Hospital Costs > In Wisconsin > St Elizabeth Hospital Appleton, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Psychoses | 135 | 163 / 9 | $9.735,36 | 54 / 2 | $7.599,19 | 351 / 13 | $6.307,47 | 351 / 13 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 88 | 476 / 39 | $31.701,90 | 299 / 12 | $15.242,80 | 1045 / 51 | $11.143,30 | 1022 / 27 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 43 | 473 / 44 | $29.033,80 | 738 / 21 | $16.543,00 | 1241 / 58 | $10.533,30 | 1220 / 39 |
| Heart Failure & Shock W Cc | 26 | 252 / 30 | $13.262,60 | 391 / 6 | $8.479,00 | 1784 / 59 | $6.107,04 | 1779 / 48 |
| Renal Failure W Cc | 23 | 198 / 27 | $12.465,60 | 251 / 7 | $7.219,57 | 1719 / 45 | $6.192,30 | 1709 / 45 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Cc | 21 | 97 / 9 | $99.809,90 | 73 / 4 | $35.629,60 | 321 / 7 | $34.366,60 | 321 / 9 |
| Renal Failure W Mcc | 21 | 174 / 16 | $16.491,00 | 111 / 3 | $10.587,20 | 1292 / 22 | $9.638,86 | 1292 / 23 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 20 | 187 / 35 | $13.463,80 | 249 / 5 | $7.912,35 | 1609 / 50 | $6.442,90 | 1602 / 44 |
| G.I. Hemorrhage W Cc | 20 | 198 / 32 | $11.382,20 | 98 / 4 | $7.537,05 | 1790 / 49 | $6.614,70 | 1786 / 51 |
| Chronic Obstructive Pulmonary Disease W Mcc | 19 | 183 / 23 | $13.181,20 | 191 / 6 | $8.492,58 | 1833 / 36 | $7.513,42 | 1825 / 43 |
| Heart Failure & Shock W Mcc | 19 | 265 / 37 | $16.558,40 | 223 / 4 | $10.304,50 | 1717 / 41 | $9.513,63 | 1712 / 43 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 18 | 106 / 16 | $7.279,06 | 63 / 4 | $5.738,50 | 602 / 17 | $4.969,06 | 601 / 23 |
| Pulmonary Edema & Respiratory Failure | 18 | 185 / 29 | $16.453,80 | 209 / 6 | $8.913,78 | 1301 / 38 | $7.416,00 | 1298 / 33 |
| Simple Pneumonia & Pleurisy W Cc | 16 | 187 / 34 | $12.447,10 | 297 / 7 | $7.416,62 | 2204 / 49 | $6.637,88 | 2196 / 54 |
| Cellulitis W/O Mcc | 15 | 174 / 31 | $8.479,80 | 131 / 2 | $6.630,07 | 2004 / 50 | $5.566,40 | 1996 / 53 |
| Spinal Fusion Except Cervical W/O Mcc | 14 | 180 / 17 | $47.726,60 | 95 / 5 | $25.013,80 | 545 / 10 | $22.078,70 | 542 / 15 |
| Major Small & Large Bowel Procedures W Cc | 13 | 95 / 17 | $31.086,50 | 61 / 2 | $16.742,10 | 81 / 10 | $11.783,30 | 81 / 2 |
| Respiratory Infections & Inflammations W Mcc | 13 | 123 / 22 | $25.709,90 | 257 / 7 | $13.786,50 | 1271 / 22 | $12.816,00 | 1256 / 24 |
| Simple Pneumonia & Pleurisy W Mcc | 13 | 192 / 36 | $14.871,10 | 119 / 3 | $10.159,50 | 1684 / 42 | $9.110,23 | 1684 / 45 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 12 | 170 / 26 | $20.487,80 | 508 / 9 | $7.778,08 | 1491 / 33 | $6.845,92 | 1488 / 40 |
| Hip & Femur Procedures Except Major Joint W Cc | 12 | 131 / 26 | $27.942,40 | 161 / 6 | $12.978,80 | 1285 / 35 | $11.937,80 | 1268 / 37 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 11 | 109 / 17 | $10.569,60 | 298 / 2 | $5.902,18 | 1679 / 20 | $4.890,45 | 1668 / 22 |
| Bronchitis & Asthma W Cc/Mcc | 11 | 65 / 10 | $10.374,80 | 59 / 1 | $6.784,00 | 852 / 7 | $6.216,27 | 848 / 11 |
| Coronary Bypass W/O Cardiac Cath W/O Mcc | 11 | 77 / 10 | $87.404,30 | 175 / 6 | $28.424,00 | 489 / 8 | $27.177,50 | 488 / 10 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 11 | 114 / 21 | $18.774,50 | 125 / 3 | $11.663,50 | 1219 / 19 | $11.086,80 | 1210 / 23 | Total 25 procedures | 623 | 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.