Hospital Costs > In Virginia > Chesapeake General Hospital, 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 | 316 | 202 / 18 | $27.699,60 | 680 / 23 | $11.147,30 | 771 / 25 | $9.879,47 | 770 / 27 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 177 | 387 / 27 | $44.889,40 | 1021 / 26 | $12.668,50 | 809 / 11 | $10.773,30 | 795 / 26 |
Heart Failure & Shock W Cc | 148 | 130 / 12 | $13.324,10 | 399 / 11 | $6.152,84 | 954 / 28 | $5.259,55 | 953 / 40 |
Spinal Fusion Except Cervical W/O Mcc | 118 | 77 / 6 | $58.412,90 | 193 / 5 | $23.705,80 | 322 / 6 | $20.707,10 | 321 / 8 |
Pulmonary Edema & Respiratory Failure | 114 | 89 / 9 | $26.382,10 | 817 / 36 | $7.995,87 | 1190 / 39 | $7.214,96 | 1188 / 59 |
Heart Failure & Shock W Mcc | 106 | 178 / 22 | $21.188,10 | 489 / 17 | $8.994,37 | 855 / 23 | $8.116,40 | 855 / 34 |
Simple Pneumonia & Pleurisy W Cc | 102 | 101 / 5 | $15.518,50 | 625 / 19 | $6.028,82 | 914 / 22 | $5.010,55 | 911 / 39 |
G.I. Hemorrhage W Cc | 102 | 116 / 13 | $19.685,10 | 724 / 28 | $6.182,39 | 867 / 21 | $5.244,02 | 865 / 41 |
Chronic Obstructive Pulmonary Disease W Mcc | 101 | 101 / 5 | $18.700,30 | 622 / 22 | $7.100,62 | 803 / 19 | $6.044,76 | 798 / 32 |
Kidney & Urinary Tract Infections W/O Mcc | 100 | 133 / 11 | $12.909,40 | 633 / 16 | $4.886,59 | 1020 / 25 | $3.975,19 | 1012 / 42 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 95 | 112 / 14 | $17.649,40 | 577 / 17 | $6.584,24 | 817 / 22 | $5.489,14 | 815 / 36 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 94 | 88 / 11 | $20.176,40 | 492 / 16 | $6.521,40 | 707 / 18 | $5.443,78 | 706 / 35 |
Transient Ischemia | 86 | 39 / 5 | $18.065,70 | 509 / 23 | $4.534,12 | 519 / 21 | $3.394,50 | 516 / 30 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 83 | 192 / 21 | $15.160,90 | 778 / 25 | $4.727,66 | 861 / 24 | $3.668,70 | 856 / 41 |
Simple Pneumonia & Pleurisy W Mcc | 81 | 124 / 15 | $21.023,30 | 447 / 16 | $8.679,77 | 1024 / 24 | $7.898,26 | 1024 / 43 |
Cellulitis W/O Mcc | 81 | 108 / 11 | $11.759,20 | 435 / 8 | $5.237,79 | 790 / 21 | $4.118,21 | 785 / 33 |
Renal Failure W Cc | 81 | 140 / 22 | $16.444,20 | 607 / 27 | $5.957,05 | 708 / 24 | $4.923,23 | 701 / 37 |
Kidney & Urinary Tract Infections W Mcc | 76 | 68 / 9 | $19.589,80 | 550 / 35 | $7.532,49 | 929 / 44 | $6.273,61 | 926 / 45 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 73 | 77 / 10 | $10.379,30 | 382 / 13 | $3.740,77 | 804 / 24 | $2.673,74 | 800 / 41 |
Syncope & Collapse | 69 | 100 / 13 | $16.455,50 | 523 / 21 | $4.641,36 | 589 / 22 | $3.643,33 | 586 / 38 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 68 | 93 / 12 | $13.935,00 | 412 / 15 | $5.030,90 | 789 / 26 | $4.100,71 | 786 / 41 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 65 | 103 / 12 | $26.876,60 | 256 / 11 | $10.456,90 | 546 / 18 | $9.456,89 | 545 / 27 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 63 | 103 / 12 | $12.574,50 | 621 / 21 | $4.501,46 | 867 / 26 | $3.554,65 | 864 / 41 |
