Hospital Costs > In Montana > Benefis Hospitals Inc, 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 | 19 | 106 / 1 | $36.259,50 | 671 / 3 | $13.578,30 | 1177 / 3 | $10.953,90 | 1172 / 3 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 12 | 41 / 2 | $19.319,90 | 274 / 2 | $5.050,33 | 308 / 2 | $3.797,58 | 305 / 2 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 23 | 66 / 1 | $19.724,70 | 88 / 1 | $7.835,35 | 356 / 3 | $5.807,83 | 355 / 3 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 39 | 122 / 2 | $15.495,00 | 571 / 5 | $5.219,54 | 936 / 2 | $4.229,08 | 933 / 2 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 22 | 101 / 4 | $33.511,50 | 1107 / 7 | $9.709,27 | 1540 / 8 | $8.869,55 | 1537 / 8 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 40 | 110 / 1 | $11.789,70 | 559 / 6 | $3.849,77 | 1002 / 3 | $2.830,27 | 997 / 4 |
| Cellulitis W/O Mcc | 30 | 159 / 4 | $13.311,00 | 631 / 7 | $5.837,40 | 984 / 4 | $4.260,17 | 978 / 4 |
| Cervical Spinal Fusion W/O Cc/Mcc | 16 | 88 / 3 | $34.046,30 | 111 / 1 | $14.660,80 | 590 / 2 | $13.510,40 | 587 / 4 |
| Chest Pain | 50 | 101 / 1 | $14.685,50 | 469 / 2 | $4.451,28 | 598 / 3 | $3.018,24 | 594 / 1 |
| Chronic Obstructive Pulmonary Disease W Cc | 46 | 133 / 1 | $16.855,50 | 692 / 4 | $6.303,78 | 1154 / 6 | $5.104,91 | 1150 / 3 |
| Chronic Obstructive Pulmonary Disease W Mcc | 54 | 148 / 2 | $18.382,90 | 596 / 4 | $7.688,80 | 1478 / 5 | $6.808,43 | 1472 / 6 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 36 | 84 / 1 | $12.398,80 | 482 / 2 | $5.310,56 | 988 / 4 | $3.719,33 | 979 / 2 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 42 | 146 / 2 | $23.996,80 | 245 / 4 | $7.546,31 | 750 / 6 | $5.809,90 | 748 / 2 |
| Coronary Bypass W/O Cardiac Cath W/O Mcc | 21 | 67 / 2 | $89.734,90 | 193 / 2 | $28.260,40 | 360 / 4 | $22.790,40 | 359 / 3 |
| Craniotomy & Endovascular Intracranial Procedures W/O Cc/Mcc | 11 | 63 / 3 | $36.941,50 | 17 / 1 | $14.726,40 | 123 / 4 | $14.014,80 | 122 / 4 |
| Degenerative Nervous System Disorders W/O Mcc | 13 | 65 / 2 | $21.644,30 | 283 / 2 | $6.515,46 | 311 / 1 | $5.313,15 | 311 / 1 |
| Disorders Of Pancreas Except Malignancy W Cc | 19 | 42 / 1 | $17.097,90 | 182 / 4 | $6.267,32 | 213 / 5 | $4.529,84 | 213 / 2 |
| Disorders Of The Biliary Tract W Cc | 12 | 42 / 1 | $21.783,10 | 90 / 1 | $6.889,00 | 118 / 1 | $5.636,17 | 118 / 1 |
| Dysequilibrium | 20 | 45 / 1 | $12.513,50 | 75 / 1 | $4.240,70 | 207 / 1 | $3.186,00 | 207 / 1 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 18 | 78 / 2 | $20.976,80 | 245 / 5 | $7.822,28 | 661 / 5 | $7.032,44 | 656 / 6 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 80 | 195 / 1 | $13.121,70 | 523 / 4 | $4.987,34 | 1289 / 3 | $3.959,70 | 1278 / 3 |
