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HCPCS MISCM

24208-0911-12 - lifitegrast ophthalmic 5% Soln

Reported by 5 hospitals in the network under the other 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 payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$10

Average

$59

Median

$54

High

$145

Hospitals reporting this code

#HospitalLocation
1Bluffton Health System LLCBluffton, IN$30$32$32$112—
2Dukes Health System LLCPeru, IN$0$1$10$160$20
3St. Joseph Health System, LLCWayne, IN$0$4$54$178$79
4HMA Santa Rosa Medical Center LLCMilton, FL$7$38$145$891$282
5Poplar Bluff Regional Medical Center LLCPoplar Bluff, MO$17$55$55$76—

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