Chronic Obstructive Pulmonary Disease W Cc | 63 | 116 / 15 | $15.601,60 | 573 / 19 | $5.731,60 | 542 / 19 | $4.590,84 | 540 / 23 |
Renal Failure W Mcc | 60 | 135 / 19 | $22.099,60 | 322 / 12 | $9.418,62 | 761 / 25 | $8.480,78 | 761 / 33 |
Hip & Femur Procedures Except Major Joint W Cc | 57 | 86 / 12 | $33.207,40 | 348 / 8 | $11.339,60 | 604 / 15 | $10.247,50 | 601 / 24 |
Respiratory Infections & Inflammations W Mcc | 53 | 83 / 9 | $31.718,70 | 447 / 26 | $11.845,50 | 745 / 24 | $11.021,50 | 737 / 30 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 53 | 70 / 14 | $22.814,00 | 513 / 18 | $8.016,49 | 1002 / 32 | $7.154,98 | 999 / 39 |
Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 52 | 37 / 3 | $18.369,20 | 67 / 5 | $6.932,96 | 200 / 6 | $5.199,92 | 200 / 7 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 49 | 77 / 10 | $18.482,50 | 330 / 17 | $6.818,78 | 427 / 14 | $5.908,71 | 424 / 28 |
Heart Failure & Shock W/O Cc/Mcc | 47 | 63 / 5 | $11.085,70 | 369 / 7 | $4.398,79 | 728 / 25 | $3.494,49 | 724 / 36 |
Chest Pain | 47 | 104 / 13 | $15.812,20 | 573 / 24 | $3.974,83 | 576 / 21 | $2.998,49 | 572 / 35 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 45 | 75 / 6 | $15.217,30 | 805 / 28 | $5.179,82 | 1378 / 41 | $4.203,76 | 1367 / 48 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 44 | 58 / 14 | $17.606,50 | 403 / 13 | $4.847,30 | 517 / 18 | $3.652,80 | 513 / 23 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 44 | 144 / 18 | $23.718,30 | 229 / 5 | $6.624,05 | 551 / 10 | $5.526,00 | 549 / 19 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 42 | 89 / 10 | $41.324,40 | 361 / 13 | $15.512,60 | 753 / 34 | $13.138,50 | 745 / 28 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 39 | 86 / 16 | $24.799,70 | 285 / 17 | $10.139,30 | 641 / 25 | $9.302,21 | 640 / 32 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 38 | 55 / 4 | $13.180,60 | 526 / 12 | $4.609,82 | 458 / 19 | $3.201,42 | 456 / 15 |
Other Digestive System Diagnoses W Cc | 38 | 59 / 10 | $16.841,90 | 235 / 10 | $6.094,32 | 348 / 13 | $4.947,32 | 345 / 15 |
Red Blood Cell Disorders W/O Mcc | 37 | 106 / 18 | $15.368,60 | 487 / 13 | $5.125,32 | 580 / 20 | $4.063,24 | 578 / 29 |
Cervical Spinal Fusion W/O Cc/Mcc | 37 | 67 / 10 | $37.186,50 | 150 / 3 | $13.114,20 | 280 / 5 | $11.512,30 | 279 / 5 |
Diabetes W Cc | 36 | 56 / 8 | $16.202,90 | 414 / 21 | $5.398,47 | 555 / 24 | $4.340,17 | 555 / 36 |
G.I. Hemorrhage W Mcc | 34 | 87 / 18 | $29.070,40 | 297 / 12 | $11.115,20 | 710 / 26 | $10.241,40 | 710 / 32 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 34 | 90 / 18 | $70.384,40 | 175 / 5 | $31.844,30 | 636 / 12 | $30.840,50 | 630 / 22 |
Respiratory Infections & Inflammations W Cc | 34 | 54 / 4 | $18.488,60 | 207 / 11 | $8.195,06 | 478 / 13 | $7.294,06 | 475 / 18 |
