Hospital Costs > In California > Fallbrook Hospital District, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 81 | 483 / 100 | $125.753,00 | 2609 / 203 | $16.884,60 | 2311 / 88 | $15.437,60 | 2266 / 111 |
| Kidney & Urinary Tract Infections W/O Mcc | 22 | 211 / 87 | $45.239,40 | 2585 / 165 | $6.202,55 | 1994 / 47 | $4.990,91 | 1983 / 32 |
| Simple Pneumonia & Pleurisy W Cc | 18 | 185 / 72 | $70.406,60 | 2768 / 197 | $7.747,83 | 2295 / 49 | $6.876,72 | 2287 / 71 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 17 | 76 / 28 | $30.225,60 | 1620 / 40 | $5.657,00 | 1600 / 24 | $4.734,65 | 1592 / 41 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 16 | 40 / 18 | $76.843,20 | 822 / 36 | $12.414,40 | 733 / 17 | $11.085,80 | 730 / 21 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 14 | 152 / 65 | $37.246,40 | 2311 / 120 | $5.653,64 | 1919 / 39 | $4.705,07 | 1912 / 47 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 13 | 194 / 96 | $48.848,50 | 2235 / 137 | $8.533,00 | 2124 / 67 | $7.698,62 | 2116 / 99 | Total 7 procedures | 181 | 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.