Hospital Costs > In Wisconsin > The Monroe Clinic, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 100 | 464 / 35 | $38.668,40 | 682 / 24 | $13.671,50 | 1517 / 28 | $12.090,70 | 1482 / 44 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 69 | 447 / 36 | $40.584,50 | 1344 / 49 | $11.984,00 | 1508 / 37 | $11.029,40 | 1478 / 42 |
| Simple Pneumonia & Pleurisy W Cc | 63 | 140 / 8 | $23.705,00 | 1511 / 50 | $6.364,81 | 1227 / 28 | $5.246,17 | 1223 / 31 |
| Cellulitis W/O Mcc | 40 | 149 / 17 | $16.853,00 | 1107 / 39 | $5.317,75 | 958 / 20 | $4.244,55 | 952 / 29 |
| Heart Failure & Shock W Mcc | 33 | 251 / 29 | $29.891,40 | 1078 / 45 | $9.880,55 | 1141 / 38 | $8.488,76 | 1138 / 33 |
| Heart Failure & Shock W Cc | 31 | 247 / 28 | $19.920,30 | 1179 / 45 | $6.308,00 | 1221 / 32 | $5.470,87 | 1218 / 37 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 26 | 181 / 29 | $28.846,70 | 1548 / 54 | $6.744,62 | 1184 / 32 | $5.852,81 | 1179 / 36 |
| Chronic Obstructive Pulmonary Disease W Cc | 20 | 159 / 17 | $19.836,20 | 985 / 26 | $5.887,05 | 943 / 19 | $4.909,40 | 940 / 19 |
| Respiratory Infections & Inflammations W Cc | 20 | 68 / 9 | $29.941,20 | 683 / 21 | $8.351,20 | 537 / 13 | $7.426,45 | 534 / 14 |
| Heart Failure & Shock W/O Cc/Mcc | 20 | 90 / 13 | $19.920,10 | 1285 / 28 | $4.234,05 | 278 / 10 | $3.068,40 | 276 / 7 |
| G.I. Hemorrhage W Cc | 19 | 199 / 33 | $18.330,80 | 594 / 19 | $6.325,89 | 1113 / 25 | $5.484,32 | 1111 / 33 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 18 | 148 / 24 | $19.224,70 | 1473 / 42 | $4.814,83 | 471 / 27 | $3.290,78 | 471 / 11 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 17 | 258 / 30 | $22.260,60 | 1655 / 53 | $4.760,12 | 1084 / 18 | $3.814,47 | 1076 / 27 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 16 | 180 / 21 | $55.545,90 | 359 / 14 | $12.906,30 | 830 / 7 | $11.767,40 | 824 / 20 |
| Simple Pneumonia & Pleurisy W Mcc | 16 | 189 / 34 | $26.551,50 | 807 / 31 | $8.871,25 | 996 / 25 | $7.869,25 | 996 / 26 |
| Kidney & Urinary Tract Infections W/O Mcc | 15 | 218 / 34 | $15.493,10 | 1010 / 27 | $4.867,53 | 902 / 22 | $3.889,80 | 895 / 23 |
| G.I. Obstruction W Cc | 15 | 77 / 14 | $25.847,40 | 1034 / 32 | $5.625,47 | 650 / 15 | $4.637,47 | 649 / 17 |
| Renal Failure W Cc | 14 | 207 / 33 | $17.845,40 | 765 / 23 | $5.920,86 | 647 / 21 | $4.874,93 | 641 / 22 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 14 | 168 / 25 | $26.027,50 | 859 / 28 | $6.785,93 | 818 / 22 | $5.570,36 | 816 / 20 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 14 | 79 / 14 | $17.038,30 | 931 / 23 | $4.443,00 | 666 / 8 | $3.387,93 | 663 / 9 |
| Chronic Obstructive Pulmonary Disease W Mcc | 14 | 188 / 27 | $33.812,90 | 1683 / 50 | $7.432,79 | 1126 / 25 | $6.371,21 | 1121 / 25 |
| Pulmonary Embolism W/O Mcc | 14 | 60 / 9 | $22.317,70 | 511 / 21 | $6.185,50 | 602 / 11 | $5.369,79 | 599 / 15 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 13 | 51 / 6 | $42.815,80 | 347 / 5 | $10.369,50 | 433 / 2 | $9.431,62 | 433 / 4 |
| Hip & Femur Procedures Except Major Joint W Cc | 13 | 130 / 25 | $41.220,00 | 692 / 27 | $12.240,70 | 1094 / 26 | $11.289,20 | 1080 / 33 |
| Major Small & Large Bowel Procedures W Cc | 11 | 97 / 19 | $61.954,70 | 679 / 22 | $17.045,70 | 645 / 12 | $14.137,90 | 639 / 14 |
| Respiratory Infections & Inflammations W/O Cc/Mcc | 11 | 18 / 3 | $22.501,80 | 52 / 4 | $6.082,45 | 39 / 2 | $5.070,45 | 39 / 2 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 11 | 150 / 29 | $23.265,50 | 1303 / 41 | $5.366,45 | 379 / 25 | $3.710,82 | 379 / 12 | Total 27 procedures | 667 | 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.