Hospital Costs > In Tennessee > Sumner Regional Medical Center Gallatin, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 108 | 408 / 30 | $55.650,90 | 1973 / 65 | $10.614,60 | 607 / 54 | $9.675,94 | 606 / 55 |
Kidney & Urinary Tract Infections W/O Mcc | 101 | 132 / 11 | $22.177,00 | 1769 / 62 | $4.682,84 | 865 / 52 | $3.867,61 | 859 / 59 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 93 | 471 / 34 | $54.379,80 | 1483 / 35 | $12.193,00 | 182 / 18 | $9.666,51 | 182 / 16 |
Chronic Obstructive Pulmonary Disease W Mcc | 80 | 122 / 16 | $29.547,20 | 1445 / 51 | $7.009,51 | 510 / 50 | $5.789,45 | 509 / 39 |
Chronic Obstructive Pulmonary Disease W Cc | 68 | 111 / 11 | $22.511,00 | 1254 / 44 | $5.642,68 | 763 / 42 | $4.769,53 | 761 / 52 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 66 | 209 / 24 | $24.984,90 | 1885 / 52 | $4.837,77 | 770 / 51 | $3.607,64 | 765 / 49 |
Heart Failure & Shock W Mcc | 63 | 221 / 26 | $43.910,70 | 1814 / 63 | $9.047,16 | 842 / 62 | $8.097,97 | 842 / 58 |
Renal Failure W Cc | 63 | 158 / 22 | $23.799,10 | 1335 / 48 | $5.915,54 | 848 / 49 | $5.039,81 | 841 / 54 |
Syncope & Collapse | 57 | 112 / 7 | $25.884,30 | 1261 / 31 | $4.542,58 | 539 / 24 | $3.587,09 | 537 / 29 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 56 | 64 / 5 | $20.184,00 | 1279 / 45 | $4.495,29 | 521 / 43 | $3.343,30 | 520 / 34 |
Simple Pneumonia & Pleurisy W Cc | 56 | 147 / 30 | $28.921,60 | 1897 / 61 | $5.875,77 | 765 / 49 | $4.873,20 | 762 / 48 |
Simple Pneumonia & Pleurisy W Mcc | 54 | 151 / 26 | $33.275,00 | 1238 / 42 | $8.259,96 | 430 / 43 | $7.219,37 | 430 / 42 |
Chest Pain | 54 | 97 / 5 | $22.636,20 | 1092 / 31 | $3.893,22 | 402 / 23 | $2.832,07 | 400 / 22 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 54 | 112 / 11 | $16.626,00 | 1154 / 39 | $4.361,59 | 635 / 45 | $3.405,28 | 633 / 40 |
Renal Failure W Mcc | 50 | 145 / 23 | $31.420,20 | 844 / 32 | $8.741,80 | 570 / 32 | $8.160,04 | 570 / 39 |
Kidney & Urinary Tract Infections W Mcc | 47 | 97 / 13 | $31.510,00 | 1235 / 43 | $6.385,96 | 461 / 29 | $5.659,85 | 460 / 36 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 46 | 142 / 17 | $35.795,50 | 795 / 22 | $6.375,43 | 413 / 15 | $5.322,91 | 411 / 22 |
Pulmonary Edema & Respiratory Failure | 45 | 158 / 27 | $35.731,20 | 1323 / 42 | $7.155,89 | 624 / 29 | $6.481,76 | 624 / 37 |
G.I. Hemorrhage W Cc | 44 | 174 / 24 | $26.726,20 | 1343 / 39 | $5.936,25 | 537 / 36 | $4.942,55 | 536 / 33 |
Heart Failure & Shock W Cc | 42 | 236 / 32 | $25.603,10 | 1715 / 57 | $5.910,38 | 1131 / 42 | $5.393,81 | 1129 / 62 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 42 | 51 / 6 | $21.283,70 | 1276 / 41 | $4.383,83 | 694 / 33 | $3.410,12 | 690 / 40 |
Cellulitis W/O Mcc | 42 | 147 / 20 | $19.359,00 | 1408 / 50 | $5.225,57 | 349 / 47 | $3.745,62 | 346 / 30 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 33 | 174 / 29 | $30.311,10 | 1640 / 50 | $6.321,48 | 415 / 38 | $5.113,03 | 413 / 34 |
Respiratory Infections & Inflammations W Cc | 32 | 56 / 8 | $36.966,50 | 899 / 26 | $7.801,94 | 414 / 17 | $7.185,44 | 411 / 24 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 30 | 101 / 22 | $65.119,80 | 1037 / 29 | $13.193,40 | 485 / 26 | $12.397,10 | 478 / 30 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 30 | 131 / 23 | $33.077,20 | 1742 / 46 | $4.851,77 | 696 / 29 | $4.008,03 | 693 / 34 |
Respiratory Infections & Inflammations W Mcc | 29 | 107 / 18 | $40.914,90 | 818 / 20 | $10.633,70 | 145 / 23 | $9.562,14 | 145 / 19 |
Transient Ischemia | 27 | 98 / 19 | $27.424,70 | 1076 / 25 | $4.351,63 | 513 / 17 | $3.387,70 | 511 / 23 |
Signs & Symptoms W/O Mcc | 27 | 64 / 8 | $15.635,30 | 376 / 15 | $4.419,15 | 292 / 20 | $3.366,41 | 291 / 17 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 26 | 99 / 16 | $67.112,70 | 1424 / 38 | $10.288,60 | 692 / 29 | $9.408,62 | 691 / 35 |
