Hospital Costs > In Indiana > Memorial Hospital Of South Bend, 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 | 380 | 203 / 9 | $55.814,70 | 1539 / 42 | $15.079,70 | 1063 / 61 | $11.167,00 | 1040 / 39 |
| Psychoses | 301 | 64 / 2 | $15.821,00 | 202 / 6 | $7.247,32 | 304 / 11 | $6.010,04 | 304 / 9 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 274 | 244 / 12 | $47.900,40 | 1706 / 56 | $12.278,70 | 1541 / 51 | $11.088,50 | 1510 / 52 |
| Heart Failure & Shock W Mcc | 126 | 158 / 13 | $34.020,10 | 1346 / 54 | $10.110,70 | 1501 / 57 | $9.048,67 | 1497 / 57 |
| Heart Failure & Shock W Cc | 120 | 158 / 11 | $25.313,30 | 1690 / 64 | $9.974,58 | 1431 / 72 | $5.686,83 | 1426 / 56 |
| Renal Failure W Cc | 105 | 116 / 8 | $23.601,70 | 1320 / 47 | $6.848,90 | 1489 / 52 | $5.740,88 | 1480 / 54 |
| Hip & Femur Procedures Except Major Joint W Cc | 92 | 51 / 3 | $62.451,00 | 1417 / 49 | $13.648,10 | 1270 / 50 | $11.851,20 | 1253 / 47 |
| Pulmonary Edema & Respiratory Failure | 86 | 117 / 15 | $31.077,30 | 1099 / 44 | $8.716,19 | 1346 / 53 | $7.482,76 | 1342 / 54 |
| Spinal Fusion Except Cervical W/O Mcc | 85 | 109 / 6 | $135.425,00 | 1029 / 31 | $28.474,00 | 704 / 27 | $23.167,60 | 700 / 22 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 85 | 122 / 6 | $24.807,80 | 1234 / 41 | $7.416,55 | 1449 / 57 | $6.175,82 | 1443 / 54 |
| G.I. Hemorrhage W Cc | 84 | 134 / 9 | $23.145,90 | 1046 / 29 | $7.240,92 | 1533 / 51 | $6.022,33 | 1529 / 49 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 80 | 102 / 12 | $25.357,20 | 816 / 30 | $7.540,69 | 1316 / 49 | $6.371,39 | 1313 / 49 |
| Chronic Obstructive Pulmonary Disease W Mcc | 77 | 125 / 20 | $26.500,20 | 1241 / 49 | $8.123,42 | 1535 / 59 | $6.881,32 | 1528 / 61 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 66 | 209 / 19 | $21.694,00 | 1582 / 56 | $5.597,44 | 1677 / 54 | $4.311,55 | 1664 / 61 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 65 | 96 / 7 | $21.250,80 | 1145 / 44 | $5.850,82 | 1408 / 46 | $4.820,66 | 1403 / 48 |
| Cellulitis W/O Mcc | 63 | 126 / 14 | $18.130,70 | 1260 / 42 | $6.221,43 | 1735 / 62 | $5.026,49 | 1727 / 64 |
| Chronic Obstructive Pulmonary Disease W Cc | 63 | 116 / 15 | $21.869,70 | 1193 / 49 | $6.715,81 | 1595 / 59 | $5.670,25 | 1588 / 60 |
| Renal Failure W Mcc | 61 | 134 / 20 | $33.138,20 | 953 / 31 | $10.079,60 | 1143 / 33 | $9.235,80 | 1143 / 42 |
| Simple Pneumonia & Pleurisy W Mcc | 60 | 145 / 27 | $37.443,10 | 1471 / 53 | $9.967,93 | 1668 / 52 | $9.076,07 | 1668 / 58 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 57 | 66 / 7 | $25.897,90 | 718 / 26 | $8.276,72 | 1075 / 37 | $7.282,49 | 1072 / 41 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 56 | 94 / 11 | $10.828,70 | 431 / 14 | $4.534,62 | 1249 / 47 | $3.090,21 | 1244 / 47 |
