Hospital Costs > In Texas > South Texas Health System, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Psychoses | 327 | 58 / 5 | $23.338,70 | 387 / 17 | $9.123,69 | 466 / 30 | $7.441,26 | 466 / 29 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 317 | 201 / 19 | $95.493,90 | 2601 / 190 | $14.005,20 | 1936 / 185 | $12.151,30 | 1901 / 178 |
| Heart Failure & Shock W Mcc | 144 | 140 / 20 | $85.406,10 | 2500 / 195 | $11.957,30 | 1997 / 178 | $10.368,00 | 1990 / 182 |
| Kidney & Urinary Tract Infections W/O Mcc | 104 | 129 / 24 | $39.689,30 | 2490 / 199 | $7.270,54 | 2320 / 206 | $5.829,15 | 2309 / 206 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 103 | 104 / 15 | $58.009,20 | 2385 / 179 | $9.327,11 | 2073 / 181 | $7.540,48 | 2065 / 185 |
| Heart Failure & Shock W Cc | 99 | 179 / 31 | $52.514,30 | 2583 / 199 | $8.716,55 | 2287 / 198 | $7.267,22 | 2281 / 199 |
| Simple Pneumonia & Pleurisy W Cc | 77 | 126 / 33 | $52.939,90 | 2607 / 203 | $8.580,91 | 2371 / 198 | $7.126,36 | 2362 / 204 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 70 | 112 / 24 | $65.171,40 | 1940 / 130 | $9.332,19 | 1675 / 131 | $7.525,49 | 1671 / 132 |
| Cellulitis W/O Mcc | 70 | 119 / 24 | $42.633,20 | 2464 / 185 | $7.809,09 | 2228 / 184 | $6.218,91 | 2220 / 190 |
| Simple Pneumonia & Pleurisy W Mcc | 68 | 137 / 32 | $78.945,20 | 2337 / 174 | $11.472,10 | 1906 / 167 | $9.718,00 | 1906 / 172 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 67 | 59 / 17 | $49.510,20 | 1485 / 109 | $9.413,61 | 1255 / 118 | $7.907,46 | 1252 / 115 |
| Renal Failure W Cc | 57 | 164 / 50 | $45.909,80 | 2180 / 159 | $8.547,96 | 2042 / 168 | $7.180,11 | 2032 / 172 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 56 | 69 / 15 | $86.065,50 | 1598 / 102 | $13.537,00 | 1246 / 106 | $11.197,70 | 1237 / 107 |
| Hip & Femur Procedures Except Major Joint W Cc | 56 | 87 / 23 | $129.990,00 | 2018 / 147 | $14.666,60 | 1506 / 132 | $12.824,40 | 1488 / 134 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 56 | 68 / 15 | $215.348,00 | 1318 / 92 | $32.828,80 | 621 / 49 | $30.637,40 | 615 / 64 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 56 | 110 / 33 | $36.037,40 | 2283 / 174 | $6.887,59 | 2196 / 188 | $5.528,16 | 2188 / 190 |
| Chronic Obstructive Pulmonary Disease W Mcc | 52 | 150 / 42 | $66.046,40 | 2419 / 181 | $9.730,25 | 2098 / 174 | $8.289,33 | 2090 / 179 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 47 | 228 / 66 | $41.603,70 | 2508 / 188 | $7.230,66 | 2319 / 189 | $5.607,89 | 2304 / 191 |
| Transient Ischemia | 46 | 79 / 23 | $48.808,80 | 1559 / 104 | $7.023,24 | 1462 / 108 | $5.557,07 | 1454 / 110 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 45 | 47 / 8 | $244.318,00 | 874 / 68 | $36.274,50 | 319 / 36 | $33.545,20 | 318 / 43 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 44 | 117 / 29 | $41.838,50 | 1938 / 138 | $7.413,18 | 1849 / 149 | $6.050,16 | 1844 / 152 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 41 | 523 / 123 | $135.049,00 | 2636 / 216 | $15.602,00 | 2072 / 181 | $13.899,00 | 2030 / 209 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 40 | 128 / 36 | $91.323,70 | 1448 / 88 | $13.436,10 | 1069 / 89 | $11.419,70 | 1064 / 87 |
| Heart Failure & Shock W/O Cc/Mcc | 39 | 71 / 17 | $41.366,50 | 1917 / 154 | $6.675,00 | 1790 / 147 | $5.517,82 | 1777 / 148 |
| Other Vascular Procedures W Mcc | 38 | 59 / 18 | $159.098,00 | 897 / 73 | $22.721,20 | 420 / 65 | $19.855,80 | 418 / 57 |
