Hospital Costs > In California > Southwest Healthcare System, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 83 | 481 / 98 | $51.776,30 | 1372 / 29 | $16.394,20 | 2125 / 72 | $14.161,30 | 2082 / 64 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 82 | 434 / 138 | $57.840,40 | 2025 / 68 | $14.804,90 | 2329 / 94 | $13.796,60 | 2288 / 99 |
Kidney & Urinary Tract Infections W/O Mcc | 61 | 172 / 50 | $24.670,50 | 1961 / 36 | $6.602,25 | 2153 / 80 | $5.337,72 | 2142 / 58 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 58 | 217 / 53 | $24.293,10 | 1826 / 33 | $6.367,76 | 2229 / 72 | $5.325,41 | 2214 / 81 |
Heart Failure & Shock W Mcc | 53 | 231 / 73 | $50.961,30 | 2009 / 63 | $12.257,20 | 2259 / 84 | $11.596,60 | 2249 / 101 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 45 | 121 / 35 | $21.223,80 | 1664 / 28 | $5.925,71 | 2078 / 60 | $5.091,58 | 2070 / 76 |
Chronic Obstructive Pulmonary Disease W Mcc | 45 | 157 / 45 | $41.748,50 | 1976 / 44 | $9.142,29 | 2097 / 46 | $8.283,96 | 2089 / 58 |
Medical Back Problems W/O Mcc | 40 | 81 / 19 | $30.828,20 | 1038 / 30 | $6.850,62 | 1138 / 34 | $5.760,75 | 1134 / 37 |
Renal Failure W Mcc | 39 | 156 / 48 | $53.228,80 | 1643 / 56 | $11.730,90 | 1674 / 34 | $11.021,10 | 1672 / 49 |
Chest Pain | 38 | 113 / 35 | $26.848,00 | 1287 / 50 | $5.758,61 | 1223 / 69 | $4.043,68 | 1216 / 40 |
Heart Failure & Shock W Cc | 38 | 240 / 64 | $28.013,30 | 1857 / 27 | $7.997,32 | 2225 / 68 | $7.067,89 | 2219 / 70 |
Renal Failure W Cc | 37 | 184 / 51 | $37.478,00 | 1967 / 64 | $7.785,92 | 1928 / 56 | $6.742,89 | 1918 / 55 |
Simple Pneumonia & Pleurisy W Cc | 35 | 168 / 55 | $33.680,00 | 2130 / 45 | $7.796,97 | 2312 / 54 | $6.933,89 | 2304 / 75 |
Simple Pneumonia & Pleurisy W Mcc | 35 | 170 / 56 | $52.249,30 | 1969 / 54 | $11.161,20 | 2081 / 51 | $10.543,20 | 2078 / 67 |
Hip & Femur Procedures Except Major Joint W Cc | 32 | 111 / 34 | $57.768,30 | 1295 / 6 | $14.757,30 | 1644 / 41 | $13.661,30 | 1625 / 45 |
Chronic Obstructive Pulmonary Disease W Cc | 27 | 152 / 46 | $35.609,20 | 1937 / 53 | $7.604,56 | 2014 / 54 | $6.753,59 | 2007 / 64 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 27 | 155 / 47 | $34.920,30 | 1354 / 21 | $8.558,81 | 1700 / 47 | $7.617,78 | 1696 / 71 |
Pulmonary Edema & Respiratory Failure | 25 | 178 / 50 | $41.429,50 | 1551 / 26 | $9.636,96 | 1849 / 28 | $9.103,20 | 1844 / 52 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 25 | 106 / 28 | $76.590,00 | 1256 / 20 | $19.629,60 | 1388 / 60 | $16.406,80 | 1374 / 24 |
Kidney & Urinary Tract Infections W Mcc | 25 | 119 / 41 | $36.112,20 | 1392 / 33 | $9.249,28 | 1647 / 69 | $8.382,76 | 1643 / 74 |
G.I. Hemorrhage W Cc | 25 | 193 / 66 | $36.036,60 | 1822 / 46 | $8.128,16 | 1997 / 53 | $7.256,48 | 1993 / 71 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 24 | 137 / 42 | $29.540,10 | 1612 / 32 | $6.650,71 | 1780 / 58 | $5.742,71 | 1775 / 72 |
Syncope & Collapse | 23 | 146 / 44 | $22.853,80 | 1094 / 20 | $6.174,04 | 1507 / 49 | $5.179,26 | 1500 / 53 |
Cellulitis W/O Mcc | 22 | 167 / 64 | $24.112,80 | 1823 / 33 | $7.021,05 | 2206 / 65 | $6.146,86 | 2198 / 92 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 21 | 105 / 38 | $43.090,60 | 1367 / 59 | $9.310,71 | 1176 / 60 | $7.581,19 | 1173 / 27 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 20 | 148 / 51 | $58.264,90 | 1113 / 26 | $13.090,30 | 1137 / 28 | $11.728,80 | 1131 / 25 |
Red Blood Cell Disorders W/O Mcc | 20 | 123 / 36 | $23.504,40 | 1153 / 18 | $6.732,85 | 1658 / 52 | $6.129,65 | 1649 / 70 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 20 | 105 / 32 | $56.929,60 | 1270 / 27 | $13.369,00 | 1444 / 43 | $12.407,40 | 1432 / 46 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 20 | 187 / 89 | $31.986,90 | 1731 / 49 | $8.382,30 | 2011 / 56 | $7.351,90 | 2003 / 66 |
