Hospital Costs > In California > Seton 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 | 184 | 332 / 88 | $148.848,00 | 2803 / 254 | $19.241,40 | 2679 / 223 | $17.669,40 | 2634 / 215 |
Heart Failure & Shock W Mcc | 105 | 179 / 31 | $124.646,00 | 2611 / 219 | $15.772,20 | 2519 / 185 | $14.814,60 | 2508 / 189 |
Heart Failure & Shock W Cc | 76 | 202 / 31 | $88.813,20 | 2756 / 224 | $9.986,78 | 2597 / 168 | $9.083,87 | 2591 / 179 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 66 | 498 / 108 | $170.983,00 | 2680 / 231 | $20.621,20 | 2507 / 181 | $17.678,40 | 2461 / 181 |
Kidney & Urinary Tract Infections W/O Mcc | 48 | 185 / 62 | $62.080,00 | 2695 / 212 | $8.220,60 | 2429 / 168 | $6.272,79 | 2418 / 132 |
G.I. Hemorrhage W Cc | 46 | 172 / 48 | $70.292,20 | 2382 / 182 | $10.165,00 | 2232 / 149 | $8.617,13 | 2228 / 145 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 43 | 164 / 68 | $96.318,70 | 2563 / 242 | $10.995,40 | 2455 / 195 | $9.968,63 | 2445 / 204 |
Simple Pneumonia & Pleurisy W Cc | 42 | 161 / 48 | $80.469,70 | 2800 / 211 | $9.433,24 | 2603 / 142 | $8.407,40 | 2594 / 156 |
Renal Failure W Cc | 39 | 182 / 49 | $78.949,80 | 2424 / 196 | $10.081,50 | 2204 / 162 | $8.114,62 | 2194 / 133 |
Kidney & Urinary Tract Infections W Mcc | 38 | 106 / 28 | $81.868,80 | 1925 / 160 | $10.409,90 | 1808 / 114 | $9.761,55 | 1804 / 130 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 37 | 159 / 36 | $193.546,00 | 1477 / 118 | $19.668,50 | 1380 / 87 | $16.732,30 | 1372 / 90 |
Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 34 | 66 / 9 | $315.306,00 | 1013 / 92 | $37.872,50 | 1013 / 86 | $36.490,40 | 1008 / 91 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 32 | 129 / 34 | $62.950,60 | 2132 / 160 | $7.781,88 | 1971 / 119 | $6.824,44 | 1966 / 127 |
Spinal Fusion Except Cervical W/O Mcc | 31 | 163 / 36 | $304.575,00 | 1353 / 93 | $41.480,40 | 1336 / 84 | $40.374,40 | 1331 / 91 |
Chronic Obstructive Pulmonary Disease W Mcc | 29 | 173 / 61 | $89.277,60 | 2537 / 181 | $11.086,70 | 2380 / 142 | $10.018,20 | 2372 / 147 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 29 | 153 / 45 | $89.744,70 | 2055 / 169 | $10.917,90 | 1867 / 147 | $8.675,83 | 1863 / 122 |
Simple Pneumonia & Pleurisy W Mcc | 28 | 177 / 63 | $85.746,90 | 2386 / 144 | $13.323,10 | 2344 / 134 | $12.532,10 | 2338 / 147 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 28 | 96 / 38 | $472.170,00 | 1579 / 149 | $69.553,20 | 1591 / 148 | $68.351,10 | 1581 / 150 |
Renal Failure W Mcc | 26 | 169 / 60 | $127.571,00 | 2151 / 178 | $14.911,60 | 2019 / 135 | $14.194,10 | 2015 / 146 |
Respiratory Infections & Inflammations W Mcc | 26 | 110 / 46 | $124.186,00 | 1743 / 123 | $19.344,00 | 1755 / 131 | $18.582,30 | 1739 / 137 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 25 | 250 / 85 | $62.186,20 | 2705 / 212 | $7.380,40 | 2460 / 135 | $6.256,12 | 2445 / 145 |
Syncope & Collapse | 25 | 144 / 42 | $59.908,80 | 1900 / 146 | $7.232,96 | 1727 / 101 | $6.308,24 | 1719 / 106 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 24 | 144 / 47 | $156.360,00 | 1619 / 150 | $17.902,00 | 1527 / 116 | $16.923,20 | 1520 / 126 |
Chemotherapy W/O Acute Leukemia As Secondary Diagnosis W Cc | 23 | 68 / 15 | $61.411,90 | 352 / 19 | $10.491,60 | 347 / 15 | $10.429,20 | 347 / 21 |
Hip & Femur Procedures Except Major Joint W Cc | 23 | 120 / 43 | $144.338,00 | 2038 / 143 | $17.684,90 | 1920 / 120 | $16.563,00 | 1900 / 123 |
Cellulitis W/O Mcc | 23 | 166 / 63 | $66.769,70 | 2623 / 216 | $8.245,91 | 2385 / 143 | $7.022,91 | 2377 / 145 |
Chest Pain | 23 | 128 / 49 | $46.746,50 | 1664 / 129 | $6.227,13 | 1465 / 88 | $5.063,57 | 1457 / 90 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 22 | 104 / 37 | $95.678,00 | 1727 / 159 | $11.083,90 | 1571 / 117 | $10.129,00 | 1568 / 118 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 21 | 145 / 58 | $59.206,10 | 2522 / 193 | $7.063,38 | 2284 / 126 | $6.002,62 | 2276 / 131 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 20 | 130 / 29 | $50.741,40 | 1966 / 134 | $5.770,35 | 1793 / 87 | $4.553,15 | 1787 / 95 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 20 | 103 / 34 | $131.721,00 | 1915 / 152 | $22.244,20 | 1819 / 151 | $11.622,60 | 1816 / 127 |
