Hospital Costs > In West Virginia > Raleigh General Hospital, 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 Cc | 26 | 65 / 8 | $17.685,40 | 201 / 7 | $6.416,62 | 273 / 6 | $5.089,35 | 273 / 7 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 31 | 94 / 7 | $29.590,80 | 427 / 14 | $8.896,55 | 77 / 2 | $7.741,23 | 77 / 3 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 14 | 39 / 8 | $13.631,50 | 110 / 3 | $4.579,29 | 233 / 4 | $3.653,14 | 232 / 5 |
| Atherosclerosis W/O Mcc | 40 | 18 / 3 | $12.476,80 | 103 / 3 | $4.100,75 | / | $2.933,60 | / |
| Bronchitis & Asthma W Cc/Mcc | 15 | 61 / 2 | $14.200,00 | 166 / 1 | $5.604,67 | 135 / 1 | $3.896,27 | 134 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 58 | 103 / 5 | $12.843,60 | 303 / 11 | $4.920,60 | 481 / 8 | $3.803,60 | 480 / 9 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 25 | 98 / 7 | $22.192,70 | 474 / 11 | $7.283,24 | 532 / 6 | $6.421,44 | 529 / 9 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 51 | 99 / 4 | $10.936,70 | 445 / 16 | $3.769,41 | 533 / 10 | $2.472,73 | 529 / 7 |
| Cellulitis W/O Mcc | 70 | 119 / 2 | $12.285,50 | 508 / 17 | $5.302,10 | 697 / 11 | $4.046,93 | 693 / 12 |
| Chest Pain | 63 | 88 / 2 | $12.351,40 | 266 / 9 | $4.068,30 | 405 / 9 | $2.836,97 | 403 / 7 |
| Chronic Obstructive Pulmonary Disease W Cc | 102 | 77 / 4 | $13.227,10 | 346 / 12 | $5.752,14 | 497 / 11 | $4.543,36 | 496 / 11 |
| Chronic Obstructive Pulmonary Disease W Mcc | 79 | 123 / 6 | $15.977,50 | 388 / 12 | $6.944,84 | 230 / 8 | $5.462,94 | 229 / 8 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 53 | 67 / 7 | $10.381,30 | 280 / 10 | $4.481,57 | 527 / 6 | $3.349,49 | 526 / 7 |
| Circulatory Disorders Except Ami, W Card Cath W Mcc | 30 | 63 / 2 | $33.630,30 | 72 / 3 | $13.350,10 | 53 / 4 | $10.109,40 | 53 / 3 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 96 | 92 / 2 | $23.282,20 | 212 / 11 | $6.454,49 | 300 / 5 | $5.144,68 | 300 / 7 |
| Cirrhosis & Alcoholic Hepatitis W Cc | 12 | 14 / 2 | $10.074,20 | 2 / 1 | $5.639,50 | 13 / 1 | $5.008,17 | 13 / 1 |
| Combined Anterior/Posterior Spinal Fusion W Cc | 14 | 32 / 1 | $214.732,00 | 58 / 1 | $52.874,40 | 45 / 1 | $46.986,20 | 45 / 1 |
| Combined Anterior/Posterior Spinal Fusion W/O Cc/Mcc | 17 | 30 / 1 | $202.618,00 | 82 / 1 | $56.236,10 | 53 / 1 | $37.195,00 | 53 / 1 |
| Diabetes W Cc | 24 | 68 / 6 | $13.854,60 | 260 / 8 | $5.292,12 | 148 / 7 | $3.713,12 | 148 / 4 |
| Diabetes W Mcc | 15 | 42 / 4 | $22.744,50 | 127 / 2 | $8.013,20 | 169 / 1 | $7.388,00 | 169 / 2 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 11 | 59 / 7 | $15.092,80 | 85 / 4 | $7.581,91 | 15 / 7 | $3.956,27 | 15 / 1 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 13 | 63 / 4 | $21.415,30 | 30 / 1 | $10.074,40 | 63 / 1 | $9.443,15 | 63 / 3 |
