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  4. /0409T
  5. /Case rate
HCPCS 0409T

HC INS/RPLC CCM; GEN ONLY

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

$5.1k

Average

$21.1k

Median

$17.3k

High

$68.2k

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1UPMC LititzLititz, PA$17.3k$17.3k——$11.5k$73.2k
2UPMC MemorialYork, PA$9.4k$11.4k$3.4k—$9.4k$75.9k
3UPMC HanoverHanover, PA$17.3k$17.3k——$16.4k$76.3k
4UPMC CarlisleCarlisle, PA$17.3k$17.3k——$11.8k$73.2k
5UPMC Pinnacle HospitalsHarrisburg, PA$11.3k$10.8k$5.0k—$5.2k$73.2k
6Saint Joseph Hospital - ElginElgin, IL$5.1k$5.1k——$5.1k$52.4k
7University Of Miami Hosp & ClinicsMiami, FL$68.2k$68.2k$4.1k—$19.6k$72.3k

Look up this code directly

Ask Claude or any MCP client for HCPCS 0409T pricing at a specific hospital — see how to connect.

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