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  5. /Case rate
HCPCS V2205

Lens sphcy bifocal 4.00d/4.2

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

$73

Average

$97

Median

$96

High

$145

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$74$127$99—$70$313
2Northwest Iowa Hospital CorporationSioux City, IA$73$73$1—$72$141
3St Luke's Methodist HospitalCedar Rapids, IA$73$73$1—$72$141
4Trinity Medical CenterRock Island, IL$78$129$97—$69$313
5Trinity Medical CenterBettendorf, IA$74$78$14—$72$141
6Unity HealthcareMuscatine, IA$98$145$86—$94$313
7Trinity Regional Medical CenterFort Dodge, IA$97$97$1—$95$141
8Meriter Hospital, IncMadison, WI$74$74——$74$74
9Central Iowa Hospital CorporationDes Moines, IA$73$73$1—$72$141
10Central Iowa Hospital CorporationDes Moines, IA$73$73$1—$72$141
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