| Disorders Of Pancreas Except Malignancy W Cc | 29 | 32 / 3 | $17.907,30 | 222 / 8 | $5.713,52 | 247 / 4 | $4.604,07 | 246 / 4 |
| Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 12 | 26 / 5 | $8.881,67 | 30 / 1 | $4.422,50 | 8 / 2 | $2.265,92 | 8 / 1 |
| Dysequilibrium | 18 | 47 / 2 | $12.913,90 | 83 / 2 | $4.343,44 | 75 / 1 | $2.630,89 | 75 / 1 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 37 | 59 / 2 | $19.650,00 | 191 / 3 | $7.098,32 | 314 / 1 | $6.267,19 | 312 / 6 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 145 | 130 / 2 | $11.860,00 | 369 / 15 | $4.737,17 | 548 / 10 | $3.444,92 | 546 / 10 |
| Extracranial Procedures W/O Cc/Mcc | 13 | 85 / 7 | $24.403,80 | 263 / 5 | $5.909,08 | 137 / 2 | $4.801,31 | 137 / 3 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 17 | 45 / 3 | $10.438,80 | 67 / 2 | $4.680,18 | 181 / 1 | $3.554,76 | 181 / 2 |
| G.I. Hemorrhage W Cc | 95 | 123 / 3 | $17.005,30 | 484 / 13 | $6.006,53 | 529 / 7 | $4.931,81 | 528 / 11 |
| G.I. Hemorrhage W Mcc | 28 | 93 / 6 | $27.654,60 | 251 / 8 | $9.738,96 | 20 / 5 | $7.982,68 | 20 / 1 |
| G.I. Hemorrhage W/O Cc/Mcc | 13 | 55 / 7 | $11.515,50 | 152 / 4 | $4.437,54 | 262 / 4 | $3.293,00 | 260 / 3 |
| G.I. Obstruction W Cc | 19 | 73 / 7 | $11.297,00 | 91 / 4 | $5.629,79 | 156 / 7 | $3.960,37 | 155 / 3 |
| G.I. Obstruction W/O Cc/Mcc | 11 | 60 / 9 | $7.558,27 | 50 / 1 | $4.359,27 | 136 / 3 | $2.404,00 | 136 / 2 |
| Heart Failure & Shock W Cc | 87 | 191 / 6 | $14.423,80 | 515 / 14 | $6.196,79 | 514 / 13 | $4.908,07 | 514 / 11 |
| Heart Failure & Shock W Mcc | 119 | 165 / 3 | $20.896,50 | 474 / 15 | $8.660,92 | 394 / 9 | $7.557,78 | 394 / 10 |
| Heart Failure & Shock W/O Cc/Mcc | 29 | 81 / 9 | $9.352,41 | 208 / 9 | $4.279,17 | 672 / 8 | $3.450,55 | 670 / 9 |
| Hip & Femur Procedures Except Major Joint W Cc | 51 | 92 / 5 | $39.029,00 | 582 / 15 | $10.936,50 | 260 / 5 | $9.644,33 | 259 / 6 |
| Hip & Femur Procedures Except Major Joint W Mcc | 24 | 38 / 2 | $49.220,80 | 144 / 3 | $15.905,90 | 48 / 1 | $14.637,30 | 48 / 1 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 14 | 42 / 4 | $32.301,90 | 243 / 5 | $8.958,36 | 35 / 2 | $7.278,57 | 35 / 1 |
| Hypertension W/O Mcc | 21 | 44 / 3 | $10.948,50 | 81 / 2 | $4.044,67 | 196 / 4 | $2.886,52 | 194 / 5 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 48 | 76 / 3 | $88.738,00 | 347 / 12 | $29.744,10 | 333 / 6 | $28.199,30 | 333 / 7 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 58 | 124 / 5 | $17.958,70 | 346 / 11 | $6.333,21 | 420 / 6 | $5.128,55 | 419 / 6 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 24 | 144 / 6 | $23.957,90 | 179 / 3 | $9.748,08 | 254 / 2 | $8.661,08 | 253 / 3 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 18 | 84 / 7 | $15.242,10 | 269 / 7 | $5.510,89 | 45 / 7 | $2.829,33 | 45 / 1 |
