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EAPG 00439

CLASS V PHARMACOTHERAPY

Reported by 5 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

$469

Average

$542

Median

$487

High

$732

Hospitals reporting this code

#HospitalLocation
1UPMC Horizon - GreenvilleGreenville, PA$451$469$469$487$18
2UPMC HamotErie, PA$444$743$732$998$267
3UPMC Childrens Hospital of PittsburghPittsburgh, PA$487$487$487$487—
4UPMC ChautauquaJamestown, NY$444$444$535$998$182
5UPMC JamesonNew Castle, PA$487$487$487$487—

Look up this code directly

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