Hospital Costs > In Virginia > Augusta Health, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Acute Myocardial Infarction, Discharged Alive W Cc | 40 | 51 / 8 | $20.335,20 | 295 / 15 | $6.583,12 | 577 / 20 | $5.615,52 | 576 / 31 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 66 | 59 / 6 | $28.038,60 | 368 / 22 | $11.812,70 | 951 / 47 | $10.146,20 | 949 / 46 |
Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 18 | 35 / 7 | $24.661,60 | 439 / 11 | $4.736,33 | 232 / 5 | $3.652,33 | 231 / 10 |
Acute Myocardial Infarction, Expired W Mcc | 14 | 16 / 6 | $20.286,00 | 13 / 2 | $10.523,90 | 55 / 2 | $9.711,29 | 55 / 3 |
Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 13 | 111 / 13 | $10.530,20 | 146 / 3 | $4.345,85 | 98 / 3 | $3.196,77 | 98 / 5 |
Amputat Of Lower Limb For Endocrine,Nutrit,& Metabol Dis W Cc | 12 | 18 / 4 | $35.459,60 | 41 / 4 | $12.711,80 | 92 / 3 | $11.541,80 | 91 / 5 |
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W/O Mcc | 17 | 46 / 2 | $107.177,00 | 183 / 6 | $22.274,90 | 159 / 3 | $20.954,20 | 158 / 8 |
Bronchitis & Asthma W Cc/Mcc | 11 | 65 / 19 | $10.993,20 | 71 / 2 | $5.504,00 | 160 / 13 | $3.964,64 | 157 / 9 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 52 | 109 / 21 | $11.099,40 | 186 / 5 | $4.973,12 | 616 / 24 | $3.929,46 | 613 / 27 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 36 | 87 / 25 | $14.298,60 | 99 / 2 | $7.613,81 | 685 / 20 | $6.642,03 | 682 / 28 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 34 | 116 / 23 | $11.062,60 | 463 / 18 | $4.040,79 | 1127 / 42 | $2.935,35 | 1122 / 52 |
Cellulitis W Mcc | 13 | 45 / 14 | $18.572,70 | 102 / 3 | $9.195,54 | 364 / 14 | $8.163,23 | 362 / 17 |
Cellulitis W/O Mcc | 56 | 133 / 23 | $11.693,10 | 429 / 7 | $5.305,04 | 849 / 24 | $4.161,86 | 843 / 37 |
Chest Pain | 23 | 128 / 23 | $9.776,52 | 141 / 3 | $3.781,00 | 361 / 15 | $2.763,35 | 360 / 24 |
Chronic Obstructive Pulmonary Disease W Cc | 44 | 135 / 24 | $10.270,90 | 117 / 3 | $6.011,05 | 697 / 28 | $4.725,09 | 695 / 29 |
Chronic Obstructive Pulmonary Disease W Mcc | 62 | 140 / 15 | $10.532,30 | 54 / 1 | $7.458,06 | 923 / 33 | $6.177,58 | 918 / 37 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 18 | 102 / 22 | $8.022,22 | 95 / 1 | $4.604,11 | 371 / 18 | $3.208,67 | 370 / 17 |
Circulatory Disorders Except Ami, W Card Cath W Mcc | 21 | 72 / 10 | $36.189,90 | 104 / 5 | $13.243,00 | 392 / 13 | $12.104,30 | 387 / 18 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 59 | 129 / 14 | $29.867,30 | 511 / 15 | $6.790,15 | 683 / 12 | $5.709,37 | 681 / 24 |
Cirrhosis & Alcoholic Hepatitis W Mcc | 13 | 29 / 4 | $29.309,00 | 48 / 2 | $10.715,30 | 86 / 3 | $9.954,08 | 86 / 4 |
Degenerative Nervous System Disorders W Mcc | 12 | 26 / 7 | $15.583,80 | 5 / 1 | $10.819,40 | 73 / 3 | $9.776,58 | 73 / 6 |
Degenerative Nervous System Disorders W/O Mcc | 12 | 66 / 17 | $13.243,20 | 74 / 2 | $6.173,42 | 293 / 8 | $5.248,25 | 293 / 17 |
Diabetes W Cc | 46 | 46 / 5 | $9.906,02 | 79 / 1 | $5.190,91 | 472 / 20 | $4.248,22 | 472 / 32 |
