Hospital Costs > In Idaho > Kootenai Health, 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 | 248 | 316 / 4 | $42.721,90 | 910 / 9 | $12.859,40 | 677 / 2 | $10.593,70 | 668 / 2 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 195 | 321 / 4 | $33.824,10 | 991 / 5 | $12.315,00 | 1410 / 4 | $10.874,10 | 1383 / 5 |
| Psychoses | 183 | 130 / 2 | $24.225,00 | 402 / 3 | $7.036,61 | 310 / 3 | $6.028,45 | 310 / 3 |
| Heart Failure & Shock W Mcc | 98 | 186 / 1 | $24.912,40 | 734 / 3 | $9.816,97 | 1496 / 5 | $9.035,09 | 1492 / 5 |
| Heart Failure & Shock W Cc | 84 | 194 / 2 | $20.063,10 | 1194 / 5 | $6.833,55 | 1521 / 6 | $5.802,58 | 1516 / 5 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 77 | 130 / 3 | $22.595,10 | 1028 / 7 | $7.320,53 | 1323 / 5 | $6.015,65 | 1318 / 5 |
| Simple Pneumonia & Pleurisy W Mcc | 76 | 129 / 1 | $26.831,00 | 823 / 4 | $9.308,55 | 1314 / 5 | $8.339,29 | 1314 / 5 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 72 | 94 / 1 | $13.587,10 | 775 / 4 | $5.009,69 | 1416 / 2 | $3.985,90 | 1411 / 6 |
| Chronic Obstructive Pulmonary Disease W Mcc | 70 | 132 / 2 | $20.409,70 | 757 / 3 | $7.830,89 | 1543 / 2 | $6.899,69 | 1536 / 5 |
| Simple Pneumonia & Pleurisy W Cc | 69 | 134 / 1 | $18.831,60 | 1000 / 4 | $6.744,54 | 1656 / 3 | $5.675,54 | 1649 / 4 |
| Pulmonary Edema & Respiratory Failure | 65 | 138 / 3 | $23.944,90 | 662 / 5 | $8.222,69 | 1144 / 5 | $7.161,03 | 1142 / 6 |
| Renal Failure W Cc | 62 | 159 / 2 | $18.548,70 | 831 / 6 | $6.771,44 | 1333 / 5 | $5.541,65 | 1325 / 4 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 61 | 135 / 3 | $54.652,60 | 327 / 4 | $14.128,70 | 810 / 4 | $11.699,00 | 805 / 4 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 56 | 126 / 2 | $19.946,00 | 471 / 3 | $7.027,23 | 972 / 4 | $5.794,38 | 969 / 2 |
| G.I. Hemorrhage W Cc | 55 | 163 / 4 | $24.649,90 | 1177 / 8 | $7.384,71 | 1597 / 6 | $6.155,84 | 1593 / 6 |
| Hip & Femur Procedures Except Major Joint W Cc | 55 | 88 / 1 | $32.697,20 | 320 / 1 | $12.446,40 | 1014 / 3 | $11.067,00 | 1001 / 4 |
| Kidney & Urinary Tract Infections W/O Mcc | 54 | 179 / 3 | $15.029,40 | 945 / 5 | $5.386,33 | 1649 / 2 | $4.492,65 | 1638 / 4 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 53 | 222 / 3 | $18.071,70 | 1138 / 5 | $5.427,30 | 1458 / 5 | $4.092,09 | 1447 / 2 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 51 | 80 / 1 | $36.043,70 | 232 / 1 | $14.643,60 | 907 / 1 | $13.756,40 | 899 / 1 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 44 | 58 / 1 | $13.804,80 | 176 / 1 | $5.515,75 | 779 / 4 | $3.970,48 | 775 / 2 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 44 | 117 / 1 | $15.953,20 | 617 / 4 | $5.493,25 | 1263 / 4 | $4.585,61 | 1258 / 5 |
