☀️medprice.ai
ExamplesConnectHospitalsCodesRequest dataGet access
☀️medprice.ai— democratizing access to medical markets
ConnectHospitalsMCP ServerTermsPrivacyContact

© 2026 Medprice AI LLC

☀️medprice.ai
ExamplesConnectHospitalsCodesRequest dataGet access
  1. Home
  2. /Codes
  3. /EAPG
  4. /00421
  5. /Case rate

EAPG 00421

TUBE REPLACEMENT, REVISION OR REMOVAL

Reported by 2 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

$390

Average

$491

Median

$491

High

$592

Hospitals reporting this code

#HospitalLocation
1UPMC HamotErie, PA$323$727$592$727$190
2UPMC ChautauquaJamestown, NY$323$323$390$727$133

Look up this code directly

Ask Claude or any MCP client for EAPG 00421 pricing at a specific hospital — see how to connect.

☀️medprice.ai— democratizing access to medical markets
ConnectHospitalsMCP ServerTermsPrivacyContact

© 2026 Medprice AI LLC