Hospital Costs > In California > Saddleback Memorial Medical Center, 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 | 13 | 78 / 23 | $48.349,20 | 1160 / 39 | $7.066,31 | 799 / 3 | $6.130,62 | 797 / 6 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 25 | 100 / 27 | $75.677,80 | 1514 / 65 | $14.481,90 | 1480 / 76 | $12.705,10 | 1468 / 50 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 17 | 107 / 22 | $28.903,50 | 677 / 16 | $4.559,12 | 365 / 1 | $3.984,76 | 365 / 3 |
| Bronchitis & Asthma W Cc/Mcc | 15 | 61 / 18 | $40.028,10 | 886 / 26 | $5.823,40 | 490 / 3 | $4.774,47 | 486 / 2 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 36 | 125 / 30 | $30.349,40 | 1642 / 35 | $5.332,39 | 819 / 7 | $4.127,06 | 816 / 2 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 39 | 84 / 15 | $40.676,50 | 1349 / 26 | $8.649,41 | 877 / 10 | $6.936,00 | 874 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 47 | 103 / 6 | $20.199,60 | 1403 / 14 | $3.842,53 | 625 / 5 | $2.536,02 | 621 / 3 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Mcc | 12 | 104 / 25 | $296.690,00 | 383 / 14 | $76.146,20 | 6 / 27 | $37.833,70 | 6 / 1 |
| Cellulitis W Mcc | 11 | 47 / 23 | $27.990,50 | 327 / 3 | $8.539,36 | 254 / 1 | $7.661,00 | 253 / 1 |
| Cellulitis W/O Mcc | 60 | 129 / 29 | $31.644,20 | 2187 / 82 | $5.668,97 | 1020 / 7 | $4.284,20 | 1014 / 2 |
| Chest Pain | 14 | 137 / 58 | $19.444,50 | 881 / 17 | $4.026,14 | 570 / 3 | $2.991,79 | 566 / 4 |
| Chronic Obstructive Pulmonary Disease W Cc | 28 | 151 / 45 | $36.762,50 | 1984 / 58 | $5.879,68 | 1160 / 1 | $5.109,04 | 1156 / 5 |
| Chronic Obstructive Pulmonary Disease W Mcc | 63 | 139 / 27 | $46.513,60 | 2109 / 61 | $8.486,10 | 1168 / 21 | $6.418,78 | 1162 / 4 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 12 | 108 / 34 | $26.063,90 | 1579 / 21 | $4.986,00 | 795 / 5 | $3.569,83 | 791 / 2 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 12 | 176 / 49 | $49.235,40 | 1185 / 27 | $7.806,83 | 251 / 6 | $5.067,00 | 251 / 1 |
| Coronary Bypass W Cardiac Cath W Mcc | 16 | 40 / 8 | $267.211,00 | 333 / 8 | $43.730,60 | 208 / 2 | $42.659,70 | 208 / 2 |
| Cranial & Peripheral Nerve Disorders W/O Mcc | 11 | 57 / 20 | $25.262,30 | 362 / 5 | $6.378,27 | 133 / 2 | $4.368,36 | 133 / 1 |
| Disorders Of Pancreas Except Malignancy W Cc | 12 | 49 / 13 | $35.452,70 | 730 / 14 | $6.142,67 | 512 / 3 | $5.330,75 | 510 / 3 |
| Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 15 | 23 / 5 | $29.805,20 | 368 / 10 | $4.259,33 | 183 / 1 | $3.287,87 | 183 / 1 |
| Disorders Of The Biliary Tract W Cc | 12 | 42 / 12 | $41.861,00 | 338 / 6 | $8.776,17 | 67 / 10 | $5.243,08 | 67 / 1 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 12 | 84 / 32 | $59.030,50 | 1269 / 74 | $8.216,58 | 802 / 3 | $7.405,42 | 797 / 6 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 93 | 182 / 26 | $28.556,40 | 2097 / 63 | $5.770,15 | 1016 / 29 | $3.771,54 | 1008 / 2 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 11 | 52 / 19 | $186.894,00 | 605 / 18 | $33.104,50 | 462 / 2 | $32.326,60 | 462 / 2 |
