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HCPCS C9043

Injection, levoleucovorin

Reported by 40 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

$4

Average

$64

Median

$8

High

$320

Hospitals reporting this code

#HospitalLocation
1The Mount Sinai HospitalNew York, NY$4$4$4$4—
2St Joseph’s Health Services IncHillsboro, WI$54$311$283$342$87
3Gundersen Luthern Medical Center IncLa Crosse, WI$52$54$54$54$1
4Gundersen Palmer Lutheran Hospital and Clinic IncWest Union, IA$54$165$172$303$118
5Moundview Memorial Hospital and Clinics, Inc.Friendship, WI$54$342$301$342$101
6Memorial Hospital of BoscobelBoscobel, WI$54$266$240$266$70
7Tri-County Memorial Hospital IncWhitehall, WI$54$267$237$267$74
8Sanford Fargo Medical CenterFargo, ND$4$4$4$4—
9Sanford Medical Center BismarckBismarck, ND$4$4$4$4—
10Sanford USD Medical CenterSioux Falls, SD$4$4$4$4—
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