Hospital Costs > In California > Coast Plaza 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 | 86 | 430 / 134 | $86.101,30 | 2507 / 161 | $14.590,60 | 2312 / 79 | $13.715,20 | 2271 / 95 |
| Chronic Obstructive Pulmonary Disease W Mcc | 37 | 165 / 53 | $50.042,80 | 2184 / 82 | $9.586,38 | 2190 / 68 | $8.776,81 | 2182 / 83 |
| Heart Failure & Shock W Mcc | 31 | 253 / 91 | $58.052,40 | 2164 / 87 | $12.057,40 | 2245 / 77 | $11.522,10 | 2235 / 98 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 27 | 248 / 83 | $27.422,30 | 2030 / 56 | $6.433,63 | 2255 / 74 | $5.408,52 | 2240 / 91 |
| Cellulitis W/O Mcc | 23 | 166 / 63 | $31.673,70 | 2188 / 83 | $7.093,65 | 2204 / 72 | $6.135,91 | 2196 / 91 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 20 | 187 / 89 | $40.392,40 | 2047 / 95 | $9.011,35 | 2016 / 113 | $7.363,65 | 2008 / 67 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 19 | 73 / 36 | $185.163,00 | 695 / 26 | $41.330,60 | 599 / 25 | $38.564,40 | 598 / 20 |
| Simple Pneumonia & Pleurisy W Cc | 18 | 185 / 72 | $47.707,70 | 2515 / 125 | $8.204,22 | 2470 / 82 | $7.564,00 | 2461 / 120 |
| Heart Failure & Shock W Cc | 18 | 260 / 82 | $40.565,40 | 2343 / 89 | $8.242,94 | 2387 / 84 | $7.721,28 | 2381 / 111 |
| Syncope & Collapse | 18 | 151 / 49 | $31.373,10 | 1484 / 46 | $6.311,50 | 1579 / 55 | $5.467,50 | 1572 / 68 |
| Seizures W/O Mcc | 16 | 92 / 26 | $26.385,10 | 826 / 16 | $6.401,94 | 950 / 22 | $5.307,44 | 948 / 21 |
| Simple Pneumonia & Pleurisy W Mcc | 16 | 189 / 75 | $63.396,10 | 2155 / 85 | $11.463,00 | 2141 / 61 | $10.876,60 | 2136 / 86 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 15 | 151 / 64 | $28.459,10 | 2072 / 70 | $6.136,80 | 2172 / 77 | $5.445,60 | 2164 / 99 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 15 | 110 / 37 | $69.129,70 | 1447 / 52 | $13.630,10 | 1539 / 47 | $13.241,30 | 1526 / 75 |
| Kidney & Urinary Tract Infections W/O Mcc | 15 | 218 / 94 | $36.266,40 | 2416 / 121 | $6.675,20 | 2266 / 85 | $5.652,53 | 2255 / 88 |
| Kidney & Urinary Tract Infections W Mcc | 15 | 129 / 51 | $36.850,50 | 1410 / 36 | $9.216,40 | 1666 / 67 | $8.445,87 | 1662 / 79 |
| Chronic Obstructive Pulmonary Disease W Cc | 14 | 165 / 59 | $42.722,00 | 2127 / 96 | $7.884,36 | 2066 / 72 | $6.967,07 | 2059 / 82 |
| Chest Pain | 14 | 137 / 58 | $24.965,00 | 1207 / 37 | $5.399,36 | 1383 / 54 | $4.587,50 | 1375 / 73 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 14 | 117 / 39 | $96.956,70 | 1478 / 37 | $17.410,80 | 1446 / 23 | $16.917,50 | 1432 / 33 |
| Diabetes W Mcc | 13 | 44 / 14 | $59.121,50 | 628 / 21 | $10.788,20 | 533 / 14 | $9.768,54 | 532 / 16 |
| G.I. Hemorrhage W Cc | 13 | 205 / 78 | $54.569,80 | 2246 / 133 | $8.352,38 | 2076 / 68 | $7.629,77 | 2072 / 91 |
| Other Circulatory System Diagnoses W Mcc | 13 | 103 / 37 | $81.639,00 | 1158 / 50 | $16.060,50 | 1147 / 58 | $15.088,20 | 1139 / 62 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 11 | 150 / 55 | $33.232,10 | 1745 / 51 | $6.793,64 | 1887 / 69 | $6.198,36 | 1882 / 103 | Total 23 procedures | 481 | 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.