Hospital Costs > In Texas > Nix Health Care System, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Acute Myocardial Infarction, Discharged Alive W Mcc | 15 | 110 / 47 | $70.359,10 | 1463 / 86 | $12.930,10 | 1409 / 104 | $12.123,70 | 1397 / 119 |
Bronchitis & Asthma W Cc/Mcc | 13 | 63 / 29 | $23.766,20 | 544 / 19 | $6.999,08 | 825 / 62 | $6.073,54 | 821 / 76 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 11 | 150 / 62 | $34.991,60 | 1803 / 120 | $6.521,73 | 1753 / 131 | $5.643,18 | 1748 / 147 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 12 | 111 / 51 | $47.680,30 | 1490 / 92 | $8.982,33 | 1326 / 98 | $8.029,00 | 1323 / 112 |
Cellulitis W/O Mcc | 19 | 170 / 70 | $21.704,60 | 1639 / 90 | $6.794,84 | 2115 / 165 | $5.844,95 | 2107 / 184 |
Chronic Obstructive Pulmonary Disease W Mcc | 19 | 183 / 74 | $33.542,40 | 1668 / 88 | $8.755,63 | 1829 / 151 | $7.503,37 | 1821 / 159 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 12 | 176 / 62 | $44.985,10 | 1075 / 68 | $8.363,42 | 1118 / 98 | $6.756,75 | 1115 / 106 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 21 | 75 / 34 | $37.267,70 | 885 / 46 | $9.024,38 | 981 / 70 | $8.097,90 | 976 / 81 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 25 | 250 / 86 | $17.417,60 | 1051 / 32 | $6.263,04 | 2227 / 169 | $5.317,88 | 2212 / 187 |
G.I. Hemorrhage W Cc | 26 | 192 / 64 | $27.101,50 | 1376 / 50 | $7.692,62 | 1867 / 134 | $6.810,15 | 1863 / 150 |
G.I. Hemorrhage W Mcc | 11 | 110 / 46 | $48.794,40 | 973 / 47 | $11.840,20 | 1079 / 69 | $11.619,10 | 1071 / 93 |
G.I. Obstruction W Cc | 12 | 80 / 38 | $30.081,80 | 1199 / 54 | $7.096,75 | 1399 / 86 | $6.214,75 | 1394 / 100 |
Heart Failure & Shock W Cc | 35 | 243 / 77 | $37.560,70 | 2251 / 155 | $7.726,66 | 2122 / 178 | $6.794,09 | 2116 / 187 |
Heart Failure & Shock W Mcc | 36 | 248 / 86 | $49.934,20 | 1986 / 124 | $10.421,90 | 1727 / 138 | $9.528,86 | 1722 / 154 |
Hip & Femur Procedures Except Major Joint W Cc | 16 | 127 / 56 | $66.962,70 | 1487 / 82 | $13.054,30 | 1361 / 103 | $12.222,30 | 1343 / 126 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 30 | 94 / 35 | $164.540,00 | 1099 / 68 | $34.253,10 | 850 / 65 | $33.256,40 | 844 / 88 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 16 | 152 / 57 | $46.919,20 | 884 / 32 | $11.986,90 | 1048 / 66 | $11.304,90 | 1043 / 84 |
Kidney & Urinary Tract Infections W Mcc | 21 | 123 / 55 | $22.373,00 | 732 / 23 | $8.311,71 | 1424 / 119 | $7.391,33 | 1420 / 124 |
Kidney & Urinary Tract Infections W/O Mcc | 24 | 209 / 85 | $21.277,00 | 1703 / 98 | $6.302,50 | 2235 / 184 | $5.536,04 | 2224 / 200 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 11 | 44 / 21 | $42.055,10 | 172 / 4 | $13.571,40 | 274 / 22 | $11.140,20 | 274 / 17 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 20 | 27 / 7 | $35.719,10 | 180 / 1 | $10.417,00 | 304 / 15 | $8.768,05 | 304 / 18 |
Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 11 | 54 / 24 | $98.118,90 | 639 / 26 | $20.514,60 | 510 / 35 | $19.415,00 | 507 / 40 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 153 | 411 / 56 | $66.660,00 | 1907 / 124 | $14.725,50 | 1698 / 144 | $12.553,10 | 1661 / 185 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 17 | 109 / 56 | $22.571,90 | 565 / 16 | $8.190,29 | 1147 / 95 | $7.484,41 | 1144 / 110 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 11 | 155 / 75 | $19.040,10 | 1458 / 66 | $5.910,82 | 2020 / 168 | $4.930,45 | 2012 / 180 |
O.R. Procedures For Obesity W/O Cc/Mcc | 11 | 66 / 31 | $55.474,80 | 303 / 24 | $11.140,30 | 280 / 18 | $9.933,00 | 280 / 33 |
Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 14 | 86 / 32 | $152.585,00 | 839 / 57 | $22.661,60 | 689 / 57 | $21.886,80 | 685 / 74 |
Psychoses | 605 | 14 / 1 | $22.842,80 | 378 / 15 | $7.775,55 | 413 / 22 | $6.914,18 | 413 / 25 |
Red Blood Cell Disorders W Mcc | 14 | 57 / 25 | $31.312,10 | 489 / 27 | $9.210,57 | 747 / 62 | $8.585,43 | 743 / 76 |
Renal Failure W Cc | 28 | 193 / 78 | $22.361,70 | 1217 / 42 | $7.392,11 | 1882 / 145 | $6.613,82 | 1872 / 164 |
Renal Failure W Mcc | 25 | 170 / 71 | $27.648,10 | 626 / 19 | $10.418,40 | 1344 / 96 | $9.764,36 | 1344 / 132 |
Respiratory Infections & Inflammations W Mcc | 20 | 116 / 44 | $56.834,60 | 1214 / 65 | $13.291,80 | 1201 / 95 | $12.563,80 | 1186 / 104 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 135 | 381 / 70 | $55.616,60 | 1970 / 123 | $12.740,00 | 1885 / 149 | $11.991,30 | 1850 / 175 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 21 | 186 / 70 | $38.152,80 | 1971 / 129 | $8.062,19 | 2018 / 154 | $7.370,38 | 2010 / 179 |
Simple Pneumonia & Pleurisy W Cc | 21 | 182 / 85 | $27.744,60 | 1826 / 94 | $7.445,67 | 2141 / 173 | $6.468,90 | 2133 / 190 |
Simple Pneumonia & Pleurisy W Mcc | 49 | 156 / 48 | $41.062,30 | 1598 / 82 | $10.205,50 | 1814 / 137 | $9.443,35 | 1814 / 160 | Total 36 procedures | 1.540 | 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.