Hospital Costs > In California > Regional Medical Center Of San Jose, 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 | 22 | 69 / 14 | $114.044,00 | 1425 / 100 | $11.224,40 | 1380 / 88 | $10.241,10 | 1378 / 94 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 29 | 96 / 23 | $176.289,00 | 1817 / 152 | $18.506,90 | 1734 / 134 | $16.576,10 | 1721 / 132 |
Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W Mcc | 13 | 14 / 6 | $139.453,00 | 135 / 10 | $21.370,80 | 113 / 11 | $13.320,80 | 113 / 7 |
Bronchitis & Asthma W Cc/Mcc | 21 | 55 / 12 | $85.476,00 | 1084 / 82 | $9.570,24 | 1023 / 68 | $8.295,33 | 1019 / 72 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 36 | 125 / 30 | $86.301,80 | 2166 / 180 | $8.900,81 | 2036 / 152 | $7.361,11 | 2031 / 148 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 36 | 87 / 18 | $97.502,60 | 1891 / 137 | $12.451,40 | 1833 / 119 | $11.916,80 | 1830 / 131 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 28 | 122 / 21 | $72.167,10 | 1988 / 148 | $7.152,75 | 1875 / 127 | $5.174,46 | 1869 / 117 |
Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Mcc | 11 | 105 / 26 | $754.725,00 | 477 / 41 | $75.301,10 | 454 / 26 | $74.428,40 | 454 / 31 |
Cellulitis W/O Mcc | 68 | 121 / 23 | $68.337,80 | 2626 / 219 | $9.887,22 | 2501 / 189 | $8.029,12 | 2493 / 179 |
Chest Pain | 61 | 90 / 17 | $71.514,00 | 1708 / 152 | $7.006,21 | 1582 / 114 | $5.993,08 | 1573 / 116 |
Chronic Obstructive Pulmonary Disease W Cc | 45 | 134 / 28 | $83.059,70 | 2433 / 185 | $9.922,80 | 2336 / 157 | $8.986,27 | 2329 / 162 |
Chronic Obstructive Pulmonary Disease W Mcc | 86 | 116 / 12 | $116.271,00 | 2567 / 197 | $12.448,00 | 2484 / 167 | $11.410,50 | 2476 / 175 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 27 | 93 / 19 | $72.418,00 | 2100 / 135 | $8.123,48 | 2006 / 117 | $6.855,15 | 1995 / 110 |
Circulatory Disorders Except Ami, W Card Cath W Mcc | 22 | 71 / 11 | $240.073,00 | 918 / 64 | $25.086,20 | 853 / 54 | $20.295,80 | 845 / 51 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 39 | 149 / 23 | $128.936,00 | 1640 / 132 | $11.986,00 | 1549 / 108 | $9.964,90 | 1546 / 108 |
Coronary Bypass W Cardiac Cath W Mcc | 13 | 43 / 11 | $689.924,00 | 439 / 33 | $69.054,60 | 419 / 21 | $68.222,60 | 419 / 23 |
Cranio W Major Dev Impl/Acute Complex Cns Pdx W Mcc Or Chemo Implant | 18 | 24 / 6 | $580.546,00 | 180 / 14 | $55.467,30 | 167 / 7 | $54.331,30 | 167 / 8 |
Craniotomy & Endovascular Intracranial Procedures W Mcc | 15 | 83 / 18 | $571.815,00 | 510 / 48 | $57.240,20 | 504 / 42 | $56.354,70 | 504 / 43 |
Degenerative Nervous System Disorders W/O Mcc | 14 | 64 / 16 | $118.790,00 | 881 / 57 | $10.599,30 | 812 / 41 | $9.829,00 | 812 / 44 |
Diabetes W Cc | 26 | 66 / 9 | $71.106,10 | 1611 / 120 | $9.601,96 | 1500 / 102 | $7.802,23 | 1495 / 99 |
Diabetes W Mcc | 22 | 35 / 7 | $128.776,00 | 743 / 44 | $14.814,20 | 700 / 41 | $13.365,70 | 699 / 41 |
Diabetes W/O Cc/Mcc | 14 | 24 / 3 | $38.669,60 | 284 / 6 | $6.844,64 | 253 / 5 | $5.367,21 | 253 / 5 |
Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 21 | 49 / 13 | $77.201,80 | 561 / 50 | $9.878,33 | 517 / 39 | $9.305,38 | 517 / 42 |
Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 21 | 55 / 16 | $113.331,00 | 531 / 54 | $18.212,40 | 487 / 49 | $16.573,20 | 487 / 50 |
