Hospital Costs > In Montana > Kalispell Regional Medical Center, 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 | 212 | 352 / 5 | $35.911,20 | 517 / 6 | $13.802,90 | 1292 / 5 | $11.565,60 | 1260 / 5 |
| Psychoses | 130 | 167 / 2 | $18.085,00 | 276 / 3 | $6.666,58 | 203 / 2 | $5.529,52 | 203 / 1 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 69 | 447 / 8 | $37.722,20 | 1194 / 8 | $11.783,80 | 1281 / 3 | $10.610,80 | 1260 / 5 |
| Simple Pneumonia & Pleurisy W Cc | 51 | 152 / 3 | $27.389,30 | 1802 / 10 | $9.081,16 | 2565 / 10 | $8.179,51 | 2556 / 10 |
| G.I. Hemorrhage W Cc | 47 | 171 / 5 | $16.625,60 | 454 / 6 | $6.531,55 | 1183 / 4 | $5.555,89 | 1181 / 6 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 42 | 154 / 5 | $60.583,50 | 466 / 6 | $13.913,70 | 745 / 4 | $11.377,30 | 741 / 5 |
| Simple Pneumonia & Pleurisy W Mcc | 38 | 167 / 7 | $24.790,20 | 688 / 6 | $9.601,13 | 810 / 4 | $7.666,92 | 810 / 3 |
| Heart Failure & Shock W Cc | 38 | 240 / 5 | $15.248,10 | 605 / 4 | $6.361,26 | 1383 / 4 | $5.628,63 | 1378 / 6 |
| Hip & Femur Procedures Except Major Joint W Cc | 37 | 106 / 5 | $35.790,10 | 442 / 4 | $11.828,90 | 877 / 3 | $10.752,10 | 864 / 3 |
| Pulmonary Edema & Respiratory Failure | 37 | 166 / 4 | $22.701,90 | 577 / 6 | $7.747,03 | 1033 / 3 | $6.997,19 | 1032 / 4 |
| Major Small & Large Bowel Procedures W Cc | 36 | 72 / 2 | $49.110,70 | 398 / 7 | $15.455,60 | 725 / 2 | $14.453,80 | 718 / 3 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 34 | 148 / 5 | $17.817,00 | 332 / 5 | $6.768,24 | 1005 / 4 | $5.844,94 | 1002 / 4 |
| Kidney & Urinary Tract Infections W/O Mcc | 31 | 202 / 3 | $14.928,50 | 921 / 6 | $5.156,39 | 1219 / 5 | $4.100,39 | 1210 / 4 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 31 | 244 / 7 | $14.148,00 | 637 / 6 | $5.162,84 | 1308 / 4 | $3.977,61 | 1297 / 4 |
| Spinal Fusion Except Cervical W/O Mcc | 30 | 164 / 7 | $81.228,80 | 542 / 4 | $26.674,90 | 635 / 5 | $22.700,40 | 631 / 4 |
| Chronic Obstructive Pulmonary Disease W Mcc | 27 | 175 / 5 | $19.994,80 | 711 / 6 | $7.506,56 | 1362 / 4 | $6.656,78 | 1356 / 5 |
| Renal Failure W Cc | 25 | 196 / 6 | $18.705,20 | 851 / 9 | $6.268,92 | 1255 / 4 | $5.449,72 | 1247 / 5 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 25 | 182 / 8 | $22.753,60 | 1047 / 8 | $7.672,92 | 999 / 7 | $5.658,48 | 996 / 4 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 23 | 145 / 4 | $31.791,40 | 401 / 4 | $10.733,40 | 685 / 2 | $9.838,78 | 684 / 2 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 23 | 143 / 6 | $12.896,20 | 659 / 3 | $4.767,43 | 1014 / 2 | $3.662,74 | 1011 / 2 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 22 | 102 / 2 | $15.777,00 | 369 / 2 | $4.654,41 | 250 / 1 | $3.663,86 | 250 / 1 |
| Heart Failure & Shock W Mcc | 21 | 263 / 8 | $17.906,00 | 304 / 2 | $9.381,62 | 1282 / 3 | $8.694,38 | 1279 / 4 |
| Extracranial Procedures W/O Cc/Mcc | 20 | 78 / 4 | $23.348,40 | 233 / 4 | $6.782,20 | 463 / 2 | $5.631,80 | 462 / 2 |
| Cellulitis W/O Mcc | 19 | 170 / 5 | $19.789,60 | 1459 / 9 | $6.370,68 | 1295 / 8 | $4.528,79 | 1289 / 6 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 19 | 169 / 4 | $25.855,40 | 322 / 5 | $7.019,58 | 814 / 3 | $5.941,68 | 812 / 3 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 19 | 70 / 2 | $29.331,10 | 285 / 3 | $7.814,74 | 284 / 2 | $5.523,05 | 283 / 2 |
| Pulmonary Embolism W/O Mcc | 19 | 55 / 3 | $20.183,70 | 390 / 5 | $6.875,89 | 520 / 6 | $5.225,32 | 518 / 3 |
| Heart Failure & Shock W/O Cc/Mcc | 18 | 92 / 3 | $12.720,40 | 565 / 4 | $4.598,67 | 1171 / 4 | $3.928,44 | 1161 / 6 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 18 | 113 / 4 | $41.911,20 | 379 / 3 | $14.053,20 | 781 / 2 | $13.247,80 | 773 / 3 |
