Hospital Costs > In California > Santa Monica - Ucla Med Ctr & Orthopaedic Hospital, 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 | 268 | 250 / 51 | $71.830,40 | 2311 / 110 | $16.973,30 | 2473 / 174 | $14.922,90 | 2429 / 149 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 232 | 332 / 40 | $63.330,80 | 1818 / 55 | $18.665,10 | 2377 / 152 | $15.993,70 | 2332 / 130 |
| Kidney & Urinary Tract Infections W/O Mcc | 152 | 82 / 4 | $29.793,50 | 2209 / 67 | $7.474,45 | 2308 / 134 | $5.792,86 | 2297 / 99 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 129 | 78 / 12 | $47.955,60 | 2222 / 134 | $10.004,30 | 2266 / 164 | $8.382,95 | 2257 / 146 |
| Chemotherapy W/O Acute Leukemia As Secondary Diagnosis W Cc | 110 | 11 / 2 | $45.868,40 | 302 / 11 | $10.080,70 | 283 / 13 | $8.972,45 | 283 / 11 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 102 | 173 / 21 | $29.687,10 | 2147 / 67 | $7.097,49 | 2346 / 118 | $5.691,69 | 2331 / 111 |
| Heart Failure & Shock W Cc | 85 | 193 / 25 | $41.590,10 | 2375 / 96 | $9.124,54 | 2410 / 133 | $7.835,87 | 2404 / 122 |
| Cellulitis W/O Mcc | 82 | 107 / 14 | $26.323,60 | 1950 / 45 | $7.784,16 | 2251 / 122 | $6.328,18 | 2243 / 109 |
| Renal Failure W Cc | 82 | 139 / 16 | $36.623,90 | 1948 / 62 | $9.054,02 | 2095 / 121 | $7.455,20 | 2085 / 100 |
| Simple Pneumonia & Pleurisy W Cc | 69 | 134 / 25 | $43.188,20 | 2416 / 97 | $9.165,42 | 2451 / 133 | $7.465,65 | 2442 / 112 |
| Heart Failure & Shock W Mcc | 68 | 216 / 60 | $70.238,50 | 2349 / 133 | $15.007,80 | 2426 / 176 | $13.079,40 | 2415 / 161 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 68 | 98 / 17 | $29.329,60 | 2111 / 76 | $6.747,10 | 2125 / 112 | $5.277,57 | 2117 / 86 |
| Respiratory Infections & Inflammations W Cc | 63 | 26 / 3 | $51.989,50 | 1173 / 37 | $12.308,30 | 1322 / 81 | $10.875,20 | 1317 / 71 |
| Syncope & Collapse | 52 | 117 / 17 | $26.243,10 | 1282 / 25 | $6.783,94 | 1616 / 82 | $5.597,63 | 1609 / 74 |
| G.I. Hemorrhage W Cc | 51 | 167 / 44 | $39.314,90 | 1934 / 70 | $9.436,59 | 2078 / 127 | $7.632,65 | 2074 / 93 |
| Respiratory Infections & Inflammations W Mcc | 49 | 87 / 27 | $119.760,00 | 1730 / 118 | $23.246,90 | 1794 / 149 | $20.903,40 | 1778 / 151 |
| Hip & Femur Procedures Except Major Joint W Cc | 47 | 96 / 22 | $72.943,90 | 1595 / 35 | $16.866,10 | 1798 / 102 | $14.985,30 | 1779 / 89 |
| Renal Failure W Mcc | 46 | 149 / 41 | $72.876,50 | 1934 / 110 | $16.117,20 | 2032 / 156 | $14.383,20 | 2028 / 151 |
| Red Blood Cell Disorders W/O Mcc | 45 | 98 / 11 | $36.331,20 | 1697 / 68 | $7.771,58 | 1697 / 92 | $6.302,60 | 1688 / 82 |
| Medical Back Problems W/O Mcc | 44 | 77 / 15 | $34.780,80 | 1146 / 38 | $8.672,77 | 1212 / 96 | $6.070,36 | 1208 / 60 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 41 | 120 / 25 | $28.378,90 | 1560 / 27 | $7.405,00 | 1844 / 105 | $6.001,46 | 1839 / 86 |
