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EAPG 00419

ANCILLARY OPHTHALMOLOGY OR OPTOMETRY SERVICES

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

$31

Average

$24.8k

Median

$99

High

$86.7k

Hospitals reporting this code

#HospitalLocation
1University of Iowa Health Care Medical Center DowntownIowa City, IA$78.4k$86.7k$86.7k$94.9k$8.2k
2University of Iowa Health Care Medical CenterIowa City, IA$78.4k$86.7k$86.7k$94.9k$8.2k
3UPMC Horizon - GreenvilleGreenville, PA$30$31$31$33$1
4UPMC HamotErie, PA$33$133$120$184$66
5UPMC Childrens Hospital of PittsburghPittsburgh, PA$33$33$33$33—
6UPMC ChautauquaJamestown, NY$82$82$99$184$34
7UPMC JamesonNew Castle, PA$33$33$33$33—

Look up this code directly

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