Hospital Costs > In New York > Phelps Memorial Hospital Assn, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 200 | 316 / 47 | $55.688,50 | 1976 / 101 | $16.406,30 | 2464 / 90 | $14.835,80 | 2420 / 91 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 160 | 404 / 36 | $98.517,80 | 2456 / 121 | $18.682,70 | 2477 / 84 | $17.173,60 | 2431 / 90 |
Alcohol/Drug Abuse Or Dependence W Rehabilitation Therapy | 125 | 15 / 1 | $45.491,00 | 75 / 21 | $11.358,40 | 73 / 20 | $9.830,28 | 73 / 20 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 75 | 132 / 34 | $40.659,10 | 2054 / 107 | $10.068,20 | 2300 / 87 | $8.645,79 | 2291 / 88 |
G.I. Hemorrhage W Cc | 68 | 150 / 35 | $36.760,60 | 1847 / 94 | $9.355,90 | 2150 / 81 | $8.034,75 | 2146 / 80 |
Heart Failure & Shock W Cc | 59 | 219 / 54 | $31.637,50 | 2044 / 95 | $8.939,71 | 2474 / 86 | $8.107,88 | 2468 / 90 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 54 | 221 / 62 | $31.742,70 | 2238 / 123 | $7.430,24 | 2436 / 88 | $6.138,04 | 2421 / 94 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 54 | 112 / 41 | $28.571,90 | 2078 / 110 | $6.931,24 | 2265 / 88 | $5.900,87 | 2257 / 90 |
Kidney & Urinary Tract Infections W/O Mcc | 50 | 183 / 54 | $29.207,80 | 2181 / 107 | $7.463,28 | 2475 / 88 | $6.541,84 | 2464 / 94 |
Cellulitis W/O Mcc | 45 | 144 / 54 | $26.284,20 | 1948 / 95 | $8.050,36 | 2363 / 88 | $6.855,69 | 2355 / 97 |
Heart Failure & Shock W Mcc | 44 | 240 / 62 | $44.405,30 | 1830 / 95 | $13.781,00 | 2226 / 82 | $11.444,30 | 2216 / 78 |
Simple Pneumonia & Pleurisy W Cc | 41 | 162 / 49 | $38.243,00 | 2280 / 120 | $9.394,32 | 2585 / 98 | $8.300,32 | 2576 / 104 |
Alcohol/Drug Abuse Or Dependence, Left Ama | 38 | 14 / 5 | $20.407,70 | 103 / 29 | $5.190,82 | 77 / 16 | $4.200,34 | 76 / 16 |
Chronic Obstructive Pulmonary Disease W Cc | 37 | 142 / 41 | $34.720,40 | 1903 / 110 | $8.775,13 | 2180 / 83 | $7.499,78 | 2173 / 85 |
Syncope & Collapse | 33 | 136 / 58 | $28.238,30 | 1363 / 91 | $7.134,85 | 1675 / 63 | $5.968,97 | 1667 / 69 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 32 | 150 / 41 | $50.363,90 | 1749 / 90 | $9.957,38 | 1871 / 64 | $8.699,06 | 1867 / 71 |
Transient Ischemia | 30 | 95 / 30 | $29.605,20 | 1161 / 76 | $6.895,57 | 1494 / 60 | $5.832,50 | 1486 / 66 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 29 | 132 / 43 | $33.015,40 | 1740 / 96 | $7.658,86 | 1953 / 69 | $6.643,62 | 1948 / 77 |
Renal Failure W Cc | 28 | 193 / 59 | $46.640,20 | 2197 / 115 | $10.114,40 | 2290 / 84 | $8.873,71 | 2280 / 87 |
Red Blood Cell Disorders W/O Mcc | 26 | 117 / 50 | $29.894,40 | 1496 / 87 | $7.840,35 | 1785 / 67 | $6.854,12 | 1776 / 74 |
Hip & Femur Procedures Except Major Joint W Cc | 25 | 118 / 45 | $68.791,90 | 1522 / 84 | $17.847,70 | 1814 / 69 | $15.121,30 | 1795 / 67 |
Chronic Obstructive Pulmonary Disease W Mcc | 24 | 178 / 64 | $58.473,40 | 2333 / 128 | $12.157,50 | 2474 / 92 | $11.212,80 | 2466 / 101 |
Medical Back Problems W/O Mcc | 23 | 98 / 41 | $39.409,80 | 1237 / 76 | $8.231,52 | 1327 / 54 | $6.930,83 | 1322 / 58 |
G.I. Obstruction W Cc | 23 | 69 / 23 | $44.336,20 | 1519 / 80 | $9.667,74 | 1629 / 68 | $7.927,30 | 1624 / 69 |
Simple Pneumonia & Pleurisy W Mcc | 23 | 182 / 52 | $60.953,00 | 2111 / 108 | $14.686,50 | 2321 / 90 | $12.382,60 | 2315 / 86 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 20 | 130 / 52 | $20.652,80 | 1433 / 85 | $5.790,00 | 1805 / 71 | $4.609,80 | 1799 / 76 |
Signs & Symptoms W/O Mcc | 20 | 71 / 30 | $39.698,80 | 1217 / 83 | $8.698,00 | 1280 / 60 | $7.639,75 | 1277 / 67 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 20 | 104 / 43 | $136.897,00 | 896 / 58 | $42.775,80 | 1292 / 40 | $41.588,20 | 1282 / 47 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 19 | 73 / 34 | $177.809,00 | 665 / 64 | $54.471,50 | 1001 / 48 | $53.080,70 | 1000 / 55 |
