Hospital Costs > In California > San Gabriel Valley Medical Center, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 320 | 198 / 31 | $137.461,00 | 2792 / 250 | $16.630,70 | 2538 / 164 | $15.551,40 | 2494 / 170 |
Heart Failure & Shock W Mcc | 83 | 201 / 45 | $95.304,70 | 2548 / 182 | $13.251,40 | 2366 / 131 | $12.509,20 | 2356 / 140 |
Respiratory Infections & Inflammations W Mcc | 67 | 69 / 13 | $135.980,00 | 1767 / 132 | $17.009,70 | 1654 / 97 | $16.043,80 | 1638 / 100 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 60 | 147 / 55 | $67.588,70 | 2476 / 210 | $9.870,20 | 2335 / 156 | $8.848,77 | 2325 / 169 |
Simple Pneumonia & Pleurisy W Mcc | 48 | 157 / 43 | $101.257,00 | 2461 / 174 | $13.259,60 | 2328 / 132 | $12.431,30 | 2322 / 140 |
Renal Failure W Mcc | 47 | 148 / 40 | $119.035,00 | 2149 / 177 | $14.420,60 | 1970 / 124 | $13.408,80 | 1966 / 133 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 44 | 122 / 36 | $43.711,40 | 2425 / 150 | $7.170,11 | 2331 / 131 | $6.271,93 | 2322 / 142 |
Simple Pneumonia & Pleurisy W Cc | 43 | 160 / 47 | $69.701,30 | 2765 / 195 | $9.303,28 | 2560 / 139 | $8.158,09 | 2551 / 147 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 42 | 233 / 68 | $52.785,30 | 2665 / 188 | $7.543,33 | 2525 / 142 | $6.681,40 | 2510 / 164 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 41 | 523 / 124 | $151.542,00 | 2660 / 224 | $18.188,00 | 2419 / 125 | $16.449,80 | 2373 / 155 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 38 | 54 / 17 | $302.334,00 | 1000 / 95 | $43.104,60 | 717 / 34 | $41.491,40 | 716 / 36 |
Renal Failure W Cc | 33 | 188 / 55 | $65.754,10 | 2393 / 179 | $9.181,85 | 2240 / 125 | $8.417,82 | 2230 / 144 |
Chronic Obstructive Pulmonary Disease W Mcc | 32 | 170 / 58 | $81.270,10 | 2514 / 171 | $10.580,80 | 2303 / 123 | $9.440,00 | 2295 / 123 |
Heart Failure & Shock W Cc | 31 | 247 / 69 | $68.065,40 | 2721 / 207 | $9.421,68 | 2523 / 143 | $8.483,00 | 2517 / 156 |
Respiratory Infections & Inflammations W Cc | 31 | 57 / 18 | $101.778,00 | 1464 / 112 | $12.370,70 | 1344 / 84 | $11.069,60 | 1339 / 79 |
G.I. Hemorrhage W Cc | 29 | 189 / 62 | $62.550,60 | 2332 / 161 | $9.395,83 | 2218 / 124 | $8.546,41 | 2214 / 140 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 27 | 155 / 47 | $69.418,40 | 1984 / 139 | $9.821,22 | 1876 / 110 | $8.752,70 | 1872 / 125 |
Kidney & Urinary Tract Infections W/O Mcc | 27 | 206 / 82 | $46.974,00 | 2608 / 173 | $7.570,37 | 2473 / 140 | $6.520,33 | 2462 / 145 |
Red Blood Cell Disorders W/O Mcc | 26 | 117 / 30 | $53.076,40 | 1933 / 130 | $7.973,54 | 1808 / 101 | $7.024,19 | 1799 / 108 |
Chest Pain | 26 | 125 / 46 | $50.578,30 | 1687 / 140 | $6.468,62 | 1552 / 98 | $5.668,96 | 1543 / 110 |
Other Vascular Procedures W Mcc | 24 | 73 / 18 | $161.342,00 | 905 / 53 | $25.551,20 | 751 / 21 | $24.724,50 | 748 / 24 |
Cellulitis W/O Mcc | 21 | 168 / 65 | $53.633,50 | 2587 / 199 | $8.328,33 | 2406 / 148 | $7.183,14 | 2398 / 153 |
G.I. Hemorrhage W Mcc | 21 | 100 / 35 | $130.825,00 | 1649 / 146 | $15.647,50 | 1469 / 90 | $14.701,10 | 1459 / 94 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 20 | 104 / 46 | $292.224,00 | 1499 / 107 | $41.925,60 | 1241 / 51 | $39.884,10 | 1231 / 56 |
Kidney & Urinary Tract Infections W Mcc | 18 | 126 / 48 | $69.393,10 | 1888 / 147 | $10.505,40 | 1781 / 117 | $9.466,50 | 1777 / 123 |
Chronic Obstructive Pulmonary Disease W Cc | 18 | 161 / 55 | $61.302,40 | 2370 / 157 | $9.005,67 | 2264 / 123 | $8.209,33 | 2257 / 140 |
Syncope & Collapse | 18 | 151 / 49 | $63.454,20 | 1909 / 151 | $7.415,06 | 1772 / 106 | $6.594,22 | 1764 / 121 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 16 | 109 / 36 | $77.872,10 | 1533 / 70 | $12.793,20 | 1411 / 31 | $12.130,90 | 1399 / 39 |
Pulmonary Edema & Respiratory Failure | 16 | 187 / 59 | $104.186,00 | 2207 / 154 | $11.250,60 | 1984 / 103 | $10.006,10 | 1978 / 99 |
Seizures W/O Mcc | 16 | 92 / 26 | $58.808,70 | 1280 / 82 | $7.656,69 | 1182 / 57 | $6.911,12 | 1180 / 71 |
Other Digestive System Diagnoses W Cc | 16 | 81 / 26 | $61.158,50 | 1366 / 104 | $9.392,12 | 1330 / 88 | $8.783,94 | 1326 / 110 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 16 | 110 / 43 | $74.360,40 | 1685 / 141 | $10.424,40 | 1528 / 95 | $9.630,25 | 1525 / 104 |
Other Circulatory System Diagnoses W Mcc | 15 | 101 / 35 | $111.072,00 | 1312 / 98 | $18.657,00 | 1271 / 94 | $17.622,70 | 1263 / 97 |
Hip & Femur Procedures Except Major Joint W Cc | 14 | 129 / 52 | $123.468,00 | 2005 / 126 | $16.477,60 | 1862 / 92 | $15.655,10 | 1842 / 107 |
Other Digestive System Diagnoses W Mcc | 14 | 48 / 20 | $111.211,00 | 740 / 73 | $15.415,00 | 658 / 53 | $14.454,70 | 657 / 55 |
Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W/O Maj O.R. | 14 | 50 / 10 | $621.108,00 | 542 / 41 | $85.419,20 | 432 / 21 | $82.028,10 | 431 / 21 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 12 | 119 / 41 | $166.416,00 | 1803 / 113 | $21.261,80 | 1662 / 86 | $19.896,00 | 1648 / 86 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 12 | 81 / 33 | $50.757,20 | 1910 / 106 | $7.259,42 | 1876 / 95 | $6.358,67 | 1868 / 110 |
Psychoses | 11 | 264 / 32 | $62.557,10 | 601 / 34 | $9.655,09 | 493 / 14 | $8.018,27 | 493 / 9 | Total 39 procedures | 1.407 | 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.