| Kidney & Urinary Tract Infections W Mcc | 59 | 85 / 1 | $15.550,70 | 286 / 9 | $6.616,05 | 377 / 5 | $5.537,61 | 376 / 8 |
| Kidney & Urinary Tract Infections W/O Mcc | 94 | 139 / 5 | $11.097,80 | 404 / 12 | $4.900,95 | 426 / 12 | $3.562,01 | 426 / 10 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 20 | 36 / 3 | $45.611,90 | 383 / 6 | $10.225,60 | 67 / 3 | $7.633,20 | 67 / 1 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 15 | 40 / 4 | $42.365,50 | 179 / 2 | $11.109,20 | 127 / 1 | $10.036,40 | 127 / 2 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 12 | 35 / 5 | $41.939,20 | 241 / 5 | $10.204,80 | 16 / 3 | $6.168,33 | 16 / 1 |
| Major Cardiovasc Procedures W Mcc | 16 | 52 / 2 | $66.315,90 | 22 / 1 | $19.780,70 | 3 / 1 | $18.868,80 | 3 / 1 |
| Major Cardiovasc Procedures W/O Mcc | 18 | 83 / 7 | $75.843,20 | 323 / 8 | $19.130,10 | 226 / 2 | $18.000,30 | 226 / 4 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 35 | 38 / 1 | $13.662,10 | 84 / 4 | $7.027,60 | 198 / 4 | $5.891,80 | 198 / 4 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 17 | 39 / 2 | $29.459,60 | 130 / 3 | $11.629,20 | 69 / 2 | $9.512,12 | 69 / 1 |
| Major Hematol/Immun Diag Exc Sickle Cell Crisis & Coagul W Cc | 22 | 31 / 1 | $21.621,40 | 85 / 2 | $7.089,68 | 96 / 2 | $6.241,68 | 96 / 3 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 13 | 52 / 4 | $59.585,30 | 251 / 2 | $17.272,80 | 85 / 2 | $15.749,80 | 85 / 1 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 58 | 506 / 18 | $60.720,40 | 1718 / 23 | $11.870,60 | 628 / 5 | $10.514,00 | 621 / 10 |
| Major Small & Large Bowel Procedures W Cc | 16 | 92 / 6 | $48.192,60 | 364 / 7 | $14.298,90 | 335 / 3 | $12.995,80 | 332 / 6 |
| Major Small & Large Bowel Procedures W Mcc | 21 | 64 / 4 | $92.858,10 | 319 / 6 | $28.347,20 | 233 / 2 | $26.721,00 | 231 / 3 |
| Medical Back Problems W/O Mcc | 27 | 94 / 3 | $15.422,00 | 246 / 6 | $5.205,89 | 292 / 4 | $3.943,67 | 292 / 3 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 27 | 99 / 4 | $13.778,90 | 111 / 3 | $6.572,96 | 260 / 3 | $5.628,41 | 258 / 4 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 30 | 136 / 11 | $8.541,47 | 191 / 7 | $4.471,33 | 596 / 10 | $3.378,50 | 594 / 10 |
| Other Circulatory System Diagnoses W Cc | 13 | 53 / 5 | $12.112,60 | 48 / 3 | $5.534,77 | 62 / 2 | $4.534,23 | 62 / 3 |
| Other Circulatory System Diagnoses W Mcc | 50 | 66 / 2 | $35.160,70 | 348 / 9 | $11.946,30 | 241 / 5 | $9.757,10 | 241 / 4 |