G.I. Hemorrhage W Mcc | 20 | 101 / 36 | $135.584,00 | 1652 / 148 | $16.660,30 | 1538 / 113 | $15.913,20 | 1528 / 121 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 17 | 75 / 38 | $435.283,00 | 1078 / 129 | $61.539,40 | 1051 / 121 | $60.473,40 | 1050 / 123 |
Chronic Obstructive Pulmonary Disease W Cc | 17 | 162 / 56 | $85.053,20 | 2437 / 188 | $8.984,65 | 2251 / 120 | $8.111,24 | 2244 / 136 |
Medical Back Problems W/O Mcc | 17 | 104 / 40 | $60.469,60 | 1461 / 112 | $8.660,82 | 1303 / 95 | $6.695,53 | 1298 / 79 |
Transient Ischemia | 16 | 109 / 40 | $61.732,70 | 1636 / 127 | $6.998,75 | 1502 / 93 | $5.863,50 | 1494 / 98 |
Diabetes W Cc | 16 | 76 / 19 | $56.931,60 | 1571 / 105 | $8.109,19 | 1447 / 77 | $7.268,56 | 1442 / 87 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 15 | 173 / 46 | $142.183,00 | 1643 / 135 | $12.111,00 | 1476 / 110 | $8.911,60 | 1473 / 83 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 15 | 87 / 33 | $62.301,40 | 1566 / 107 | $7.524,40 | 1458 / 82 | $6.304,93 | 1454 / 90 |
Major Small & Large Bowel Procedures W Cc | 15 | 93 / 40 | $204.048,00 | 1518 / 110 | $24.544,40 | 1381 / 88 | $20.470,10 | 1367 / 74 |
Bronchitis & Asthma W Cc/Mcc | 15 | 61 / 18 | $67.466,00 | 1067 / 69 | $8.479,53 | 968 / 49 | $7.415,20 | 964 / 58 |
Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 14 | 81 / 16 | $163.826,00 | 585 / 33 | $17.937,90 | 539 / 26 | $16.893,30 | 535 / 30 |
Other Digestive System Diagnoses W Cc | 14 | 83 / 28 | $72.582,40 | 1406 / 121 | $9.429,79 | 1236 / 91 | $7.765,07 | 1232 / 82 |
Peripheral Vascular Disorders W Cc | 14 | 70 / 19 | $106.231,00 | 1259 / 96 | $9.771,21 | 1162 / 69 | $8.880,21 | 1159 / 75 |
Respiratory Infections & Inflammations W Cc | 14 | 74 / 34 | $92.527,70 | 1441 / 102 | $13.018,10 | 1417 / 94 | $12.400,10 | 1412 / 103 |
Pulmonary Edema & Respiratory Failure | 14 | 189 / 61 | $128.160,00 | 2228 / 169 | $12.026,60 | 2101 / 129 | $11.403,20 | 2095 / 136 |
Heart Failure & Shock W/O Cc/Mcc | 14 | 96 / 31 | $53.630,60 | 1988 / 121 | $6.809,50 | 1819 / 87 | $5.679,36 | 1806 / 86 |
Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 14 | 49 / 16 | $299.478,00 | 729 / 45 | $51.390,90 | 687 / 46 | $42.860,90 | 687 / 41 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 13 | 107 / 33 | $63.120,20 | 2087 / 129 | $7.230,77 | 1917 / 88 | $6.034,08 | 1906 / 86 |
Combined Anterior/Posterior Spinal Fusion W Cc | 13 | 33 / 12 | $542.811,00 | 118 / 16 | $77.743,90 | 108 / 11 | $76.513,30 | 108 / 11 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 13 | 112 / 39 | $151.371,00 | 1807 / 148 | $16.271,80 | 1590 / 112 | $13.909,00 | 1577 / 94 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 12 | 81 / 33 | $66.797,30 | 1951 / 126 | $7.041,42 | 1830 / 89 | $5.916,83 | 1822 / 100 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 12 | 84 / 32 | $120.974,00 | 1466 / 135 | $15.069,20 | 1444 / 124 | $14.142,90 | 1439 / 132 |
Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 11 | 45 / 19 | $132.004,00 | 853 / 60 | $14.812,40 | 772 / 49 | $12.069,10 | 768 / 35 |
Circulatory Disorders Except Ami, W Card Cath W Mcc | 11 | 82 / 22 | $188.218,00 | 911 / 60 | $22.888,50 | 882 / 51 | $21.880,10 | 874 / 54 |
G.I. Obstruction W/O Cc/Mcc | 11 | 60 / 30 | $52.951,50 | 1293 / 94 | $6.224,64 | 1226 / 67 | $5.237,00 | 1223 / 80 |
Red Blood Cell Disorders W/O Mcc | 11 | 132 / 45 | $61.455,90 | 1972 / 146 | $7.876,36 | 1835 / 98 | $7.203,91 | 1826 / 116 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 11 | 62 / 23 | $113.284,00 | 1107 / 79 | $11.103,70 | 1038 / 59 | $10.202,10 | 1036 / 64 | Total 58 procedures | 1.615 | 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.