Spinal Fusion Except Cervical W/O Mcc | 19 | 175 / 47 | $170.168,00 | 1194 / 51 | $35.663,80 | 1277 / 62 | $34.518,60 | 1272 / 73 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 17 | 76 / 28 | $24.843,50 | 1448 / 23 | $6.051,00 | 1707 / 48 | $5.198,29 | 1699 / 64 |
G.I. Obstruction W Cc | 17 | 75 / 35 | $24.457,10 | 960 / 8 | $7.110,76 | 1391 / 35 | $6.188,41 | 1386 / 48 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 17 | 133 / 32 | $23.198,10 | 1561 / 28 | $5.367,00 | 1573 / 71 | $3.667,47 | 1567 / 48 |
Heart Failure & Shock W/O Cc/Mcc | 16 | 94 / 29 | $27.186,70 | 1635 / 33 | $5.867,94 | 1603 / 38 | $4.733,94 | 1590 / 40 |
Respiratory System Diagnosis W Ventilator Support 96+ Hours | 16 | 55 / 17 | $163.543,00 | 618 / 14 | $38.120,10 | 703 / 16 | $37.220,00 | 702 / 19 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 16 | 86 / 32 | $20.723,30 | 630 / 1 | $6.321,88 | 1211 / 36 | $4.879,44 | 1207 / 32 |
Traumatic Stupor & Coma, Coma <1 Hr W Cc | 16 | 50 / 15 | $45.615,50 | 403 / 4 | $8.841,69 | 401 / 8 | $8.163,69 | 400 / 14 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 15 | 77 / 40 | $197.258,00 | 738 / 36 | $51.944,30 | 977 / 91 | $51.383,30 | 976 / 101 |
Cervical Spinal Fusion W/O Cc/Mcc | 15 | 89 / 22 | $79.529,10 | 666 / 14 | $17.234,00 | 747 / 20 | $16.113,90 | 744 / 29 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 15 | 81 / 29 | $37.300,40 | 886 / 20 | $10.460,40 | 1210 / 61 | $9.419,33 | 1205 / 64 |
Traumatic Stupor & Coma, Coma <1 Hr W/O Cc/Mcc | 15 | 39 / 13 | $32.148,70 | 304 / 1 | $6.269,60 | 278 / 8 | $5.136,80 | 278 / 7 |
Seizures W/O Mcc | 15 | 93 / 27 | $28.619,30 | 911 / 22 | $6.451,93 | 954 / 24 | $5.323,40 | 952 / 22 |
Respiratory Infections & Inflammations W Mcc | 15 | 121 / 57 | $57.690,70 | 1226 / 20 | $14.584,10 | 1453 / 36 | $13.941,90 | 1438 / 41 |
Atherosclerosis W/O Mcc | 14 | 44 / 12 | $16.435,60 | 222 / 5 | $5.377,50 | / 14 | $4.776,36 | / |
Degenerative Nervous System Disorders W/O Mcc | 14 | 64 / 16 | $30.881,40 | 522 / 10 | $7.638,43 | 613 / 9 | $6.779,00 | 613 / 12 |
Fractures Of Hip & Pelvis W/O Mcc | 14 | 47 / 17 | $24.652,40 | 646 / 10 | $6.118,71 | 778 / 35 | $5.083,29 | 777 / 36 |
G.I. Hemorrhage W Mcc | 13 | 108 / 43 | $49.213,80 | 986 / 22 | $13.468,90 | 1066 / 37 | $11.567,80 | 1058 / 15 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 13 | 60 / 21 | $41.888,20 | 854 / 18 | $9.828,69 | 982 / 39 | $9.361,00 | 980 / 48 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 12 | 108 / 34 | $33.503,70 | 1807 / 48 | $6.953,33 | 1740 / 76 | $5.103,67 | 1729 / 45 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 12 | 35 / 10 | $38.460,20 | 203 / 1 | $11.637,80 | 430 / 7 | $10.731,20 | 430 / 16 |
Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 12 | 35 / 14 | $35.352,20 | 239 / 2 | $9.683,33 | 502 / 10 | $8.574,00 | 501 / 22 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 12 | 111 / 42 | $46.634,20 | 1468 / 38 | $9.565,92 | 1519 / 32 | $8.763,25 | 1516 / 41 |
Major Small & Large Bowel Procedures W Cc | 12 | 96 / 43 | $80.214,30 | 1008 / 6 | $20.518,80 | 1326 / 43 | $19.311,00 | 1312 / 61 |
Signs & Symptoms W/O Mcc | 12 | 79 / 26 | $24.177,70 | 861 / 15 | $5.970,50 | 1074 / 32 | $5.269,17 | 1071 / 44 |
Permanent Cardiac Pacemaker Implant W Mcc | 11 | 41 / 13 | $75.990,70 | 184 / 1 | $25.274,80 | 392 / 6 | $24.285,70 | 392 / 7 |
Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 11 | 78 / 34 | $39.791,20 | 464 / 6 | $8.752,00 | 631 / 22 | $7.652,36 | 630 / 35 |
Transient Ischemia | 11 | 114 / 45 | $21.254,50 | 755 / 6 | $6.018,36 | 1376 / 46 | $5.136,91 | 1369 / 68 | Total 57 procedures | 1.442 | 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.