Seizures W/O Mcc | 32 | 76 / 13 | $14.221,30 | 220 / 3 | $4.929,09 | 304 / 10 | $3.760,44 | 302 / 14 |
Acute Myocardial Infarction, Discharged Alive W Cc | 31 | 60 / 13 | $18.567,00 | 238 / 11 | $6.230,03 | 293 / 16 | $5.138,55 | 293 / 17 |
Major Small & Large Bowel Procedures W Cc | 31 | 77 / 13 | $39.433,10 | 181 / 6 | $14.465,60 | 255 / 4 | $12.681,60 | 253 / 10 |
Renal Failure W/O Cc/Mcc | 29 | 27 / 2 | $11.615,90 | 192 / 10 | $4.201,76 | 202 / 12 | $2.932,97 | 201 / 15 |
G.I. Obstruction W Cc | 29 | 63 / 13 | $14.027,50 | 225 / 8 | $5.544,07 | 449 / 13 | $4.405,66 | 448 / 24 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 29 | 167 / 21 | $51.242,00 | 249 / 9 | $12.396,90 | 143 / 7 | $9.631,14 | 143 / 6 |
G.I. Obstruction W/O Cc/Mcc | 28 | 43 / 8 | $10.346,00 | 162 / 8 | $4.108,07 | 188 / 18 | $2.516,57 | 188 / 8 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 28 | 45 / 8 | $17.476,20 | 197 / 11 | $6.926,79 | 186 / 5 | $5.872,00 | 186 / 12 |
Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 25 | 31 / 2 | $25.230,10 | 93 / 4 | $9.585,24 | 302 / 5 | $8.497,48 | 301 / 9 |
Pulmonary Embolism W/O Mcc | 25 | 49 / 11 | $14.040,70 | 117 / 6 | $6.113,08 | 323 / 10 | $4.851,56 | 323 / 14 |
Major Small & Large Bowel Procedures W/O Cc/Mcc | 24 | 40 / 10 | $29.077,00 | 118 / 7 | $9.736,67 | 232 / 6 | $8.214,88 | 232 / 12 |
Medical Back Problems W/O Mcc | 22 | 99 / 18 | $13.064,90 | 133 / 4 | $5.545,36 | 322 / 17 | $3.985,68 | 322 / 13 |
Signs & Symptoms W/O Mcc | 22 | 69 / 13 | $14.470,80 | 298 / 11 | $4.468,09 | 475 / 11 | $3.623,64 | 474 / 18 |
Major Small & Large Bowel Procedures W Mcc | 22 | 63 / 14 | $106.231,00 | 445 / 17 | $41.030,20 | 1081 / 33 | $40.189,90 | 1079 / 36 |
Other Kidney & Urinary Tract Diagnoses W Mcc | 21 | 80 / 21 | $29.658,70 | 374 / 17 | $9.723,90 | 432 / 16 | $8.878,19 | 431 / 26 |
Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 21 | 32 / 5 | $13.989,10 | 116 / 5 | $4.789,67 | 358 / 7 | $3.894,00 | 355 / 16 |
Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 21 | 75 / 8 | $39.836,70 | 171 / 8 | $12.830,60 | 322 / 6 | $11.668,60 | 319 / 14 |
Peripheral Vascular Disorders W Cc | 21 | 63 / 12 | $13.541,10 | 127 / 4 | $5.901,71 | 350 / 10 | $4.999,24 | 348 / 13 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 20 | 76 / 16 | $27.145,10 | 527 / 22 | $8.604,40 | 927 / 31 | $7.890,75 | 922 / 35 |
Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 20 | 46 / 8 | $26.674,80 | 37 / 2 | $10.961,00 | 142 / 3 | $9.796,65 | 142 / 4 |
O.R. Procedures For Obesity W/O Cc/Mcc | 19 | 58 / 5 | $29.144,30 | 75 / 3 | $9.840,00 | 29 / 4 | $6.973,42 | 29 / 1 |
Disorders Of Pancreas Except Malignancy W Cc | 19 | 42 / 11 | $14.091,80 | 97 / 3 | $5.701,00 | 378 / 8 | $4.975,11 | 377 / 25 |
Poisoning & Toxic Effects Of Drugs W/O Mcc | 19 | 42 / 9 | $9.196,05 | 75 / 4 | $4.165,68 | 224 / 6 | $3.175,63 | 223 / 10 |
