Hospital Costs > In Kentucky > Middlesboro Appalachian Regional Healthcare Hospit, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Cellulitis W/O Mcc | 42 | 147 / 15 | $13.713,80 | 691 / 23 | $4.865,29 | 486 / 6 | $3.865,64 | 483 / 15 |
| Chronic Obstructive Pulmonary Disease W Cc | 40 | 139 / 21 | $19.025,40 | 903 / 39 | $5.330,58 | 368 / 6 | $4.392,40 | 367 / 12 |
| Chronic Obstructive Pulmonary Disease W Mcc | 30 | 172 / 32 | $22.002,60 | 903 / 35 | $6.676,90 | 398 / 10 | $5.680,97 | 397 / 14 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 29 | 91 / 23 | $15.940,40 | 898 / 41 | $4.229,62 | 308 / 7 | $3.146,24 | 308 / 9 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 27 | 248 / 35 | $16.015,70 | 873 / 30 | $4.360,89 | 344 / 4 | $3.279,85 | 343 / 10 |
| G.I. Hemorrhage W Cc | 17 | 201 / 35 | $20.817,20 | 815 / 25 | $5.625,76 | 368 / 4 | $4.774,12 | 368 / 13 |
| Heart Failure & Shock W Cc | 45 | 233 / 23 | $21.612,40 | 1357 / 41 | $5.616,07 | 364 / 8 | $4.745,13 | 364 / 10 |
| Heart Failure & Shock W Mcc | 35 | 249 / 32 | $28.321,70 | 993 / 31 | $8.177,29 | 261 / 7 | $7.349,69 | 261 / 12 |
| Heart Failure & Shock W/O Cc/Mcc | 14 | 96 / 27 | $13.870,10 | 715 / 26 | $3.976,07 | 391 / 7 | $3.203,93 | 389 / 13 |
| Kidney & Urinary Tract Infections W/O Mcc | 28 | 205 / 33 | $15.078,90 | 955 / 28 | $4.445,11 | 376 / 5 | $3.517,39 | 376 / 12 |
| Pulmonary Edema & Respiratory Failure | 20 | 183 / 34 | $27.136,30 | 861 / 32 | $6.859,30 | 406 / 3 | $6.232,30 | 406 / 14 |
| Red Blood Cell Disorders W/O Mcc | 18 | 125 / 19 | $15.901,70 | 529 / 18 | $5.004,50 | 112 / 18 | $3.451,83 | 112 / 4 |
| Renal Failure W Mcc | 12 | 183 / 37 | $22.452,40 | 341 / 13 | $8.007,83 | 82 / 1 | $7.157,08 | 82 / 2 |
| Respiratory Infections & Inflammations W Cc | 15 | 73 / 16 | $32.111,60 | 755 / 27 | $7.792,27 | 309 / 6 | $6.996,80 | 307 / 10 |
| Respiratory Infections & Inflammations W Mcc | 16 | 120 / 20 | $34.127,80 | 561 / 22 | $10.282,50 | 68 / 4 | $9.214,50 | 68 / 5 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 26 | 490 / 44 | $29.235,10 | 745 / 17 | $9.728,96 | 151 / 7 | $8.802,58 | 151 / 7 |
| Simple Pneumonia & Pleurisy W Cc | 45 | 158 / 30 | $20.416,50 | 1167 / 42 | $5.681,98 | 271 / 9 | $4.431,67 | 271 / 9 |
| Simple Pneumonia & Pleurisy W Mcc | 12 | 193 / 39 | $27.323,30 | 854 / 28 | $7.781,33 | 345 / 2 | $7.106,50 | 345 / 12 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 20 | 73 / 20 | $18.599,80 | 1088 / 46 | $4.162,65 | 404 / 9 | $3.146,15 | 402 / 14 | Total 19 procedures | 491 | 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.