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EAPG 25

LEVEL I SHOULDER AND UPPER ARM PROCEDURES

Reported by 29 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

$3.4k

Average

$7.7k

Median

$9.0k

High

$11.1k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$8.7k$8.7k$9.0k$9.6k$415
2Northwest Iowa Hospital CorporationSioux City, IA$8.7k$8.7k$9.0k$9.6k$415
3St Luke'sJones Regional Medical CenterAnamosa, IA$10.2k$10.2k$10.6k$11.3k$491
4St Luke's Methodist HospitalCedar Rapids, IA$8.7k$8.7k$9.0k$9.6k$415
5Trinity Medical CenterRock Island, IL$8.4k$11.4k$11.1k$11.4k$943
6Trinity Medical CenterBettendorf, IA$8.7k$8.7k$9.0k$9.6k$415
7Unity HealthcareMuscatine, IA$10.2k$10.2k$10.6k$11.3k$491
8Trinity Regional Medical CenterFort Dodge, IA$10.2k$10.2k$10.6k$11.3k$491
9Central Iowa Hospital CorporationDes Moines, IA$8.7k$8.7k$9.0k$9.6k$415
10Central Iowa Hospital CorporationDes Moines, IA$8.7k$8.7k$9.0k$9.6k$415
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