| Spinal Fusion Except Cervical W/O Mcc | 40 | 154 / 28 | $82.320,90 | 560 / 5 | $34.472,90 | 1096 / 56 | $28.016,60 | 1091 / 33 |
| Chest Pain | 37 | 114 / 36 | $24.259,60 | 1172 / 32 | $5.832,11 | 1415 / 73 | $4.757,59 | 1407 / 80 |
| Chronic Obstructive Pulmonary Disease W Cc | 36 | 143 / 37 | $38.308,60 | 2031 / 68 | $8.367,03 | 2115 / 98 | $7.183,17 | 2108 / 95 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 35 | 54 / 14 | $33.827,20 | 363 / 2 | $9.751,23 | 643 / 36 | $7.849,43 | 642 / 37 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 34 | 58 / 21 | $214.092,00 | 793 / 45 | $56.092,40 | 970 / 109 | $51.152,90 | 969 / 99 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 34 | 92 / 25 | $66.530,10 | 1649 / 129 | $15.467,20 | 1707 / 153 | $13.362,60 | 1703 / 156 |
| Simple Pneumonia & Pleurisy W Mcc | 34 | 171 / 57 | $77.717,30 | 2324 / 134 | $14.878,40 | 2376 / 169 | $13.040,20 | 2370 / 163 |
| Other Circulatory System Diagnoses W Mcc | 33 | 83 / 18 | $96.043,60 | 1247 / 76 | $18.886,10 | 1241 / 97 | $16.796,70 | 1233 / 85 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 32 | 164 / 40 | $53.056,50 | 285 / 2 | $16.914,00 | 1321 / 45 | $15.645,50 | 1314 / 72 |
| Chronic Obstructive Pulmonary Disease W Mcc | 31 | 171 / 59 | $44.470,10 | 2059 / 55 | $10.191,50 | 2204 / 106 | $8.854,48 | 2196 / 85 |
| Signs & Symptoms W/O Mcc | 31 | 60 / 7 | $28.166,20 | 987 / 22 | $6.682,39 | 1056 / 49 | $5.155,61 | 1053 / 41 |
| Kidney & Urinary Tract Infections W Mcc | 30 | 114 / 36 | $40.053,80 | 1505 / 52 | $9.494,20 | 1604 / 78 | $8.123,07 | 1600 / 66 |
| Degenerative Nervous System Disorders W/O Mcc | 29 | 49 / 4 | $33.440,20 | 574 / 15 | $10.429,50 | 652 / 40 | $7.130,62 | 652 / 19 |
| Revision Of Hip Or Knee Replacement W Cc | 28 | 58 / 11 | $116.562,00 | 529 / 9 | $41.752,00 | 659 / 38 | $37.309,90 | 657 / 36 |
| G.I. Obstruction W Cc | 28 | 64 / 24 | $34.342,90 | 1331 / 37 | $8.183,43 | 1471 / 83 | $6.602,93 | 1466 / 69 |
| Heart Failure & Shock W/O Cc/Mcc | 26 | 84 / 19 | $30.853,50 | 1726 / 50 | $6.524,58 | 1690 / 73 | $5.043,88 | 1677 / 52 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 26 | 99 / 26 | $74.194,00 | 1500 / 60 | $16.433,80 | 1672 / 114 | $14.922,60 | 1659 / 118 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 25 | 163 / 36 | $45.654,80 | 1090 / 18 | $9.524,44 | 1390 / 55 | $8.099,92 | 1387 / 60 |
| Major Small & Large Bowel Procedures W Cc | 25 | 83 / 30 | $102.662,00 | 1237 / 28 | $23.247,30 | 1362 / 70 | $20.121,80 | 1348 / 68 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 24 | 126 / 25 | $20.449,00 | 1418 / 15 | $5.370,42 | 1690 / 72 | $4.048,71 | 1684 / 73 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 24 | 158 / 50 | $47.087,70 | 1677 / 59 | $9.470,92 | 1709 / 93 | $7.670,75 | 1705 / 73 |
| Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 24 | 42 / 12 | $54.632,60 | 307 / 2 | $15.978,20 | 474 / 19 | $14.250,10 | 470 / 18 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 24 | 38 / 8 | $28.029,60 | 573 / 12 | $7.096,00 | 662 / 33 | $5.584,96 | 660 / 30 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 23 | 70 / 22 | $30.991,10 | 1644 / 42 | $6.825,13 | 1684 / 80 | $5.063,91 | 1676 / 56 |
| Pathological Fractures & Musculoskelet & Conn Tiss Malig W Cc | 22 | 18 / 2 | $49.043,20 | 235 / 8 | $10.568,50 | 239 / 12 | $9.019,00 | 239 / 12 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 22 | 49 / 11 | $230.138,00 | 826 / 34 | $57.119,70 | 946 / 77 | $51.959,20 | 945 / 77 |
| Fractures Of Hip & Pelvis W/O Mcc | 22 | 39 / 9 | $22.913,20 | 604 / 7 | $6.778,18 | 811 / 48 | $5.354,32 | 810 / 45 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 21 | 82 / 18 | $45.041,20 | 704 / 22 | $8.760,90 | 630 / 29 | $7.166,81 | 630 / 18 |
| Other Digestive System Diagnoses W Cc | 21 | 76 / 21 | $28.836,10 | 827 / 17 | $9.890,24 | 1100 / 102 | $6.890,71 | 1096 / 42 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 21 | 103 / 45 | $265.755,00 | 1449 / 87 | $62.467,80 | 1559 / 138 | $58.314,30 | 1549 / 138 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 21 | 102 / 33 | $51.578,20 | 1560 / 57 | $10.703,20 | 1597 / 78 | $9.184,05 | 1594 / 63 |
| Major Small & Large Bowel Procedures W Mcc | 20 | 65 / 20 | $145.535,00 | 779 / 4 | $47.020,90 | 1017 / 59 | $37.987,10 | 1015 / 26 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 19 | 77 / 25 | $57.688,80 | 1251 / 69 | $15.621,70 | 1433 / 126 | $13.588,80 | 1428 / 128 |
| Diabetes W Cc | 19 | 73 / 16 | $36.964,40 | 1344 / 43 | $7.284,63 | 1255 / 49 | $5.973,26 | 1250 / 38 |
| Peripheral Vascular Disorders W Cc | 19 | 65 / 14 | $30.719,70 | 828 / 12 | $8.589,11 | 1016 / 49 | $7.355,74 | 1013 / 43 |
| Transient Ischemia | 19 | 106 / 37 | $33.106,00 | 1282 / 40 | $6.683,68 | 1316 / 78 | $4.914,89 | 1310 / 49 |
| Respiratory Neoplasms W Mcc | 19 | 33 / 7 | $59.953,60 | 457 / 7 | $14.727,30 | 507 / 20 | $12.579,50 | 504 / 14 |
| Cervical Spinal Fusion W/O Cc/Mcc | 19 | 85 / 19 | $76.055,10 | 641 / 11 | $19.942,10 | 760 / 35 | $16.287,60 | 757 / 32 |
| G.I. Hemorrhage W Mcc | 19 | 102 / 37 | $67.692,00 | 1311 / 62 | $15.276,80 | 1409 / 83 | $13.962,50 | 1399 / 78 |
| Respiratory Neoplasms W Cc | 19 | 28 / 5 | $56.077,20 | 427 / 15 | $12.060,20 | 450 / 22 | $10.369,50 | 449 / 22 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 18 | 55 / 16 | $39.086,10 | 811 / 9 | $9.602,78 | 868 / 34 | $8.274,72 | 866 / 21 |
| Seizures W/O Mcc | 18 | 90 / 24 | $36.290,90 | 1080 / 38 | $7.047,33 | 1016 / 44 | $5.629,67 | 1014 / 34 |
