$201——$79$447
8Warsaw Health System LLCWarsaw, IN$201$201——$87$420
9Lutheran Musculoskeletal Center LLCFort Wayne, IN$206$206——$102$447
10Sanford Fargo Medical CenterFargo, ND$194$193$5—$179$359
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