Other Kidney & Urinary Tract Diagnoses W Cc | 19 | 84 / 10 | $14.742,70 | 97 / 5 | $6.064,37 | 204 / 7 | $5.220,37 | 204 / 8 |
Red Blood Cell Disorders W Mcc | 18 | 53 / 13 | $33.489,90 | 547 / 18 | $12.225,60 | 1009 / 28 | $11.490,40 | 1005 / 29 |
Degenerative Nervous System Disorders W/O Mcc | 18 | 60 / 12 | $14.283,70 | 94 / 5 | $5.996,83 | 176 / 6 | $4.884,17 | 176 / 7 |
Postoperative & Post-Traumatic Infections W/O Mcc | 18 | 36 / 5 | $18.989,40 | 112 / 6 | $6.070,67 | 127 / 2 | $5.443,33 | 127 / 4 |
Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 18 | 51 / 10 | $36.059,30 | 33 / 1 | $11.018,00 | 136 / 5 | $9.168,22 | 136 / 5 |
Diabetes W Mcc | 17 | 40 / 10 | $19.758,40 | 76 / 6 | $7.743,88 | 31 / 4 | $6.372,65 | 31 / 3 |
Other Circulatory System Diagnoses W Mcc | 17 | 99 / 20 | $34.867,80 | 340 / 11 | $11.795,60 | 495 / 9 | $10.761,10 | 493 / 18 |
Cellulitis W Mcc | 17 | 41 / 11 | $18.044,20 | 89 / 2 | $8.682,12 | 269 / 7 | $7.710,94 | 268 / 9 |
Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 17 | 21 / 3 | $12.095,70 | 73 / 2 | $4.233,06 | 147 / 3 | $3.144,12 | 147 / 9 |
Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 17 | 30 / 5 | $26.270,90 | 98 / 4 | $7.648,24 | 71 / 4 | $5.427,29 | 71 / 3 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 17 | 75 / 14 | $78.056,80 | 79 / 2 | $31.842,00 | 163 / 2 | $31.175,40 | 163 / 3 |
Seizures W Mcc | 17 | 49 / 12 | $34.421,40 | 253 / 14 | $9.805,29 | 278 / 13 | $8.729,18 | 278 / 18 |
Cranial & Peripheral Nerve Disorders W/O Mcc | 16 | 52 / 12 | $14.256,90 | 92 / 3 | $5.495,81 | 181 / 5 | $4.565,44 | 181 / 11 |
Other Vascular Procedures W Cc | 16 | 86 / 19 | $40.134,80 | 94 / 2 | $15.782,30 | 293 / 15 | $13.909,40 | 292 / 11 |
Other Circulatory System O.R. Procedures | 16 | 39 / 6 | $42.530,70 | 72 / 3 | $17.642,40 | 189 / 5 | $16.761,00 | 189 / 8 |
Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 16 | 49 / 11 | $82.422,10 | 508 / 20 | $27.094,60 | 843 / 26 | $26.212,60 | 839 / 30 |
Respiratory Neoplasms W Mcc | 16 | 36 / 11 | $31.712,70 | 131 / 5 | $9.983,50 | 154 / 2 | $9.183,50 | 154 / 6 |
Permanent Cardiac Pacemaker Implant W Cc | 15 | 62 / 16 | $45.324,70 | 145 / 4 | $15.964,40 | 15 / 10 | $12.306,20 | 15 / 2 |
Respiratory System Diagnosis W Ventilator Support 96+ Hours | 15 | 56 / 10 | $70.579,90 | 73 / 1 | $30.236,10 | 313 / 3 | $29.345,70 | 313 / 9 |
Circulatory Disorders Except Ami, W Card Cath W Mcc | 15 | 78 / 12 | $38.164,10 | 127 / 7 | $12.655,90 | 23 / 8 | $9.693,00 | 23 / 3 |
Other Digestive System Diagnoses W Mcc | 15 | 47 / 10 | $23.299,50 | 75 / 5 | $9.730,60 | 140 / 2 | $9.055,27 | 140 / 7 |
Peripheral Vascular Disorders W Mcc | 15 | 34 / 7 | $19.015,50 | 56 / 3 | $7.994,60 | 109 / 3 | $7.073,67 | 109 / 4 |
Fractures Of Hip & Pelvis W/O Mcc | 14 | 47 / 15 | $10.073,90 | 85 / 6 | $4.576,50 | 394 / 14 | $3.688,21 | 395 / 21 |