| Red Blood Cell Disorders W Mcc | 18 | 53 / 13 | $72.607,60 | 1044 / 74 | $14.815,20 | 1058 / 77 | $13.376,30 | 1054 / 77 |
| Disorders Of Pancreas Except Malignancy W Cc | 18 | 43 / 7 | $51.445,30 | 871 / 37 | $9.302,17 | 862 / 39 | $7.798,39 | 859 / 40 |
| Hip & Femur Procedures Except Major Joint W Mcc | 18 | 44 / 10 | $106.775,00 | 733 / 15 | $25.942,80 | 836 / 53 | $23.762,70 | 833 / 45 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 18 | 47 / 15 | $106.339,00 | 697 / 13 | $29.525,10 | 859 / 45 | $27.620,70 | 855 / 46 |
| Cellulitis W Mcc | 17 | 41 / 17 | $84.786,50 | 920 / 70 | $17.185,00 | 939 / 85 | $14.865,50 | 937 / 86 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 17 | 151 / 54 | $61.616,00 | 1156 / 31 | $14.838,50 | 1322 / 74 | $13.174,10 | 1316 / 67 |
| Chemotherapy W/O Acute Leukemia As Secondary Diagnosis W Mcc | 17 | 17 / 3 | $71.999,30 | 31 / 1 | $22.946,30 | 26 / 1 | $19.380,90 | 26 / 1 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 17 | 39 / 9 | $73.001,50 | 562 / 20 | $17.062,90 | 557 / 36 | $14.526,30 | 556 / 29 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 16 | 104 / 30 | $30.989,50 | 1734 / 33 | $6.570,12 | 1861 / 63 | $5.648,75 | 1850 / 76 |
| Pulmonary Embolism W/O Mcc | 16 | 58 / 14 | $38.135,20 | 1022 / 19 | $9.352,75 | 1135 / 52 | $7.472,12 | 1132 / 49 |
| Digestive Malignancy W Mcc | 16 | 21 / 5 | $105.317,00 | 135 / 2 | $24.420,50 | 137 / 5 | $20.573,80 | 137 / 6 |
| Other Disorders Of Nervous System W Cc | 16 | 40 / 11 | $37.957,40 | 472 / 14 | $8.129,69 | 478 / 28 | $6.575,38 | 478 / 18 |
| Peripheral Vascular Disorders W Mcc | 15 | 34 / 7 | $64.453,40 | 503 / 14 | $12.287,60 | 483 / 24 | $10.902,30 | 483 / 25 |
| Major Male Pelvic Procedures W/O Cc/Mcc | 14 | 59 / 16 | $26.947,50 | 54 / 1 | $11.472,20 | 283 / 18 | $8.430,93 | 283 / 13 |
| Urinary Stones W/O Esw Lithotripsy W/O Mcc | 14 | 32 / 4 | $24.613,40 | 230 / 2 | $6.519,86 | 320 / 6 | $4.992,93 | 319 / 6 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 14 | 88 / 34 | $33.236,60 | 1193 / 24 | $7.112,71 | 1284 / 66 | $5.164,07 | 1280 / 43 |
| Trauma To The Skin, Subcut Tiss & Breast W/O Mcc | 13 | 31 / 11 | $25.080,10 | 160 / 2 | $6.947,46 | 223 / 15 | $5.437,08 | 223 / 14 |
| Postoperative & Post-Traumatic Infections W/O Mcc | 13 | 41 / 10 | $39.053,60 | 365 / 8 | $8.837,00 | 369 / 10 | $8.027,38 | 369 / 13 |
| Digestive Malignancy W Cc | 13 | 34 / 10 | $63.608,90 | 358 / 16 | $11.663,60 | 307 / 12 | $9.532,23 | 305 / 8 |
| Bronchitis & Asthma W Cc/Mcc | 13 | 63 / 20 | $32.056,00 | 759 / 15 | $7.941,15 | 912 / 40 | $6.621,00 | 908 / 42 |
| Stomach, Esophageal & Duodenal Proc W/O Cc/Mcc | 13 | 35 / 10 | $41.681,20 | 110 / 1 | $12.701,20 | 181 / 6 | $11.115,50 | 180 / 9 |
| Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W/O Maj O.R. | 13 | 51 / 11 | $433.461,00 | 466 / 19 | $118.465,00 | 532 / 49 | $108.595,00 | 531 / 46 |
