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  5. /Case rate
HCPCS V2020

Vision svcs frames purchases

Reported by 38 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

$82

Average

$114

Median

$103

High

$183

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1The Finley HospitalDubuque, IA$83$171$163—$79$475
2Northwest Iowa Hospital CorporationSioux City, IA$82$82$1—$81$151
3St Luke's Methodist HospitalCedar Rapids, IA$82$82$1—$81$151
4Trinity Medical CenterRock Island, IL$95$178$156—$85$475
5Trinity Medical CenterBettendorf, IA$83$88$16—$81$151
6Unity HealthcareMuscatine, IA$105$183$147—$100$475
7Trinity Regional Medical CenterFort Dodge, IA$104$104$2—$102$152
8Meriter Hospital, IncMadison, WI$90$90——$90$90
9Central Iowa Hospital CorporationDes Moines, IA$82$82$1—$81$151
10Central Iowa Hospital CorporationDes Moines, IA$82$82$1—$81$159
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