| Other Circulatory System O.R. Procedures | 14 | 41 / 4 | $49.569,10 | 99 / 4 | $15.208,70 | 54 / 2 | $14.040,90 | 54 / 1 |
| Other Digestive System Diagnoses W Cc | 11 | 86 / 7 | $14.688,40 | 141 / 2 | $5.921,36 | 344 / 3 | $4.939,82 | 341 / 5 |
| Other Digestive System Diagnoses W Mcc | 16 | 46 / 2 | $20.161,20 | 44 / 1 | $9.153,75 | 66 / 1 | $8.556,69 | 66 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 13 | 90 / 6 | $17.380,10 | 168 / 6 | $6.826,31 | 13 / 5 | $4.218,46 | 13 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 33 | 68 / 1 | $21.443,10 | 152 / 5 | $8.677,61 | 158 / 1 | $7.831,48 | 158 / 2 |
| Other Resp System O.R. Procedures W Cc | 16 | 31 / 2 | $34.966,10 | 47 / 2 | $12.998,80 | 7 / 3 | $8.968,12 | 7 / 1 |
| Other Resp System O.R. Procedures W Mcc | 32 | 31 / 1 | $48.899,30 | 54 / 3 | $19.277,60 | 43 / 1 | $17.931,20 | 43 / 2 |
| Other Vascular Procedures W Cc | 19 | 83 / 8 | $45.615,60 | 144 / 3 | $14.091,40 | 35 / 2 | $12.067,00 | 35 / 1 |
| Other Vascular Procedures W Mcc | 26 | 71 / 4 | $51.246,30 | 89 / 2 | $17.870,00 | 73 / 1 | $16.640,10 | 73 / 2 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 18 | 82 / 7 | $67.575,20 | 141 / 4 | $17.618,20 | 107 / 2 | $16.399,90 | 107 / 2 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 65 | 131 / 6 | $46.839,90 | 169 / 7 | $12.090,60 | 176 / 3 | $9.722,69 | 176 / 4 |
| Peripheral Vascular Disorders W Cc | 37 | 47 / 2 | $14.444,10 | 160 / 8 | $5.969,62 | 160 / 5 | $4.549,00 | 160 / 4 |
| Peripheral Vascular Disorders W Mcc | 17 | 32 / 2 | $20.548,80 | 62 / 1 | $7.942,88 | 16 / 1 | $6.153,24 | 16 / 1 |
| Peripheral Vascular Disorders W/O Cc/Mcc | 20 | 25 / 3 | $11.920,40 | 79 / 5 | $4.784,55 | 31 / 3 | $2.756,60 | 31 / 1 |
| Permanent Cardiac Pacemaker Implant W Cc | 17 | 60 / 5 | $58.787,00 | 327 / 8 | $15.228,70 | 210 / 4 | $14.098,30 | 209 / 5 |
| Permanent Cardiac Pacemaker Implant W Mcc | 11 | 41 / 3 | $66.595,00 | 121 / 1 | $21.237,80 | 152 / 1 | $20.086,50 | 152 / 1 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 19 | 53 / 5 | $19.018,20 | 88 / 2 | $8.202,58 | 164 / 2 | $7.095,05 | 163 / 1 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 21 | 40 / 4 | $9.697,48 | 87 / 4 | $4.124,52 | 180 / 4 | $3.086,62 | 179 / 3 |
| Pulmonary Edema & Respiratory Failure | 98 | 105 / 5 | $13.544,60 | 90 / 6 | $7.274,22 | 360 / 5 | $6.165,89 | 360 / 8 |
| Pulmonary Embolism W Mcc | 14 | 29 / 2 | $21.150,10 | 54 / 1 | $8.460,43 | 67 / 1 | $7.480,64 | 67 / 1 |
| Pulmonary Embolism W/O Mcc | 16 | 58 / 8 | $17.327,00 | 252 / 6 | $6.523,56 | 216 / 4 | $4.631,31 | 216 / 4 |
| Red Blood Cell Disorders W Mcc | 13 | 58 / 6 | $17.087,50 | 92 / 3 | $7.933,00 | 18 / 7 | $5.520,15 | 18 / 3 |
