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  4. /0875T
  5. /Fee schedule
HCPCS 0875T

Prgrm subq prtl asct pmp sys

Reported by 60 hospitals in the network under the fee schedule 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 negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$29

Average

$584

Median

$75

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.
1Crawford Long HospitalAtlanta, GA$39$45$15—$38$80
2Dekalb Medical Center, IncDecatur, GA$39$44$14—$37$79
3Emory UniversityAtlanta, GA$39$44$14—$37$79
4Logan Health Medical CenterKalispell, MT$40$62$32—$38$107
5Billings ClinicBillings, MT$74$68$22—$32$92
6Providence Health System - Southern CaliforniaBurbank, CA$76$292$351—$48$965
7Providence Health System - Southern CaliforniaMission Hills, CA$76$298$361—$48$993
8Providence Health System - Southern CaliforniaTorrance, CA$57$96$93—$48$353
9Swedish Health ServicesSeattle, WA$67$83$43—$43$183
10Providence Health System - Southern CaliforniaSanta Monica, CA$76$388$514—$48$1.3k
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