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  5. /Case rate
HCPCS 15110

EPIDM AUTOGRF T/ARMLEG <=100CM

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

$266

Average

$3.4k

Median

$3.3k

High

$6.6k

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.
1The George Washington University HospitalWashington, DC$2.6k$2.9k$2.2k———
2Northwest Texas Healthcare SystemAmarillo, TX$1.2k$1.9k$1.3k———
3Manatee Memorial HospitalBradenton, FL$3.6k$3.6k$1.5k———
4Lakewood RanchLakewood Ranch, FL$3.0k$3.3k$1.2k———
5Adventist Health DelanoDelano, CA$266$266——$266$6.0k
6San Joaquin Community HospitalBakersfield, CA$6.2k$5.1k$2.9k—$279$7.8k
7University Of Miami Hosp & ClinicsMiami, FL$7.0k$6.6k$2.4k—$1.9k$10.0k

Look up this code directly

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