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EAPG 00713

DIABETES WITHOUT COMPLICATIONS

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

$42

Average

$95.6k

Median

$128

High

$334.3k

Hospitals reporting this code

#HospitalLocation
1University of Iowa Health Care Medical Center DowntownIowa City, IA$302.5k$334.3k$334.3k$366.1k$31.8k
2University of Iowa Health Care Medical CenterIowa City, IA$302.5k$334.3k$334.3k$366.1k$31.8k
3UPMC Horizon - GreenvilleGreenville, PA$40$42$42$44$2
4UPMC HamotErie, PA$44$173$157$239$85
5UPMC Childrens Hospital of PittsburghPittsburgh, PA$44$44$44$44—
6UPMC ChautauquaJamestown, NY$106$106$128$239$44
7UPMC JamesonNew Castle, PA$44$44$44$44—

Look up this code directly

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