| Organic Disturbances & Mental Retardation | 36 | 23 / 2 | $41.950,70 | 456 / 16 | $9.133,64 | 400 / 19 | $7.306,97 | 400 / 19 |
| Renal Failure W Mcc | 34 | 161 / 63 | $89.484,40 | 2067 / 160 | $12.637,80 | 1690 / 146 | $11.121,60 | 1688 / 149 |
| Kidney & Urinary Tract Infections W Mcc | 32 | 112 / 45 | $50.427,80 | 1692 / 124 | $9.401,94 | 1536 / 138 | $7.770,59 | 1532 / 138 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 31 | 71 / 25 | $47.368,90 | 1461 / 90 | $7.220,10 | 1388 / 97 | $5.721,26 | 1384 / 98 |
| Syncope & Collapse | 31 | 138 / 35 | $40.125,90 | 1699 / 107 | $6.783,97 | 1627 / 123 | $5.653,65 | 1620 / 126 |
| G.I. Hemorrhage W Cc | 30 | 188 / 60 | $60.783,20 | 2313 / 163 | $8.695,30 | 1969 / 154 | $7.143,30 | 1965 / 158 |
| Chronic Obstructive Pulmonary Disease W Cc | 30 | 149 / 45 | $51.620,10 | 2274 / 150 | $8.330,17 | 2047 / 159 | $6.878,43 | 2040 / 159 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 30 | 61 / 16 | $60.659,40 | 1300 / 77 | $9.019,33 | 1175 / 82 | $7.505,73 | 1173 / 85 |
| Cirrhosis & Alcoholic Hepatitis W Mcc | 29 | 14 / 6 | $55.636,80 | 191 / 16 | $13.020,70 | 155 / 19 | $11.642,40 | 155 / 21 |
| Other Circulatory System Diagnoses W Mcc | 29 | 87 / 29 | $110.003,00 | 1310 / 101 | $15.036,50 | 848 / 88 | $12.430,40 | 843 / 82 |
| Hip & Femur Procedures Except Major Joint W Mcc | 29 | 33 / 13 | $191.902,00 | 943 / 65 | $21.953,10 | 645 / 55 | $19.805,80 | 642 / 59 |
| Diabetes W Cc | 29 | 63 / 22 | $45.478,70 | 1496 / 104 | $7.791,76 | 1271 / 103 | $6.041,90 | 1266 / 102 |
| Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W/O Maj O.R. | 28 | 36 / 9 | $392.144,00 | 426 / 35 | $51.147,70 | 36 / 7 | $47.732,80 | 36 / 7 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 27 | 29 / 8 | $109.857,00 | 903 / 74 | $12.552,90 | 710 / 71 | $10.781,00 | 707 / 73 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 27 | 169 / 47 | $115.753,00 | 1297 / 104 | $14.655,30 | 1083 / 80 | $13.080,20 | 1076 / 119 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 27 | 161 / 47 | $95.695,40 | 1615 / 133 | $9.219,78 | 1328 / 110 | $7.662,44 | 1325 / 122 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 27 | 66 / 27 | $45.062,50 | 1873 / 156 | $6.979,26 | 1775 / 154 | $5.490,67 | 1767 / 153 |
| Red Blood Cell Disorders W/O Mcc | 25 | 118 / 42 | $40.150,50 | 1763 / 132 | $7.490,72 | 1679 / 141 | $6.233,76 | 1670 / 147 |
| Seizures W/O Mcc | 25 | 83 / 22 | $46.635,60 | 1198 / 77 | $7.285,00 | 1035 / 77 | $5.795,76 | 1033 / 79 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 25 | 95 / 31 | $42.047,50 | 1980 / 138 | $6.987,92 | 1870 / 143 | $5.678,48 | 1859 / 145 |
| Other Vascular Procedures W Cc | 25 | 77 / 29 | $157.627,00 | 1078 / 91 | $18.051,20 | 682 / 70 | $16.265,60 | 679 / 80 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 24 | 99 / 39 | $50.962,60 | 1547 / 100 | $9.917,08 | 1481 / 120 | $8.581,08 | 1478 / 126 |
| Respiratory Infections & Inflammations W Mcc | 24 | 112 / 40 | $105.109,00 | 1677 / 112 | $14.878,20 | 1276 / 112 | $12.831,90 | 1261 / 112 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 24 | 23 / 6 | $93.605,50 | 496 / 27 | $11.489,30 | 396 / 22 | $9.844,17 | 396 / 27 |
| Coronary Bypass W Cardiac Cath W Mcc | 24 | 32 / 8 | $400.274,00 | 412 / 45 | $45.721,80 | 219 / 28 | $43.324,50 | 219 / 30 |
| Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 24 | 57 / 9 | $468.973,00 | 247 / 18 | $71.776,90 | 6 / 2 | $67.758,90 | 6 / 2 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 23 | 47 / 12 | $42.232,70 | 482 / 53 | $8.284,48 | 437 / 51 | $7.480,30 | 437 / 54 |