| Cellulitis W/O Mcc | 43 | 146 / 2 | $18.964,40 | 1363 / 5 | $5.800,00 | 1624 / 2 | $4.872,00 | 1617 / 5 |
| Renal Failure W Mcc | 42 | 153 / 3 | $26.100,70 | 526 / 4 | $10.589,80 | 1200 / 3 | $9.446,24 | 1200 / 4 |
| Coronary Bypass W Cardiac Cath W/O Mcc | 42 | 34 / 1 | $97.449,10 | 108 / 1 | $34.583,70 | 189 / 2 | $24.760,20 | 189 / 2 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 41 | 109 / 1 | $11.106,50 | 474 / 2 | $4.061,12 | 1229 / 2 | $3.059,76 | 1224 / 3 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 39 | 129 / 3 | $25.150,50 | 211 / 1 | $11.088,20 | 595 / 1 | $9.609,05 | 594 / 1 |
| Chronic Obstructive Pulmonary Disease W Cc | 38 | 141 / 1 | $18.191,30 | 827 / 4 | $6.400,08 | 1231 / 3 | $5.198,66 | 1226 / 2 |
| Major Small & Large Bowel Procedures W Cc | 37 | 71 / 2 | $49.798,80 | 416 / 2 | $18.114,40 | 745 / 4 | $14.533,90 | 737 / 3 |
| Respiratory Infections & Inflammations W Mcc | 36 | 100 / 2 | $28.209,60 | 333 / 2 | $12.348,50 | 1023 / 3 | $11.776,90 | 1010 / 4 |
| Kidney & Urinary Tract Infections W Mcc | 35 | 109 / 2 | $17.392,50 | 392 / 1 | $7.303,77 | 1126 / 2 | $6.616,23 | 1122 / 3 |
| Spinal Fusion Except Cervical W/O Mcc | 34 | 160 / 9 | $74.164,90 | 440 / 6 | $25.965,50 | 621 / 3 | $22.560,80 | 617 / 5 |
| Major Small & Large Bowel Procedures W Mcc | 30 | 55 / 1 | $86.672,80 | 259 / 2 | $33.685,60 | 637 / 2 | $31.302,00 | 635 / 3 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 30 | 95 / 2 | $31.578,00 | 496 / 2 | $10.918,60 | 884 / 3 | $9.954,30 | 883 / 3 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 29 | 94 / 2 | $19.423,90 | 305 / 1 | $8.207,90 | 749 / 3 | $6.724,41 | 746 / 3 |
| Major Cardiovasc Procedures W/O Mcc | 28 | 73 / 2 | $65.274,80 | 189 / 4 | $22.320,00 | 466 / 3 | $20.004,80 | 466 / 3 |
| Transient Ischemia | 28 | 97 / 1 | $12.808,60 | 165 / 2 | $4.936,96 | 843 / 1 | $3.770,11 | 839 / 2 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 28 | 98 / 3 | $21.764,00 | 511 / 3 | $7.921,79 | 785 / 3 | $6.556,18 | 782 / 3 |
| Other Digestive System Diagnoses W Cc | 27 | 70 / 2 | $19.296,60 | 366 / 5 | $6.577,67 | 826 / 1 | $5.858,26 | 822 / 3 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 27 | 66 / 2 | $14.378,20 | 657 / 4 | $5.066,89 | 1032 / 3 | $3.705,85 | 1026 / 1 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Cc | 27 | 91 / 2 | $92.419,70 | 48 / 1 | $33.497,20 | 261 / 1 | $32.422,20 | 261 / 2 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 27 | 97 / 3 | $91.546,00 | 394 / 4 | $34.272,90 | 866 / 2 | $33.434,40 | 860 / 2 |
