▸ Payer

direct care america

Negotiated rates published by hospitals for direct care america across 1 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

194

States

Rate rows

1,821

Median neg. rate

$80

Top procedures for direct care america

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
Knee arthroscopy with meniscectomy	CPT	29881	8	$80
Shoulder arthroscopy with decompression	CPT	29826	8	$80
Total hip replacement	CPT	27130	8	$80
Total knee replacement	CPT	27447	8	$80
CABG single arterial graft	CPT	33533	8	$80
CABG 2 arterial grafts	CPT	33534	8	$80
Total shoulder arthroplasty	CPT	23472	8	$80
Hip hemiarthroplasty	CPT	27125	8	$80
Knee revision arthroplasty single component	CPT	27486	8	$80
Knee revision arthroplasty all components	CPT	27487	8	$80
Shoulder arthroscopy with rotator cuff repair	CPT	29827	8	$80
ACL reconstruction	CPT	29888	8	$80
Heart failure & shock w MCC	MS-DRG	291	8	$80
Heart failure & shock w CC	MS-DRG	292	8	$80
Heart failure & shock w/o CC/MCC	MS-DRG	293	8	$80
Cardiac arrhythmia w MCC	MS-DRG	308	8	$80
Cardiac arrhythmia w CC	MS-DRG	309	8	$80
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	8	$80
AMI discharged alive w MCC	MS-DRG	280	8	$80
AMI discharged alive w CC	MS-DRG	281	8	$80
AMI discharged alive w/o CC/MCC	MS-DRG	282	8	$80
Simple pneumonia & pleurisy w CC	MS-DRG	194	8	$80
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	8	$80
Respiratory infections & inflammations w MCC	MS-DRG	177	8	$80
COPD w MCC	MS-DRG	190	8	$80
COPD w CC	MS-DRG	191	8	$80
COPD w/o CC/MCC	MS-DRG	192	8	$80
Major small/large bowel procedures w MCC	MS-DRG	329	8	$80
Major small/large bowel procedures w CC	MS-DRG	330	8	$80
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	8	$80

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Claiborne Medical Center	—	—	$80
Morristown-Hamblen Hospital	Morristown	TN	$425.41
Cumberland Medical Center, Inc.	—	—	$425.41
LeConte Medical Center	—	—	$425.41
Fort Loudoun Medical Center	Lenoir City	TN	$425.41
Methodist Medical Center of Oak Ridge	—	—	$425.41
Roane County Medical Center	Harriman	TN	$425.41
Parkwest Medical Center	—	—	$445.61

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States with hospitals publishing rates for direct care america.

State	Hospitals	Avg rate
TN	3	$425.41

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