| G.I. Hemorrhage W Mcc | 22 | 99 / 35 | $83.350,50 | 1468 / 93 | $13.359,30 | 1095 / 100 | $11.683,20 | 1087 / 94 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 22 | 102 / 6 | $21.711,20 | 530 / 8 | $6.865,59 | 680 / 20 | $5.463,41 | 679 / 20 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 22 | 33 / 10 | $105.566,00 | 591 / 33 | $14.847,60 | 455 / 28 | $12.940,70 | 451 / 35 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 21 | 110 / 45 | $112.048,00 | 1621 / 119 | $16.500,60 | 1166 / 113 | $14.909,70 | 1153 / 116 |
| Permanent Cardiac Pacemaker Implant W Cc | 21 | 56 / 18 | $129.077,00 | 892 / 62 | $18.403,40 | 609 / 55 | $16.862,80 | 608 / 63 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 20 | 36 / 16 | $122.778,00 | 848 / 71 | $12.738,80 | 681 / 63 | $10.950,00 | 678 / 69 |
| Degenerative Nervous System Disorders W/O Mcc | 19 | 59 / 12 | $54.114,30 | 797 / 48 | $8.853,32 | 656 / 46 | $7.244,89 | 656 / 49 |
| Disorders Of Pancreas Except Malignancy W Cc | 19 | 42 / 12 | $55.041,40 | 895 / 53 | $8.339,21 | 786 / 48 | $6.720,68 | 783 / 54 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 18 | 132 / 47 | $31.283,40 | 1787 / 121 | $5.876,67 | 1804 / 134 | $4.609,11 | 1798 / 134 |
| Red Blood Cell Disorders W Mcc | 18 | 53 / 21 | $51.819,30 | 868 / 60 | $10.202,00 | 764 / 71 | $8.734,44 | 760 / 80 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 18 | 58 / 14 | $62.418,10 | 374 / 35 | $13.602,70 | 321 / 40 | $12.507,60 | 321 / 45 |
| Coronary Bypass W Cardiac Cath W/O Mcc | 18 | 58 / 18 | $360.562,00 | 602 / 44 | $32.291,20 | 431 / 35 | $29.885,80 | 431 / 41 |
| Kidney Transplant | 18 | 83 / 16 | $386.462,00 | 171 / 18 | $23.865,90 | 78 / 2 | $21.807,30 | 78 / 14 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 17 | 84 / 24 | $78.294,40 | 1004 / 51 | $11.938,20 | 740 / 41 | $10.469,90 | 738 / 41 |
| Coronary Bypass W/O Cardiac Cath W Mcc | 16 | 43 / 10 | $381.841,00 | 233 / 18 | $40.123,00 | 145 / 12 | $38.115,10 | 144 / 16 |
| Pulmonary Edema & Respiratory Failure | 16 | 187 / 65 | $76.510,00 | 2108 / 147 | $10.129,60 | 1744 / 142 | $8.665,31 | 1739 / 145 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 16 | 84 / 30 | $157.381,00 | 856 / 63 | $21.661,60 | 555 / 45 | $20.243,60 | 551 / 63 |
| Other Digestive System Diagnoses W Cc | 16 | 81 / 28 | $55.374,10 | 1326 / 82 | $8.536,88 | 1164 / 79 | $7.188,25 | 1160 / 83 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 16 | 24 / 9 | $151.766,00 | 439 / 36 | $17.865,50 | 304 / 28 | $15.963,40 | 303 / 33 |
| Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 16 | 31 / 11 | $116.209,00 | 576 / 56 | $10.061,50 | 486 / 50 | $8.397,50 | 485 / 54 |
| Medical Back Problems W/O Mcc | 16 | 105 / 34 | $52.314,00 | 1426 / 102 | $7.935,56 | 1236 / 93 | $6.209,56 | 1232 / 93 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 15 | 56 / 26 | $215.905,00 | 791 / 57 | $34.572,80 | 497 / 53 | $32.465,10 | 496 / 58 |
| Peripheral Vascular Disorders W Mcc | 15 | 34 / 12 | $58.063,50 | 473 / 37 | $11.140,90 | 373 / 39 | $9.128,07 | 373 / 42 |
| Peripheral Vascular Disorders W Cc | 15 | 69 / 27 | $44.570,10 | 1086 / 67 | $8.095,47 | 911 / 74 | $6.693,87 | 908 / 76 |
| Hypertension W/O Mcc | 15 | 50 / 18 | $41.174,90 | 741 / 66 | $6.453,73 | 669 / 64 | $5.035,07 | 667 / 64 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 15 | 81 / 40 | $50.992,70 | 1180 / 72 | $9.886,00 | 994 / 84 | $8.128,13 | 989 / 83 |
