Hospital Costs > In California > Hoag Orthopedic Institute, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Bilateral Or Multiple Major Joint Procs Of Lower Extremity W/O Mcc | 35 | 28 / 3 | $105.958,00 | 177 / 1 | $25.499,20 | 101 / 2 | $18.739,80 | 101 / 1 |
| Cervical Spinal Fusion W Cc | 22 | 31 / 5 | $70.878,60 | 174 / 2 | $20.454,50 | 137 / 4 | $15.916,40 | 136 / 1 |
| Cervical Spinal Fusion W/O Cc/Mcc | 23 | 81 / 16 | $70.818,70 | 588 / 5 | $15.681,70 | 383 / 5 | $12.047,70 | 382 / 3 |
| Combined Anterior/Posterior Spinal Fusion W Cc | 18 | 28 / 9 | $191.315,00 | 49 / 2 | $53.684,20 | 69 / 2 | $52.612,20 | 69 / 3 |
| Combined Anterior/Posterior Spinal Fusion W/O Cc/Mcc | 13 | 34 / 10 | $155.720,00 | 63 / 3 | $50.750,90 | 24 / 7 | $31.685,40 | 24 / 1 |
| Hip & Femur Procedures Except Major Joint W Cc | 68 | 75 / 10 | $44.235,50 | 814 / 1 | $12.847,00 | 990 / 2 | $11.017,50 | 977 / 1 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 23 | 33 / 11 | $35.655,10 | 318 / 1 | $10.681,80 | 552 / 2 | $9.503,65 | 550 / 6 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 44 | 52 / 5 | $61.169,00 | 490 / 7 | $14.953,60 | 532 / 2 | $13.081,40 | 529 / 3 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 25 | 40 / 8 | $69.253,00 | 370 / 1 | $17.309,80 | 33 / 1 | $14.696,30 | 33 / 1 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 1342 | 5 / 1 | $59.276,70 | 1667 / 43 | $14.800,10 | 1363 / 14 | $11.715,70 | 1330 / 5 |
| Major Joint/Limb Reattachment Procedure Of Upper Extremities | 17 | 52 / 10 | $62.285,90 | 219 / 1 | $17.469,90 | 272 / 1 | $15.248,40 | 272 / 1 |
| Revision Of Hip Or Knee Replacement W Cc | 61 | 30 / 4 | $85.674,90 | 342 / 3 | $21.809,90 | 322 / 1 | $19.673,00 | 321 / 1 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 42 | 27 / 4 | $73.585,40 | 286 / 2 | $18.663,50 | 312 / 5 | $16.214,40 | 311 / 3 |
| Spinal Fusion Except Cervical W/O Mcc | 113 | 81 / 7 | $99.345,40 | 727 / 10 | $27.882,00 | 811 / 8 | $24.214,30 | 807 / 3 | Total 14 procedures | 1.846 | 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.