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HCPCS Q4176

99999-1024-57 - Dehydrated Human Placental Membran

Reported by 12 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

$144

Average

$172

Median

$160

High

$222

Hospitals reporting this code

#HospitalLocation
1Porter Hospital LLCValparaiso, IN$117$211$215$537$54
2West Virginia University Hospitals, Inc.Morgantown, WV$82$133$151$335$47
3Camden-Clark Memorial Hospital CorporationParkersburg, WV$127$133$151$221$30
4Wheeling Hospital, Inc.Wheeling, WV$82$133$168$536$107
5Reynolds Memorial Hospital, Inc.Glen Dale, WV$82$133$144$287$30
6Herbert J Thomas Memorial Hospital AssociationSouth Charleston, WV$127$134$222$640$180
7Uniontown HospitalUniontown, PA$127$134$166$295$53
8City Hospital, Inc.Martinsburg, WV$127$134$151$287$31
9Princeton Community Hospital Assn Inc.Princeton, WV$127$134$215$737$193
10Wetzel County Hospital, Inc.New Martinsville, WV$127$133$144$287$26
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