Hospital Costs > In Ohio > Grand Lake Health System, 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 | 56 | 508 / 73 | $31.665,20 | 297 / 13 | $14.267,10 | 1497 / 75 | $12.041,20 | 1463 / 93 |
| Heart Failure & Shock W Cc | 35 | 243 / 66 | $11.233,10 | 214 / 12 | $6.560,89 | 1134 / 70 | $5.394,94 | 1132 / 70 |
| Chronic Obstructive Pulmonary Disease W Cc | 25 | 154 / 56 | $12.246,80 | 259 / 17 | $5.932,00 | 907 / 50 | $4.880,44 | 904 / 60 |
| Simple Pneumonia & Pleurisy W Cc | 23 | 180 / 54 | $13.444,00 | 391 / 21 | $6.233,48 | 1285 / 59 | $5.287,52 | 1281 / 82 |
| Pulmonary Edema & Respiratory Failure | 21 | 182 / 57 | $15.101,80 | 151 / 11 | $8.160,57 | 700 / 60 | $6.589,05 | 700 / 50 |
| Cellulitis W/O Mcc | 21 | 168 / 56 | $9.958,43 | 238 / 14 | $5.345,95 | 997 / 39 | $4.270,48 | 991 / 65 |
| Chronic Obstructive Pulmonary Disease W Mcc | 18 | 184 / 61 | $13.008,20 | 185 / 9 | $7.465,17 | 1432 / 56 | $6.749,28 | 1426 / 83 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 15 | 192 / 52 | $13.574,70 | 253 / 13 | $6.710,53 | 1179 / 42 | $5.847,87 | 1174 / 69 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 15 | 135 / 42 | $8.982,67 | 235 / 15 | $4.005,93 | 380 / 58 | $2.338,53 | 377 / 23 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 13 | 107 / 40 | $11.638,70 | 413 / 31 | $4.704,85 | 226 / 43 | $3.049,77 | 226 / 19 |
| Kidney & Urinary Tract Infections W/O Mcc | 13 | 220 / 68 | $9.849,54 | 279 / 16 | $4.913,38 | 982 / 46 | $3.949,92 | 974 / 63 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 13 | 153 / 51 | $12.031,50 | 553 / 31 | $4.480,85 | 775 / 40 | $3.505,08 | 772 / 48 |
| Diabetes W Cc | 12 | 80 / 27 | $9.531,08 | 71 / 4 | $6.211,25 | 187 / 50 | $3.805,17 | 187 / 17 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 12 | 81 / 29 | $9.075,00 | 151 / 6 | $5.601,08 | 248 / 63 | $2.989,08 | 246 / 15 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 12 | 263 / 74 | $10.866,50 | 278 / 12 | $4.744,17 | 1076 / 36 | $3.807,75 | 1068 / 67 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 11 | 505 / 94 | $18.605,80 | 207 / 9 | $11.592,80 | 1250 / 63 | $10.554,30 | 1229 / 74 |
| Renal Failure W Cc | 11 | 210 / 66 | $11.007,90 | 148 / 7 | $6.141,18 | 664 / 49 | $4.892,18 | 657 / 40 |
| Heart Failure & Shock W/O Cc/Mcc | 11 | 99 / 35 | $9.978,73 | 259 / 14 | $4.331,27 | 497 / 29 | $3.307,27 | 495 / 28 |
| Simple Pneumonia & Pleurisy W Mcc | 11 | 194 / 60 | $15.012,20 | 124 / 10 | $8.899,00 | 1094 / 52 | $7.979,27 | 1094 / 73 |
| G.I. Hemorrhage W Cc | 11 | 207 / 65 | $16.987,80 | 481 / 25 | $6.412,82 | 1303 / 51 | $5.697,18 | 1300 / 79 | Total 20 procedures | 359 | 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.