| Kidney & Urinary Tract Infections W/O Mcc | 51 | 182 / 23 | $18.935,50 | 1453 / 54 | $5.788,24 | 1666 / 62 | $4.515,20 | 1655 / 60 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 51 | 117 / 10 | $34.067,20 | 489 / 18 | $12.757,80 | 671 / 38 | $9.803,25 | 670 / 26 |
| Simple Pneumonia & Pleurisy W Cc | 50 | 153 / 23 | $22.712,00 | 1417 / 50 | $7.993,84 | 1691 / 70 | $5.712,10 | 1684 / 63 |
| Other Vascular Procedures W Cc | 47 | 55 / 6 | $136.387,00 | 1034 / 35 | $20.328,80 | 900 / 31 | $18.726,00 | 895 / 33 |
| Red Blood Cell Disorders W/O Mcc | 43 | 100 / 10 | $20.873,90 | 973 / 29 | $6.180,42 | 1203 / 41 | $4.798,95 | 1195 / 40 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 39 | 157 / 22 | $73.708,10 | 754 / 27 | $14.157,50 | 890 / 31 | $12.045,90 | 884 / 33 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 38 | 128 / 24 | $17.557,30 | 1274 / 46 | $5.125,79 | 1608 / 54 | $4.190,89 | 1603 / 56 |
| Respiratory Infections & Inflammations W Mcc | 37 | 99 / 16 | $56.004,60 | 1195 / 46 | $13.060,30 | 1078 / 38 | $11.971,60 | 1064 / 38 |
| Syncope & Collapse | 36 | 133 / 18 | $18.563,10 | 732 / 26 | $5.475,56 | 1137 / 40 | $4.283,36 | 1130 / 42 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 36 | 60 / 5 | $56.833,50 | 437 / 10 | $14.923,70 | 473 / 16 | $12.622,40 | 470 / 19 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 34 | 67 / 10 | $33.267,20 | 477 / 21 | $9.723,47 | 414 / 15 | $8.782,76 | 413 / 17 |
| Extracranial Procedures W/O Cc/Mcc | 32 | 66 / 9 | $25.862,60 | 308 / 7 | $7.541,22 | 625 / 26 | $6.203,78 | 623 / 26 |
| Major Small & Large Bowel Procedures W Cc | 32 | 76 / 11 | $64.382,10 | 733 / 28 | $17.308,80 | 688 / 32 | $14.297,50 | 682 / 26 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 32 | 93 / 14 | $45.230,90 | 998 / 35 | $11.914,20 | 1157 / 41 | $10.869,90 | 1152 / 43 |
| Major Cardiovasc Procedures W/O Mcc | 31 | 70 / 10 | $110.354,00 | 671 / 25 | $22.768,40 | 414 / 23 | $19.537,30 | 414 / 16 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 30 | 72 / 14 | $19.707,00 | 556 / 23 | $6.088,43 | 1033 / 42 | $4.422,33 | 1029 / 41 |
| Medical Back Problems W/O Mcc | 30 | 91 / 12 | $24.418,60 | 800 / 25 | $6.566,13 | 773 / 31 | $4.698,60 | 770 / 28 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 29 | 95 / 19 | $155.259,00 | 1056 / 33 | $34.087,20 | 815 / 19 | $32.912,90 | 809 / 26 |
| Other Digestive System Diagnoses W Cc | 29 | 68 / 11 | $24.484,40 | 648 / 23 | $6.855,41 | 739 / 30 | $5.659,76 | 735 / 28 |
| Peripheral Vascular Disorders W Cc | 28 | 56 / 8 | $29.695,80 | 796 / 26 | $7.018,68 | 765 / 27 | $6.069,86 | 762 / 26 |
| Transient Ischemia | 27 | 98 / 18 | $17.972,80 | 501 / 21 | $5.279,59 | 1006 / 37 | $4.051,74 | 1001 / 36 |
| G.I. Hemorrhage W Mcc | 26 | 95 / 15 | $32.693,50 | 417 / 11 | $11.279,90 | 756 / 25 | $10.428,20 | 754 / 31 |
| G.I. Obstruction W Cc | 26 | 66 / 12 | $23.014,80 | 867 / 33 | $7.480,81 | 497 / 44 | $4.472,00 | 496 / 17 |
