Hospital Costs > In New Mexico > Gila Regional Medical Center, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Cellulitis W/O Mcc | 21 | 168 / 8 | $16.559,40 | 1060 / 8 | $5.570,14 | 1632 / 4 | $4.879,86 | 1625 / 7 |
| Chronic Obstructive Pulmonary Disease W Cc | 15 | 164 / 9 | $18.238,10 | 830 / 3 | $6.154,60 | 1442 / 4 | $5.429,27 | 1437 / 4 |
| Chronic Obstructive Pulmonary Disease W Mcc | 13 | 189 / 14 | $23.322,20 | 1001 / 4 | $7.661,08 | 1549 / 5 | $6.912,77 | 1542 / 8 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 12 | 108 / 10 | $16.044,60 | 910 / 4 | $4.827,50 | 1259 / 3 | $4.022,17 | 1249 / 6 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 25 | 250 / 12 | $12.925,70 | 498 / 6 | $4.995,48 | 1316 / 6 | $3.984,28 | 1305 / 7 |
| Heart Failure & Shock W Cc | 22 | 256 / 13 | $18.722,60 | 1015 / 6 | $6.467,68 | 1526 / 6 | $5.810,23 | 1521 / 7 |
| Hip & Femur Procedures Except Major Joint W Cc | 11 | 132 / 10 | $33.019,50 | 336 / 1 | $12.292,50 | 1063 / 4 | $11.192,80 | 1049 / 5 |
| Kidney & Urinary Tract Infections W/O Mcc | 29 | 204 / 9 | $12.908,00 | 630 / 5 | $5.114,24 | 1385 / 4 | $4.237,00 | 1376 / 7 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 18 | 78 / 2 | $49.244,30 | 323 / 3 | $13.912,10 | 484 / 2 | $12.703,20 | 481 / 2 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 93 | 471 / 7 | $40.836,50 | 800 / 3 | $14.261,40 | 1342 / 9 | $11.682,80 | 1310 / 5 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 25 | 141 / 8 | $14.593,80 | 904 / 4 | $4.751,92 | 1351 / 4 | $3.930,16 | 1346 / 4 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 13 | 48 / 4 | $9.517,85 | 81 / 1 | $4.278,15 | 412 / 1 | $3.625,85 | 411 / 2 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 37 | 479 / 15 | $29.879,20 | 774 / 9 | $11.575,80 | 1308 / 6 | $10.661,60 | 1286 / 8 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 16 | 191 / 14 | $20.424,00 | 824 / 7 | $6.845,38 | 1308 / 3 | $5.996,88 | 1303 / 4 |
| Simple Pneumonia & Pleurisy W Cc | 42 | 161 / 10 | $20.427,00 | 1169 / 10 | $6.402,71 | 1529 / 6 | $5.541,76 | 1523 / 6 |
| Simple Pneumonia & Pleurisy W Mcc | 13 | 192 / 14 | $22.832,40 | 559 / 5 | $9.150,38 | 1188 / 5 | $8.121,46 | 1188 / 4 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 13 | 80 / 14 | $14.932,20 | 730 / 8 | $4.760,08 | 956 / 5 | $3.637,62 | 951 / 5 | Total 17 procedures | 418 | 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.