Hospital Costs > In Pennsylvania > Somerset Hospital, 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 / 28 | $16.012,20 | 145 / 13 | $6.326,85 | 396 / 24 | $5.302,85 | 395 / 31 |
| Cellulitis W/O Mcc | 11 | 178 / 74 | $12.122,80 | 484 / 34 | $5.193,09 | 1053 / 40 | $4.311,64 | 1047 / 65 |
| Chronic Obstructive Pulmonary Disease W Cc | 14 | 165 / 61 | $14.263,20 | 445 / 23 | $5.706,07 | 636 / 38 | $4.666,07 | 634 / 43 |
| Chronic Obstructive Pulmonary Disease W Mcc | 15 | 187 / 59 | $20.131,30 | 726 / 38 | $6.918,33 | 938 / 28 | $6.190,87 | 933 / 59 |
| G.I. Hemorrhage W Cc | 13 | 205 / 62 | $14.284,60 | 246 / 16 | $5.937,31 | 821 / 27 | $5.193,92 | 819 / 47 |
| Heart Failure & Shock W Cc | 20 | 258 / 86 | $14.994,30 | 573 / 31 | $5.999,40 | 826 / 42 | $5.157,80 | 825 / 57 |
| Heart Failure & Shock W Mcc | 18 | 266 / 78 | $20.224,70 | 434 / 27 | $8.661,78 | 276 / 26 | $7.381,94 | 276 / 19 |
| Kidney & Urinary Tract Infections W Mcc | 19 | 125 / 33 | $18.860,80 | 495 / 23 | $6.688,16 | 685 / 26 | $5.928,58 | 684 / 40 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 16 | 548 / 95 | $32.379,60 | 328 / 21 | $12.605,40 | 496 / 45 | $10.310,80 | 493 / 39 |
| Pulmonary Edema & Respiratory Failure | 12 | 191 / 52 | $17.475,10 | 253 / 17 | $7.217,92 | 563 / 22 | $6.409,92 | 563 / 41 |
| Renal Failure W Cc | 20 | 201 / 61 | $13.766,90 | 362 / 22 | $5.744,85 | 891 / 32 | $5.079,25 | 883 / 53 |
| Renal Failure W Mcc | 13 | 182 / 52 | $25.321,50 | 482 / 23 | $8.864,38 | 536 / 21 | $8.118,54 | 536 / 32 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 55 | 461 / 77 | $21.297,10 | 329 / 22 | $10.479,70 | 662 / 28 | $9.744,24 | 661 / 41 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 22 | 185 / 59 | $18.038,80 | 601 / 34 | $6.355,59 | 976 / 26 | $5.641,41 | 973 / 60 |
| Simple Pneumonia & Pleurisy W Cc | 17 | 186 / 63 | $14.193,20 | 463 / 25 | $5.930,53 | 837 / 39 | $4.940,41 | 834 / 52 |
| Simple Pneumonia & Pleurisy W Mcc | 12 | 193 / 60 | $23.129,80 | 575 / 26 | $8.390,08 | 725 / 21 | $7.590,08 | 725 / 36 | Total 16 procedures | 290 | 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.