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  4. /SUP91057
  5. /Percent of billed charges

LOCAL SUP91057

SPHINCTEROTOME JAGTOME RX W/GW

Reported by 4 hospitals in the network under the percent of billed charges 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 percentage of total billed charges.

National pricing summary

Based on 170–233 billing samples across every hospital reporting.

Low

$728

Average

$744

Median

$740

High

$767

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.
1Vanderbilt University Medical CenterNashville, TN$761$767$240168–213$525$1.4k
2Vanderbilt Wilson County HospitalLebanon, TN$598$744$2241–10$525$1.4k
3Vanderbilt Tullahoma-Harton HospitalTullahoma, TN$598$737$2351–10$362$1.4k
4Vanderbilt Bedford HospitalShelbyville, TN$598$728$230—$362$1.4k

Look up this code directly

Ask Claude or any MCP client for LOCAL SUP91057 pricing at a specific hospital — see how to connect.

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