| Pulmonary Embolism W/O Mcc | 25 | 49 / 8 | $23.563,50 | 577 / 18 | $7.529,28 | 659 / 33 | $5.472,32 | 656 / 21 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 25 | 106 / 24 | $58.813,60 | 884 / 41 | $15.798,40 | 601 / 43 | $12.703,60 | 593 / 20 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 25 | 101 / 20 | $37.107,80 | 1230 / 40 | $7.938,64 | 936 / 28 | $6.857,00 | 933 / 32 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 24 | 96 / 25 | $17.678,60 | 1079 / 45 | $5.689,83 | 993 / 55 | $3.723,67 | 984 / 44 |
| Respiratory Infections & Inflammations W Cc | 23 | 65 / 10 | $33.262,50 | 797 / 31 | $8.799,35 | 813 / 29 | $8.028,22 | 808 / 32 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 23 | 165 / 28 | $33.358,50 | 674 / 27 | $8.515,78 | 905 / 44 | $6.135,78 | 902 / 40 |
| Seizures W/O Mcc | 23 | 85 / 11 | $18.594,50 | 469 / 17 | $5.793,35 | 677 / 26 | $4.454,43 | 674 / 25 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 22 | 44 / 4 | $21.434,90 | 92 / 3 | $7.596,82 | 253 / 9 | $6.515,73 | 253 / 9 |
| Major Joint/Limb Reattachment Procedure Of Upper Extremities | 22 | 47 / 3 | $69.466,60 | 275 / 7 | $17.980,60 | 236 / 9 | $14.799,70 | 236 / 7 |
| Diabetes W Cc | 22 | 70 / 15 | $19.742,90 | 679 / 24 | $5.995,59 | 906 / 30 | $4.915,95 | 902 / 31 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 21 | 43 / 6 | $48.412,50 | 441 / 11 | $13.221,50 | 321 / 20 | $8.694,33 | 321 / 12 |
| Kidney & Urinary Tract Infections W Mcc | 21 | 123 / 30 | $21.826,50 | 694 / 25 | $7.153,33 | 877 / 31 | $6.187,62 | 875 / 34 |
| Heart Failure & Shock W/O Cc/Mcc | 21 | 89 / 24 | $15.576,10 | 907 / 37 | $5.366,38 | 1068 / 51 | $3.806,14 | 1060 / 43 |
| Other Circulatory System Diagnoses W Mcc | 21 | 95 / 13 | $54.918,10 | 849 / 32 | $12.081,80 | 621 / 19 | $11.210,60 | 619 / 25 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 20 | 76 / 16 | $35.209,60 | 805 / 26 | $8.237,70 | 795 / 22 | $7.378,50 | 790 / 26 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 20 | 45 / 7 | $88.472,20 | 559 / 18 | $21.036,90 | 536 / 17 | $19.739,20 | 533 / 16 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 20 | 53 / 8 | $26.339,10 | 537 / 19 | $9.095,20 | 490 / 27 | $6.625,05 | 488 / 18 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 19 | 81 / 17 | $97.778,90 | 462 / 16 | $21.968,00 | 358 / 21 | $18.383,00 | 356 / 18 |
| Major Small & Large Bowel Procedures W Mcc | 18 | 67 / 17 | $160.145,00 | 864 / 30 | $36.260,10 | 883 / 28 | $35.075,30 | 881 / 31 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 18 | 73 / 17 | $22.888,10 | 417 / 11 | $7.253,22 | 831 / 29 | $6.193,67 | 829 / 28 |
| Cervical Spinal Fusion W/O Cc/Mcc | 17 | 87 / 13 | $54.441,60 | 394 / 11 | $14.317,50 | 545 / 16 | $13.150,90 | 542 / 21 |
| Chest Pain | 17 | 134 / 20 | $15.989,90 | 585 / 19 | $4.690,06 | 1204 / 35 | $4.005,82 | 1197 / 36 |
