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NDC 70092113544

LIDOCAINE 4 %-RACEPINEPHRINE 0.05 %-TETRACAINE 0.5 % TOPICAL GEL

Reported by 11 hospitals in the network under the other 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 payer-specific billing methodology not covered by the standard categories.

National pricing summary

Based on 341–431 billing samples across every hospital reporting.

Low

$19

Average

$33

Median

$27

High

$64

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.
1Carolinas Medical CenterCharlotte, NC$17$20$467–112$14$61
2The Charlotte Mecklenburg Hospital AuthorityMonroe, NC$39$39—71$9$63
3Carolinas Medical CenterCharlotte, NC$27$27—61$14$59
4Atrium Health Hospitals IncShelby, NC$36$36—52$9$63
5The Charlotte Mecklenburg Hospital AuthorityConcord, NC$26$26—48$8$63
6The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$23$23—37$7$64
7North Carolina Baptist HospitalWinston Salem, NC$19$19—1–10$19$101
8North Carolina Baptist HospitalBermuda Run, NC$19$19—1–10$19$101
9The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$54$54—1–10$7$61
10Floyd Healthcare Management IncRome, GA$38$38—1–10$19$98
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Look up this code directly

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