Other Digestive System Diagnoses W Cc | 19 | 78 / 30 | $29.116,00 | 839 / 37 | $9.292,84 | 1240 / 41 | $7.817,68 | 1236 / 44 |
Respiratory Infections & Inflammations W Cc | 18 | 70 / 28 | $52.381,70 | 1176 / 66 | $11.739,90 | 1305 / 51 | $10.594,60 | 1300 / 53 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 17 | 108 / 46 | $40.656,20 | 832 / 52 | $13.489,90 | 1455 / 52 | $12.493,10 | 1443 / 56 |
Seizures W/O Mcc | 16 | 92 / 43 | $30.263,80 | 963 / 83 | $7.446,50 | 1126 / 54 | $6.408,62 | 1124 / 58 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 16 | 104 / 39 | $29.794,10 | 1703 / 104 | $6.973,75 | 1929 / 76 | $6.093,38 | 1918 / 84 |
Other Kidney & Urinary Tract Diagnoses W Mcc | 16 | 85 / 32 | $41.929,50 | 658 / 27 | $13.040,50 | 891 / 31 | $11.962,60 | 887 / 33 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 16 | 107 / 44 | $30.523,60 | 987 / 52 | $10.931,40 | 1689 / 60 | $9.817,38 | 1686 / 65 |
Diabetes W Cc | 15 | 77 / 34 | $37.453,50 | 1351 / 82 | $7.711,80 | 1379 / 48 | $6.662,87 | 1374 / 54 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 14 | 154 / 46 | $67.322,60 | 1239 / 67 | $17.807,40 | 1513 / 54 | $16.514,60 | 1506 / 60 |
Heart Failure & Shock W/O Cc/Mcc | 14 | 96 / 49 | $20.857,10 | 1347 / 74 | $6.555,50 | 1740 / 71 | $5.277,36 | 1727 / 69 |
Major Small & Large Bowel Procedures W Cc | 14 | 94 / 34 | $92.932,30 | 1146 / 62 | $26.649,30 | 1502 / 65 | $24.992,40 | 1488 / 72 |
Other Circulatory System Diagnoses W Mcc | 13 | 103 / 35 | $42.295,40 | 550 / 26 | $13.009,70 | 820 / 12 | $12.194,80 | 815 / 16 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 13 | 89 / 40 | $34.655,40 | 1232 / 61 | $7.440,31 | 1441 / 46 | $6.121,08 | 1437 / 56 |
Pulmonary Edema & Respiratory Failure | 13 | 190 / 52 | $66.840,50 | 2020 / 100 | $11.904,50 | 2072 / 76 | $10.919,10 | 2066 / 78 |
Fever | 13 | 33 / 16 | $35.177,20 | 264 / 22 | $8.347,00 | 297 / 19 | $7.342,85 | 297 / 22 |
Degenerative Nervous System Disorders W/O Mcc | 13 | 65 / 34 | $39.385,50 | 667 / 52 | $9.248,69 | 728 / 34 | $8.104,38 | 728 / 39 |
Permanent Cardiac Pacemaker Implant W Cc | 13 | 64 / 28 | $59.319,80 | 336 / 18 | $22.348,40 | 860 / 27 | $21.004,40 | 856 / 28 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 13 | 60 / 23 | $45.022,20 | 897 / 39 | $10.797,50 | 1022 / 33 | $9.909,54 | 1020 / 39 |
Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 13 | 49 / 31 | $23.302,50 | 471 / 36 | $7.072,31 | 691 / 43 | $5.865,08 | 689 / 45 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 13 | 113 / 48 | $32.878,50 | 1089 / 53 | $10.104,70 | 1485 / 43 | $9.320,54 | 1482 / 50 |
Renal Failure W Mcc | 13 | 182 / 57 | $60.750,50 | 1771 / 90 | $14.040,40 | 1938 / 60 | $13.106,50 | 1934 / 64 |
G.I. Hemorrhage W Mcc | 12 | 109 / 42 | $57.957,20 | 1156 / 57 | $15.707,30 | 1476 / 48 | $14.856,30 | 1466 / 50 |
Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 12 | 45 / 24 | $52.113,80 | 306 / 15 | $18.104,20 | 648 / 18 | $16.875,40 | 647 / 22 |
Spinal Fusion Except Cervical W/O Mcc | 12 | 182 / 38 | $121.537,00 | 943 / 45 | $31.790,30 | 1140 / 32 | $29.111,10 | 1135 / 40 |
Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 11 | 36 / 16 | $49.488,50 | 410 / 33 | $11.078,00 | 541 / 24 | $9.713,64 | 540 / 26 |
Other Digestive System Diagnoses W/O Cc/Mcc | 11 | 32 / 16 | $21.580,60 | 191 / 16 | $6.450,27 | 318 / 17 | $5.595,91 | 318 / 21 | Total 55 procedures | 1.788 | 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.