| Extracranial Procedures W/O Cc/Mcc | 41 | 57 / 1 | $21.374,00 | 181 / 3 | $7.155,15 | 516 / 4 | $5.802,54 | 515 / 4 |
| Fractures Of Hip & Pelvis W/O Mcc | 21 | 40 / 1 | $11.253,90 | 125 / 2 | $4.769,10 | 375 / 2 | $3.633,24 | 376 / 2 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 13 | 49 / 2 | $13.576,50 | 143 / 1 | $5.039,77 | 296 / 1 | $3.884,08 | 296 / 1 |
| G.I. Hemorrhage W Cc | 67 | 151 / 2 | $19.113,30 | 672 / 10 | $6.955,75 | 967 / 5 | $5.337,79 | 965 / 3 |
| G.I. Hemorrhage W Mcc | 18 | 103 / 5 | $31.357,60 | 369 / 4 | $11.539,40 | 886 / 5 | $10.803,20 | 881 / 5 |
| G.I. Hemorrhage W/O Cc/Mcc | 12 | 56 / 1 | $8.284,83 | 52 / 1 | $4.671,25 | 388 / 1 | $3.542,67 | 385 / 2 |
| G.I. Obstruction W Cc | 26 | 66 / 2 | $11.508,40 | 100 / 2 | $5.950,38 | 751 / 4 | $4.763,12 | 749 / 4 |
| G.I. Obstruction W/O Cc/Mcc | 21 | 50 / 2 | $9.110,29 | 92 / 2 | $4.276,81 | 547 / 3 | $3.017,62 | 546 / 4 |
| Heart Failure & Shock W Cc | 49 | 229 / 4 | $20.625,70 | 1248 / 9 | $6.553,94 | 1353 / 5 | $5.604,22 | 1349 / 5 |
| Heart Failure & Shock W Mcc | 26 | 258 / 7 | $24.000,90 | 664 / 7 | $9.863,23 | 1430 / 6 | $8.922,85 | 1426 / 6 |
| Heart Failure & Shock W/O Cc/Mcc | 15 | 95 / 5 | $12.966,30 | 595 / 5 | $4.556,27 | 817 / 3 | $3.566,87 | 813 / 3 |
| Hip & Femur Procedures Except Major Joint W Cc | 45 | 98 / 1 | $37.532,20 | 520 / 7 | $13.946,50 | 1263 / 8 | $11.831,60 | 1246 / 7 |
| Hip & Femur Procedures Except Major Joint W Mcc | 22 | 40 / 2 | $56.007,80 | 254 / 5 | $20.754,00 | 633 / 4 | $19.682,00 | 630 / 4 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 11 | 45 / 5 | $29.861,50 | 187 / 4 | $10.676,50 | 536 / 4 | $9.425,27 | 534 / 5 |
| Hypertension W/O Mcc | 13 | 52 / 1 | $11.660,30 | 102 / 1 | $4.232,85 | 308 / 1 | $3.179,38 | 306 / 1 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 34 | 90 / 3 | $113.956,00 | 668 / 5 | $42.623,50 | 1279 / 6 | $41.160,80 | 1269 / 6 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 64 | 118 / 2 | $17.762,90 | 328 / 4 | $7.181,94 | 1080 / 5 | $5.959,36 | 1077 / 6 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 22 | 146 / 5 | $25.108,40 | 209 / 1 | $11.411,30 | 852 / 6 | $10.421,30 | 850 / 6 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 36 | 66 / 1 | $13.210,40 | 142 / 2 | $5.045,19 | 835 / 4 | $4.042,78 | 831 / 5 |
| Kidney & Urinary Tract Infections W Mcc | 14 | 130 / 2 | $13.679,40 | 177 / 1 | $7.386,64 | 949 / 3 | $6.308,07 | 946 / 2 |