| Red Blood Cell Disorders W/O Mcc | 31 | 112 / 6 | $10.742,10 | 141 / 5 | $4.901,68 | 596 / 8 | $4.076,71 | 592 / 13 |
| Renal Failure W Cc | 93 | 128 / 5 | $16.123,40 | 577 / 16 | $5.973,63 | 452 / 10 | $4.700,38 | 449 / 8 |
| Renal Failure W Mcc | 79 | 116 / 2 | $23.557,40 | 390 / 10 | $8.875,35 | 271 / 6 | $7.680,52 | 271 / 4 |
| Renal Failure W/O Cc/Mcc | 18 | 38 / 6 | $10.186,40 | 126 / 7 | $4.065,44 | 239 / 4 | $3.002,89 | 238 / 5 |
| Respiratory Infections & Inflammations W Cc | 23 | 65 / 5 | $15.948,60 | 126 / 5 | $7.896,52 | 242 / 3 | $6.847,61 | 240 / 6 |
| Respiratory Infections & Inflammations W Mcc | 68 | 68 / 2 | $33.094,30 | 516 / 11 | $11.219,50 | 178 / 6 | $9.668,68 | 178 / 3 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 39 | 92 / 7 | $35.175,20 | 213 / 11 | $12.707,50 | 192 / 3 | $11.517,30 | 191 / 7 |
| Seizures W/O Mcc | 26 | 82 / 4 | $11.071,00 | 101 / 4 | $4.691,85 | 313 / 4 | $3.775,69 | 311 / 4 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 13 | 79 / 7 | $84.547,20 | 108 / 1 | $31.866,50 | 113 / 1 | $30.304,80 | 113 / 1 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 219 | 297 / 5 | $28.527,90 | 714 / 18 | $10.671,30 | 434 / 10 | $9.394,97 | 434 / 11 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 66 | 141 / 5 | $17.712,70 | 582 / 15 | $6.587,20 | 430 / 10 | $5.126,58 | 428 / 7 |
| Signs & Symptoms W/O Mcc | 25 | 66 / 5 | $11.651,80 | 167 / 4 | $4.676,20 | 164 / 5 | $3.149,64 | 164 / 4 |
| Simple Pneumonia & Pleurisy W Cc | 56 | 147 / 10 | $13.163,20 | 368 / 12 | $5.870,79 | 644 / 9 | $4.772,21 | 641 / 13 |
| Simple Pneumonia & Pleurisy W Mcc | 87 | 118 / 3 | $23.264,60 | 586 / 15 | $8.510,51 | 455 / 12 | $7.262,66 | 455 / 12 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 32 | 61 / 5 | $10.669,20 | 285 / 10 | $4.466,84 | 610 / 8 | $3.326,94 | 607 / 12 |
| Spinal Fusion Except Cervical W/O Mcc | 15 | 179 / 7 | $136.039,00 | 1035 / 8 | $26.482,00 | 831 / 4 | $24.441,40 | 827 / 5 |
| Syncope & Collapse | 52 | 117 / 2 | $12.243,80 | 210 / 8 | $4.627,50 | 337 / 5 | $3.374,69 | 335 / 6 |
| Transient Ischemia | 85 | 40 / 2 | $12.446,80 | 139 / 8 | $4.456,44 | 475 / 7 | $3.349,78 | 474 / 10 |
| Transurethral Procedures W Cc | 18 | 23 / 2 | $33.468,70 | 157 / 4 | $8.203,44 | 91 / 2 | $6.477,22 | 91 / 1 |
| Trauma To The Skin, Subcut Tiss & Breast W/O Mcc | 14 | 30 / 1 | $11.498,30 | 33 / 1 | $4.703,00 | 34 / 1 | $3.336,43 | 34 / 1 |
| Urinary Stones W/O Esw Lithotripsy W/O Mcc | 11 | 35 / 4 | $12.603,70 | 46 / 2 | $7.535,91 | 4 / 6 | $2.346,64 | 4 / 1 | Total 107 procedures | 3.968 | 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.