Hospital Costs > In Illinois > Genesis Health System, 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 | 120 | 396 / 60 | $22.890,00 | 412 / 5 | $10.312,90 | 488 / 6 | $9.491,55 | 488 / 8 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 83 | 481 / 68 | $34.088,30 | 399 / 4 | $12.464,90 | 876 / 8 | $10.859,00 | 857 / 29 |
Pulmonary Edema & Respiratory Failure | 67 | 136 / 15 | $17.884,60 | 280 / 4 | $7.258,36 | 203 / 16 | $5.923,82 | 203 / 4 |
Simple Pneumonia & Pleurisy W Mcc | 61 | 144 / 34 | $17.059,20 | 219 / 2 | $8.393,41 | 414 / 11 | $7.201,79 | 414 / 7 |
Heart Failure & Shock W Mcc | 58 | 226 / 57 | $19.692,80 | 414 / 7 | $8.306,91 | 533 / 9 | $7.723,74 | 533 / 12 |
G.I. Hemorrhage W Cc | 42 | 176 / 44 | $13.190,80 | 177 / 2 | $5.871,69 | 457 / 14 | $4.868,36 | 456 / 16 |
Kidney & Urinary Tract Infections W/O Mcc | 41 | 192 / 54 | $10.930,50 | 375 / 2 | $4.573,20 | 466 / 19 | $3.598,37 | 466 / 19 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 39 | 236 / 66 | $12.022,20 | 396 / 4 | $4.589,26 | 747 / 20 | $3.598,08 | 743 / 30 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 28 | 133 / 42 | $14.858,60 | 501 / 8 | $5.251,43 | 262 / 39 | $3.564,82 | 262 / 9 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 27 | 180 / 53 | $15.476,30 | 391 / 6 | $6.213,70 | 551 / 10 | $5.264,00 | 549 / 21 |
Renal Failure W Cc | 27 | 194 / 64 | $14.484,90 | 418 / 7 | $5.708,56 | 510 / 17 | $4.767,52 | 506 / 22 |
Heart Failure & Shock W Cc | 26 | 252 / 75 | $14.057,80 | 476 / 8 | $5.676,00 | 589 / 13 | $4.979,38 | 589 / 19 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 24 | 142 / 52 | $11.382,30 | 474 / 7 | $4.321,42 | 794 / 22 | $3.516,08 | 791 / 35 |
Chronic Obstructive Pulmonary Disease W Mcc | 24 | 178 / 61 | $13.200,00 | 193 / 4 | $6.590,42 | 506 / 5 | $5.785,08 | 505 / 12 |
Cellulitis W/O Mcc | 24 | 165 / 58 | $13.200,50 | 615 / 15 | $5.115,54 | 850 / 19 | $4.162,21 | 844 / 36 |
Simple Pneumonia & Pleurisy W Cc | 24 | 179 / 69 | $13.409,10 | 389 / 4 | $5.687,88 | 727 / 8 | $4.835,88 | 724 / 25 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 22 | 174 / 43 | $48.493,30 | 196 / 3 | $11.764,10 | 554 / 4 | $10.773,60 | 550 / 29 |
Hip & Femur Procedures Except Major Joint W Cc | 21 | 122 / 42 | $33.985,00 | 377 / 5 | $11.097,30 | 419 / 12 | $9.952,90 | 418 / 15 |
Acute Myocardial Infarction, Discharged Alive W Cc | 18 | 73 / 19 | $16.952,60 | 174 / 5 | $6.216,28 | 295 / 11 | $5.142,50 | 295 / 9 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 18 | 132 / 37 | $9.536,22 | 306 / 5 | $3.557,56 | 462 / 20 | $2.410,89 | 459 / 26 |
Kidney & Urinary Tract Infections W Mcc | 18 | 126 / 40 | $13.973,70 | 189 / 3 | $6.440,72 | 501 / 14 | $5.706,50 | 500 / 21 |
Renal Failure W Mcc | 17 | 178 / 55 | $20.465,80 | 243 / 8 | $8.662,82 | 314 / 7 | $7.756,47 | 314 / 8 |
Respiratory Infections & Inflammations W Mcc | 16 | 120 / 48 | $24.526,30 | 216 / 1 | $10.902,90 | 384 / 7 | $10.224,90 | 383 / 11 |
Red Blood Cell Disorders W/O Mcc | 16 | 127 / 42 | $10.501,60 | 129 / 1 | $5.000,25 | 322 / 24 | $3.786,56 | 321 / 15 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 16 | 109 / 34 | $19.189,60 | 138 / 3 | $10.696,60 | 121 / 30 | $7.992,44 | 121 / 2 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 15 | 116 / 41 | $39.935,50 | 326 / 9 | $13.110,50 | 446 / 11 | $12.306,30 | 441 / 18 |
Syncope & Collapse | 15 | 154 / 47 | $13.345,60 | 287 / 4 | $4.501,33 | 566 / 18 | $3.618,13 | 563 / 32 |
G.I. Hemorrhage W Mcc | 15 | 106 / 37 | $23.236,40 | 134 / 1 | $9.898,87 | 216 / 9 | $8.943,13 | 216 / 10 |
Chest Pain | 15 | 136 / 40 | $14.010,00 | 399 / 15 | $4.268,47 | 488 / 30 | $2.909,87 | 485 / 23 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 14 | 109 / 48 | $22.646,40 | 500 / 16 | $7.566,93 | 731 / 40 | $6.705,21 | 728 / 49 |
Poisoning & Toxic Effects Of Drugs W Mcc | 13 | 59 / 9 | $16.306,60 | 43 / 1 | $8.024,77 | 247 / 3 | $7.470,92 | 246 / 7 |
Diabetes W Cc | 13 | 79 / 27 | $10.925,70 | 116 / 2 | $4.998,38 | 99 / 15 | $3.605,85 | 99 / 4 |
Hip & Femur Procedures Except Major Joint W Mcc | 13 | 49 / 20 | $41.144,20 | 61 / 1 | $15.876,50 | 72 / 1 | $14.950,90 | 72 / 1 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 13 | 80 / 36 | $10.562,20 | 272 / 2 | $4.282,00 | 419 / 14 | $3.164,46 | 417 / 23 |
Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 13 | 27 / 9 | $33.352,40 | 18 / 1 | $14.191,30 | 103 / 1 | $13.177,20 | 103 / 3 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 12 | 176 / 51 | $24.101,00 | 250 / 4 | $6.605,42 | 153 / 11 | $4.873,83 | 153 / 5 |
Heart Failure & Shock W/O Cc/Mcc | 12 | 98 / 43 | $10.488,90 | 317 / 2 | $4.001,00 | 612 / 16 | $3.398,33 | 610 / 36 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 11 | 115 / 44 | $16.762,00 | 238 / 4 | $11.033,20 | 21 / 86 | $4.769,27 | 21 / 1 |
Major Small & Large Bowel Procedures W Mcc | 11 | 74 / 29 | $75.245,20 | 163 / 2 | $26.894,30 | 190 / 3 | $26.239,70 | 189 / 5 |
Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 11 | 54 / 20 | $36.038,00 | 19 / 1 | $16.530,20 | 61 / 1 | $15.433,50 | 61 / 1 |
Chronic Obstructive Pulmonary Disease W Cc | 11 | 168 / 66 | $13.924,40 | 403 / 7 | $5.661,36 | 642 / 18 | $4.672,27 | 640 / 27 | Total 41 procedures | 1.084 | 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.