| Cervical Spinal Fusion W Cc | 13 | 40 / 14 | $122.102,00 | 326 / 13 | $25.043,20 | 327 / 16 | $23.107,40 | 326 / 17 |
| Complications Of Treatment W Mcc | 12 | 39 / 11 | $107.469,00 | 287 / 18 | $16.632,80 | 239 / 9 | $14.927,20 | 239 / 12 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 12 | 44 / 18 | $56.247,60 | 541 / 7 | $13.928,20 | 756 / 37 | $11.784,20 | 752 / 31 |
| Malignancy Of Hepatobiliary System Or Pancreas W Cc | 12 | 19 / 6 | $37.033,80 | 115 / 1 | $10.299,20 | 153 / 2 | $9.014,00 | 153 / 4 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 12 | 89 / 36 | $61.196,80 | 894 / 27 | $14.463,10 | 973 / 55 | $13.265,30 | 969 / 52 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 12 | 64 / 24 | $129.253,00 | 550 / 61 | $24.875,60 | 543 / 57 | $22.121,00 | 543 / 58 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 12 | 58 / 22 | $39.313,50 | 467 / 24 | $8.506,00 | 416 / 24 | $7.097,42 | 416 / 18 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 12 | 57 / 20 | $88.586,30 | 374 / 6 | $23.620,00 | 416 / 23 | $19.396,90 | 415 / 15 |
| Other Circulatory System Diagnoses W Cc | 12 | 54 / 14 | $32.441,80 | 450 / 4 | $8.707,00 | 539 / 17 | $7.332,33 | 538 / 15 |
| Endocrine Disorders W Cc | 12 | 26 / 9 | $44.506,30 | 254 / 5 | $10.824,70 | 273 / 14 | $9.341,33 | 273 / 13 |
| Other Respiratory System Diagnoses W/O Mcc | 12 | 34 / 11 | $34.782,80 | 254 / 8 | $7.553,33 | 252 / 8 | $6.235,25 | 252 / 10 |
| Complications Of Treatment W Cc | 11 | 41 / 13 | $29.863,10 | 214 / 2 | $8.888,55 | 290 / 7 | $8.158,27 | 290 / 9 |
| Organic Disturbances & Mental Retardation | 11 | 48 / 13 | $33.854,50 | 392 / 10 | $9.243,82 | 434 / 13 | $7.943,73 | 434 / 11 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 11 | 120 / 42 | $110.747,00 | 1611 / 62 | $22.746,20 | 1711 / 104 | $20.821,00 | 1697 / 101 |
| Other Vascular Procedures W Mcc | 11 | 86 / 31 | $106.418,00 | 644 / 14 | $29.203,70 | 811 / 56 | $25.976,90 | 808 / 41 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 11 | 42 / 12 | $34.104,30 | 651 / 14 | $6.873,09 | 758 / 24 | $5.847,45 | 754 / 25 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 11 | 36 / 11 | $47.194,60 | 288 / 3 | $13.036,80 | 450 / 15 | $11.341,60 | 450 / 20 |
| Malignancy Of Hepatobiliary System Or Pancreas W Mcc | 11 | 42 / 12 | $64.007,40 | 236 / 4 | $16.653,90 | 286 / 13 | $14.957,70 | 287 / 12 |
| Disorders Of The Biliary Tract W Cc | 11 | 43 / 13 | $45.292,50 | 369 / 11 | $9.507,27 | 384 / 19 | $8.215,73 | 384 / 19 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Cc | 11 | 33 / 13 | $93.831,50 | 289 / 7 | $29.585,70 | 247 / 24 | $17.906,50 | 245 / 4 | Total 105 procedures | 3.527 | 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.