| Revision Of Hip Or Knee Replacement W Cc | 17 | 69 / 7 | $80.105,60 | 298 / 6 | $21.115,50 | 348 / 5 | $20.084,50 | 347 / 9 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 17 | 86 / 12 | $27.627,90 | 469 / 19 | $6.849,00 | 443 / 20 | $6.025,00 | 443 / 20 |
| Coronary Bypass W Cardiac Cath W/O Mcc | 17 | 59 / 9 | $155.126,00 | 377 / 12 | $26.992,20 | 240 / 2 | $25.736,20 | 240 / 8 |
| Cellulitis W Mcc | 16 | 42 / 10 | $40.253,80 | 598 / 23 | $9.747,19 | 503 / 22 | $8.769,19 | 501 / 22 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 16 | 60 / 6 | $50.629,20 | 306 / 12 | $11.501,20 | 153 / 5 | $10.494,20 | 153 / 6 |
| Major Chest Procedures W Cc | 16 | 58 / 3 | $60.919,20 | 203 / 5 | $16.510,00 | 254 / 5 | $15.334,00 | 252 / 7 |
| Other Vascular Procedures W/O Cc/Mcc | 16 | 40 / 8 | $55.517,20 | 342 / 9 | $12.366,60 | 404 / 12 | $11.334,60 | 403 / 15 |
| Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 15 | 80 / 11 | $68.308,30 | 248 / 10 | $15.336,50 | 227 / 16 | $11.215,90 | 225 / 10 |
| Amputation For Circ Sys Disorders Exc Upper Limb & Toe W Mcc | 15 | 19 / 3 | $142.021,00 | 141 / 6 | $32.248,20 | 83 / 4 | $27.730,40 | 83 / 3 |
| Permanent Cardiac Pacemaker Implant W Mcc | 15 | 37 / 9 | $80.550,00 | 208 / 12 | $30.887,30 | 153 / 19 | $20.105,70 | 153 / 8 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 15 | 78 / 20 | $16.656,70 | 897 / 32 | $6.445,73 | 823 / 49 | $3.521,07 | 819 / 30 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 15 | 77 / 16 | $167.949,00 | 622 / 26 | $36.982,20 | 370 / 10 | $34.459,80 | 369 / 15 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Mcc | 14 | 102 / 10 | $268.360,00 | 349 / 10 | $57.798,60 | 316 / 8 | $56.506,70 | 316 / 10 |
| Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 14 | 43 / 11 | $43.080,50 | 196 / 9 | $13.853,90 | 405 / 12 | $12.752,20 | 404 / 16 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 14 | 33 / 7 | $46.209,40 | 276 / 9 | $10.888,10 | 231 / 10 | $8.134,00 | 231 / 10 |
| Nonspecific Cerebrovascular Disorders W Cc | 14 | 42 / 5 | $21.428,60 | 154 / 4 | $6.729,79 | 283 / 9 | $6.019,50 | 283 / 11 |
| Signs & Symptoms W/O Mcc | 14 | 77 / 14 | $15.202,40 | 344 / 7 | $5.377,93 | 771 / 24 | $4.203,36 | 768 / 24 |
| Permanent Cardiac Pacemaker Implant W Cc | 14 | 63 / 15 | $59.341,20 | 337 / 13 | $17.020,20 | 520 / 18 | $16.071,10 | 519 / 21 |
| Hip & Femur Procedures Except Major Joint W Mcc | 14 | 48 / 14 | $79.645,60 | 526 / 18 | $24.821,70 | 174 / 24 | $15.720,60 | 173 / 6 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 13 | 56 / 9 | $50.620,60 | 112 / 3 | $16.921,30 | 287 / 7 | $15.782,80 | 286 / 11 |
| Biopsies Of Musculoskeletal System & Connective Tissue W Cc | 13 | 19 / 1 | $68.169,40 | 70 / 2 | $13.600,20 | 56 / 1 | $12.435,20 | 56 / 1 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 13 | 43 / 11 | $44.692,80 | 367 / 13 | $14.008,20 | 133 / 18 | $10.090,20 | 133 / 7 |