| Chronic Obstructive Pulmonary Disease W Cc | 18 | 161 / 5 | $14.020,90 | 417 / 2 | $6.128,94 | 1224 / 3 | $5.190,28 | 1219 / 4 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 17 | 76 / 4 | $14.301,60 | 648 / 6 | $4.767,06 | 957 / 5 | $3.637,65 | 952 / 4 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 16 | 104 / 3 | $13.619,10 | 620 / 4 | $4.838,50 | 1051 / 2 | $3.786,50 | 1042 / 3 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 16 | 86 / 5 | $15.003,20 | 251 / 6 | $5.097,81 | 888 / 5 | $4.115,81 | 884 / 7 |
| Medical Back Problems W/O Mcc | 16 | 105 / 5 | $13.102,60 | 135 / 3 | $6.180,69 | 290 / 6 | $3.936,94 | 290 / 3 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 16 | 53 / 2 | $55.954,60 | 212 / 3 | $11.308,80 | 262 / 2 | $10.178,80 | 262 / 2 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 16 | 108 / 5 | $122.753,00 | 767 / 7 | $38.363,20 | 1147 / 5 | $37.761,20 | 1139 / 5 |
| Major Small & Large Bowel Procedures W Mcc | 16 | 69 / 3 | $82.606,30 | 214 / 2 | $31.526,10 | 375 / 4 | $28.292,80 | 373 / 1 |
| G.I. Hemorrhage W Mcc | 15 | 106 / 6 | $30.659,30 | 347 / 3 | $10.766,30 | 611 / 2 | $9.966,33 | 612 / 2 |
| Major Cardiovasc Procedures W/O Mcc | 15 | 86 / 4 | $77.158,10 | 344 / 4 | $20.927,50 | 451 / 1 | $19.880,10 | 451 / 3 |
| Other Digestive System Diagnoses W Cc | 15 | 82 / 3 | $19.479,50 | 377 / 7 | $6.303,40 | 666 / 4 | $5.501,27 | 662 / 5 |
| Fractures Of Hip & Pelvis W/O Mcc | 15 | 46 / 2 | $12.251,00 | 173 / 3 | $4.821,80 | 467 / 3 | $3.855,40 | 467 / 4 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 15 | 146 / 5 | $14.080,30 | 422 / 3 | $5.262,33 | 1229 / 3 | $4.539,13 | 1224 / 5 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 14 | 109 / 5 | $21.580,40 | 427 / 5 | $7.730,71 | 664 / 4 | $6.613,00 | 661 / 4 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 14 | 42 / 2 | $26.943,10 | 127 / 2 | $10.029,80 | 404 / 2 | $8.822,93 | 402 / 3 |
| G.I. Obstruction W/O Cc/Mcc | 14 | 57 / 4 | $11.229,50 | 219 / 6 | $4.681,14 | 437 / 7 | $2.881,07 | 436 / 3 |
| Disorders Of Pancreas Except Malignancy W Cc | 14 | 47 / 3 | $16.380,40 | 161 / 3 | $6.031,57 | 389 / 2 | $4.993,86 | 388 / 3 |
| Renal Failure W Mcc | 13 | 182 / 7 | $39.529,20 | 1274 / 8 | $9.736,54 | 1036 / 2 | $8.990,69 | 1036 / 5 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 13 | 87 / 3 | $88.471,80 | 365 / 3 | $23.218,30 | 275 / 3 | $17.708,90 | 273 / 1 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Cc | 13 | 105 / 4 | $131.106,00 | 218 / 3 | $33.630,30 | 267 / 3 | $32.510,30 | 267 / 3 |
| Respiratory Infections & Inflammations W Mcc | 13 | 123 / 8 | $33.195,60 | 524 / 6 | $12.500,60 | 1051 / 3 | $11.845,80 | 1037 / 3 |
| Respiratory Infections & Inflammations W Cc | 12 | 76 / 3 | $21.361,60 | 317 / 2 | $8.708,75 | 840 / 2 | $8.103,42 | 835 / 4 |
| Craniotomy & Endovascular Intracranial Procedures W/O Cc/Mcc | 12 | 62 / 2 | $43.586,20 | 36 / 2 | $13.796,30 | 68 / 1 | $12.788,30 | 68 / 1 |
| Coronary Bypass W Cardiac Cath W/O Mcc | 12 | 64 / 3 | $123.034,00 | 242 / 3 | $29.241,80 | 378 / 1 | $28.233,80 | 378 / 2 |
| Other Vascular Procedures W Cc | 12 | 90 / 3 | $43.796,70 | 131 / 2 | $15.762,80 | 501 / 2 | $14.960,20 | 498 / 3 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 12 | 79 / 3 | $30.839,70 | 764 / 4 | $6.760,50 | 545 / 2 | $5.552,50 | 544 / 2 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 12 | 84 / 5 | $20.456,70 | 222 / 4 | $7.619,75 | 495 / 3 | $6.614,42 | 492 / 3 |
| Major Male Pelvic Procedures W/O Cc/Mcc | 11 | 62 / 4 | $41.460,50 | 194 / 4 | $8.219,27 | 194 / 1 | $7.012,00 | 194 / 3 |
| Stomach, Esophageal & Duodenal Proc W Cc | 11 | 39 / 1 | $57.854,40 | 67 / 1 | $17.340,40 | 105 / 1 | $16.464,70 | 105 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 11 | 139 / 6 | $9.520,18 | 303 / 3 | $3.904,82 | 847 / 4 | $2.703,36 | 843 / 3 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 11 | 54 / 5 | $46.157,40 | 92 / 2 | $20.255,90 | 485 / 2 | $19.153,40 | 482 / 3 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 11 | 115 / 5 | $31.421,90 | 1021 / 5 | $7.541,73 | 1010 / 4 | $7.102,45 | 1007 / 5 | Total 61 procedures | 1.602 | 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.