Hospital Costs > In Illinois > Graham Hospital Association, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Simple Pneumonia & Pleurisy W Cc | 52 | 151 / 46 | $17.217,80 | 823 / 15 | $6.528,50 | 933 / 52 | $5.029,23 | 930 / 37 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 37 | 527 / 84 | $55.689,80 | 1534 / 54 | $15.656,80 | 1337 / 70 | $11.675,60 | 1305 / 56 |
Kidney & Urinary Tract Infections W/O Mcc | 33 | 200 / 60 | $11.963,50 | 508 / 6 | $5.098,18 | 576 / 53 | $3.675,94 | 574 / 25 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 33 | 133 / 45 | $11.510,80 | 489 / 8 | $4.673,18 | 749 / 45 | $3.484,55 | 747 / 33 |
Heart Failure & Shock W Cc | 27 | 251 / 74 | $17.455,70 | 870 / 24 | $6.499,04 | 1206 / 53 | $5.454,48 | 1203 / 52 |
Chronic Obstructive Pulmonary Disease W Mcc | 23 | 179 / 62 | $21.230,30 | 832 / 20 | $7.703,70 | 1333 / 47 | $6.613,35 | 1327 / 60 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 22 | 71 / 27 | $13.483,60 | 548 / 18 | $4.699,18 | 675 / 38 | $3.394,82 | 672 / 39 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 22 | 139 / 47 | $21.929,30 | 1202 / 40 | $6.148,86 | 1587 / 73 | $5.169,18 | 1582 / 79 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 21 | 254 / 79 | $12.902,50 | 496 / 6 | $4.870,19 | 577 / 37 | $3.469,38 | 575 / 26 |
Simple Pneumonia & Pleurisy W Mcc | 20 | 185 / 67 | $22.137,70 | 519 / 9 | $9.079,45 | 886 / 40 | $7.746,70 | 886 / 31 |
Kidney & Urinary Tract Infections W Mcc | 20 | 124 / 38 | $17.076,70 | 370 / 7 | $7.371,30 | 844 / 50 | $6.153,10 | 842 / 44 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 19 | 497 / 99 | $26.447,90 | 613 / 12 | $12.076,20 | 1286 / 50 | $10.618,60 | 1265 / 46 |
Heart Failure & Shock W/O Cc/Mcc | 18 | 92 / 37 | $14.220,20 | 748 / 22 | $4.419,39 | 523 / 38 | $3.321,89 | 521 / 30 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 18 | 102 / 36 | $14.190,30 | 690 / 17 | $4.805,33 | 935 / 38 | $3.680,00 | 926 / 55 |
Chronic Obstructive Pulmonary Disease W Cc | 18 | 161 / 63 | $14.012,70 | 415 / 8 | $6.083,56 | 803 / 44 | $4.798,00 | 801 / 33 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 17 | 190 / 59 | $15.905,60 | 427 / 7 | $7.021,41 | 1196 / 47 | $5.872,82 | 1191 / 50 |
Cellulitis W/O Mcc | 15 | 174 / 66 | $18.194,00 | 1264 / 46 | $8.378,27 | 166 / 108 | $3.509,87 | 166 / 2 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 15 | 87 / 31 | $14.943,90 | 248 / 3 | $4.951,40 | 548 / 24 | $3.683,80 | 544 / 35 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 15 | 135 / 40 | $11.132,70 | 476 / 10 | $4.398,33 | 512 / 63 | $2.453,40 | 508 / 29 |
G.I. Hemorrhage W Cc | 14 | 204 / 67 | $23.034,40 | 1034 / 31 | $6.563,86 | 1000 / 48 | $5.363,86 | 998 / 49 |
Red Blood Cell Disorders W/O Mcc | 14 | 129 / 44 | $16.658,00 | 596 / 18 | $5.215,43 | 796 / 39 | $4.293,14 | 791 / 45 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 13 | 169 / 58 | $14.514,50 | 124 / 1 | $6.514,23 | 699 / 21 | $5.432,62 | 698 / 35 |
Pulmonary Edema & Respiratory Failure | 12 | 191 / 59 | $23.403,90 | 621 / 16 | $8.343,08 | 1234 / 51 | $7.283,92 | 1232 / 55 |
Red Blood Cell Disorders W Mcc | 11 | 60 / 26 | $23.662,10 | 252 / 9 | $8.192,91 | 366 / 30 | $7.017,45 | 364 / 26 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 11 | 112 / 51 | $24.629,40 | 634 / 28 | $7.936,82 | 767 / 49 | $6.757,73 | 764 / 51 |
Hip & Femur Procedures Except Major Joint W Cc | 11 | 132 / 52 | $45.482,70 | 862 / 23 | $13.513,30 | 1248 / 73 | $11.793,50 | 1232 / 72 |
G.I. Hemorrhage W/O Cc/Mcc | 11 | 57 / 18 | $16.050,70 | 381 / 14 | $4.587,64 | 241 / 18 | $3.249,91 | 239 / 13 | Total 27 procedures | 542 | 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.