Hospital Costs > In Missouri > Lake Regional 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 | 100 | 464 / 33 | $62.552,30 | 1790 / 52 | $14.860,60 | 2018 / 49 | $13.682,30 | 1976 / 53 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 78 | 118 / 9 | $65.989,60 | 595 / 27 | $14.668,20 | 1050 / 36 | $12.857,00 | 1043 / 38 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 69 | 447 / 40 | $34.701,30 | 1037 / 25 | $12.854,30 | 1882 / 51 | $11.980,30 | 1847 / 52 |
| Simple Pneumonia & Pleurisy W Mcc | 49 | 156 / 29 | $29.407,60 | 999 / 27 | $9.997,73 | 1590 / 46 | $8.894,06 | 1590 / 46 |
| Heart Failure & Shock W Cc | 49 | 229 / 31 | $23.382,10 | 1531 / 41 | $6.910,98 | 1688 / 50 | $5.982,12 | 1683 / 50 |
| Heart Failure & Shock W Mcc | 49 | 235 / 32 | $35.199,20 | 1410 / 34 | $10.430,80 | 1754 / 47 | $9.610,22 | 1749 / 49 |
| Pulmonary Edema & Respiratory Failure | 47 | 156 / 27 | $32.637,50 | 1185 / 32 | $8.529,45 | 1442 / 41 | $7.706,66 | 1437 / 40 |
| G.I. Hemorrhage W Cc | 45 | 173 / 24 | $26.234,50 | 1307 / 33 | $7.087,38 | 1578 / 45 | $6.103,93 | 1574 / 44 |
| Simple Pneumonia & Pleurisy W Cc | 43 | 160 / 30 | $23.531,80 | 1500 / 47 | $6.910,28 | 1803 / 53 | $5.848,86 | 1795 / 51 |
| Chronic Obstructive Pulmonary Disease W Mcc | 42 | 160 / 26 | $27.640,30 | 1321 / 41 | $8.156,00 | 1665 / 51 | $7.133,29 | 1657 / 53 |
| Kidney & Urinary Tract Infections W/O Mcc | 40 | 193 / 27 | $18.237,80 | 1375 / 41 | $5.364,05 | 1669 / 46 | $4.516,55 | 1658 / 50 |
| Chronic Obstructive Pulmonary Disease W Cc | 38 | 141 / 21 | $24.496,70 | 1418 / 47 | $6.408,37 | 1296 / 46 | $5.268,76 | 1291 / 39 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 38 | 144 / 22 | $32.950,90 | 1277 / 37 | $7.482,29 | 1313 / 37 | $6.367,18 | 1310 / 37 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 37 | 129 / 23 | $17.587,10 | 1277 / 40 | $4.805,14 | 1331 / 42 | $3.912,57 | 1326 / 43 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 37 | 151 / 20 | $38.101,30 | 882 / 35 | $7.537,27 | 1029 / 33 | $6.418,89 | 1026 / 37 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 36 | 239 / 35 | $24.417,30 | 1838 / 53 | $5.176,33 | 1431 / 41 | $4.069,31 | 1420 / 44 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 34 | 173 / 26 | $25.203,00 | 1273 / 29 | $7.439,29 | 1630 / 42 | $6.469,62 | 1623 / 44 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 33 | 67 / 9 | $95.015,80 | 437 / 24 | $25.287,40 | 615 / 28 | $20.983,80 | 611 / 24 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 31 | 94 / 13 | $52.980,40 | 1204 / 36 | $14.323,20 | 917 / 41 | $10.059,20 | 916 / 31 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 30 | 90 / 15 | $21.258,10 | 1352 / 47 | $4.970,33 | 1119 / 35 | $3.843,47 | 1110 / 37 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 30 | 93 / 19 | $30.031,00 | 961 / 23 | $8.424,57 | 1143 / 34 | $7.454,20 | 1140 / 35 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 30 | 120 / 21 | $13.618,20 | 814 / 23 | $3.837,80 | 963 / 26 | $2.793,43 | 958 / 31 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 30 | 131 / 26 | $17.187,30 | 773 / 18 | $5.470,87 | 1327 / 35 | $4.701,00 | 1322 / 38 |
| Hip & Femur Procedures Except Major Joint W Cc | 27 | 116 / 25 | $50.290,30 | 1056 / 32 | $13.657,10 | 1419 / 41 | $12.453,20 | 1401 / 41 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 25 | 106 / 22 | $44.587,50 | 468 / 13 | $15.814,40 | 1170 / 36 | $14.939,20 | 1157 / 37 |
| Cellulitis W/O Mcc | 25 | 164 / 35 | $17.033,10 | 1130 / 33 | $5.850,12 | 1618 / 47 | $4.866,96 | 1611 / 50 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 25 | 68 / 17 | $21.059,80 | 1263 / 37 | $4.890,72 | 1056 / 35 | $3.728,28 | 1050 / 35 |
| Renal Failure W Cc | 24 | 197 / 40 | $20.747,10 | 1051 / 32 | $6.750,62 | 1272 / 45 | $5.468,46 | 1264 / 39 |
| Extracranial Procedures W/O Cc/Mcc | 23 | 75 / 14 | $34.486,40 | 541 / 19 | $7.251,09 | 599 / 20 | $6.112,00 | 597 / 21 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 23 | 68 / 9 | $33.092,20 | 853 / 24 | $7.325,00 | 891 / 24 | $6.332,39 | 889 / 25 |
