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EAPG 564

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES

Reported by 30 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

$79

Average

$359

Median

$468

High

$575

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$452$452$468$498$22
2Northwest Iowa Hospital CorporationSioux City, IA$452$452$468$498$22
3St Luke'sJones Regional Medical CenterAnamosa, IA$532$532$550$586$26
4St Luke's Methodist HospitalCedar Rapids, IA$452$452$468$498$22
5Trinity Medical CenterRock Island, IL$436$593$575$593$49
6Trinity Medical CenterBettendorf, IA$452$452$468$498$22
7Unity HealthcareMuscatine, IA$532$532$550$586$26
8Trinity Regional Medical CenterFort Dodge, IA$532$532$550$586$26
9Meriter Hospital, IncMadison, WI$79$79$79$79—
10Central Iowa Hospital CorporationDes Moines, IA$452$452$468$498$22
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