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  5. /Case rate
CPT D0385

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Reported by 26 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

$75

Average

$120

Median

$108

High

$209

Hospitals reporting this code

#HospitalLocation
1Virginia Mason Medical CenterSeattle, WA$81$119$209$392$122
2IHC Health Services Inc., DBA Intermountain Health Intermountain Medical CenterMurray, UT$102$106$106$118$4
3IHC Health Services Inc., DBA Intermountain Health Utah Valley HospitalProvo, UT$87$105$105$122$10
4IHC Health Services Inc., DBA Intermountain Health McKay-Dee HospitalOgden, UT$87$105$107$120$8
5IHC Health Services Inc., DBA Intermountain Health St George Regional HospitalSt. George, UT$100$106$108$116$5
6IHC Health Services Inc., DBA Intermountain Health LDS HospitalSalt Lake City, UT$100$105$109$122$6
7Scl Health - Montana, Dba Intermountain Health St. Vincent HealthcareBillings, MT$106$202$191$292$67
8Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph HospitalDENVER, CO$106$106$170$278$83
9IHC Health Services Inc., DBA Intermountain Health Logan Regional HospitalLogan, UT$87$105$105$116$8
10St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional HospitalJUNCTION, CO$107$107$108$110$1
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