| Major Small & Large Bowel Procedures W Cc | 22 | 86 / 20 | $67.666,00 | 814 / 25 | $18.271,20 | 1146 / 29 | $17.024,80 | 1133 / 31 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 21 | 81 / 18 | $29.029,30 | 1067 / 35 | $5.368,19 | 755 / 29 | $3.939,71 | 751 / 25 |
| Kidney & Urinary Tract Infections W Mcc | 20 | 124 / 24 | $23.523,30 | 819 / 23 | $7.808,20 | 1286 / 33 | $6.958,30 | 1282 / 33 |
| Other Digestive System Diagnoses W Cc | 20 | 77 / 15 | $26.320,20 | 729 / 22 | $6.750,00 | 807 / 24 | $5.812,40 | 803 / 25 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 17 | 109 / 24 | $20.692,80 | 446 / 14 | $7.711,24 | 865 / 33 | $6.728,12 | 862 / 29 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 17 | 151 / 29 | $42.842,10 | 774 / 26 | $12.172,60 | 1063 / 30 | $11.377,60 | 1058 / 32 |
| G.I. Obstruction W Cc | 16 | 76 / 21 | $17.187,60 | 443 / 11 | $6.157,94 | 997 / 33 | $5.116,12 | 994 / 32 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 15 | 56 / 12 | $93.752,70 | 208 / 5 | $36.425,10 | 638 / 20 | $35.541,40 | 637 / 21 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 15 | 58 / 13 | $23.164,70 | 405 / 11 | $8.833,27 | 579 / 27 | $6.901,67 | 577 / 21 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 15 | 109 / 21 | $85.105,90 | 298 / 9 | $36.831,80 | 1019 / 29 | $35.739,60 | 1013 / 31 |
| Red Blood Cell Disorders W/O Mcc | 15 | 128 / 27 | $22.390,30 | 1099 / 31 | $5.558,27 | 1195 / 31 | $4.783,53 | 1187 / 35 |
| Diabetes W Cc | 14 | 78 / 20 | $20.810,40 | 748 / 23 | $5.856,07 | 697 / 26 | $4.527,07 | 695 / 25 |
| G.I. Obstruction W/O Cc/Mcc | 14 | 57 / 16 | $15.096,40 | 534 / 16 | $4.223,21 | 639 / 19 | $3.148,00 | 637 / 16 |
| Renal Failure W Mcc | 14 | 181 / 35 | $33.054,60 | 949 / 23 | $10.706,90 | 1343 / 37 | $9.761,71 | 1343 / 37 |
| G.I. Hemorrhage W Mcc | 14 | 107 / 22 | $38.314,90 | 630 / 17 | $12.189,40 | 1032 / 30 | $11.400,00 | 1024 / 31 |
| Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 13 | 34 / 9 | $34.405,00 | 226 / 8 | $8.486,69 | 425 / 12 | $7.514,38 | 424 / 13 |
| Major Small & Large Bowel Procedures W Mcc | 13 | 72 / 18 | $120.711,00 | 565 / 21 | $35.998,20 | 858 / 22 | $34.578,70 | 856 / 25 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 13 | 59 / 18 | $31.544,90 | 384 / 11 | $9.739,15 | 590 / 20 | $9.027,46 | 588 / 20 |
| Respiratory Infections & Inflammations W Mcc | 12 | 124 / 36 | $46.587,20 | 990 / 30 | $13.886,10 | 1250 / 37 | $12.712,30 | 1235 / 38 |
| Major Cardiovasc Procedures W/O Mcc | 12 | 89 / 21 | $89.105,00 | 486 / 17 | $23.296,10 | 671 / 22 | $22.203,70 | 670 / 22 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 12 | 52 / 13 | $42.777,30 | 346 / 14 | $11.388,40 | 515 / 18 | $10.084,30 | 515 / 18 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 12 | 84 / 23 | $29.512,50 | 619 / 21 | $8.268,83 | 798 / 27 | $7.385,42 | 793 / 27 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 12 | 41 / 9 | $33.329,70 | 638 / 14 | $5.252,58 | 438 / 11 | $4.111,08 | 435 / 10 |
| Disorders Of Pancreas Except Malignancy W Cc | 12 | 49 / 14 | $20.378,30 | 312 / 11 | $6.390,58 | 544 / 14 | $5.418,50 | 541 / 15 |
| Other Vascular Procedures W Cc | 12 | 90 / 22 | $85.511,80 | 703 / 25 | $17.805,80 | 761 / 21 | $16.908,60 | 756 / 23 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 17 | $17.496,60 | 169 / 6 | $6.873,64 | 447 / 18 | $6.036,00 | 447 / 19 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 11 | 90 / 22 | $35.324,50 | 531 / 18 | $10.914,30 | 661 / 25 | $9.929,82 | 659 / 25 |
| Heart Failure & Shock W/O Cc/Mcc | 11 | 99 / 26 | $15.107,50 | 861 / 24 | $4.675,18 | 1202 / 30 | $3.973,36 | 1192 / 34 |
| Syncope & Collapse | 11 | 158 / 29 | $25.560,30 | 1244 / 34 | $5.046,73 | 1033 / 31 | $4.107,09 | 1026 / 31 | Total 59 procedures | 1.603 | 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.