Hospital Costs > In South Dakota > Avera St Lukes, 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 Mcc | 15 | 110 / 5 | $23.071,10 | 235 / 1 | $9.770,07 | 405 / 2 | $8.766,87 | 405 / 2 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 26 | 98 / 1 | $8.389,19 | 83 / 1 | $4.015,15 | 22 / 1 | $2.713,04 | 22 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 17 | 144 / 4 | $12.024,90 | 238 / 2 | $4.444,29 | 68 / 1 | $3.218,35 | 68 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 12 | 111 / 6 | $19.208,40 | 293 / 1 | $6.926,08 | 268 / 1 | $5.984,00 | 267 / 2 |
| Cellulitis W Mcc | 11 | 47 / 4 | $15.331,70 | 42 / 1 | $7.896,91 | 138 / 1 | $7.198,64 | 138 / 1 |
| Circulatory Disorders Except Ami, W Card Cath W Mcc | 11 | 82 / 4 | $29.449,70 | 45 / 1 | $10.330,00 | 13 / 1 | $9.527,55 | 13 / 1 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 16 | 172 / 4 | $19.799,50 | 102 / 2 | $6.152,44 | 260 / 1 | $5.074,38 | 260 / 2 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 13 | 262 / 9 | $15.309,00 | 796 / 3 | $4.547,92 | 65 / 4 | $2.875,85 | 65 / 1 |
| Extracranial Procedures W/O Cc/Mcc | 12 | 86 / 3 | $21.582,20 | 191 / 1 | $5.973,33 | 121 / 1 | $4.761,33 | 121 / 2 |
| G.I. Hemorrhage W Cc | 56 | 162 / 4 | $17.337,70 | 518 / 2 | $5.793,48 | 180 / 1 | $4.533,11 | 180 / 1 |
| G.I. Hemorrhage W Mcc | 14 | 107 / 4 | $25.470,00 | 192 / 2 | $9.544,07 | 141 / 1 | $8.637,71 | 141 / 1 |
| G.I. Obstruction W Cc | 13 | 79 / 4 | $15.509,80 | 326 / 1 | $5.085,46 | 183 / 1 | $4.030,38 | 182 / 1 |
| Heart Failure & Shock W Cc | 27 | 251 / 7 | $14.431,00 | 516 / 2 | $5.575,93 | 471 / 3 | $4.871,74 | 471 / 4 |
| Heart Failure & Shock W Mcc | 57 | 227 / 4 | $20.012,50 | 425 / 4 | $8.346,84 | 402 / 3 | $7.560,40 | 402 / 3 |
| Hip & Femur Procedures Except Major Joint W Cc | 24 | 119 / 7 | $36.691,50 | 478 / 3 | $11.115,30 | 466 / 1 | $10.018,80 | 465 / 1 |
| Hip & Femur Procedures Except Major Joint W Mcc | 20 | 42 / 4 | $49.791,70 | 153 / 1 | $17.712,80 | 327 / 1 | $16.744,60 | 324 / 1 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 26 | 98 / 4 | $76.637,30 | 228 / 1 | $30.470,30 | 496 / 1 | $29.464,00 | 492 / 1 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 22 | 160 / 4 | $22.382,10 | 632 / 4 | $6.093,45 | 170 / 1 | $4.768,95 | 170 / 1 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 16 | 152 / 4 | $34.538,90 | 508 / 1 | $9.611,56 | 277 / 1 | $8.728,00 | 276 / 1 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 35 | 30 / 2 | $42.609,30 | 63 / 2 | $19.068,10 | 169 / 1 | $16.512,80 | 169 / 1 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 85 | 479 / 11 | $35.274,40 | 479 / 5 | $13.181,90 | 737 / 9 | $10.681,20 | 727 / 4 |
| Major Small & Large Bowel Procedures W Cc | 13 | 95 / 6 | $44.290,20 | 280 / 2 | $16.975,10 | 199 / 2 | $12.483,80 | 197 / 1 |
| Major Small & Large Bowel Procedures W Mcc | 26 | 59 / 4 | $81.152,40 | 205 / 1 | $30.229,70 | 391 / 1 | $28.447,20 | 389 / 1 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 11 | 155 / 8 | $10.560,40 | 381 / 2 | $3.912,64 | 84 / 1 | $2.795,64 | 84 / 1 |
| Other Circulatory System Diagnoses W Mcc | 11 | 105 / 4 | $26.808,40 | 151 / 1 | $10.437,20 | 214 / 1 | $9.629,73 | 214 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 12 | 89 / 4 | $26.471,90 | 285 / 1 | $8.322,83 | 100 / 1 | $7.564,00 | 100 / 1 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 15 | 181 / 5 | $37.422,50 | 50 / 1 | $11.638,00 | 436 / 1 | $10.488,50 | 435 / 2 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 18 | 51 / 3 | $38.913,90 | 50 / 1 | $10.415,30 | 148 / 1 | $9.245,00 | 148 / 2 |
| Permanent Cardiac Pacemaker Implant W Cc | 12 | 65 / 5 | $35.461,20 | 46 / 1 | $15.233,80 | 241 / 2 | $14.294,90 | 240 / 3 |
| Pulmonary Edema & Respiratory Failure | 43 | 160 / 4 | $18.239,80 | 306 / 2 | $7.228,79 | 154 / 2 | $5.815,40 | 154 / 1 |
| Renal Failure W Cc | 32 | 189 / 4 | $16.050,50 | 568 / 2 | $5.583,94 | 333 / 1 | $4.571,25 | 331 / 1 |
| Renal Failure W Mcc | 26 | 169 / 4 | $24.479,60 | 432 / 1 | $7.949,73 | 96 / 1 | $7.212,58 | 96 / 1 |
| Respiratory Infections & Inflammations W Mcc | 30 | 106 / 4 | $26.995,00 | 291 / 1 | $11.113,70 | 529 / 1 | $10.542,00 | 523 / 1 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 248 | 268 / 4 | $28.841,40 | 731 / 6 | $10.417,50 | 438 / 2 | $9.406,86 | 438 / 2 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 46 | 161 / 5 | $19.953,70 | 777 / 5 | $6.161,43 | 252 / 2 | $4.937,85 | 251 / 2 |
| Simple Pneumonia & Pleurisy W Mcc | 36 | 169 / 5 | $18.805,40 | 315 / 2 | $8.097,47 | 354 / 2 | $7.119,33 | 354 / 2 | Total 36 procedures | 1.107 | 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.