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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 1 hospital in the network under the fee schedule 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 negotiated fee schedule rates with commercial payers.

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

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