| Alcohol/Drug Abuse Or Dependence W Rehabilitation Therapy | 27 | 54 / 1 | $25.868,10 | 54 / 1 | $7.969,04 | 41 / 1 | $7.388,30 | 41 / 1 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 26 | 98 / 2 | $17.293,10 | 423 / 2 | $4.848,35 | 376 / 2 | $4.012,65 | 376 / 5 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 25 | 75 / 1 | $84.069,10 | 323 / 4 | $23.460,90 | 629 / 4 | $21.060,10 | 625 / 5 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 23 | 68 / 2 | $25.496,70 | 543 / 1 | $7.484,22 | 730 / 2 | $5.951,00 | 728 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 23 | 78 / 1 | $22.425,30 | 171 / 1 | $10.027,20 | 300 / 1 | $8.369,39 | 300 / 1 |
| Respiratory Infections & Inflammations W Cc | 22 | 66 / 2 | $21.827,60 | 339 / 2 | $8.300,73 | 486 / 1 | $7.314,55 | 483 / 1 |
| Red Blood Cell Disorders W/O Mcc | 22 | 121 / 1 | $18.896,80 | 793 / 2 | $5.623,59 | 887 / 1 | $4.398,00 | 882 / 1 |
| Pulmonary Embolism W/O Mcc | 22 | 52 / 4 | $17.735,00 | 272 / 3 | $7.203,36 | 344 / 6 | $4.883,32 | 344 / 2 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 21 | 99 / 1 | $14.170,20 | 685 / 2 | $5.040,71 | 1240 / 1 | $4.001,48 | 1231 / 1 |
| G.I. Obstruction W/O Cc/Mcc | 21 | 50 / 2 | $11.179,50 | 214 / 1 | $4.622,38 | 655 / 4 | $3.164,95 | 653 / 2 |
| Revision Of Hip Or Knee Replacement W Cc | 21 | 65 / 2 | $62.384,00 | 161 / 1 | $21.589,60 | 37 / 2 | $15.890,10 | 37 / 1 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 20 | 41 / 2 | $11.218,50 | 149 / 2 | $4.994,40 | 308 / 4 | $3.349,90 | 307 / 1 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 20 | 76 / 3 | $22.391,20 | 312 / 2 | $13.009,50 | 553 / 5 | $6.738,60 | 548 / 2 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 20 | 56 / 1 | $32.691,20 | 131 / 1 | $12.051,00 | 216 / 1 | $11.203,00 | 216 / 1 |
| Cervical Spinal Fusion W/O Cc/Mcc | 19 | 85 / 6 | $39.957,20 | 192 / 4 | $14.399,40 | 552 / 4 | $13.188,50 | 549 / 6 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 19 | 54 / 2 | $16.442,40 | 162 / 1 | $7.645,16 | 573 / 1 | $6.877,16 | 571 / 2 |
| G.I. Hemorrhage W Mcc | 18 | 103 / 3 | $39.530,20 | 677 / 4 | $12.337,80 | 1188 / 3 | $12.135,10 | 1180 / 5 |
| Medical Back Problems W/O Mcc | 18 | 103 / 4 | $13.387,30 | 143 / 1 | $6.461,72 | 675 / 4 | $4.528,28 | 673 / 2 |
| Heart Failure & Shock W/O Cc/Mcc | 18 | 92 / 2 | $14.448,70 | 787 / 2 | $4.795,39 | 1112 / 2 | $3.858,50 | 1103 / 2 |
| Other Vascular Procedures W Cc | 18 | 84 / 2 | $55.628,30 | 288 / 4 | $17.976,80 | 655 / 3 | $15.988,20 | 652 / 3 |
| Other Circulatory System Diagnoses W Mcc | 18 | 98 / 2 | $34.115,60 | 319 / 1 | $12.476,60 | 713 / 1 | $11.673,10 | 711 / 2 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 18 | 53 / 1 | $94.570,40 | 213 / 1 | $32.341,60 | 446 / 1 | $31.470,60 | 446 / 1 |
