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  5. /Case rate
HCPCS V2209

Lens sphcy bifocal 4.25-7/4.

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

$83

Average

$109

Median

$106

High

$163

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$91$151$111—$87$358
2Northwest Iowa Hospital CorporationSioux City, IA$90$90$1—$88$156
3St Luke's Methodist HospitalCedar Rapids, IA$90$90$1—$88$160
4Trinity Medical CenterRock Island, IL$89$148$111—$79$358
5Trinity Medical CenterBettendorf, IA$91$97$17—$88$156
6Unity HealthcareMuscatine, IA$109$163$99—$103$358
7Trinity Regional Medical CenterFort Dodge, IA$107$107$2—$105$166
8Meriter Hospital, IncMadison, WI$85$85——$85$85
9Central Iowa Hospital CorporationDes Moines, IA$90$90$1—$88$156
10Central Iowa Hospital CorporationDes Moines, IA$90$90$1—$88$173
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