Diabetes W Mcc | 13 | 44 / 13 | $20.738,90 | 95 / 8 | $8.692,92 | 260 / 11 | $7.881,54 | 260 / 16 |
Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 23 | 47 / 6 | $13.235,00 | 56 / 3 | $6.125,52 | 136 / 6 | $4.976,48 | 136 / 8 |
Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 14 | 62 / 8 | $39.337,60 | 203 / 10 | $12.682,90 | 257 / 12 | $11.652,80 | 257 / 15 |
Disorders Of Pancreas Except Malignancy W Cc | 17 | 44 / 12 | $15.736,50 | 143 / 6 | $5.808,94 | 291 / 11 | $4.727,06 | 290 / 17 |
Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 21 | 17 / 2 | $16.250,60 | 161 / 7 | $4.333,76 | 87 / 4 | $2.877,00 | 87 / 5 |
Disorders Of The Biliary Tract W Cc | 14 | 40 / 9 | $26.614,80 | 157 / 11 | $6.639,07 | 95 / 5 | $5.429,93 | 95 / 7 |
Disorders Of The Biliary Tract W Mcc | 11 | 28 / 7 | $38.508,50 | 92 / 4 | $10.443,00 | 61 / 4 | $9.211,18 | 61 / 5 |
Endocrine Disorders W Cc | 11 | 27 / 7 | $10.428,50 | 9 / 1 | $6.390,27 | 61 / 3 | $5.291,18 | 61 / 5 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 26 | 70 / 13 | $13.641,60 | 59 / 1 | $7.469,62 | 461 / 13 | $6.548,38 | 458 / 21 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 79 | 196 / 23 | $12.356,90 | 440 / 8 | $4.740,87 | 766 / 25 | $3.605,56 | 761 / 37 |
Extracranial Procedures W/O Cc/Mcc | 17 | 81 / 14 | $35.814,40 | 569 / 17 | $6.909,24 | 318 / 12 | $5.254,82 | 318 / 13 |
Fractures Of Hip & Pelvis W/O Mcc | 18 | 43 / 11 | $7.353,00 | 24 / 1 | $4.506,39 | 316 / 11 | $3.512,17 | 317 / 17 |
Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 18 | 44 / 8 | $10.015,10 | 59 / 1 | $4.844,17 | 197 / 7 | $3.597,06 | 197 / 7 |
G.I. Hemorrhage W Cc | 93 | 125 / 18 | $14.806,50 | 289 / 4 | $6.408,13 | 873 / 30 | $5.245,48 | 871 / 42 |
G.I. Hemorrhage W Mcc | 34 | 87 / 18 | $18.211,90 | 52 / 1 | $10.973,80 | 649 / 21 | $10.062,20 | 650 / 29 |
G.I. Hemorrhage W/O Cc/Mcc | 19 | 49 / 7 | $11.907,50 | 161 / 9 | $4.660,53 | 116 / 14 | $2.983,37 | 116 / 3 |
G.I. Obstruction W Cc | 26 | 66 / 16 | $12.064,40 | 122 / 3 | $5.596,88 | 500 / 15 | $4.479,81 | 499 / 26 |
G.I. Obstruction W Mcc | 16 | 26 / 6 | $25.672,00 | 74 / 7 | $10.219,90 | 184 / 7 | $9.130,44 | 184 / 9 |
G.I. Obstruction W/O Cc/Mcc | 22 | 49 / 13 | $11.557,50 | 248 / 12 | $3.867,59 | 262 / 8 | $2.643,32 | 262 / 12 |
Heart Failure & Shock W Cc | 93 | 185 / 25 | $10.244,20 | 136 / 3 | $6.222,66 | 994 / 33 | $5.290,83 | 993 / 43 |
Heart Failure & Shock W Mcc | 163 | 121 / 11 | $13.039,90 | 83 / 1 | $9.474,75 | 1175 / 40 | $8.549,99 | 1172 / 52 |
Heart Failure & Shock W/O Cc/Mcc | 33 | 77 / 11 | $6.983,67 | 56 / 1 | $4.243,82 | 340 / 19 | $3.148,88 | 338 / 21 |
Hip & Femur Procedures Except Major Joint W Cc | 64 | 79 / 8 | $48.472,30 | 995 / 37 | $12.298,50 | 1024 / 38 | $11.089,70 | 1011 / 44 |
Hip & Femur Procedures Except Major Joint W Mcc | 18 | 44 / 10 | $70.732,90 | 423 / 18 | $21.894,00 | 703 / 24 | $20.572,40 | 700 / 25 |
Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 21 | 35 / 5 | $38.742,50 | 379 / 13 | $10.189,20 | 438 / 10 | $8.958,00 | 436 / 15 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 34 | 90 / 18 | $71.179,50 | 181 / 6 | $34.129,70 | 816 / 22 | $32.946,90 | 810 / 27 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 71 | 111 / 20 | $14.596,70 | 133 / 3 | $6.854,76 | 759 / 31 | $5.502,37 | 757 / 39 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 37 | 131 / 21 | $19.341,00 | 81 / 4 | $10.912,20 | 712 / 27 | $9.926,22 | 711 / 36 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 34 | 68 / 20 | $12.292,80 | 106 / 3 | $4.926,09 | 353 / 21 | $3.436,85 | 350 / 16 |
Kidney & Urinary Tract Infections W Mcc | 79 | 65 / 7 | $10.590,70 | 62 / 1 | $7.036,80 | 758 / 28 | $6.038,68 | 757 / 41 |
Kidney & Urinary Tract Infections W/O Mcc | 54 | 179 / 30 | $9.567,81 | 251 / 2 | $4.847,72 | 843 / 22 | $3.850,50 | 838 / 35 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 13 | 42 / 9 | $76.036,50 | 464 / 15 | $17.059,70 | 569 / 18 | $15.822,20 | 565 / 19 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 15 | 32 / 6 | $49.303,10 | 309 / 13 | $9.412,47 | 246 / 8 | $8.246,33 | 246 / 13 |
Major Cardiovasc Procedures W Mcc | 11 | 57 / 12 | $148.285,00 | 342 / 10 | $47.259,00 | 496 / 13 | $40.193,60 | 495 / 14 |
Major Cardiovasc Procedures W/O Mcc | 13 | 88 / 20 | $101.691,00 | 596 / 21 | $27.183,80 | 866 / 27 | $26.486,50 | 865 / 28 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 22 | 51 / 12 | $12.545,30 | 59 / 2 | $7.366,91 | 420 / 17 | $6.450,45 | 419 / 22 |
Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 15 | 41 / 12 | $18.980,30 | 34 / 1 | $11.850,40 | 259 / 16 | $11.012,40 | 258 / 15 |
Major Hematol/Immun Diag Exc Sickle Cell Crisis & Coagul W Cc | 15 | 38 / 7 | $16.995,30 | 37 / 2 | $7.485,07 | 113 / 6 | $6.378,53 | 113 / 8 |
Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 17 | 79 / 11 | $78.161,50 | 653 / 19 | $19.077,20 | 447 / 21 | $12.456,50 | 444 / 19 |
Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 13 | 52 / 14 | $70.124,20 | 378 / 14 | $22.245,80 | 621 / 23 | $20.908,00 | 618 / 24 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 415 | 173 / 11 | $61.310,40 | 1739 / 42 | $14.563,80 | 1178 / 45 | $11.340,40 | 1150 / 42 |
Major Small & Large Bowel Procedures W Cc | 28 | 80 / 15 | $55.828,20 | 551 / 21 | $15.996,60 | 796 / 15 | $14.731,40 | 788 / 31 |
Major Small & Large Bowel Procedures W Mcc | 24 | 61 / 12 | $96.591,30 | 351 / 13 | $35.857,50 | 846 / 27 | $34.393,00 | 844 / 31 |
Major Small & Large Bowel Procedures W/O Cc/Mcc | 13 | 51 / 17 | $50.282,00 | 462 / 19 | $10.289,20 | 370 / 14 | $8.984,08 | 370 / 21 |
Medical Back Problems W/O Mcc | 23 | 98 / 17 | $11.380,90 | 86 / 1 | $5.357,00 | 501 / 12 | $4.229,00 | 501 / 22 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 26 | 100 / 19 | $11.037,90 | 44 / 2 | $7.192,08 | 400 / 26 | $5.875,08 | 397 / 27 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 47 | 119 / 22 | $8.135,00 | 159 / 2 | $4.404,87 | 752 / 23 | $3.486,23 | 750 / 39 |
Nonspecific Cerebrovascular Disorders W Cc | 14 | 42 / 11 | $13.121,90 | 27 / 1 | $6.165,93 | 145 / 12 | $5.161,50 | 145 / 12 |
Other Circulatory System Diagnoses W Mcc | 15 | 101 / 22 | $18.198,50 | 33 / 1 | $11.782,50 | 562 / 8 | $10.989,60 | 560 / 19 |
