Hospital Costs > In New Mexico > Presbyterian Espanola Hospital, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 62 | 502 / 12 | $48.213,20 | 1207 / 7 | $20.554,90 | 2453 / 17 | $16.871,80 | 2407 / 17 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 41 | 475 / 14 | $31.185,90 | 838 / 10 | $16.657,10 | 2561 / 20 | $15.743,90 | 2517 / 20 |
| Simple Pneumonia & Pleurisy W Cc | 34 | 169 / 12 | $24.554,30 | 1590 / 16 | $8.752,50 | 2507 / 18 | $7.759,56 | 2498 / 18 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 31 | 176 / 9 | $18.294,90 | 616 / 6 | $9.620,19 | 2253 / 17 | $8.316,35 | 2244 / 17 |
| Cellulitis W/O Mcc | 30 | 159 / 5 | $16.245,30 | 1023 / 7 | $7.801,70 | 2147 / 16 | $5.938,00 | 2139 / 14 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 30 | 63 / 6 | $19.096,40 | 1126 / 13 | $6.270,60 | 1724 / 16 | $5.265,80 | 1716 / 17 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 21 | 254 / 13 | $18.639,70 | 1234 / 10 | $6.623,95 | 2330 / 17 | $5.647,19 | 2315 / 19 |
| Kidney & Urinary Tract Infections W/O Mcc | 17 | 216 / 13 | $16.306,60 | 1122 / 8 | $6.894,18 | 2342 / 16 | $5.900,29 | 2331 / 16 |
| Chronic Obstructive Pulmonary Disease W Cc | 15 | 164 / 9 | $19.164,40 | 922 / 5 | $8.529,40 | 2060 / 13 | $6.923,47 | 2053 / 13 |
| G.I. Hemorrhage W Cc | 13 | 205 / 11 | $18.071,50 | 575 / 1 | $8.953,15 | 2174 / 10 | $8.207,31 | 2170 / 10 | Total 10 procedures | 294 | 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.