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HCPCS P9604

HC ONE-WAY ALLOW PRORATED TRIP

Reported by 9 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

$2

Average

$22

Median

$21

High

$61

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$9$24$24$24—
2Trinity Medical CenterRock Island, IL$9$24$24$24—
3Unity HealthcareMuscatine, IA$8$24$24$24—
4Ukiah Adventist HospitalUkiah, CA$8$13$12$34$2
5White Memorial Medical CenterAngeles, CA$1$2$2$15$0
6St Helena HospitalHelena, CA$38$63$61$722$3
7Willits Hospital IncWillits, CA$4$22$20$34$4
8Mercy Health Hackley CampusMuskogen, MI$0$11$11$11$0
9St Peters HospitalAlbany, NY$1$25$21$44$6

Look up this code directly

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