Hospital Costs > In Texas > Texas Health Center For Diagnostics & Surgery Plan, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Spinal Fusion Except Cervical W/O Mcc | 19 | 175 / 54 | $64.304,40 | 267 / 13 | $24.553,30 | 242 / 40 | $20.114,50 | 241 / 34 |
| Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 16 | 50 / 19 | $42.572,80 | 190 / 9 | $10.505,00 | 89 / 5 | $9.299,00 | 89 / 10 |
| Combined Anterior/Posterior Spinal Fusion W/O Cc/Mcc | 14 | 33 / 6 | $144.444,00 | 53 / 7 | $47.678,00 | 25 / 12 | $31.756,50 | 25 / 4 |
| Other Skin, Subcut Tiss & Breast Proc W/O Cc/Mcc | 12 | 15 / 4 | $72.589,80 | 57 / 6 | $11.041,50 | 37 / 6 | $7.628,83 | 37 / 6 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 11 | 78 / 29 | $29.838,80 | 296 / 13 | $6.735,18 | 33 / 12 | $4.424,55 | 33 / 9 | Total 5 procedures | 72 | 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.