Hospital Costs > In North Carolina > North Carolina Specialty Hospital, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 31 | 58 / 8 | $23.115,70 | 145 / 4 | $6.053,81 | 116 / 2 | $4.869,42 | 116 / 4 |
| Bilateral Or Multiple Major Joint Procs Of Lower Extremity W/O Mcc | 11 | 52 / 8 | $46.703,50 | 29 / 1 | $19.499,30 | 87 / 1 | $18.258,50 | 87 / 3 |
| Cervical Spinal Fusion W/O Cc/Mcc | 27 | 77 / 15 | $37.352,40 | 152 / 3 | $12.439,40 | 231 / 5 | $11.258,90 | 231 / 7 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 22 | 74 / 14 | $33.863,20 | 83 / 2 | $12.363,10 | 214 / 3 | $11.133,30 | 212 / 7 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 311 | 259 / 14 | $29.562,30 | 207 / 7 | $11.567,10 | 530 / 1 | $10.361,40 | 526 / 22 |
| Major Joint/Limb Reattachment Procedure Of Upper Extremities | 20 | 49 / 8 | $36.379,60 | 31 / 1 | $14.677,10 | 134 / 2 | $13.448,40 | 134 / 5 |
| Revision Of Hip Or Knee Replacement W Cc | 18 | 68 / 14 | $38.126,80 | 19 / 1 | $18.181,30 | 108 / 2 | $17.073,60 | 108 / 4 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 13 | 56 / 12 | $42.568,50 | 58 / 2 | $15.328,40 | 132 / 1 | $14.070,20 | 132 / 6 |
| Spinal Fusion Except Cervical W/O Mcc | 27 | 167 / 24 | $65.675,30 | 299 / 6 | $22.410,70 | 397 / 7 | $21.220,50 | 396 / 15 | Total 9 procedures | 480 | 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.