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EAPG 00255

LEVEL IV EAR, NOSE, MOUTH AND THROAT PROCEDURES

Reported by 7 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

$2.2k

Average

$1378.7k

Median

$3.7k

High

$4817.7k

Hospitals reporting this code

#HospitalLocation
1University of Iowa Health Care Medical Center DowntownIowa City, IA$4359.9k$4817.7k$4817.7k$5275.4k$457.8k
2University of Iowa Health Care Medical CenterIowa City, IA$4359.9k$4817.7k$4817.7k$5275.4k$457.8k
3UPMC Horizon - GreenvilleGreenville, PA$2.1k$2.2k$2.2k$2.3k$84
4UPMC HamotErie, PA$2.3k$5.0k$4.8k$6.9k$2.1k
5UPMC Childrens Hospital of PittsburghPittsburgh, PA$2.3k$2.3k$2.3k$2.3k—
6UPMC ChautauquaJamestown, NY$3.1k$3.1k$3.7k$6.9k$1.3k
7UPMC JamesonNew Castle, PA$2.3k$2.3k$2.3k$2.3k—

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