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HIPPS BALC1

Major Joint Replacement or Spinal Surgery, 6-9; SA None, Neither; CDE2 Conditions requiring complex medical care e.g. pneumonia, surgical wounds, burns, Yes, 0-5; NC 6-8; PPS 5-day Assessment

Reported by 2 hospitals in the network.

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.

National pricing summary

Low

$933

Average

$933

Median

$933

High

$933

Hospitals reporting this code

#HospitalLocation
1HCA Houston Rehabilitation Hospital SoutheastPasadena, TX$751$942$933$1.2k$171
2Hca Houston Healthcare SoutheastPASADENA, TX$751$942$933$1.2k$171

Look up this code directly

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