| Extracranial Procedures W/O Cc/Mcc | 16 | 82 / 24 | $45.058,30 | 715 / 14 | $6.981,94 | 424 / 2 | $5.539,94 | 423 / 1 |
| Fractures Of Hip & Pelvis W/O Mcc | 18 | 43 / 13 | $22.598,70 | 596 / 6 | $4.495,67 | 364 / 1 | $3.618,28 | 365 / 4 |
| G.I. Hemorrhage W Cc | 64 | 154 / 32 | $36.418,20 | 1834 / 48 | $7.430,66 | 1181 / 19 | $5.554,92 | 1179 / 4 |
| G.I. Hemorrhage W Mcc | 24 | 97 / 32 | $86.325,70 | 1483 / 94 | $17.086,70 | 1406 / 120 | $13.943,20 | 1396 / 77 |
| G.I. Hemorrhage W/O Cc/Mcc | 15 | 53 / 14 | $17.681,00 | 457 / 3 | $4.608,33 | 358 / 1 | $3.480,20 | 355 / 4 |
| G.I. Obstruction W Cc | 31 | 61 / 21 | $36.060,90 | 1372 / 45 | $5.905,29 | 977 / 4 | $5.080,13 | 974 / 8 |
| G.I. Obstruction W/O Cc/Mcc | 35 | 36 / 7 | $26.283,90 | 1034 / 30 | $4.063,51 | 582 / 4 | $3.059,37 | 581 / 7 |
| Heart Failure & Shock W Cc | 77 | 201 / 30 | $40.039,80 | 2329 / 86 | $6.658,09 | 959 / 12 | $5.263,23 | 958 / 5 |
| Heart Failure & Shock W Mcc | 96 | 188 / 37 | $52.011,60 | 2037 / 69 | $9.658,21 | 1047 / 4 | $8.354,82 | 1045 / 2 |
| Heart Failure & Shock W/O Cc/Mcc | 18 | 92 / 27 | $27.608,90 | 1641 / 35 | $4.457,44 | 673 / 4 | $3.450,56 | 671 / 2 |
| Hip & Femur Procedures Except Major Joint W Cc | 52 | 91 / 17 | $69.367,20 | 1535 / 23 | $12.892,60 | 1168 / 4 | $11.534,60 | 1154 / 7 |
| Hip & Femur Procedures Except Major Joint W Mcc | 13 | 49 / 15 | $116.898,00 | 778 / 21 | $20.883,80 | 641 / 9 | $19.765,50 | 638 / 11 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 13 | 43 / 21 | $50.310,60 | 583 / 4 | $10.550,80 | 440 / 1 | $8.961,69 | 438 / 2 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 18 | 106 / 48 | $156.916,00 | 1063 / 25 | $33.582,80 | 797 / 8 | $32.700,40 | 791 / 11 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 43 | 139 / 34 | $37.367,40 | 1438 / 29 | $6.814,37 | 872 / 2 | $5.658,33 | 870 / 2 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 30 | 138 / 41 | $57.640,00 | 1101 / 25 | $10.586,80 | 631 / 1 | $9.696,63 | 630 / 2 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 39 | 63 / 10 | $34.596,20 | 1227 / 27 | $4.950,28 | 706 / 1 | $3.861,92 | 702 / 5 |
| Kidney & Urinary Tract Infections W Mcc | 16 | 128 / 50 | $40.039,40 | 1503 / 51 | $6.823,38 | 778 / 2 | $6.069,81 | 777 / 5 |
| Kidney & Urinary Tract Infections W/O Mcc | 65 | 168 / 46 | $28.158,70 | 2137 / 53 | $4.965,40 | 988 / 2 | $3.952,95 | 980 / 3 |
| Major Cardiovasc Procedures W/O Mcc | 12 | 89 / 29 | $74.534,20 | 310 / 2 | $22.030,10 | 562 / 1 | $20.917,90 | 562 / 2 |