| Extracranial Procedures W/O Cc/Mcc | 17 | 81 / 3 | $20.407,40 | 147 / 1 | $7.076,06 | 533 / 1 | $5.869,47 | 532 / 3 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 17 | 39 / 4 | $27.619,40 | 141 / 1 | $10.640,50 | 553 / 3 | $9.507,29 | 551 / 3 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 17 | 171 / 5 | $23.570,20 | 224 / 1 | $7.444,88 | 889 / 3 | $6.105,53 | 886 / 5 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 17 | 55 / 6 | $31.081,80 | 374 / 6 | $9.222,24 | 383 / 4 | $8.083,41 | 382 / 4 |
| Other Vascular Procedures W Mcc | 17 | 80 / 1 | $79.159,60 | 369 / 3 | $26.353,00 | 780 / 4 | $25.287,60 | 777 / 4 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 16 | 31 / 1 | $33.508,60 | 154 / 1 | $10.698,40 | 80 / 1 | $7.050,62 | 80 / 2 |
| G.I. Hemorrhage W/O Cc/Mcc | 16 | 52 / 1 | $17.480,70 | 450 / 1 | $4.929,50 | 512 / 1 | $3.801,50 | 508 / 1 |
| G.I. Obstruction W Cc | 16 | 76 / 4 | $18.538,90 | 550 / 4 | $6.036,19 | 1053 / 3 | $5.204,19 | 1050 / 5 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 16 | 48 / 3 | $29.153,50 | 121 / 1 | $10.673,80 | 482 / 2 | $9.767,81 | 482 / 3 |
| Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 16 | 79 / 1 | $78.370,60 | 324 / 1 | $13.798,90 | 369 / 1 | $12.678,80 | 365 / 1 |
| Coronary Bypass W/O Cardiac Cath W/O Mcc | 15 | 73 / 3 | $76.146,90 | 109 / 1 | $24.206,40 | 378 / 2 | $23.158,90 | 377 / 3 |
| Fractures Of Hip & Pelvis W/O Mcc | 15 | 46 / 3 | $11.486,30 | 138 / 1 | $5.023,87 | 552 / 2 | $4.057,47 | 552 / 3 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 14 | 51 / 5 | $68.664,80 | 360 / 5 | $20.545,60 | 530 / 2 | $19.686,30 | 527 / 4 |
| Major Chest Procedures W Cc | 14 | 60 / 3 | $60.021,70 | 193 / 2 | $17.885,60 | 328 / 2 | $16.767,90 | 326 / 2 |
| Renal Failure W/O Cc/Mcc | 14 | 42 / 1 | $9.863,43 | 110 / 1 | $4.489,21 | 449 / 2 | $3.446,93 | 448 / 2 |
| Syncope & Collapse | 14 | 155 / 5 | $14.714,50 | 366 / 4 | $5.105,00 | 1061 / 3 | $4.154,14 | 1054 / 2 |
| Coronary Bypass W Cardiac Cath W Mcc | 13 | 43 / 1 | $118.143,00 | 36 / 1 | $50.037,20 | 177 / 1 | $41.032,50 | 177 / 1 |
| Major Cardiovasc Procedures W Mcc | 13 | 55 / 3 | $77.279,50 | 44 / 1 | $40.520,30 | 15 / 3 | $24.175,90 | 15 / 1 |
| Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 13 | 44 / 2 | $51.869,90 | 305 / 3 | $14.728,70 | 292 / 2 | $11.899,10 | 291 / 2 |
| Peritoneal Adhesiolysis W Cc | 13 | 26 / 1 | $35.155,70 | 22 / 1 | $14.091,30 | 99 / 1 | $12.971,30 | 99 / 1 |