Hip & Femur Procedures Except Major Joint W Mcc | 14 | 48 / 13 | $47.512,00 | 122 / 7 | $17.134,10 | 224 / 6 | $16.041,10 | 223 / 9 |
Other Disorders Of Nervous System W Mcc | 14 | 26 / 4 | $18.790,80 | 13 / 2 | $9.304,86 | 22 / 1 | $7.601,29 | 22 / 1 |
Hypertension W/O Mcc | 14 | 51 / 10 | $16.314,10 | 268 / 13 | $4.083,43 | 284 / 5 | $3.116,00 | 282 / 16 |
Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 13 | 43 / 12 | $32.429,30 | 134 / 7 | $9.776,31 | 292 / 4 | $8.632,62 | 292 / 9 |
Infectious & Parasitic Diseases W O.R. Procedure W Cc | 13 | 23 / 7 | $44.891,30 | 79 / 3 | $14.852,60 | 62 / 6 | $12.505,40 | 62 / 5 |
Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 13 | 44 / 13 | $42.179,30 | 185 / 6 | $13.258,10 | 1 / 7 | $8.650,62 | 1 / 1 |
Bronchitis & Asthma W Cc/Mcc | 12 | 64 / 18 | $13.084,70 | 128 / 6 | $5.445,92 | 248 / 12 | $4.219,58 | 245 / 16 |
Other Circulatory System Diagnoses W Cc | 12 | 54 / 13 | $15.044,40 | 81 / 3 | $5.900,92 | 235 / 5 | $5.275,58 | 234 / 11 |
Major Cardiovasc Procedures W/O Mcc | 12 | 89 / 21 | $59.264,70 | 124 / 5 | $20.683,50 | 148 / 7 | $17.317,70 | 148 / 6 |
Poisoning & Toxic Effects Of Drugs W Mcc | 12 | 60 / 15 | $18.979,00 | 87 / 3 | $8.296,17 | 296 / 6 | $7.655,50 | 295 / 12 |
Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 12 | 64 / 10 | $18.788,10 | 17 / 1 | $10.630,10 | 114 / 3 | $9.994,92 | 114 / 4 |
Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 11 | 45 / 15 | $20.470,10 | 43 / 4 | $10.409,80 | 99 / 2 | $9.816,36 | 99 / 6 |
G.I. Hemorrhage W/O Cc/Mcc | 11 | 57 / 13 | $9.859,09 | 98 / 5 | $4.664,00 | 207 / 15 | $3.192,09 | 206 / 8 |
Peritoneal Adhesiolysis W/O Cc/Mcc | 11 | 13 / 3 | $27.008,00 | 7 / 1 | $9.288,00 | 11 / 1 | $8.278,55 | 11 / 1 |
Nonspecific Cerebrovascular Disorders W Cc | 11 | 45 / 14 | $15.662,00 | 50 / 4 | $5.966,82 | 190 / 9 | $5.395,36 | 190 / 18 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 11 | 36 / 10 | $30.435,50 | 119 / 5 | $9.488,18 | 23 / 9 | $6.287,64 | 23 / 2 |
Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 11 | 89 / 19 | $68.760,70 | 155 / 6 | $21.439,30 | 570 / 9 | $20.478,70 | 566 / 17 |
Diabetes W/O Cc/Mcc | 11 | 27 / 6 | $10.536,00 | 47 / 2 | $3.826,91 | 42 / 1 | $2.709,45 | 42 / 1 |
Uterine & Adnexa Proc For Non-Malignancy W/O Cc/Mcc | 11 | 35 / 5 | $23.529,10 | 70 / 1 | $6.231,18 | 38 / 1 | $4.438,55 | 38 / 1 |
Atherosclerosis W/O Mcc | 11 | 47 / 10 | $11.640,50 | 80 / 3 | $3.994,55 | / | $3.321,45 | / |
Revision Of Hip Or Knee Replacement W Cc | 11 | 75 / 14 | $67.205,20 | 199 / 6 | $21.212,20 | 358 / 10 | $20.187,40 | 357 / 13 |
Cirrhosis & Alcoholic Hepatitis W Mcc | 11 | 31 / 6 | $33.135,30 | 75 / 4 | $14.014,40 | 212 / 6 | $13.522,70 | 212 / 7 | Total 113 procedures | 4.581 | 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.