Peripheral Vascular Disorders W Cc | 25 | 59 / 8 | $25.572,70 | 661 / 15 | $6.022,76 | 198 / 11 | $4.641,88 | 198 / 8 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 24 | 126 / 21 | $16.141,20 | 1114 / 29 | $3.650,67 | 788 / 26 | $2.665,21 | 784 / 33 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 22 | 104 / 18 | $30.486,90 | 984 / 29 | $6.478,91 | 287 / 14 | $5.683,27 | 284 / 16 |
Acute Myocardial Infarction, Discharged Alive W Cc | 22 | 69 / 17 | $38.556,80 | 1004 / 28 | $6.514,86 | 310 / 21 | $5.163,45 | 309 / 17 |
G.I. Obstruction W Cc | 20 | 72 / 15 | $24.521,40 | 963 / 28 | $5.235,45 | 522 / 17 | $4.507,45 | 521 / 25 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 20 | 162 / 30 | $29.566,10 | 1123 / 28 | $6.308,90 | 670 / 28 | $5.401,70 | 669 / 36 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 19 | 54 / 12 | $26.807,30 | 553 / 20 | $6.776,68 | 323 / 14 | $6.205,74 | 322 / 20 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 18 | 105 / 24 | $40.164,60 | 1332 / 33 | $7.214,72 | 521 / 23 | $6.394,56 | 518 / 26 |
Transurethral Procedures W Cc | 18 | 23 / 3 | $43.042,80 | 243 / 6 | $7.482,67 | 71 / 4 | $6.313,78 | 71 / 4 |
Heart Failure & Shock W/O Cc/Mcc | 17 | 93 / 24 | $20.140,60 | 1293 / 37 | $4.227,53 | 660 / 31 | $3.442,59 | 658 / 32 |
Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 16 | 37 / 10 | $26.497,80 | 502 / 15 | $5.294,38 | 241 / 17 | $3.666,81 | 240 / 13 |
Hip & Femur Procedures Except Major Joint W Cc | 16 | 127 / 30 | $49.176,50 | 1020 / 26 | $11.676,80 | 226 / 36 | $9.550,69 | 225 / 23 |
Diabetes W Cc | 16 | 76 / 19 | $19.670,60 | 672 / 21 | $5.055,06 | 588 / 18 | $4.377,06 | 587 / 27 |
G.I. Hemorrhage W/O Cc/Mcc | 16 | 52 / 8 | $19.285,90 | 525 / 17 | $5.215,38 | 173 / 18 | $3.124,44 | 173 / 13 |
Other Kidney & Urinary Tract Diagnoses W Mcc | 15 | 86 / 13 | $29.180,50 | 360 / 10 | $8.557,33 | 34 / 9 | $7.073,20 | 34 / 6 |
Other Digestive System Diagnoses W Cc | 15 | 82 / 18 | $27.403,00 | 771 / 20 | $5.822,93 | 253 / 13 | $4.771,20 | 250 / 12 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 14 | 182 / 31 | $73.593,10 | 751 / 17 | $15.681,70 | 13 / 35 | $8.391,07 | 13 / 3 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 14 | 110 / 21 | $113.629,00 | 665 / 13 | $27.716,50 | 219 / 9 | $27.113,10 | 219 / 14 |
Hypertension W/O Mcc | 13 | 52 / 12 | $20.199,90 | 420 / 13 | $3.931,23 | 246 / 10 | $3.000,77 | 244 / 14 |
Poisoning & Toxic Effects Of Drugs W Mcc | 13 | 59 / 18 | $30.780,90 | 366 / 19 | $7.813,23 | 89 / 17 | $6.789,23 | 89 / 15 |
Atherosclerosis W/O Mcc | 13 | 45 / 7 | $25.026,30 | 392 / 10 | $3.850,46 | / | $3.104,62 | / |
Other Kidney & Urinary Tract Diagnoses W Cc | 12 | 91 / 12 | $29.763,90 | 521 / 13 | $5.879,42 | 266 / 8 | $5.375,42 | 266 / 11 |
Medical Back Problems W/O Mcc | 12 | 109 / 23 | $18.486,60 | 423 / 12 | $4.884,83 | 313 / 15 | $3.972,83 | 313 / 15 |
Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 12 | 44 / 14 | $43.914,20 | 342 / 13 | $10.280,70 | 120 / 17 | $7.949,33 | 120 / 13 |
Fractures Of Hip & Pelvis W/O Mcc | 12 | 49 / 12 | $19.995,30 | 515 / 22 | $4.435,67 | 242 / 17 | $3.334,33 | 243 / 15 |
Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc | 11 | 59 / 11 | $27.403,90 | 329 / 10 | $5.612,55 | 213 / 4 | $5.397,27 | 213 / 10 |
Red Blood Cell Disorders W/O Mcc | 11 | 132 / 29 | $26.205,50 | 1326 / 33 | $4.917,18 | 506 / 28 | $3.986,27 | 505 / 27 |
Disorders Of The Biliary Tract W Cc | 11 | 43 / 8 | $22.978,80 | 105 / 4 | $5.941,18 | 22 / 3 | $4.825,18 | 22 / 3 |
Hip & Femur Procedures Except Major Joint W Mcc | 11 | 51 / 17 | $68.839,60 | 399 / 13 | $16.893,80 | 222 / 14 | $16.015,30 | 221 / 16 |
Seizures W/O Mcc | 11 | 97 / 18 | $25.980,80 | 814 / 20 | $4.690,27 | 328 / 7 | $3.808,82 | 326 / 13 |
Digestive Malignancy W Cc | 11 | 36 / 8 | $27.638,60 | 109 / 3 | $7.524,09 | 39 / 5 | $6.140,09 | 39 / 3 | Total 61 procedures | 2.045 | 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.