Other Digestive System Diagnoses W Cc | 28 | 69 / 14 | $13.644,10 | 115 / 2 | $6.066,25 | 459 / 12 | $5.138,68 | 456 / 20 |
Other Digestive System Diagnoses W Mcc | 12 | 50 / 12 | $18.413,80 | 25 / 1 | $10.367,10 | 234 / 11 | $9.697,92 | 234 / 15 |
Other Disorders Of Nervous System W Cc | 20 | 36 / 7 | $14.044,50 | 72 / 3 | $5.615,50 | 143 / 6 | $4.595,50 | 143 / 10 |
Other Kidney & Urinary Tract Diagnoses W Cc | 16 | 87 / 11 | $16.182,90 | 130 / 6 | $6.089,94 | 286 / 8 | $5.430,62 | 286 / 12 |
Other Kidney & Urinary Tract Diagnoses W Mcc | 23 | 78 / 20 | $16.598,10 | 64 / 2 | $9.746,22 | 454 / 17 | $8.970,48 | 453 / 27 |
Other Musculoskelet Sys & Conn Tiss O.R. Proc W Cc | 18 | 22 / 2 | $46.387,40 | 69 / 4 | $13.022,80 | 119 / 6 | $11.834,00 | 119 / 6 |
Other Vascular Procedures W Cc | 14 | 88 / 21 | $67.933,90 | 485 / 21 | $16.488,80 | 563 / 19 | $15.316,80 | 560 / 22 |
Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 26 | 74 / 13 | $103.332,00 | 526 / 13 | $23.511,00 | 603 / 16 | $20.838,20 | 599 / 19 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 72 | 124 / 10 | $79.848,10 | 864 / 27 | $15.549,70 | 1072 / 29 | $13.019,30 | 1065 / 33 |
Peripheral Vascular Disorders W Cc | 17 | 67 / 15 | $14.210,40 | 149 / 5 | $6.059,24 | 427 / 15 | $5.150,53 | 425 / 18 |
Permanent Cardiac Pacemaker Implant W Cc | 19 | 58 / 14 | $80.042,10 | 622 / 17 | $20.302,20 | 777 / 22 | $19.122,30 | 773 / 22 |
Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 13 | 44 / 13 | $81.871,30 | 586 / 18 | $16.256,50 | 580 / 18 | $15.008,50 | 579 / 18 |
Poisoning & Toxic Effects Of Drugs W Mcc | 30 | 42 / 3 | $20.347,30 | 120 / 4 | $9.750,00 | 526 / 18 | $8.631,07 | 524 / 21 |
Psychoses | 148 | 154 / 7 | $8.150,87 | 27 / 1 | $6.439,84 | 162 / 6 | $5.365,91 | 162 / 6 |
Pulmonary Edema & Respiratory Failure | 115 | 88 / 8 | $12.556,40 | 55 / 1 | $7.747,58 | 702 / 31 | $6.592,39 | 702 / 36 |
Pulmonary Embolism W Mcc | 23 | 20 / 3 | $16.474,00 | 18 / 1 | $9.443,83 | 253 / 10 | $8.597,83 | 253 / 17 |
Pulmonary Embolism W/O Mcc | 24 | 50 / 12 | $9.833,04 | 30 / 1 | $6.193,50 | 472 / 15 | $5.148,75 | 470 / 19 |
Red Blood Cell Disorders W/O Mcc | 22 | 121 / 28 | $8.616,14 | 56 / 2 | $5.255,77 | 333 / 25 | $3.798,59 | 332 / 17 |
Renal Failure W Cc | 104 | 117 / 13 | $10.068,00 | 100 / 1 | $6.089,72 | 876 / 32 | $5.061,46 | 868 / 45 |
Renal Failure W Mcc | 80 | 115 / 11 | $18.992,20 | 188 / 7 | $10.220,10 | 1092 / 40 | $9.118,24 | 1092 / 48 |
Renal Failure W/O Cc/Mcc | 20 | 36 / 8 | $9.185,15 | 91 / 3 | $3.923,60 | 174 / 4 | $2.873,10 | 173 / 13 |
Respiratory Infections & Inflammations W Cc | 21 | 67 / 11 | $14.108,00 | 76 / 4 | $8.704,33 | 671 / 25 | $7.701,29 | 667 / 27 |
Respiratory Infections & Inflammations W Mcc | 53 | 83 / 9 | $15.740,60 | 28 / 1 | $12.399,50 | 930 / 33 | $11.507,40 | 920 / 40 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 38 | 93 / 11 | $24.360,20 | 53 / 1 | $14.182,50 | 731 / 20 | $13.062,90 | 723 / 25 |
Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 12 | 57 / 14 | $97.663,00 | 412 / 18 | $25.511,70 | 489 / 19 | $24.284,20 | 488 / 20 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 11 | 81 / 18 | $80.754,70 | 90 / 4 | $36.911,40 | 427 / 12 | $35.420,80 | 426 / 15 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 293 | 225 / 22 | $19.983,80 | 266 / 4 | $11.622,40 | 1181 / 35 | $10.455,40 | 1163 / 43 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 96 | 111 / 13 | $14.678,30 | 324 / 7 | $6.740,42 | 1043 / 28 | $5.700,60 | 1040 / 46 |
Signs & Symptoms W/O Mcc | 15 | 76 / 18 | $10.492,80 | 108 / 2 | $4.362,07 | 247 / 8 | $3.293,93 | 246 / 12 |
Simple Pneumonia & Pleurisy W Cc | 70 | 133 / 11 | $10.926,80 | 171 / 2 | $6.127,31 | 877 / 26 | $4.974,54 | 874 / 35 |
Simple Pneumonia & Pleurisy W Mcc | 114 | 91 / 4 | $12.797,60 | 52 / 1 | $9.094,97 | 1065 / 35 | $7.945,67 | 1065 / 45 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 23 | 70 / 12 | $11.300,50 | 348 / 6 | $4.848,74 | 741 / 28 | $3.445,74 | 737 / 24 |
Spinal Fusion Except Cervical W/O Mcc | 28 | 166 / 25 | $215.997,00 | 1305 / 35 | $62.286,10 | 1358 / 37 | $53.165,80 | 1353 / 37 |
Syncope & Collapse | 25 | 144 / 28 | $10.264,10 | 118 / 3 | $4.555,96 | 355 / 18 | $3.398,12 | 353 / 25 |
Transient Ischemia | 25 | 100 / 25 | $10.301,00 | 68 / 1 | $4.380,28 | 329 / 16 | $3.188,20 | 329 / 17 |
Urinary Stones W/O Esw Lithotripsy W/O Mcc | 18 | 28 / 2 | $16.578,60 | 99 / 5 | $4.309,89 | 105 / 3 | $3.247,56 | 105 / 3 | Total 108 procedures | 4.310 | discharges |
Source: Medicare Provider Utilization and Payment Data: Inpatient for FY2014
Average Covered Charges: The provider's average charge for services covered by Medicare for all discharges in the MS-DRG. These will vary from hospital to hospital because of differences in hospital charge structures.
Average Total Payments: The average total payments to all providers for the MS-DRG including the MSDRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Also included in average total payments are co-payment and deductible amounts that the patient is responsible for and any additional payments by third parties for coordination of benefits.
Average Medicare Payments: The average amount that Medicare pays to the provider for Medicare's share of the MS-DRG. Average Medicare payment amounts include the MS-DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Medicare payments DO NOT include beneficiary co-payments and deductible amounts nor any additional payments from third parties for coordination of benefits. Note: In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, incurred a 2 percent reduction in Medicare payment. This is in response to mandatory across-the-board reductions in Federal spending, also known as sequestration
Hospital Rank: We have calculated the rank for each procedure within a hospital. The left number is the national ranking, the right one is the state ranking. For discharges, ranking is from highest # of discharges to lower (hospital with highest number of discharges ranks first). For charges and payments, lowest means a higher ranking.