Hospital Costs > In Massachusetts > Cambridge Health Alliance, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 127 | 389 / 32 | $23.472,20 | 447 / 33 | $18.095,00 | 2629 / 49 | $16.698,60 | 2584 / 49 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 100 | 175 / 25 | $12.081,40 | 408 / 34 | $8.783,25 | 2582 / 52 | $7.193,76 | 2567 / 53 |
Renal Failure W Cc | 75 | 146 / 22 | $13.564,10 | 345 / 38 | $10.529,40 | 2326 / 48 | $9.259,40 | 2316 / 51 |
Chronic Obstructive Pulmonary Disease W Cc | 74 | 105 / 14 | $13.475,00 | 366 / 43 | $10.155,90 | 2337 / 50 | $8.991,54 | 2330 / 53 |
Simple Pneumonia & Pleurisy W Cc | 69 | 134 / 23 | $12.592,70 | 311 / 30 | $10.275,70 | 2668 / 50 | $8.963,13 | 2659 / 53 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 69 | 97 / 16 | $11.335,30 | 468 / 35 | $8.043,59 | 2421 / 50 | $7.000,57 | 2412 / 53 |
Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 69 | 58 / 7 | $12.404,70 | 215 / 30 | $8.121,19 | 774 / 40 | $6.911,09 | 773 / 43 |
Heart Failure & Shock W Cc | 67 | 211 / 33 | $14.667,90 | 540 / 39 | $10.841,40 | 2613 / 51 | $9.263,00 | 2607 / 53 |
Cellulitis W/O Mcc | 65 | 124 / 27 | $10.113,90 | 253 / 31 | $9.419,68 | 2510 / 53 | $8.137,37 | 2502 / 55 |
Kidney & Urinary Tract Infections W/O Mcc | 60 | 173 / 30 | $11.945,90 | 506 / 39 | $8.741,78 | 2582 / 51 | $7.445,18 | 2571 / 53 |
Heart Failure & Shock W Mcc | 59 | 225 / 34 | $18.381,90 | 334 / 32 | $14.958,10 | 2447 / 49 | $13.397,10 | 2436 / 49 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 54 | 66 / 10 | $11.586,10 | 404 / 38 | $8.284,56 | 2016 / 43 | $6.985,50 | 2004 / 47 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 45 | 116 / 22 | $12.097,70 | 240 / 33 | $9.052,67 | 2072 / 47 | $7.995,36 | 2067 / 50 |
Chest Pain | 44 | 107 / 9 | $9.436,52 | 127 / 18 | $7.190,43 | 1594 / 38 | $6.163,91 | 1585 / 40 |
Chronic Obstructive Pulmonary Disease W Mcc | 39 | 163 / 30 | $16.504,90 | 437 / 43 | $12.567,60 | 2476 / 50 | $11.216,40 | 2468 / 54 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 38 | 169 / 30 | $16.428,80 | 472 / 40 | $11.475,10 | 2474 / 47 | $10.280,30 | 2464 / 51 |
Syncope & Collapse | 36 | 133 / 27 | $10.853,30 | 136 / 27 | $8.404,78 | 1810 / 47 | $7.135,94 | 1802 / 48 |
Renal Failure W Mcc | 34 | 161 / 28 | $19.474,90 | 209 / 25 | $15.828,50 | 2036 / 42 | $14.418,30 | 2032 / 44 |
Heart Failure & Shock W/O Cc/Mcc | 32 | 78 / 18 | $10.420,60 | 304 / 36 | $7.956,91 | 1907 / 49 | $6.554,03 | 1894 / 50 |
G.I. Hemorrhage W Cc | 31 | 187 / 36 | $16.959,70 | 479 / 38 | $10.831,20 | 2316 / 48 | $9.535,71 | 2312 / 50 |
Poisoning & Toxic Effects Of Drugs W/O Mcc | 30 | 31 / 6 | $9.444,63 | 77 / 11 | $7.467,67 | 853 / 32 | $6.690,87 | 852 / 35 |
Poisoning & Toxic Effects Of Drugs W Mcc | 28 | 44 / 7 | $25.794,30 | 237 / 26 | $15.163,80 | 919 / 26 | $13.901,80 | 916 / 27 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 28 | 65 / 14 | $9.993,00 | 216 / 30 | $8.184,71 | 1905 / 44 | $6.953,61 | 1897 / 46 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 25 | 106 / 16 | $31.614,60 | 147 / 20 | $21.126,90 | 1637 / 33 | $19.507,30 | 1623 / 33 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 24 | 540 / 49 | $37.467,30 | 611 / 35 | $22.333,30 | 2627 / 53 | $20.742,70 | 2581 / 54 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 24 | 99 / 24 | $16.511,60 | 177 / 28 | $12.911,70 | 1784 / 42 | $11.006,20 | 1781 / 42 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 24 | 126 / 25 | $8.243,46 | 171 / 23 | $6.719,21 | 1906 / 44 | $5.544,12 | 1900 / 47 |
Simple Pneumonia & Pleurisy W Mcc | 23 | 182 / 40 | $24.553,50 | 675 / 48 | $14.906,70 | 2391 / 48 | $13.290,30 | 2385 / 51 |
