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  5. /Case rate
CPT C9605

PTCA WITH DRUG ELUTING STENT

Reported by 71 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

$20.4k

Median

$16.1k

High

$88.3k

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.
1Agh Laveen LlcPhoenix, AZ$94.4k$88.3k$9.7k—$74.6k$96.0k
2Agh Mesa LlcMesa, AZ$94.4k$88.3k$9.7k—$74.6k$96.0k
3Virginia Mason Medical CenterSeattle, WA$18.7k$18.7k——$18.7k$18.7k
4Saint Alphonsus Regional Medical Center - BoiseBoise, ID$45k$45k——$5.4k$45k
5Saint Francis Hospital and Medical CenterHartford, CT$31.3k$31.3k——$11.8k$31.3k
6Saint Alphonsus Medical Center - NampaNampa, ID$30k$30k——$4.7k$30k
7Holy Cross Hospital-Ft. LauderdaleFt. Lauderdale, FL$54.5k$51.6k$8.8k—$1.5k$54.5k
8St Mary Medical CenterLanghorne, PA$5.7k$4.8k$1.5k—$2.0k$17.0k
9St Peters HospitalAlbany, NY$29.7k$29.0k$1.4k—$2.1k$29.7k
10Samaritan HospitalTroy, NY$29.7k$29.0k$1.4k—$5.3k$29.7k
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