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NDC 46783022152

polidocanol 20 mg/2 mL Injection

Reported by 4 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

$85

Average

$88

Median

$85

High

$96

Hospitals reporting this code

#HospitalLocation
1Northwest Sahurita Hospital LLCAZ 85748, AZ$15$77$85$104$14
2Northwest Sahurita Hospital LLCAZ 85629, AZ$15$77$85$104$14
3Northwest Hospital LLCAZ 85741, AZ$16$77$85$104$14
4Bullhead City Hospital CorporationAZ 86442, AZ$53$96$96$397$22

Look up this code directly

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