| Major Chest Procedures W Mcc | 15 | 34 / 10 | $170.023,00 | 239 / 3 | $33.770,30 | 151 / 2 | $30.867,10 | 151 / 2 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 11 | 62 / 23 | $42.818,00 | 872 / 22 | $8.195,00 | 458 / 6 | $6.557,64 | 457 / 2 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 14 | 42 / 12 | $49.996,40 | 422 / 2 | $11.648,60 | 261 / 1 | $11.021,90 | 260 / 2 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 167 | 397 / 58 | $59.800,40 | 1687 / 46 | $14.319,90 | 1710 / 7 | $12.581,90 | 1672 / 18 |
| Major Small & Large Bowel Procedures W Cc | 19 | 89 / 36 | $102.416,00 | 1233 / 27 | $18.886,90 | 897 / 17 | $15.228,50 | 889 / 3 |
| Major Small & Large Bowel Procedures W Mcc | 19 | 66 / 21 | $211.322,00 | 1077 / 35 | $35.921,90 | 884 / 6 | $35.085,30 | 882 / 11 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 16 | 48 / 14 | $71.894,60 | 647 / 15 | $12.190,60 | 387 / 9 | $9.082,19 | 387 / 1 |
| Medical Back Problems W/O Mcc | 25 | 96 / 32 | $29.861,00 | 1008 / 27 | $5.437,68 | 698 / 2 | $4.564,56 | 695 / 5 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 15 | 111 / 44 | $28.178,40 | 866 / 12 | $7.116,33 | 596 / 1 | $6.188,73 | 593 / 1 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 36 | 130 / 44 | $26.901,60 | 1991 / 59 | $4.620,78 | 942 / 2 | $3.612,86 | 939 / 6 |
| Nonspecific Cerebrovascular Disorders W Cc | 17 | 39 / 9 | $36.724,60 | 346 / 10 | $6.568,00 | 223 / 2 | $5.644,18 | 223 / 2 |
| Nonspecific Cerebrovascular Disorders W Mcc | 14 | 37 / 11 | $51.105,40 | 270 / 10 | $12.219,80 | 119 / 11 | $9.103,57 | 119 / 1 |
| Other Digestive System Diagnoses W Cc | 12 | 85 / 30 | $30.769,90 | 892 / 20 | $6.473,08 | 644 / 3 | $5.465,33 | 640 / 3 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 21 | 80 / 27 | $33.376,70 | 479 / 1 | $8.618,48 | 174 / 1 | $7.895,81 | 174 / 1 |
| Other Vascular Procedures W Cc | 18 | 84 / 26 | $93.247,50 | 775 / 12 | $16.841,50 | 659 / 1 | $16.033,40 | 656 / 4 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 11 | 89 / 31 | $140.255,00 | 780 / 27 | $23.950,10 | 761 / 12 | $22.955,60 | 756 / 15 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 43 | 153 / 30 | $88.787,20 | 1032 / 28 | $15.611,00 | 736 / 21 | $11.347,60 | 732 / 2 |
| Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 14 | 81 / 16 | $87.065,20 | 389 / 9 | $13.261,20 | 343 / 2 | $12.304,30 | 339 / 5 |
| Peripheral Vascular Disorders W Cc | 14 | 70 / 19 | $42.224,40 | 1045 / 41 | $8.344,29 | 443 / 44 | $5.183,14 | 441 / 2 |
| Permanent Cardiac Pacemaker Implant W Cc | 24 | 53 / 11 | $63.809,30 | 395 / 4 | $19.583,30 | 273 / 14 | $14.471,00 | 272 / 1 |
| Permanent Cardiac Pacemaker Implant W Mcc | 11 | 41 / 13 | $118.219,00 | 412 / 10 | $24.592,50 | 132 / 4 | $19.893,80 | 132 / 1 |
| Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 22 | 35 / 5 | $53.985,70 | 320 / 3 | $14.464,10 | 464 / 1 | $13.363,80 | 463 / 5 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 16 | 56 / 19 | $45.574,20 | 644 / 10 | $9.188,56 | 413 / 2 | $8.201,38 | 412 / 1 |