| Kidney & Urinary Tract Infections W/O Mcc | 48 | 185 / 1 | $13.214,90 | 672 / 4 | $5.118,23 | 1470 / 4 | $4.323,04 | 1461 / 5 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 21 | 35 / 1 | $30.432,00 | 99 / 1 | $10.914,40 | 478 / 2 | $9.466,10 | 476 / 1 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 15 | 25 / 2 | $45.951,50 | 71 / 2 | $16.975,00 | 301 / 1 | $15.930,90 | 300 / 2 |
| Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 16 | 31 / 1 | $18.848,50 | 22 / 1 | $8.011,81 | 334 / 1 | $6.861,25 | 333 / 1 |
| Major Cardiovasc Procedures W Mcc | 13 | 55 / 3 | $119.673,00 | 209 / 2 | $39.122,20 | 450 / 3 | $38.065,60 | 449 / 3 |
| Major Cardiovasc Procedures W/O Mcc | 31 | 70 / 2 | $72.983,60 | 296 / 3 | $23.087,90 | 668 / 5 | $22.135,10 | 667 / 5 |
| Major Chest Procedures W Cc | 12 | 62 / 4 | $49.082,20 | 100 / 2 | $19.560,40 | 188 / 4 | $14.475,80 | 188 / 1 |
| Major Chest Procedures W Mcc | 11 | 38 / 2 | $79.336,70 | 48 / 2 | $35.839,10 | 224 / 2 | $34.611,20 | 223 / 2 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 16 | 57 / 1 | $19.668,10 | 282 / 3 | $7.719,62 | 513 / 2 | $6.680,50 | 511 / 2 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 14 | 82 / 6 | $47.598,70 | 296 / 7 | $14.568,60 | 561 / 7 | $13.336,60 | 558 / 8 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 12 | 53 / 4 | $56.320,90 | 195 / 4 | $23.820,40 | 738 / 5 | $22.850,50 | 735 / 5 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 172 | 392 / 7 | $40.620,70 | 787 / 9 | $15.055,10 | 1606 / 10 | $12.339,30 | 1569 / 9 |
| Major Small & Large Bowel Procedures W Cc | 27 | 81 / 3 | $41.153,80 | 215 / 5 | $16.767,00 | 969 / 6 | $15.619,00 | 958 / 7 |
| Major Small & Large Bowel Procedures W Mcc | 20 | 65 / 2 | $85.443,90 | 242 / 5 | $35.208,40 | 760 / 5 | $33.010,40 | 758 / 5 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 20 | 44 / 2 | $32.782,30 | 175 / 3 | $13.274,90 | 323 / 3 | $8.708,75 | 323 / 1 |
| Medical Back Problems W/O Mcc | 30 | 91 / 1 | $13.908,50 | 167 / 5 | $5.619,07 | 562 / 3 | $4.328,03 | 560 / 4 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 16 | 110 / 4 | $28.422,60 | 887 / 4 | $7.750,06 | 980 / 5 | $6.993,19 | 977 / 4 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 52 | 114 / 1 | $13.173,20 | 709 / 4 | $4.838,38 | 1249 / 4 | $3.843,56 | 1245 / 4 |
| O.R. Procedures For Obesity W/O Cc/Mcc | 34 | 43 / 1 | $30.102,10 | 84 / 2 | $10.822,30 | 211 / 2 | $8.959,56 | 211 / 2 |
| Other Circulatory System Diagnoses W Mcc | 11 | 105 / 3 | $44.416,30 | 615 / 2 | $12.418,10 | 762 / 1 | $11.905,80 | 758 / 1 |
| Other Digestive System Diagnoses W Cc | 35 | 62 / 1 | $12.138,30 | 62 / 2 | $6.338,94 | 603 / 5 | $5.405,94 | 600 / 4 |
