Hospital Costs > In Texas > Hamilton General Hospital, 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 | 33 | 156 / 57 | $9.799,15 | 224 / 6 | $4.603,18 | 163 / 5 | $3.503,18 | 163 / 10 |
| Chronic Obstructive Pulmonary Disease W Cc | 19 | 160 / 56 | $10.745,80 | 138 / 2 | $5.020,95 | 175 / 4 | $4.123,63 | 175 / 13 |
| Chronic Obstructive Pulmonary Disease W Mcc | 30 | 172 / 63 | $12.480,70 | 148 / 3 | $6.400,30 | 214 / 7 | $5.439,23 | 213 / 14 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 30 | 90 / 26 | $9.412,43 | 185 / 3 | $3.897,97 | 229 / 1 | $3.054,23 | 229 / 13 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 27 | 248 / 84 | $7.927,22 | 89 / 1 | $4.048,63 | 169 / 4 | $3.060,19 | 169 / 15 |
| Heart Failure & Shock W Cc | 24 | 254 / 88 | $16.211,20 | 712 / 17 | $5.597,21 | 402 / 18 | $4.789,08 | 402 / 34 |
| Heart Failure & Shock W Mcc | 20 | 264 / 100 | $14.270,70 | 120 / 3 | $7.943,00 | 77 / 2 | $6.867,75 | 77 / 4 |
| Heart Failure & Shock W/O Cc/Mcc | 31 | 79 / 25 | $10.546,50 | 330 / 7 | $3.683,52 | 114 / 4 | $2.803,00 | 113 / 5 |
| Kidney & Urinary Tract Infections W Mcc | 14 | 130 / 62 | $15.481,60 | 279 / 5 | $6.131,93 | 374 / 9 | $5.528,50 | 373 / 28 |
| Kidney & Urinary Tract Infections W/O Mcc | 40 | 193 / 71 | $9.001,65 | 197 / 12 | $4.192,75 | 347 / 6 | $3.493,77 | 347 / 31 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 13 | 153 / 73 | $9.642,77 | 279 / 12 | $3.805,00 | 236 / 3 | $3.057,54 | 236 / 18 |
| Renal Failure W Cc | 13 | 208 / 92 | $11.554,20 | 180 / 3 | $5.300,31 | 397 / 5 | $4.650,46 | 394 / 36 |
| Respiratory Infections & Inflammations W Cc | 26 | 62 / 19 | $16.758,40 | 147 / 4 | $7.666,62 | 55 / 14 | $6.285,04 | 55 / 2 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 20 | 496 / 137 | $16.201,70 | 103 / 7 | $9.913,40 | 323 / 2 | $9.217,40 | 323 / 18 |
| Signs & Symptoms W/O Mcc | 13 | 78 / 29 | $9.474,08 | 77 / 2 | $3.797,31 | 41 / 2 | $2.773,31 | 41 / 1 |
| Simple Pneumonia & Pleurisy W Cc | 42 | 161 / 65 | $14.738,00 | 526 / 15 | $5.337,33 | 364 / 4 | $4.526,83 | 362 / 25 |
| Simple Pneumonia & Pleurisy W Mcc | 15 | 190 / 79 | $18.224,60 | 277 / 5 | $7.983,40 | 23 / 12 | $6.154,80 | 23 / 2 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 18 | 75 / 36 | $8.767,61 | 130 / 2 | $3.851,89 | 165 / 2 | $2.842,11 | 163 / 12 | Total 18 procedures | 428 | 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.