Disorders Of Pancreas Except Malignancy W Cc | 12 | 49 / 13 | $66.333,00 | 930 / 52 | $9.919,75 | 918 / 47 | $8.965,08 | 915 / 50 |
Disorders Of The Biliary Tract W Cc | 14 | 40 / 10 | $122.117,00 | 480 / 40 | $11.129,30 | 450 / 26 | $10.007,00 | 450 / 29 |
Dysequilibrium | 12 | 53 / 15 | $72.973,40 | 566 / 40 | $7.543,42 | 509 / 36 | $5.483,75 | 509 / 30 |
Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 11 | 70 / 18 | $1.668.860,00 | 450 / 33 | $186.904,00 | 428 / 24 | $183.376,00 | 427 / 24 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 23 | 73 / 21 | $70.920,30 | 1368 / 100 | $12.327,30 | 1357 / 101 | $11.316,80 | 1352 / 111 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 58 | 217 / 53 | $80.899,40 | 2731 / 229 | $8.649,93 | 2613 / 184 | $7.608,28 | 2598 / 188 |
Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 19 | 44 / 11 | $341.290,00 | 742 / 49 | $41.927,90 | 668 / 33 | $41.376,40 | 668 / 37 |
Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 11 | 51 / 20 | $63.526,80 | 805 / 62 | $8.425,09 | 772 / 51 | $7.543,64 | 770 / 56 |
G.I. Hemorrhage W Cc | 90 | 128 / 16 | $75.826,10 | 2400 / 191 | $10.744,90 | 2335 / 166 | $9.834,36 | 2331 / 175 |
G.I. Hemorrhage W Mcc | 46 | 75 / 11 | $110.073,00 | 1598 / 134 | $17.366,50 | 1571 / 124 | $16.580,40 | 1561 / 130 |
G.I. Hemorrhage W/O Cc/Mcc | 15 | 53 / 14 | $45.771,70 | 960 / 51 | $7.805,40 | 965 / 54 | $6.917,93 | 961 / 61 |
G.I. Obstruction W Cc | 29 | 63 / 23 | $60.939,30 | 1681 / 115 | $9.636,03 | 1686 / 119 | $8.672,72 | 1681 / 126 |
G.I. Obstruction W/O Cc/Mcc | 17 | 54 / 24 | $59.439,80 | 1303 / 100 | $7.063,41 | 1269 / 86 | $5.922,71 | 1266 / 92 |
Heart Failure & Shock W Cc | 69 | 209 / 37 | $90.817,70 | 2757 / 225 | $10.699,70 | 2599 / 183 | $9.101,00 | 2593 / 180 |
Heart Failure & Shock W Mcc | 121 | 163 / 20 | $148.973,00 | 2628 / 233 | $15.594,40 | 2526 / 184 | $14.916,80 | 2515 / 192 |
Heart Failure & Shock W/O Cc/Mcc | 24 | 86 / 21 | $71.328,00 | 2010 / 132 | $7.622,67 | 1912 / 106 | $6.617,33 | 1899 / 106 |
Hip & Femur Procedures Except Major Joint W Cc | 38 | 105 / 29 | $197.581,00 | 2055 / 155 | $19.829,50 | 1997 / 140 | $18.754,10 | 1975 / 144 |
Infectious & Parasitic Diseases W O.R. Procedure W Cc | 18 | 18 / 5 | $265.941,00 | 363 / 29 | $27.522,40 | 357 / 26 | $26.381,10 | 356 / 27 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 71 | 53 / 7 | $530.033,00 | 1587 / 155 | $63.033,30 | 1556 / 140 | $58.068,20 | 1546 / 136 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 54 | 128 / 24 | $137.111,00 | 2083 / 186 | $11.349,50 | 1983 / 152 | $10.255,00 | 1979 / 158 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 73 | 95 / 9 | $218.583,00 | 1638 / 162 | $19.890,80 | 1578 / 134 | $18.914,40 | 1571 / 143 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 26 | 76 / 22 | $89.334,40 | 1608 / 127 | $8.459,88 | 1533 / 105 | $7.298,04 | 1529 / 110 |
Kidney & Urinary Tract Infections W Mcc | 41 | 103 / 25 | $84.799,10 | 1928 / 162 | $11.382,30 | 1859 / 143 | $10.447,70 | 1855 / 146 |
Kidney & Urinary Tract Infections W/O Mcc | 115 | 118 / 9 | $65.983,50 | 2702 / 217 | $8.541,87 | 2591 / 177 | $7.572,13 | 2580 / 179 |
Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 15 | 41 / 15 | $133.781,00 | 854 / 61 | $16.691,80 | 852 / 60 | $15.648,60 | 848 / 65 |
Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 26 | 14 / 2 | $229.141,00 | 459 / 44 | $26.814,40 | 449 / 42 | $23.761,00 | 448 / 40 |
Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 15 | 32 / 11 | $108.146,00 | 574 / 46 | $12.341,30 | 564 / 42 | $10.770,10 | 563 / 44 |
Major Cardiovasc Procedures W Mcc | 17 | 51 / 13 | $594.864,00 | 648 / 52 | $61.969,80 | 620 / 43 | $53.791,50 | 619 / 40 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 57 | 507 / 112 | $186.136,00 | 2690 / 235 | $21.551,10 | 2565 / 195 | $19.048,10 | 2519 / 203 |
Major Small & Large Bowel Procedures W Cc | 12 | 96 / 43 | $297.226,00 | 1537 / 121 | $26.931,80 | 1470 / 100 | $23.248,00 | 1456 / 103 |
Medical Back Problems W/O Mcc | 24 | 97 / 33 | $79.115,00 | 1490 / 128 | $9.241,42 | 1422 / 107 | $8.284,08 | 1417 / 111 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 34 | 92 / 25 | $106.178,00 | 1736 / 163 | $12.631,50 | 1668 / 140 | $11.957,60 | 1664 / 145 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 83 | 83 / 10 | $58.551,30 | 2520 / 192 | $7.877,06 | 2411 / 156 | $6.898,29 | 2402 / 165 |
Other Circulatory System Diagnoses W Mcc | 37 | 79 / 14 | $139.080,00 | 1365 / 122 | $18.722,50 | 1282 / 96 | $17.891,20 | 1274 / 100 |
Other Digestive System Diagnoses W Cc | 23 | 74 / 19 | $54.730,30 | 1318 / 93 | $10.206,50 | 1353 / 112 | $9.204,74 | 1349 / 114 |
Other Digestive System Diagnoses W Mcc | 13 | 49 / 21 | $139.745,00 | 753 / 77 | $21.374,00 | 719 / 75 | $17.258,30 | 718 / 70 |
Other Digestive System Diagnoses W/O Cc/Mcc | 11 | 32 / 8 | $55.451,50 | 357 / 10 | $7.630,09 | 350 / 12 | $6.748,64 | 350 / 13 |
Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 28 | $78.834,90 | 854 / 54 | $11.417,70 | 769 / 47 | $8.844,09 | 769 / 44 |
Other Kidney & Urinary Tract Diagnoses W Mcc | 12 | 89 / 36 | $179.387,00 | 1108 / 83 | $15.403,20 | 1035 / 61 | $14.803,20 | 1031 / 65 |
Other Resp System O.R. Procedures W Mcc | 11 | 52 / 7 | $380.149,00 | 593 / 27 | $40.613,90 | 581 / 19 | $39.624,90 | 580 / 22 |
Other Vascular Procedures W Cc | 13 | 89 / 31 | $347.215,00 | 1137 / 81 | $33.087,80 | 1128 / 77 | $29.473,00 | 1123 / 76 |
Other Vascular Procedures W Mcc | 32 | 65 / 12 | $353.229,00 | 1006 / 89 | $34.601,40 | 961 / 71 | $33.737,30 | 958 / 71 |
Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 31 | 69 / 12 | $297.981,00 | 1010 / 89 | $31.159,80 | 958 / 70 | $29.176,40 | 953 / 70 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 29 | 167 / 43 | $200.218,00 | 1481 / 120 | $20.245,20 | 1444 / 93 | $19.164,90 | 1436 / 107 |
Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 12 | 83 / 18 | $185.608,00 | 593 / 37 | $19.618,00 | 580 / 31 | $19.116,70 | 576 / 37 |
Peripheral Vascular Disorders W Cc | 17 | 67 / 16 | $77.668,40 | 1243 / 89 | $11.168,60 | 1173 / 82 | $9.126,53 | 1170 / 79 |
Permanent Cardiac Pacemaker Implant W Cc | 28 | 49 / 7 | $208.930,00 | 966 / 81 | $26.034,00 | 946 / 71 | $25.086,60 | 942 / 76 |
Permanent Cardiac Pacemaker Implant W Mcc | 17 | 35 / 7 | $306.541,00 | 608 / 49 | $35.065,50 | 582 / 39 | $34.282,50 | 582 / 42 |
Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 16 | 41 / 10 | $170.769,00 | 714 / 50 | $22.726,20 | 689 / 47 | $19.108,40 | 687 / 48 |
Poisoning & Toxic Effects Of Drugs W Mcc | 17 | 55 / 18 | $156.683,00 | 988 / 84 | $14.592,10 | 895 / 63 | $12.954,20 | 892 / 61 |
Poisoning & Toxic Effects Of Drugs W/O Mcc | 14 | 47 / 11 | $70.900,90 | 925 / 50 | $7.310,43 | 849 / 40 | $6.620,14 | 848 / 43 |
