Hospital Costs > In Texas > Metroplex Hospital, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Psychoses | 96 | 195 / 13 | $15.944,40 | 209 / 4 | $6.452,29 | 220 / 6 | $5.588,46 | 220 / 9 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 84 | 432 / 93 | $39.533,90 | 1298 / 58 | $10.897,00 | 805 / 53 | $9.927,26 | 804 / 67 |
Heart Failure & Shock W Mcc | 58 | 226 / 65 | $37.110,60 | 1512 / 64 | $9.145,17 | 1126 / 73 | $8.458,83 | 1123 / 91 |
Pulmonary Edema & Respiratory Failure | 56 | 147 / 31 | $30.404,30 | 1064 / 32 | $7.685,88 | 990 / 47 | $6.931,59 | 989 / 73 |
Chronic Obstructive Pulmonary Disease W Mcc | 47 | 155 / 46 | $27.925,40 | 1340 / 51 | $7.854,87 | 760 / 107 | $6.015,64 | 755 / 55 |
Heart Failure & Shock W Cc | 47 | 231 / 66 | $22.833,70 | 1468 / 56 | $6.179,19 | 1044 / 70 | $5.321,66 | 1042 / 85 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 43 | 521 / 121 | $54.882,00 | 1503 / 84 | $13.331,40 | 1114 / 80 | $11.240,70 | 1089 / 131 |
Renal Failure W Cc | 38 | 183 / 68 | $25.040,60 | 1423 / 64 | $6.506,74 | 1040 / 102 | $5.226,24 | 1032 / 87 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 36 | 90 / 40 | $22.240,20 | 541 / 14 | $6.980,53 | 640 / 47 | $6.269,19 | 637 / 57 |
Renal Failure W Mcc | 35 | 160 / 62 | $29.308,90 | 720 / 28 | $9.873,60 | 877 / 77 | $8.688,69 | 877 / 78 |
Simple Pneumonia & Pleurisy W Mcc | 30 | 175 / 66 | $40.793,10 | 1584 / 79 | $8.901,40 | 1224 / 66 | $8.178,20 | 1224 / 99 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 30 | 136 / 56 | $18.916,50 | 1442 / 64 | $4.808,80 | 1026 / 91 | $3.669,03 | 1023 / 81 |
Chronic Obstructive Pulmonary Disease W Cc | 28 | 151 / 47 | $23.452,40 | 1341 / 42 | $6.013,71 | 1196 / 69 | $5.150,86 | 1192 / 90 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 28 | 247 / 83 | $21.940,50 | 1618 / 74 | $4.999,04 | 1509 / 77 | $4.133,89 | 1497 / 126 |
G.I. Hemorrhage W Cc | 27 | 191 / 63 | $22.461,80 | 976 / 22 | $7.077,33 | 1006 / 106 | $5.371,52 | 1004 / 75 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 27 | 180 / 64 | $25.790,50 | 1313 / 58 | $6.721,26 | 1165 / 68 | $5.830,00 | 1160 / 102 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 23 | 173 / 51 | $71.262,50 | 713 / 40 | $14.402,70 | 517 / 76 | $10.684,90 | 515 / 63 |
Red Blood Cell Disorders W/O Mcc | 21 | 122 / 46 | $19.342,00 | 841 / 30 | $5.330,86 | 1086 / 61 | $4.639,05 | 1079 / 94 |
Cellulitis W/O Mcc | 20 | 169 / 69 | $16.652,10 | 1074 / 38 | $5.568,95 | 1370 / 88 | $4.599,35 | 1364 / 116 |
Hip & Femur Procedures Except Major Joint W Cc | 19 | 124 / 53 | $53.683,00 | 1166 / 56 | $11.860,70 | 862 / 58 | $10.717,20 | 851 / 74 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 18 | 113 / 48 | $58.361,20 | 875 / 41 | $13.561,50 | 718 / 40 | $13.022,80 | 710 / 71 |
Kidney & Urinary Tract Infections W/O Mcc | 18 | 215 / 91 | $19.766,20 | 1551 / 80 | $5.054,33 | 1243 / 81 | $4.117,44 | 1234 / 105 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 17 | 108 / 45 | $41.370,80 | 868 / 28 | $10.085,40 | 176 / 34 | $8.219,82 | 176 / 5 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 16 | 172 / 58 | $33.202,40 | 664 / 19 | $6.891,00 | 800 / 42 | $5.907,00 | 798 / 74 |
Kidney & Urinary Tract Infections W Mcc | 16 | 128 / 60 | $21.999,60 | 707 / 22 | $6.742,94 | 542 / 46 | $5.760,94 | 541 / 43 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 16 | 134 / 49 | $17.217,90 | 1217 / 51 | $3.949,00 | 1218 / 62 | $3.049,00 | 1213 / 90 |
Chest Pain | 16 | 135 / 50 | $18.592,50 | 814 / 20 | $4.219,81 | 888 / 42 | $3.387,81 | 883 / 67 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 15 | 146 / 58 | $19.079,90 | 972 / 28 | $5.272,07 | 1087 / 69 | $4.384,60 | 1083 / 93 |
Syncope & Collapse | 15 | 154 / 50 | $24.191,10 | 1176 / 41 | $4.906,60 | 900 / 53 | $3.940,20 | 895 / 66 |
Diabetes W Cc | 13 | 79 / 38 | $16.352,60 | 438 / 4 | $8.359,92 | 182 / 106 | $3.796,69 | 182 / 9 |
Simple Pneumonia & Pleurisy W Cc | 12 | 191 / 94 | $23.668,70 | 1507 / 63 | $6.331,50 | 1409 / 86 | $5.427,50 | 1403 / 113 |
Red Blood Cell Disorders W Mcc | 11 | 60 / 28 | $21.934,20 | 211 / 5 | $7.871,09 | 326 / 28 | $6.879,09 | 324 / 32 |
Diabetes W Mcc | 11 | 46 / 25 | $34.143,20 | 358 / 11 | $8.620,55 | 185 / 15 | $7.490,36 | 185 / 16 | Total 33 procedures | 987 | 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.