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NDC 25682-0028-01

RAVU-CWVZ1.1G/11MLSDVJWTB

Reported by 24 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

$234

Average

$3.5k

Median

$327

High

$19.8k

Hospitals reporting this code

#HospitalLocation
1Dignity HealthSanta Cruz, CA$220$309$309$59.9k—
2Dignity HealthCarmichael, CA$220$296$345$93.6k$70
3Dignity HealthPhoenix, AZ$182$234$234$89.0k—
4Alegent Creighton HealthOmaha, NE$188$222$250$101.8k$79
5Alegent Creighton HealthPapillion, NE$188$222$250$101.8k$79
6Alegent Health Bergan Mercy Health SystemOmaha, NE$219$222$248$101.8k$74
7Alegent Health Immanuel Medical CenterOmaha, NE$188$222$250$101.8k$79
8Alegent Health Bergan Mercy Health SystemCouncil Bluffs, IA$188$222$250$101.8k$79
9Alegent Health Bergan Mercy Health SystemOmaha, NE$188$222$248$101.8k$74
10Franciscan Health SystemTacoma, WA$221$263$348$359.6k$220
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