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  4. /0875T
HCPCS 0875T

PRGRM SUBQ PRTL ASCT PMP SYS

Reported by 98 hospitals in the network.

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.

National pricing summary

Low

$27

Average

$428

Median

$68

High

$7.7k

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.
1Gundersen Luthern Medical Center IncLa Crosse, WI$40$40——$40$40
2Ascension SetonLuling, TX$123$119$30—$62$150
3Ascension SetonAustin, TX$123$119$30—$62$150
4Ascension SetonBurnet, TX$123$119$30—$62$150
5Ascension SetonAustin, TX$123$119$30—$62$150
6Ascension SetonSmithville, TX$123$119$30—$62$150
7Ascension SetonAustin, TX$123$119$30—$62$150
8Ascension SetonAustin, TX$123$119$30—$62$150
9Ascension Cedar ParkPark, TX$123$119$30—$62$150
10Ascension SetonKyle, TX$123$119$30—$62$150
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