| Other Digestive System Diagnoses W Mcc | 13 | 49 / 1 | $35.272,70 | 246 / 2 | $11.510,00 | 370 / 2 | $10.602,80 | 369 / 2 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 12 | 89 / 4 | $24.692,20 | 237 / 3 | $10.254,80 | 547 / 5 | $9.284,08 | 545 / 5 |
| Other Resp System O.R. Procedures W Cc | 12 | 35 / 1 | $30.502,10 | 27 / 1 | $13.016,90 | 184 / 1 | $12.144,70 | 184 / 1 |
| Other Resp System O.R. Procedures W Mcc | 12 | 51 / 2 | $72.250,10 | 164 / 2 | $25.207,20 | 301 / 2 | $22.536,00 | 300 / 2 |
| Other Vascular Procedures W Cc | 25 | 77 / 2 | $63.461,30 | 421 / 3 | $17.652,10 | 751 / 4 | $16.827,90 | 747 / 4 |
| Other Vascular Procedures W Mcc | 11 | 86 / 2 | $85.004,10 | 438 / 2 | $25.133,90 | 745 / 2 | $24.470,20 | 742 / 2 |
| Other Vascular Procedures W/O Cc/Mcc | 13 | 43 / 2 | $37.112,50 | 139 / 3 | $14.673,10 | 197 / 3 | $9.131,38 | 196 / 1 |
| Pathological Fractures & Musculoskelet & Conn Tiss Malig W Cc | 13 | 27 / 1 | $25.114,60 | 97 / 1 | $7.392,85 | 107 / 1 | $6.505,15 | 107 / 1 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 44 | 152 / 4 | $49.426,30 | 214 / 4 | $14.412,70 | 845 / 5 | $11.833,20 | 839 / 7 |
| Peripheral Vascular Disorders W Cc | 18 | 66 / 1 | $30.967,70 | 834 / 2 | $7.379,00 | 834 / 2 | $6.328,94 | 831 / 2 |
| Peripheral Vascular Disorders W/O Cc/Mcc | 11 | 34 / 1 | $11.346,20 | 69 / 1 | $4.502,91 | 162 / 1 | $3.604,27 | 162 / 1 |
| Peritoneal Adhesiolysis W Cc | 11 | 28 / 1 | $34.045,10 | 18 / 1 | $15.410,80 | 146 / 1 | $14.235,20 | 146 / 1 |
| Permanent Cardiac Pacemaker Implant W Cc | 12 | 65 / 2 | $51.355,80 | 229 / 2 | $17.481,30 | 566 / 3 | $16.413,70 | 565 / 2 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 16 | 56 / 3 | $26.759,50 | 271 / 2 | $13.601,80 | 354 / 3 | $7.920,19 | 353 / 2 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 30 | 31 / 1 | $8.991,93 | 65 / 1 | $4.280,67 | 259 / 1 | $3.254,33 | 258 / 1 |
| Psychoses | 13 | 262 / 3 | $10.289,20 | 64 / 2 | $6.595,46 | 207 / 1 | $5.540,15 | 207 / 2 |
| Pulmonary Edema & Respiratory Failure | 72 | 131 / 2 | $23.639,20 | 644 / 7 | $8.010,15 | 1068 / 5 | $7.039,61 | 1066 / 5 |
| Pulmonary Embolism W/O Mcc | 13 | 61 / 5 | $16.867,60 | 229 / 3 | $6.508,38 | 687 / 3 | $5.534,62 | 684 / 4 |
| Red Blood Cell Disorders W/O Mcc | 28 | 115 / 1 | $19.296,50 | 835 / 4 | $5.293,25 | 776 / 2 | $4.267,43 | 771 / 2 |
| Renal Failure W Cc | 72 | 149 / 1 | $13.422,40 | 331 / 4 | $101.474,00 | 970 / 10 | $5.151,19 | 962 / 4 |
| Renal Failure W Mcc | 23 | 172 / 4 | $24.248,00 | 418 / 3 | $10.085,40 | 1176 / 4 | $9.344,43 | 1176 / 6 |
