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HCPCS D5612

Rep resin part dent base max

Reported by 26 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

$53

Average

$215

Median

$156

High

$734

Hospitals reporting this code

#HospitalLocation
1The Mount Sinai HospitalNew York, NY$67$67$67$67—
2Ukiah Adventist HospitalUkiah, CA$183$381$385$505$105
3Adventist Health Medical Center TehachapiTehachapi, CA$202$481$459$685$125
4Sonora Community HospitalSonora, CA$152$274$360$716$215
5Reedley Community HospitalReedley, CA$200$481$480$676$106
6Adventist Health Mendocino CoastBragg, CA$182$481$734$1.4k$508
7Lodi Memorial Hospital Association IncLodi, CA$125$155$289$687$183
8Willits Hospital IncWillits, CA$250$405$424$481$33
9Santa Rosa Hospital - Westover HillsSan Antonio, TX$53$53$53$53—
10Santa Rosa Hospital - Alamo HeightsSan Antonio, TX$53$53$53$53—
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