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  5. /Case rate
HCPCS Q4113

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Reported by 27 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

$11

Average

$3.3k

Median

$4.7k

High

$15k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$990$2.7k$2.7k$2.7k—
2Trinity Medical CenterRock Island, IL$990$2.7k$2.7k$2.7k—
3Unity HealthcareMuscatine, IA$990$2.7k$2.7k$2.7k—
4Hca Florida Capital HospitalTALLAHASSEE, FL$394$15k$15k$15k—
5Hca Houston Healthcare PearlandPearland, TX$4.7k$4.7k$4.7k$4.7k—
6Hca Houston Healthcare TomballHOUSTON, TX$4.7k$4.7k$4.7k$4.7k—
7Hca Houston MainlandTexas City, TX$4.7k$4.7k$4.7k$4.7k—
8Hca Houston Healthcare NorthwestSPRING, TX$4.7k$4.7k$4.7k$4.7k—
9Hca Houston Healthcare Medical CenterHouston, TX$4.7k$4.7k$4.7k$4.7k—
10HCA Houston Rehabilitation Hospital SoutheastPasadena, TX$4.7k$4.7k$4.7k$4.7k—
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