Hospital Costs > In Indiana > Riverview Health, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W/O Mcc | 153 | 2 / 1 | $47.437,90 | 33 / 3 | $21.455,40 | 103 / 3 | $18.760,30 | 103 / 6 |
Simple Pneumonia & Pleurisy W Cc | 70 | 133 / 17 | $19.322,80 | 1065 / 27 | $6.015,77 | 803 / 21 | $4.909,36 | 800 / 28 |
Simple Pneumonia & Pleurisy W Mcc | 48 | 157 / 30 | $24.266,50 | 652 / 18 | $8.461,46 | 826 / 15 | $7.681,46 | 826 / 31 |
Spinal Fusion Except Cervical W/O Mcc | 47 | 147 / 16 | $61.442,40 | 234 / 5 | $23.446,20 | 577 / 9 | $22.320,70 | 574 / 18 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 43 | 521 / 52 | $46.941,60 | 1130 / 24 | $12.833,30 | 1367 / 20 | $11.731,20 | 1334 / 52 |
Chronic Obstructive Pulmonary Disease W Mcc | 36 | 166 / 40 | $24.744,40 | 1106 / 42 | $7.144,50 | 882 / 23 | $6.137,39 | 877 / 29 |
Heart Failure & Shock W Mcc | 30 | 254 / 43 | $23.665,20 | 639 / 18 | $8.906,70 | 978 / 24 | $8.263,50 | 977 / 37 |
Kidney & Urinary Tract Infections W/O Mcc | 28 | 205 / 40 | $13.730,00 | 758 / 18 | $4.822,29 | 1122 / 25 | $4.035,43 | 1114 / 45 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 26 | 67 / 12 | $11.821,10 | 404 / 10 | $4.634,50 | 512 / 22 | $3.245,19 | 510 / 16 |
Cellulitis W/O Mcc | 26 | 163 / 32 | $12.892,50 | 570 / 12 | $5.419,31 | 638 / 33 | $4.003,88 | 635 / 22 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 25 | 250 / 36 | $14.104,00 | 634 / 11 | $4.701,92 | 958 / 16 | $3.734,24 | 950 / 35 |
Renal Failure W Cc | 25 | 196 / 40 | $21.989,10 | 1175 / 41 | $5.901,12 | 780 / 23 | $4.983,36 | 773 / 27 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 23 | 493 / 61 | $28.699,70 | 726 / 18 | $11.074,30 | 1073 / 23 | $10.285,50 | 1060 / 33 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 22 | 160 / 35 | $16.131,70 | 222 / 7 | $6.549,55 | 361 / 24 | $5.047,68 | 360 / 12 |
Chronic Obstructive Pulmonary Disease W Cc | 20 | 159 / 42 | $19.268,10 | 931 / 33 | $5.823,00 | 800 / 28 | $4.795,80 | 798 / 26 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 20 | 146 / 35 | $13.365,10 | 743 / 20 | $4.412,20 | 883 / 23 | $3.562,60 | 880 / 34 |
Heart Failure & Shock W Cc | 19 | 259 / 50 | $16.642,40 | 766 / 20 | $6.107,16 | 739 / 28 | $5.094,95 | 738 / 23 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 19 | 101 / 30 | $15.782,80 | 874 / 33 | $4.483,26 | 680 / 14 | $3.469,37 | 678 / 30 |
Hip & Femur Procedures Except Major Joint W Cc | 18 | 125 / 31 | $42.521,50 | 743 / 22 | $11.987,40 | 948 / 35 | $10.913,60 | 935 / 39 |
Pulmonary Embolism W/O Mcc | 18 | 56 / 13 | $27.939,70 | 767 / 28 | $6.590,50 | 767 / 21 | $5.714,00 | 764 / 28 |
Respiratory Infections & Inflammations W Cc | 17 | 71 / 15 | $28.816,30 | 642 / 21 | $8.361,76 | 544 / 20 | $7.437,53 | 541 / 20 |
Respiratory Infections & Inflammations W Mcc | 16 | 120 / 30 | $34.015,50 | 553 / 16 | $11.852,90 | 682 / 24 | $10.872,80 | 674 / 26 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 16 | 172 / 34 | $25.964,60 | 330 / 8 | $7.375,69 | 310 / 29 | $5.156,50 | 310 / 12 |
G.I. Hemorrhage W Cc | 16 | 202 / 39 | $15.716,40 | 361 / 5 | $6.183,06 | 1068 / 20 | $5.429,06 | 1066 / 33 |
Pulmonary Edema & Respiratory Failure | 16 | 187 / 47 | $23.831,20 | 656 / 26 | $7.536,75 | 531 / 19 | $6.367,94 | 531 / 16 |
Red Blood Cell Disorders W/O Mcc | 15 | 128 / 29 | $14.623,10 | 414 / 8 | $5.042,67 | 666 / 17 | $4.153,07 | 662 / 22 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 14 | 193 / 45 | $22.613,50 | 1030 / 30 | $6.572,50 | 1056 / 22 | $5.710,79 | 1053 / 40 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 14 | 88 / 26 | $14.468,60 | 214 / 7 | $4.910,64 | 365 / 20 | $3.447,50 | 362 / 11 |
Cervical Spinal Fusion W/O Cc/Mcc | 13 | 91 / 16 | $37.671,50 | 154 / 2 | $13.367,00 | 410 / 8 | $12.158,40 | 409 / 14 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 13 | 112 / 27 | $22.497,00 | 218 / 6 | $9.911,77 | 577 / 13 | $9.168,38 | 576 / 19 |
Renal Failure W Mcc | 12 | 183 / 36 | $25.610,20 | 493 / 13 | $9.068,75 | 529 / 15 | $8.106,08 | 529 / 14 |
Major Small & Large Bowel Procedures W Cc | 12 | 96 / 26 | $71.432,10 | 882 / 32 | $15.289,40 | 683 / 17 | $14.281,50 | 677 / 25 |
Major Small & Large Bowel Procedures W Mcc | 12 | 73 / 23 | $105.684,00 | 438 / 16 | $32.899,30 | 662 / 20 | $31.798,10 | 660 / 22 |
Respiratory System Diagnosis W Ventilator Support 96+ Hours | 12 | 59 / 16 | $75.477,10 | 92 / 3 | $29.536,10 | 248 / 7 | $28.462,10 | 248 / 11 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 12 | 184 / 33 | $64.912,00 | 564 / 19 | $12.222,50 | 656 / 9 | $11.118,50 | 652 / 26 |
Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 11 | 58 / 11 | $51.370,10 | 119 / 4 | $16.328,20 | 233 / 4 | $15.123,80 | 232 / 10 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 11 | 112 / 37 | $18.722,80 | 275 / 7 | $7.393,27 | 544 / 20 | $6.431,82 | 541 / 25 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 11 | 139 / 38 | $9.528,91 | 305 / 7 | $3.625,36 | 607 / 20 | $2.522,82 | 603 / 24 | Total 38 procedures | 959 | 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.