Hospital Costs > In California > Pioneers Memorial Healthcare District, 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 | 122 | 394 / 115 | $53.196,10 | 1895 / 52 | $14.610,10 | 2340 / 80 | $13.846,80 | 2298 / 104 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 55 | 509 / 114 | $62.439,20 | 1782 / 54 | $17.274,50 | 2346 / 101 | $15.678,60 | 2301 / 120 |
Simple Pneumonia & Pleurisy W Cc | 46 | 157 / 44 | $39.086,50 | 2300 / 66 | $8.678,26 | 2501 / 114 | $7.703,65 | 2492 / 128 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 37 | 170 / 73 | $34.803,40 | 1852 / 65 | $8.938,65 | 2174 / 106 | $7.893,03 | 2165 / 116 |
Simple Pneumonia & Pleurisy W Mcc | 35 | 170 / 56 | $49.517,70 | 1905 / 44 | $12.279,80 | 2213 / 95 | $11.418,50 | 2207 / 108 |
Heart Failure & Shock W Cc | 31 | 247 / 69 | $31.524,90 | 2040 / 41 | $8.357,35 | 2364 / 91 | $7.617,23 | 2358 / 106 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 29 | 139 / 42 | $55.416,60 | 1056 / 22 | $13.091,90 | 1212 / 29 | $12.212,40 | 1206 / 41 |
Heart Failure & Shock W Mcc | 28 | 256 / 94 | $56.304,40 | 2130 / 78 | $12.478,60 | 2288 / 95 | $11.744,90 | 2278 / 113 |
Cellulitis W/O Mcc | 28 | 161 / 58 | $34.631,50 | 2288 / 103 | $7.540,68 | 2296 / 105 | $6.507,54 | 2288 / 125 |
G.I. Hemorrhage W Cc | 25 | 193 / 66 | $33.730,90 | 1744 / 38 | $8.718,72 | 2144 / 89 | $7.991,68 | 2140 / 119 |
Kidney & Urinary Tract Infections W/O Mcc | 23 | 210 / 86 | $29.698,50 | 2206 / 66 | $7.070,09 | 2441 / 115 | $6.332,70 | 2430 / 135 |
G.I. Hemorrhage W Mcc | 22 | 99 / 34 | $42.473,60 | 781 / 13 | $13.711,00 | 1318 / 45 | $12.996,90 | 1308 / 51 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 22 | 144 / 57 | $28.813,10 | 2087 / 73 | $6.580,18 | 2228 / 108 | $5.697,27 | 2220 / 117 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 20 | 105 / 32 | $58.887,90 | 1309 / 33 | $13.329,80 | 1414 / 42 | $12.141,80 | 1402 / 40 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 18 | 113 / 35 | $75.823,80 | 1245 / 18 | $18.212,10 | 1495 / 35 | $17.472,60 | 1481 / 42 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 18 | 108 / 41 | $38.624,20 | 1274 / 42 | $10.178,30 | 1291 / 89 | $8.062,56 | 1288 / 45 |
Renal Failure W Cc | 17 | 204 / 71 | $28.512,40 | 1632 / 26 | $8.064,53 | 2058 / 76 | $7.279,59 | 2048 / 88 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 17 | 165 / 57 | $40.318,30 | 1525 / 36 | $9.142,12 | 1776 / 72 | $8.078,59 | 1772 / 90 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 17 | 144 / 49 | $34.755,20 | 1796 / 60 | $7.126,24 | 1903 / 87 | $6.273,53 | 1898 / 108 |
Heart Failure & Shock W/O Cc/Mcc | 15 | 95 / 30 | $24.482,00 | 1533 / 25 | $6.370,87 | 1809 / 70 | $5.647,67 | 1796 / 82 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 14 | 261 / 96 | $39.756,60 | 2469 / 135 | $6.860,29 | 2427 / 106 | $6.090,00 | 2412 / 135 |
G.I. Hemorrhage W/O Cc/Mcc | 13 | 55 / 16 | $30.960,40 | 823 / 25 | $6.533,23 | 865 / 33 | $5.514,15 | 861 / 41 |
Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 13 | 40 / 10 | $30.927,00 | 594 / 9 | $6.843,85 | 769 / 23 | $6.004,46 | 765 / 27 |
Chronic Obstructive Pulmonary Disease W Mcc | 12 | 190 / 78 | $43.150,00 | 2022 / 49 | $10.021,10 | 2273 / 97 | $9.218,42 | 2265 / 111 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 12 | 80 / 43 | $193.237,00 | 724 / 32 | $46.752,10 | 881 / 66 | $46.048,10 | 880 / 73 |
Renal Failure W Mcc | 12 | 183 / 74 | $53.574,90 | 1647 / 57 | $12.729,60 | 1822 / 74 | $12.025,60 | 1818 / 87 |
Kidney & Urinary Tract Infections W Mcc | 12 | 132 / 54 | $34.003,20 | 1331 / 26 | $9.258,33 | 1684 / 70 | $8.557,00 | 1680 / 85 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 11 | 82 / 34 | $33.175,70 | 1693 / 51 | $6.572,73 | 1768 / 77 | $5.476,00 | 1760 / 81 |
Transient Ischemia | 11 | 114 / 45 | $26.551,50 | 1031 / 19 | $6.544,00 | 1461 / 76 | $5.554,91 | 1453 / 85 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 11 | 112 / 43 | $51.991,60 | 1571 / 62 | $11.537,70 | 1774 / 102 | $10.883,20 | 1771 / 113 |
Other Disorders Of Nervous System W Mcc | 11 | 29 / 12 | $51.959,00 | 219 / 7 | $12.688,50 | 251 / 11 | $12.025,20 | 251 / 16 |
Chronic Obstructive Pulmonary Disease W Cc | 11 | 168 / 62 | $39.386,70 | 2056 / 74 | $8.299,00 | 2140 / 93 | $7.309,91 | 2133 / 106 | Total 32 procedures | 768 | 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.