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  5. /Percent of billed charges
CPT 99461

PR INITIAL NORMAL NEWBORN CARE, EXCEPT HOSPITAL OR BIRTH CENTER

Reported by 18 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

$54

Average

$137

Median

$98

High

$272

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$192$192——$56$192
2Northwest Iowa Hospital CorporationSioux City, IA$54$54——$54$141
3IOM Health System LPFort Wayne, IN$75$83$34—$34$199
4Bluffton Health System LLCBluffton, IN$104$104$40—$33$179
5Dukes Health System LLCPeru, IN$86$92$32—$26$318
6Warsaw Health System LLCWarsaw, IN$82$82$28—$29$139
7Lutheran Musculoskeletal Center LLCFort Wayne, IN$67$73$26—$33$139
8St. Joseph Health System, LLCWayne, IN$83$86$32—$33$139
9Dupont Hospital LLCWayne, IN$74$78$29—$34$125
10La Porte Hospital Company LLCLa Porte, IN$152$155$46—$44$221
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