Hospital Costs > In Oregon > St Alphonsus Medical Center - Ontario, Inc, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Cellulitis W/O Mcc | 13 | 176 / 19 | $11.762,80 | 437 / 3 | $6.122,38 | 1874 / 8 | $5.290,38 | 1866 / 14 |
| Chronic Obstructive Pulmonary Disease W Cc | 12 | 167 / 15 | $18.029,10 | 810 / 14 | $6.817,08 | 1615 / 7 | $5.707,75 | 1608 / 7 |
| Chronic Obstructive Pulmonary Disease W Mcc | 19 | 183 / 12 | $21.631,50 | 868 / 11 | $9.358,21 | 1713 / 18 | $7.237,84 | 1705 / 8 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 21 | 254 / 19 | $13.725,70 | 591 / 7 | $5.466,67 | 1462 / 7 | $4.098,67 | 1451 / 6 |
| G.I. Hemorrhage W Cc | 17 | 201 / 22 | $18.658,90 | 631 / 10 | $7.615,00 | 1402 / 13 | $5.824,24 | 1399 / 6 |
| Heart Failure & Shock W Cc | 35 | 243 / 16 | $14.610,20 | 532 / 5 | $7.224,09 | 2027 / 10 | $6.571,29 | 2022 / 16 |
| Heart Failure & Shock W/O Cc/Mcc | 23 | 87 / 4 | $15.518,20 | 904 / 14 | $4.905,13 | 1360 / 3 | $4.167,74 | 1349 / 10 |
| Hip & Femur Procedures Except Major Joint W Cc | 19 | 124 / 13 | $33.026,70 | 337 / 1 | $14.453,20 | 1439 / 14 | $12.520,20 | 1421 / 9 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 11 | 45 / 6 | $30.695,70 | 204 / 3 | $12.012,10 | 650 / 8 | $10.185,60 | 647 / 8 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 22 | 160 / 15 | $18.900,50 | 409 / 6 | $7.843,91 | 1493 / 10 | $6.851,91 | 1490 / 15 |
| Kidney & Urinary Tract Infections W/O Mcc | 32 | 201 / 10 | $13.557,60 | 726 / 5 | $5.618,47 | 1740 / 7 | $4.601,47 | 1729 / 7 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 79 | 485 / 18 | $35.360,50 | 488 / 6 | $15.884,20 | 2116 / 14 | $14.105,10 | 2073 / 22 |
| Major Small & Large Bowel Procedures W Cc | 11 | 97 / 16 | $32.961,50 | 82 / 1 | $18.562,80 | 1201 / 6 | $17.463,20 | 1187 / 11 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 25 | 141 / 9 | $13.549,80 | 767 / 4 | $5.106,28 | 1642 / 4 | $4.237,16 | 1637 / 7 |
| Pulmonary Edema & Respiratory Failure | 14 | 189 / 20 | $32.749,70 | 1191 / 16 | $8.996,43 | 1515 / 6 | $7.874,14 | 1510 / 7 |
| Pulmonary Embolism W/O Mcc | 11 | 63 / 8 | $17.043,00 | 239 / 5 | $7.188,36 | 969 / 6 | $6.423,27 | 966 / 10 |
| Respiratory Infections & Inflammations W Cc | 14 | 74 / 3 | $20.228,60 | 269 / 2 | $10.141,10 | 1148 / 4 | $9.366,29 | 1143 / 4 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 31 | 485 / 28 | $23.960,00 | 479 / 6 | $13.428,50 | 2062 / 15 | $12.612,00 | 2025 / 20 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 31 | 176 / 14 | $19.765,50 | 761 / 12 | $7.790,74 | 1838 / 11 | $6.892,68 | 1830 / 16 |
| Simple Pneumonia & Pleurisy W Cc | 56 | 147 / 3 | $18.168,50 | 935 / 12 | $7.130,07 | 1930 / 9 | $6.047,21 | 1922 / 13 |
| Simple Pneumonia & Pleurisy W Mcc | 17 | 188 / 18 | $22.235,60 | 522 / 10 | $10.535,10 | 1833 / 12 | $9.505,65 | 1833 / 16 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 29 | 64 / 2 | $15.265,20 | 761 / 5 | $5.107,17 | 1303 / 5 | $4.051,72 | 1296 / 5 | Total 22 procedures | 542 | 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.