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HCPCS M0221

Non-Surgical Cases

Reported by 10 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

$60

Average

$266

Median

$60

High

$744

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$457$744$744$744—
2Trinity Medical CenterRock Island, IL$364$744$744$744—
3Unity HealthcareMuscatine, IA$744$744$744$744—
4Catholic Health Initiatives ColoradoColorado Springs, CO$47$60$60$316$9
5Catholic Health Initiatives ColoradoColorado Springs, CO$47$60$60$316$9
6St Francis HospitalColorado Springs, CO$47$60$60$306$9
7Longmont United HospitalLongmont, CO$47$60$60$324$9
8Catholic Health Initiatives ColoradoPueblo, CO$57$63$64$316$7
9Catholic Health Initiatives ColoradoLakewood, CO$47$60$60$316$9
10Catholic Health Iniatives ColoradoWestminster, CO$47$60$60$316$9

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