Pulmonary Edema & Respiratory Failure | 44 | 159 / 34 | $145.667,00 | 2239 / 178 | $13.346,40 | 2156 / 146 | $12.525,30 | 2150 / 150 |
Red Blood Cell Disorders W Mcc | 24 | 47 / 7 | $78.908,70 | 1065 / 80 | $12.965,50 | 1040 / 68 | $12.412,20 | 1036 / 73 |
Red Blood Cell Disorders W/O Mcc | 39 | 104 / 17 | $58.011,70 | 1966 / 143 | $8.838,46 | 1893 / 126 | $7.938,36 | 1884 / 130 |
Renal Failure W Cc | 58 | 163 / 32 | $72.575,90 | 2411 / 187 | $10.156,90 | 2329 / 163 | $9.285,41 | 2319 / 170 |
Renal Failure W Mcc | 62 | 133 / 27 | $130.959,00 | 2154 / 179 | $15.998,00 | 2054 / 153 | $14.943,10 | 2050 / 159 |
Renal Failure W/O Cc/Mcc | 16 | 40 / 5 | $58.662,10 | 855 / 31 | $7.719,69 | 816 / 30 | $5.927,31 | 814 / 29 |
Respiratory Infections & Inflammations W Cc | 30 | 58 / 19 | $110.143,00 | 1474 / 119 | $13.831,80 | 1434 / 101 | $13.028,60 | 1429 / 106 |
Respiratory Infections & Inflammations W Mcc | 36 | 100 / 37 | $214.350,00 | 1806 / 155 | $20.327,40 | 1761 / 141 | $18.852,50 | 1745 / 142 |
Respiratory Neoplasms W Mcc | 11 | 41 / 15 | $131.472,00 | 624 / 33 | $17.132,40 | 612 / 32 | $16.477,80 | 609 / 34 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 41 | 90 / 14 | $266.282,00 | 1851 / 145 | $25.368,30 | 1778 / 123 | $22.995,00 | 1764 / 118 |
Respiratory System Diagnosis W Ventilator Support 96+ Hours | 14 | 57 / 19 | $583.710,00 | 986 / 90 | $205.582,00 | 956 / 93 | $54.032,50 | 955 / 80 |
Seizures W Mcc | 33 | 33 / 4 | $174.162,00 | 771 / 57 | $15.852,30 | 708 / 39 | $15.194,90 | 708 / 43 |
Seizures W/O Mcc | 16 | 92 / 26 | $105.463,00 | 1321 / 102 | $10.972,90 | 1201 / 91 | $7.094,38 | 1199 / 76 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 38 | 54 / 17 | $649.557,00 | 1101 / 147 | $65.397,20 | 1068 / 125 | $64.361,30 | 1067 / 128 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 464 | 98 / 9 | $180.460,00 | 2821 / 267 | $19.153,80 | 2715 / 221 | $18.283,30 | 2670 / 227 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 121 | 86 / 15 | $97.022,70 | 2564 / 243 | $11.264,70 | 2475 / 199 | $10.301,80 | 2465 / 213 |
Signs & Symptoms W/O Mcc | 13 | 78 / 25 | $81.372,30 | 1342 / 94 | $7.724,31 | 1250 / 70 | $6.976,00 | 1247 / 75 |
Simple Pneumonia & Pleurisy W Cc | 59 | 144 / 32 | $82.025,70 | 2805 / 214 | $10.527,00 | 2699 / 179 | $9.314,24 | 2690 / 184 |
Simple Pneumonia & Pleurisy W Mcc | 86 | 119 / 14 | $141.690,00 | 2515 / 198 | $14.565,20 | 2422 / 162 | $13.821,40 | 2416 / 174 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 36 | 57 / 10 | $65.824,10 | 1950 / 125 | $8.267,08 | 1889 / 119 | $6.516,17 | 1881 / 115 |
Syncope & Collapse | 50 | 119 / 19 | $88.918,00 | 1929 / 164 | $8.245,48 | 1823 / 130 | $7.257,34 | 1815 / 134 |
Transient Ischemia | 34 | 91 / 23 | $80.217,40 | 1661 / 143 | $8.289,76 | 1573 / 120 | $6.558,35 | 1565 / 118 |
Traumatic Stupor & Coma, Coma <1 Hr W Cc | 15 | 51 / 16 | $147.598,00 | 533 / 39 | $12.433,50 | 485 / 31 | $10.078,40 | 484 / 30 |
Traumatic Stupor & Coma, Coma <1 Hr W Mcc | 17 | 34 / 11 | $217.878,00 | 349 / 26 | $24.101,90 | 308 / 23 | $18.251,40 | 308 / 18 |
Traumatic Stupor & Coma, Coma <1 Hr W/O Cc/Mcc | 20 | 34 / 8 | $124.600,00 | 409 / 29 | $16.206,80 | 377 / 28 | $7.274,40 | 377 / 21 | Total 100 procedures | 3.719 | 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.