| Chest Pain | 15 | 136 / 51 | $42.394,30 | 1626 / 120 | $6.272,07 | 1470 / 116 | $5.085,93 | 1461 / 118 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 15 | 38 / 14 | $52.085,10 | 800 / 38 | $7.516,40 | 647 / 42 | $4.931,07 | 643 / 39 |
| Bronchitis & Asthma W Cc/Mcc | 14 | 62 / 28 | $49.442,10 | 1000 / 71 | $7.920,93 | 840 / 79 | $6.163,21 | 836 / 77 |
| Cirrhosis & Alcoholic Hepatitis W Cc | 14 | 12 / 4 | $38.592,90 | 69 / 6 | $8.228,29 | 61 / 11 | $7.348,29 | 61 / 11 |
| Acute Myocardial Infarction, Expired W Mcc | 14 | 16 / 6 | $81.568,10 | 164 / 7 | $12.648,70 | 110 / 6 | $11.453,30 | 110 / 7 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 14 | 52 / 15 | $67.785,30 | 498 / 39 | $9.650,29 | 374 / 31 | $7.746,29 | 373 / 32 |
| Seizures W Mcc | 13 | 53 / 21 | $69.846,20 | 636 / 47 | $11.473,80 | 461 / 43 | $10.103,90 | 461 / 48 |
| Bronchitis & Asthma W/O Cc/Mcc | 13 | 32 / 11 | $34.265,10 | 336 / 30 | $6.374,00 | 299 / 34 | $4.693,31 | 299 / 35 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W Card Cath W Mcc | 13 | 56 / 10 | $498.009,00 | 269 / 15 | $57.972,30 | 74 / 8 | $55.712,00 | 74 / 10 |
| Other Digestive System Diagnoses W Mcc | 13 | 49 / 17 | $68.079,30 | 621 / 47 | $12.710,20 | 405 / 43 | $10.883,70 | 404 / 42 |
| Spinal Fusion Except Cervical W/O Mcc | 13 | 181 / 60 | $199.493,00 | 1275 / 108 | $25.852,20 | 683 / 55 | $23.000,60 | 679 / 81 |
| Cellulitis W Mcc | 13 | 45 / 20 | $75.458,60 | 894 / 67 | $11.818,20 | 698 / 61 | $9.984,38 | 696 / 68 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Mcc | 12 | 104 / 20 | $476.228,00 | 460 / 24 | $53.032,60 | 228 / 12 | $50.814,00 | 228 / 16 |
| Traumatic Stupor & Coma, Coma <1 Hr W Mcc | 12 | 39 / 13 | $74.205,80 | 251 / 12 | $13.771,40 | 152 / 10 | $12.147,40 | 152 / 12 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 12 | 53 / 23 | $217.634,00 | 906 / 54 | $24.226,70 | 696 / 48 | $22.024,00 | 693 / 50 |
| Respiratory Infections & Inflammations W Cc | 12 | 76 / 33 | $79.891,40 | 1392 / 105 | $11.465,50 | 1243 / 110 | $10.014,80 | 1238 / 113 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 12 | 51 / 23 | $172.860,00 | 556 / 37 | $30.245,50 | 234 / 24 | $27.772,20 | 234 / 24 |
| Coronary Bypass W/O Cardiac Cath W/O Mcc | 12 | 76 / 25 | $318.970,00 | 587 / 48 | $25.841,10 | 400 / 33 | $23.747,80 | 399 / 41 |
| O.R. Procedures For Obesity W/O Cc/Mcc | 12 | 65 / 30 | $126.280,00 | 410 / 38 | $12.307,80 | 249 / 30 | $9.518,83 | 249 / 28 |
| Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 11 | 46 / 15 | $123.265,00 | 692 / 37 | $15.433,50 | 508 / 31 | $13.888,80 | 507 / 37 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 11 | 78 / 29 | $123.835,00 | 770 / 60 | $9.187,27 | 632 / 49 | $7.654,18 | 631 / 56 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 27 | $48.468,20 | 737 / 41 | $8.614,82 | 672 / 36 | $7.474,45 | 672 / 44 |
| G.I. Obstruction W Cc | 11 | 81 / 39 | $54.159,50 | 1633 / 101 | $8.049,55 | 1435 / 101 | $6.385,55 | 1430 / 102 |
| Renal Failure W/O Cc/Mcc | 11 | 45 / 22 | $32.943,00 | 765 / 62 | $6.415,82 | 777 / 63 | $5.141,64 | 775 / 64 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 11 | 61 / 27 | $44.012,00 | 622 / 28 | $11.203,60 | 472 / 50 | $8.423,27 | 470 / 35 |
| Tendonitis, Myositis & Bursitis W/O Mcc | 11 | 31 / 9 | $44.454,40 | 297 / 13 | $7.727,00 | 276 / 14 | $6.272,45 | 275 / 14 | Total 104 procedures | 3.653 | 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.