| Respiratory Neoplasms W Mcc | 13 | 39 / 12 | $38.575,20 | 245 / 7 | $11.205,70 | 291 / 12 | $10.127,50 | 291 / 13 |
| Red Blood Cell Disorders W Mcc | 13 | 58 / 14 | $27.274,50 | 382 / 13 | $9.564,46 | 212 / 23 | $6.588,08 | 212 / 7 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 13 | 57 / 6 | $17.969,30 | 141 / 2 | $6.554,15 | 274 / 8 | $5.826,15 | 274 / 11 |
| Kidney & Ureter Procedures For Neoplasm W Cc | 12 | 32 / 4 | $41.135,10 | 31 / 2 | $13.090,80 | 60 / 4 | $11.792,80 | 60 / 3 |
| Craniotomy & Endovascular Intracranial Procedures W Mcc | 12 | 86 / 4 | $122.925,00 | 274 / 8 | $28.237,10 | 34 / 6 | $22.186,20 | 34 / 2 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 12 | 44 / 13 | $37.945,80 | 363 / 10 | $10.776,80 | 544 / 22 | $9.474,08 | 542 / 24 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 12 | 50 / 11 | $17.343,50 | 273 / 6 | $5.631,83 | 490 / 13 | $4.547,83 | 488 / 14 |
| Major Cardiovasc Procedures W Mcc | 12 | 56 / 12 | $186.961,00 | 477 / 17 | $35.486,70 | 371 / 14 | $34.790,00 | 370 / 16 |
| Other Vascular Procedures W Mcc | 12 | 85 / 17 | $120.753,00 | 739 / 23 | $20.784,00 | 427 / 10 | $19.925,20 | 425 / 14 |
| Traumatic Stupor & Coma, Coma <1 Hr W Mcc | 12 | 39 / 5 | $40.636,20 | 100 / 2 | $12.938,30 | 55 / 4 | $10.528,20 | 55 / 3 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 11 | 113 / 16 | $14.849,10 | 330 / 13 | $5.219,00 | 415 / 16 | $4.155,00 | 415 / 15 |
| Organic Disturbances & Mental Retardation | 11 | 48 / 7 | $29.094,50 | 334 / 7 | $6.938,45 | 201 / 5 | $5.671,00 | 201 / 3 |
| Cranial & Peripheral Nerve Disorders W/O Mcc | 11 | 57 / 12 | $17.738,50 | 162 / 4 | $6.339,27 | 444 / 16 | $5.617,09 | 444 / 19 |
| Acute Ischemic Stroke W Use Of Thrombolytic Agent W Cc | 11 | 20 / 3 | $69.646,00 | 100 / 2 | $12.109,80 | 64 / 2 | $11.012,40 | 64 / 2 |
| Infectious & Parasitic Diseases W O.R. Procedure W Cc | 11 | 25 / 7 | $61.422,90 | 177 / 4 | $19.578,10 | 135 / 5 | $13.837,90 | 135 / 3 |
| Peripheral Vascular Disorders W Mcc | 11 | 38 / 11 | $33.376,10 | 268 / 11 | $9.167,27 | 259 / 9 | $8.118,55 | 259 / 11 |
| Disorders Of Pancreas Except Malignancy W Cc | 11 | 50 / 14 | $21.841,70 | 362 / 12 | $6.616,00 | 620 / 18 | $5.738,91 | 617 / 23 |
| Disorders Of The Biliary Tract W Cc | 11 | 43 / 9 | $28.877,90 | 193 / 5 | $7.378,55 | 208 / 6 | $6.179,27 | 208 / 7 |
| Respiratory Neoplasms W Cc | 11 | 36 / 9 | $36.690,50 | 277 / 8 | $8.137,55 | 237 / 7 | $7.009,55 | 236 / 7 |
| Bronchitis & Asthma W Cc/Mcc | 11 | 65 / 13 | $26.680,00 | 631 / 17 | $7.981,64 | 347 / 20 | $4.434,36 | 343 / 11 |
| Diabetes W Mcc | 11 | 46 / 13 | $43.185,30 | 493 / 20 | $9.032,55 | 301 / 13 | $8.121,27 | 301 / 14 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 11 | 44 / 8 | $69.873,30 | 430 / 13 | $13.902,10 | 444 / 13 | $12.835,20 | 440 / 14 | Total 110 procedures | 4.249 | 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.