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HCPCS S9986

S9986 NOT MEDICALLY NECESSARY SVC

Reported by 8 hospitals in the network under the percent of billed charges 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 percentage of total billed charges.

National pricing summary

Low

$203

Average

$251

Median

$228

High

$451

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$95$185$208$385$78
2Bluffton Health System LLCBluffton, IN$92$244$237$347$80
3Dukes Health System LLCPeru, IN$76$213$229$616$69
4Warsaw Health System LLCWarsaw, IN$81$227$227$385$78
5Lutheran Musculoskeletal Center LLCFort Wayne, IN$92$187$203$385$73
6St. Joseph Health System, LLCIN 46802, IN$92$231$238$385$88
7Dupont Hospital LLCIN 46825, IN$93$204$216$347$80
8Memorial Hospital of Laramie CountyCheyenne, WY$443$443$451$483$15

Look up this code directly

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