Hip & Femur Procedures Except Major Joint W Cc | 20 | 123 / 29 | $29.054,00 | 194 / 27 | $19.965,60 | 1987 / 43 | $18.214,90 | 1966 / 45 |
Peripheral Vascular Disorders W Cc | 19 | 65 / 15 | $12.667,70 | 96 / 21 | $10.258,30 | 1172 / 28 | $9.114,63 | 1169 / 32 |
Alcohol/Drug Abuse Or Dependence, Left Ama | 19 | 30 / 6 | $7.785,47 | 53 / 7 | $5.794,00 | 88 / 10 | $5.219,95 | 87 / 11 |
G.I. Hemorrhage W Mcc | 19 | 102 / 25 | $28.043,40 | 265 / 28 | $17.737,00 | 1541 / 33 | $15.996,40 | 1531 / 34 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 18 | 107 / 30 | $15.778,30 | 63 / 13 | $14.385,30 | 1545 / 32 | $13.383,60 | 1532 / 32 |
Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 18 | 44 / 16 | $12.599,20 | 121 / 21 | $8.503,33 | 765 / 29 | $7.282,44 | 763 / 32 |
Pulmonary Edema & Respiratory Failure | 17 | 186 / 36 | $15.147,90 | 154 / 25 | $12.647,60 | 2114 / 41 | $11.572,50 | 2108 / 41 |
Other Digestive System Diagnoses W Cc | 17 | 80 / 22 | $14.108,80 | 127 / 27 | $10.726,40 | 1378 / 38 | $9.711,65 | 1374 / 41 |
Transient Ischemia | 16 | 109 / 24 | $11.847,90 | 122 / 17 | $8.053,81 | 1577 / 36 | $6.735,62 | 1569 / 37 |
Respiratory Infections & Inflammations W Cc | 15 | 73 / 26 | $17.777,10 | 184 / 31 | $13.787,30 | 1379 / 35 | $11.696,70 | 1374 / 35 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 15 | 58 / 18 | $16.154,80 | 150 / 24 | $12.523,70 | 1076 / 29 | $11.155,00 | 1074 / 31 |
Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W Mcc | 15 | 12 / 7 | $23.059,90 | 25 / 10 | $17.325,00 | 126 / 15 | $15.237,50 | 126 / 15 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 15 | 167 / 32 | $17.840,20 | 336 / 37 | $11.345,70 | 1960 / 44 | $9.832,73 | 1956 / 46 |
Acute Myocardial Infarction, Discharged Alive W Cc | 15 | 76 / 21 | $13.409,90 | 84 / 15 | $10.990,60 | 1359 / 30 | $9.655,93 | 1357 / 32 |
Signs & Symptoms W/O Mcc | 14 | 77 / 24 | $11.760,60 | 176 / 25 | $8.035,50 | 1259 / 37 | $7.131,14 | 1256 / 39 |
Disorders Of Pancreas Except Malignancy W Cc | 14 | 47 / 19 | $16.699,50 | 170 / 26 | $10.316,60 | 919 / 30 | $9.088,07 | 916 / 32 |
Red Blood Cell Disorders W/O Mcc | 14 | 129 / 34 | $12.881,70 | 272 / 30 | $9.012,07 | 1895 / 43 | $7.976,57 | 1886 / 45 |
Bronchitis & Asthma W Cc/Mcc | 14 | 62 / 21 | $11.149,10 | 74 / 21 | $9.747,07 | 1031 / 33 | $8.485,36 | 1027 / 36 |
G.I. Obstruction W/O Cc/Mcc | 13 | 58 / 20 | $12.478,40 | 321 / 28 | $7.364,31 | 1272 / 32 | $6.018,77 | 1269 / 35 |
Diabetes W Cc | 13 | 79 / 27 | $15.785,70 | 385 / 37 | $9.567,46 | 1534 / 38 | $8.388,15 | 1529 / 42 |
G.I. Hemorrhage W/O Cc/Mcc | 13 | 55 / 15 | $8.934,08 | 70 / 8 | $8.554,77 | 915 / 26 | $6.044,46 | 911 / 24 |
Seizures W/O Mcc | 13 | 95 / 26 | $15.315,50 | 278 / 37 | $8.774,85 | 1240 / 39 | $7.857,15 | 1238 / 42 |
Respiratory Infections & Inflammations W Mcc | 13 | 123 / 35 | $24.781,30 | 222 / 28 | $19.693,10 | 1748 / 38 | $18.293,50 | 1732 / 43 |
G.I. Obstruction W Cc | 13 | 79 / 28 | $16.119,80 | 369 / 37 | $9.723,38 | 1673 / 39 | $8.471,15 | 1668 / 43 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 12 | 114 / 21 | $12.719,10 | 80 / 13 | $11.895,80 | 1622 / 32 | $10.857,20 | 1619 / 36 |
Organic Disturbances & Mental Retardation | 12 | 47 / 10 | $8.614,92 | 17 / 4 | $9.855,75 | 477 / 18 | $8.732,42 | 477 / 18 |
Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 11 | 42 / 16 | $10.221,20 | 51 / 10 | $8.572,55 | 833 / 24 | $7.654,64 | 829 / 27 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 11 | 81 / 17 | $101.877,00 | 189 / 13 | $66.544,40 | 1062 / 21 | $63.535,60 | 1061 / 22 |
Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 19 | $15.278,70 | 107 / 20 | $10.360,50 | 770 / 23 | $8.852,45 | 770 / 25 | Total 57 procedures | 1.822 | 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.