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  5. /Case rate
HCPCS V5264

Ear mold/insert

Reported by 8 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

$74

Average

$5.5k

Median

$564

High

$19.7k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$564$564$564$564—
2Trinity Medical CenterRock Island, IL$564$564$564$564—
3Unity HealthcareMuscatine, IA$564$564$564$564—
4Glendale Adventist Medical CenterGlendale, CA$36$174$168$459$8
5White Memorial Medical CenterAngeles, CA$36$77$74$599$4
6Geisinger Wyoming ValleyWilkes-Barre, PA$72$19.7k$19.7k$23.2k$3.5k
7Geisinger Lewistown HospitalLewistown, PA$66$16.7k$17.5k$24.4k$4.3k
8Barnesville Hospital Association, Inc.Barnesville, OH$4.7k$4.7k$4.7k$4.7k—

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