Hospital Costs > In California > St Johns Pleasant Valley Hospital, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Cardiac Arrhythmia & Conduction Disorders W Cc | 12 | 149 / 54 | $56.023,80 | 2106 / 153 | $5.304,33 | 1004 / 6 | $4.301,67 | 1001 / 7 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 17 | 133 / 32 | $45.771,70 | 1953 / 125 | $5.123,65 | 794 / 58 | $2.668,53 | 790 / 7 |
Cellulitis W/O Mcc | 24 | 165 / 62 | $37.763,00 | 2361 / 128 | $5.826,75 | 1658 / 10 | $4.916,08 | 1651 / 16 |
Chronic Obstructive Pulmonary Disease W Cc | 20 | 159 / 53 | $75.197,20 | 2420 / 177 | $7.641,15 | 2099 / 58 | $7.098,75 | 2092 / 88 |
Chronic Obstructive Pulmonary Disease W Mcc | 14 | 188 / 76 | $76.406,10 | 2493 / 166 | $8.159,00 | 1628 / 14 | $7.039,00 | 1620 / 11 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 16 | 104 / 30 | $40.079,30 | 1957 / 85 | $4.851,50 | 1262 / 2 | $4.023,50 | 1252 / 8 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 19 | 256 / 91 | $41.262,70 | 2496 / 141 | $5.133,21 | 1556 / 8 | $4.178,26 | 1543 / 16 |
G.I. Hemorrhage W Cc | 33 | 185 / 58 | $50.146,80 | 2169 / 117 | $7.354,45 | 1442 / 17 | $5.880,21 | 1438 / 14 |
G.I. Obstruction W Cc | 13 | 79 / 39 | $46.269,40 | 1554 / 77 | $6.120,62 | 1097 / 7 | $5.288,62 | 1094 / 11 |
G.I. Obstruction W/O Cc/Mcc | 15 | 56 / 26 | $38.161,30 | 1219 / 69 | $4.199,47 | 734 / 6 | $3.307,73 | 731 / 11 |
Heart Failure & Shock W Cc | 27 | 251 / 73 | $58.650,50 | 2654 / 178 | $6.785,56 | 1647 / 15 | $5.934,59 | 1642 / 20 |
Heart Failure & Shock W Mcc | 37 | 247 / 86 | $67.685,40 | 2309 / 121 | $10.247,50 | 1693 / 13 | $9.463,03 | 1688 / 16 |
Hip & Femur Procedures Except Major Joint W Cc | 17 | 126 / 49 | $77.750,30 | 1675 / 48 | $13.269,60 | 1357 / 8 | $12.207,90 | 1339 / 13 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 18 | 106 / 48 | $251.955,00 | 1427 / 80 | $44.614,20 | 1350 / 71 | $43.707,60 | 1340 / 76 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 14 | 88 / 34 | $42.930,60 | 1405 / 59 | $5.161,36 | 831 / 5 | $4.036,79 | 827 / 9 |
Kidney & Urinary Tract Infections W Mcc | 12 | 132 / 54 | $57.315,60 | 1780 / 119 | $7.569,00 | 1212 / 12 | $6.786,33 | 1208 / 15 |
Kidney & Urinary Tract Infections W/O Mcc | 29 | 204 / 80 | $35.825,00 | 2398 / 114 | $6.160,34 | 1158 / 45 | $4.059,59 | 1150 / 7 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 12 | 61 / 22 | $69.101,80 | 1055 / 62 | $7.888,08 | 714 / 4 | $7.384,08 | 712 / 9 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 57 | 507 / 112 | $97.714,40 | 2446 / 151 | $16.065,60 | 1823 / 54 | $12.959,80 | 1782 / 29 |
Major Small & Large Bowel Procedures W Cc | 12 | 96 / 43 | $92.382,20 | 1140 / 15 | $15.288,90 | 685 / 1 | $14.283,60 | 679 / 1 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 29 | 137 / 51 | $35.473,90 | 2271 / 110 | $4.838,93 | 1240 / 5 | $3.838,10 | 1236 / 11 |
Other Digestive System Diagnoses W Cc | 12 | 85 / 30 | $58.400,30 | 1352 / 100 | $7.237,08 | 985 / 11 | $6.431,67 | 981 / 21 |
Pulmonary Edema & Respiratory Failure | 11 | 192 / 64 | $48.234,70 | 1717 / 41 | $8.411,73 | 1624 / 6 | $8.190,64 | 1619 / 20 |
Renal Failure W Cc | 20 | 201 / 68 | $48.083,80 | 2224 / 120 | $6.518,75 | 1187 / 10 | $5.368,35 | 1179 / 8 |
Renal Failure W Mcc | 11 | 184 / 75 | $114.739,00 | 2144 / 173 | $14.006,60 | 1976 / 116 | $13.456,80 | 1972 / 134 |
Respiratory Infections & Inflammations W Cc | 11 | 77 / 37 | $68.388,10 | 1326 / 71 | $9.455,91 | 947 / 12 | $8.466,82 | 942 / 11 |
Respiratory Infections & Inflammations W Mcc | 13 | 123 / 59 | $95.217,00 | 1629 / 87 | $16.913,30 | 1163 / 95 | $12.340,50 | 1149 / 15 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 13 | 118 / 40 | $112.157,00 | 1622 / 66 | $18.190,70 | 1493 / 34 | $17.444,80 | 1479 / 41 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 12 | 80 / 43 | $257.075,00 | 916 / 66 | $39.580,60 | 610 / 16 | $38.772,50 | 609 / 22 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 106 | 410 / 124 | $78.023,50 | 2404 / 130 | $13.329,50 | 1910 / 28 | $12.076,50 | 1875 / 26 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 63 | 144 / 53 | $51.658,00 | 2292 / 158 | $7.366,73 | 1617 / 20 | $6.449,02 | 1610 / 28 |
Simple Pneumonia & Pleurisy W Cc | 31 | 172 / 59 | $59.081,50 | 2684 / 165 | $6.618,94 | 1553 / 7 | $5.567,06 | 1547 / 9 |
Simple Pneumonia & Pleurisy W Mcc | 22 | 183 / 69 | $70.982,20 | 2246 / 112 | $9.910,27 | 1712 / 12 | $9.183,73 | 1712 / 17 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 28 | 65 / 17 | $39.306,40 | 1796 / 74 | $4.877,93 | 1115 / 8 | $3.795,64 | 1109 / 10 |
Spinal Fusion Except Cervical W/O Mcc | 11 | 183 / 55 | $152.204,00 | 1123 / 35 | $27.766,30 | 1009 / 6 | $26.553,20 | 1004 / 15 |
Syncope & Collapse | 11 | 158 / 56 | $59.860,10 | 1899 / 145 | $5.009,45 | 874 / 7 | $3.915,64 | 870 / 4 |
Transient Ischemia | 17 | 108 / 39 | $40.117,00 | 1442 / 72 | $4.825,29 | 724 / 4 | $3.620,59 | 720 / 5 | Total 37 procedures | 839 | 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.