| Pulmonary Edema & Respiratory Failure | 37 | 166 / 39 | $45.912,90 | 1665 / 36 | $9.108,65 | 885 / 16 | $6.798,54 | 885 / 1 |
| Pulmonary Embolism W Mcc | 15 | 28 / 5 | $58.696,90 | 478 / 5 | $11.466,60 | 175 / 7 | $8.133,27 | 175 / 1 |
| Pulmonary Embolism W/O Mcc | 11 | 63 / 19 | $33.852,80 | 943 / 11 | $6.670,64 | 444 / 3 | $5.088,45 | 442 / 1 |
| Red Blood Cell Disorders W/O Mcc | 31 | 112 / 25 | $32.086,90 | 1582 / 48 | $5.826,81 | 924 / 8 | $4.435,61 | 918 / 8 |
| Renal Failure W Cc | 43 | 178 / 45 | $29.777,40 | 1683 / 31 | $6.067,47 | 983 / 1 | $5.166,28 | 975 / 4 |
| Renal Failure W Mcc | 28 | 167 / 59 | $66.653,90 | 1856 / 94 | $10.518,10 | 1328 / 11 | $9.734,64 | 1328 / 12 |
| Respiratory Infections & Inflammations W Cc | 32 | 56 / 17 | $43.996,00 | 1041 / 16 | $8.295,81 | 539 / 3 | $7.429,47 | 536 / 4 |
| Respiratory Infections & Inflammations W Mcc | 56 | 80 / 21 | $59.060,10 | 1249 / 24 | $12.266,10 | 948 / 1 | $11.557,80 | 938 / 1 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 25 | 106 / 28 | $118.765,00 | 1671 / 71 | $16.825,60 | 1337 / 11 | $15.986,00 | 1324 / 15 |
| Seizures W Mcc | 20 | 46 / 10 | $46.408,20 | 435 / 10 | $9.709,25 | 296 / 1 | $8.860,75 | 296 / 3 |
| Seizures W/O Mcc | 11 | 97 / 31 | $30.041,80 | 952 / 26 | $4.759,73 | 376 / 1 | $3.875,91 | 374 / 1 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 11 | 81 / 44 | $302.278,00 | 999 / 94 | $49.140,10 | 929 / 76 | $48.352,60 | 928 / 87 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 244 | 272 / 60 | $64.602,60 | 2195 / 89 | $12.435,90 | 1662 / 13 | $11.355,70 | 1630 / 16 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 115 | 92 / 17 | $34.183,10 | 1827 / 60 | $7.106,62 | 982 / 13 | $5.644,19 | 979 / 4 |
| Signs & Symptoms W/O Mcc | 11 | 80 / 27 | $28.413,90 | 994 / 23 | $4.534,18 | 415 / 1 | $3.548,55 | 414 / 2 |
| Simple Pneumonia & Pleurisy W Cc | 58 | 145 / 33 | $36.583,10 | 2234 / 54 | $6.257,74 | 1263 / 1 | $5.266,72 | 1259 / 3 |
| Simple Pneumonia & Pleurisy W Mcc | 55 | 150 / 38 | $65.641,50 | 2184 / 96 | $9.550,53 | 1353 / 5 | $8.404,65 | 1353 / 7 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 20 | 73 / 25 | $24.652,20 | 1433 / 22 | $4.699,85 | 920 / 3 | $3.609,40 | 915 / 6 |
| Spinal Fusion Except Cervical W/O Mcc | 32 | 162 / 35 | $110.668,00 | 841 / 14 | $31.893,00 | 215 / 36 | $19.970,20 | 214 / 1 |
| Syncope & Collapse | 31 | 138 / 36 | $30.116,00 | 1436 / 39 | $4.851,68 | 831 / 4 | $3.878,52 | 827 / 3 |
| Transient Ischemia | 16 | 109 / 40 | $36.468,90 | 1363 / 53 | $4.666,12 | 718 / 3 | $3.609,94 | 714 / 4 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 12 | 54 / 18 | $50.878,40 | 425 / 8 | $7.685,92 | 137 / 2 | $5.812,08 | 137 / 1 | Total 88 procedures | 2.769 | 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.