| Other Circulatory System Diagnoses W Cc | 12 | 54 / 2 | $23.120,10 | 263 / 1 | $6.370,75 | 333 / 1 | $5.664,08 | 332 / 1 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 12 | 43 / 3 | $34.700,00 | 80 / 1 | $12.860,30 | 227 / 1 | $10.766,40 | 227 / 1 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 12 | 44 / 2 | $28.701,80 | 72 / 1 | $11.486,80 | 381 / 2 | $8.985,83 | 381 / 1 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 12 | 28 / 2 | $40.715,50 | 43 / 1 | $16.466,00 | 142 / 1 | $13.681,30 | 141 / 1 |
| Permanent Cardiac Pacemaker Implant W Cc | 12 | 65 / 3 | $47.792,70 | 185 / 2 | $17.006,70 | 499 / 2 | $15.897,30 | 498 / 2 |
| Major Joint/Limb Reattachment Procedure Of Upper Extremities | 11 | 58 / 1 | $58.029,80 | 184 / 2 | $18.051,10 | 179 / 2 | $14.006,80 | 179 / 2 |
| Other Resp System O.R. Procedures W Cc | 11 | 36 / 1 | $35.378,80 | 49 / 1 | $16.558,30 | 34 / 1 | $9.569,45 | 34 / 1 |
| Seizures W/O Mcc | 11 | 97 / 5 | $14.669,90 | 248 / 2 | $5.319,36 | 579 / 3 | $4.216,82 | 576 / 2 |
| Organic Disturbances & Mental Retardation | 11 | 48 / 1 | $16.759,40 | 124 / 1 | $6.827,73 | 266 / 1 | $6.053,91 | 266 / 1 |
| Pulmonary Embolism W Mcc | 11 | 32 / 4 | $22.821,40 | 75 / 1 | $9.676,09 | 185 / 1 | $8.208,73 | 185 / 1 |
| Nonspecific Cerebrovascular Disorders W Cc | 11 | 45 / 2 | $23.944,50 | 201 / 3 | $7.299,45 | 345 / 2 | $6.636,18 | 345 / 3 |
| Postoperative & Post-Traumatic Infections W/O Mcc | 11 | 43 / 2 | $15.105,80 | 50 / 1 | $6.578,09 | 179 / 1 | $5.810,09 | 179 / 1 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 11 | 42 / 2 | $13.605,80 | 108 / 1 | $5.307,55 | 436 / 1 | $4.100,27 | 433 / 1 |
| Chemotherapy W/O Acute Leukemia As Secondary Diagnosis W Cc | 11 | 80 / 1 | $30.886,90 | 172 / 1 | $11.275,70 | 5 / 1 | $4.616,36 | 5 / 1 |
| Craniotomy & Endovascular Intracranial Procedures W Mcc | 11 | 87 / 3 | $61.996,80 | 33 / 1 | $23.120,80 | 15 / 1 | $20.829,30 | 15 / 1 |
| Red Blood Cell Disorders W Mcc | 11 | 60 / 1 | $19.759,30 | 152 / 1 | $8.299,55 | 548 / 1 | $7.639,18 | 546 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 1 | $24.064,70 | 359 / 1 | $6.993,27 | 173 / 1 | $5.089,27 | 173 / 1 |
| Digestive Malignancy W Cc | 11 | 36 / 1 | $34.407,90 | 189 / 1 | $9.702,00 | 25 / 1 | $5.955,00 | 25 / 1 |
| Cellulitis W Mcc | 11 | 47 / 3 | $34.282,60 | 471 / 3 | $9.139,82 | 446 / 2 | $8.476,55 | 444 / 2 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 11 | 58 / 2 | $56.180,90 | 213 / 2 | $11.867,70 | 330 / 1 | $10.771,10 | 329 / 1 |
| Major Hematol/Immun Diag Exc Sickle Cell Crisis & Coagul W Cc | 11 | 42 / 2 | $20.321,20 | 64 / 2 | $7.955,27 | 181 / 1 | $6.861,45 | 181 / 1 | Total 104 procedures | 3.438 | 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.