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ExamplesConnectHospitalsCodesRequest dataGet access
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  5. /Case rate
HCPCS 12047

LAC REP INT FEET HAN >30 450

Reported by 22 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

$1.5k

Average

$3.5k

Median

$3.1k

High

$8.9k

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.
1McAllen Hospitals, LPMcAllen, TX$783$1.8k$1.3k———
2McAllen Hospitals, LPEdinburg, TX$783$1.8k$1.3k———
3McAllen Hospitals, LPMcAllen, TX$783$1.8k$1.3k———
4McAllen Hospitals, LPEdinburg, TX$783$1.8k$1.3k———
5Northwest Texas Healthcare System, Inc.Amarillo, TX$1.0k$1.5k$1.1k———
6Wellington Regional Medical CenterWellington, FL$7.9k$6.2k$3.2k———
7Palmdale Regional Medical CenterPalmdale, CA$3.0k$3.5k$1.1k———
8Temecula Valley HospitalTemecula, CA$5.3k$5.4k$2.9k———
9Southwest HealthcareTemecula, CA$2.0k$3.4k$3.4k———
10Northwest Texas Healthcare SystemAmarillo, TX$1.0k$1.5k$1.1k———
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