| Renal Failure W/O Cc/Mcc | 15 | 41 / 1 | $11.830,90 | 205 / 1 | $4.263,60 | 322 / 1 | $3.178,87 | 321 / 1 |
| Respiratory Infections & Inflammations W Cc | 23 | 65 / 1 | $21.642,80 | 330 / 3 | $9.205,43 | 830 / 3 | $8.071,52 | 825 / 3 |
| Respiratory Infections & Inflammations W Mcc | 40 | 96 / 1 | $31.709,70 | 445 / 5 | $14.129,40 | 1116 / 6 | $12.138,50 | 1102 / 5 |
| Respiratory Neoplasms W Cc | 12 | 35 / 1 | $27.870,50 | 166 / 1 | $7.734,83 | 189 / 1 | $6.642,67 | 188 / 1 |
| Respiratory Neoplasms W Mcc | 11 | 41 / 2 | $33.353,40 | 152 / 3 | $11.205,20 | 289 / 2 | $10.122,00 | 289 / 2 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 29 | 102 / 2 | $44.575,60 | 467 / 4 | $15.470,70 | 845 / 5 | $13.483,10 | 837 / 4 |
| Seizures W Mcc | 11 | 55 / 1 | $33.528,00 | 230 / 1 | $9.964,91 | 356 / 1 | $9.236,55 | 356 / 1 |
| Seizures W/O Mcc | 30 | 78 / 1 | $12.316,50 | 146 / 1 | $5.042,80 | 601 / 1 | $4.256,27 | 598 / 3 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 14 | 78 / 2 | $124.803,00 | 355 / 1 | $43.705,60 | 781 / 2 | $42.761,90 | 780 / 2 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 147 | 369 / 5 | $32.670,60 | 921 / 6 | $12.455,40 | 1632 / 7 | $11.284,70 | 1600 / 8 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 73 | 134 / 2 | $19.606,60 | 747 / 5 | $7.280,22 | 1283 / 5 | $5.958,05 | 1278 / 7 |
| Signs & Symptoms Of Musculoskeletal System & Conn Tissue W/O Mcc | 14 | 33 / 1 | $9.127,86 | 25 / 1 | $4.744,79 | 120 / 1 | $3.858,00 | 120 / 1 |
| Signs & Symptoms W/O Mcc | 23 | 68 / 1 | $15.314,50 | 356 / 3 | $4.670,22 | 478 / 3 | $3.626,35 | 477 / 4 |
| Simple Pneumonia & Pleurisy W Cc | 88 | 115 / 1 | $17.196,40 | 816 / 6 | $6.427,73 | 1343 / 3 | $5.353,28 | 1338 / 4 |
| Simple Pneumonia & Pleurisy W Mcc | 71 | 134 / 5 | $23.923,70 | 628 / 5 | $9.951,69 | 1390 / 7 | $8.477,51 | 1390 / 7 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 21 | 72 / 2 | $14.935,10 | 731 / 7 | $4.724,14 | 1030 / 4 | $3.703,00 | 1024 / 5 |
| Spinal Fusion Except Cervical W/O Mcc | 34 | 160 / 5 | $86.238,50 | 595 / 6 | $27.116,30 | 959 / 6 | $25.891,60 | 954 / 7 |
| Syncope & Collapse | 41 | 128 / 1 | $15.911,80 | 473 / 4 | $4.858,83 | 803 / 3 | $3.847,39 | 799 / 3 |
| Transient Ischemia | 26 | 99 / 2 | $11.972,20 | 129 / 1 | $4.680,65 | 733 / 2 | $3.634,19 | 729 / 3 |
| Transurethral Procedures W Cc | 11 | 30 / 1 | $24.807,10 | 62 / 1 | $8.331,36 | 182 / 1 | $7.194,55 | 182 / 1 |
| Trauma To The Skin, Subcut Tiss & Breast W/O Mcc | 13 | 31 / 1 | $11.822,80 | 38 / 1 | $5.212,77 | 58 / 1 | $3.599,85 | 58 / 1 | Total 104 procedures | 3.040 | 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.