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  5. /Percent of billed charges

NDC 70092113544

Lidocaine-Epinephrine-Tetracaine Gel 4-0.05-0.5%,Lidocaine HCl-Racepinephrine-Tetracaine HCl Gel 4-0.05-0.5%

Reported by 66 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 5,662–6,436 billing samples across every hospital reporting.

Low

$5

Average

$42

Median

$35

High

$84

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.
1The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$32$33$17928–982$7$61
2The Charlotte Mecklenburg Hospital AuthorityMonroe, NC$31$34$17793–847$9$63
3Carolinas Medical CenterCharlotte, NC$35$37$14654–735$14$59
4The Charlotte Mecklenburg Hospital AuthorityConcord, NC$33$35$17597–651$8$63
5North Carolina Baptist HospitalWinston Salem, NC$37$49$25567–612$21$101
6North Carolina Baptist HospitalBermuda Run, NC$37$49$25567–612$21$101
7The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$33$34$17408–462$7$64
8High Point Regional HealthHigh Point, NC$46$50$27299–326$16$107
9Atrium Health Hospitals IncShelby, NC$35$36$17282–336$9$63
10Carolinas Medical CenterCharlotte, NC$33$35$15229–265$14$61
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