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HCPCS D5876

ADD METAL SUB TO ACRYLC DENT

Reported by 18 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

$60

Average

$192

Median

$116

High

$579

Hospitals reporting this code

#HospitalLocation
1Santa Rosa Hospital - Westover HillsSan Antonio, TX$60$60$60$60—
2Santa Rosa Hospital - Alamo HeightsSan Antonio, TX$60$60$60$60—
3Santa Rosa Emergency Center - AlonSan Antonio, TX$60$60$60$60—
4St. Michael Hospital - AtlantaAtlanta, TX$403$403$403$403—
5St. Michael Rehabilitation HospitalTexarkana, TX$403$403$403$403—
6East Cooper Medical Center LLCMt Pleasant, SC$84$84$84$84—
7South Carolina Coastal Medical Center LLCHardeeville, SC$84$84$84$84—
8CHRISTUS Health - Pine StreetTexarkana, TX$403$403$403$403—
9St. Michael Health System - TexarkanaTexarkana, TX$403$403$403$403—
10Hilton Head Medical Center LLCHilton Head Island, SC$84$84$84$84—
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