Hospital Costs > In South Carolina > Tuomey Healthcare System, procedure costs
Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
---|---|---|---|---|---|---|---|---|
Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
Acute Myocardial Infarction, Discharged Alive W Cc | 18 | 73 / 16 | $13.847,70 | 91 / 1 | $6.082,72 | 307 / 9 | $5.157,39 | 306 / 9 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 40 | 85 / 6 | $23.919,80 | 259 / 1 | $9.706,35 | 443 / 12 | $8.869,45 | 443 / 14 |
Amputation For Circ Sys Disorders Exc Upper Limb & Toe W Cc | 18 | 14 / 3 | $39.302,60 | 41 / 2 | $13.763,90 | 44 / 2 | $13.079,70 | 44 / 3 |
Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 11 | 55 / 6 | $59.596,30 | 346 / 5 | $11.402,90 | 190 / 3 | $10.144,10 | 189 / 4 |
Bronchitis & Asthma W Cc/Mcc | 16 | 60 / 9 | $15.132,10 | 198 / 1 | $5.748,50 | 358 / 5 | $4.466,25 | 354 / 10 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 38 | 123 / 14 | $15.030,60 | 522 / 4 | $5.257,32 | 983 / 19 | $4.274,68 | 980 / 26 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 33 | 90 / 11 | $19.089,10 | 286 / 1 | $7.429,33 | 370 / 11 | $6.162,88 | 368 / 8 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 22 | 128 / 22 | $10.084,80 | 358 / 2 | $4.242,32 | 863 / 25 | $2.720,09 | 859 / 23 |
Cellulitis W Mcc | 11 | 47 / 10 | $19.989,30 | 123 / 1 | $8.436,00 | 255 / 3 | $7.664,00 | 254 / 4 |
Cellulitis W/O Mcc | 37 | 152 / 16 | $14.859,80 | 843 / 10 | $5.640,46 | 1296 / 25 | $4.529,32 | 1290 / 35 |
Cervical Spinal Fusion W/O Cc/Mcc | 14 | 90 / 18 | $49.476,30 | 333 / 7 | $13.118,10 | 366 / 6 | $11.964,40 | 365 / 16 |
Chemotherapy W/O Acute Leukemia As Secondary Diagnosis W Cc | 47 | 44 / 2 | $15.689,00 | 41 / 1 | $6.989,83 | 95 / 3 | $6.638,85 | 95 / 4 |
Chest Pain | 17 | 134 / 16 | $8.818,35 | 98 / 1 | $4.246,65 | 797 / 17 | $3.253,47 | 792 / 18 |
Chronic Obstructive Pulmonary Disease W Cc | 62 | 117 / 12 | $19.156,90 | 919 / 7 | $6.608,23 | 1456 / 30 | $5.453,15 | 1451 / 34 |
Chronic Obstructive Pulmonary Disease W Mcc | 83 | 119 / 7 | $21.299,00 | 839 / 8 | $7.255,99 | 995 / 20 | $6.235,99 | 990 / 25 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 32 | 88 / 11 | $13.441,70 | 597 / 6 | $4.907,88 | 865 / 28 | $3.622,06 | 860 / 23 |
Diabetes W Cc | 36 | 56 / 9 | $13.996,80 | 269 / 2 | $5.548,89 | 669 / 16 | $4.491,78 | 667 / 18 |
Diabetes W Mcc | 19 | 38 / 6 | $19.766,90 | 78 / 1 | $8.500,63 | 139 / 9 | $7.195,47 | 139 / 11 |
Digestive Malignancy W Cc | 13 | 34 / 3 | $27.130,70 | 103 / 2 | $7.843,92 | 113 / 2 | $6.919,31 | 112 / 5 |
Disorders Of Pancreas Except Malignancy W Cc | 26 | 35 / 3 | $17.300,30 | 194 / 2 | $5.981,04 | 360 / 8 | $4.914,88 | 359 / 12 |
Disorders Of Pancreas Except Malignancy W Mcc | 15 | 31 / 4 | $18.361,20 | 11 / 1 | $10.398,80 | 53 / 4 | $9.201,40 | 53 / 3 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 25 | 71 / 8 | $18.597,40 | 157 / 1 | $7.368,24 | 381 / 9 | $6.399,12 | 379 / 9 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 53 | 222 / 23 | $14.521,80 | 690 / 3 | $5.056,98 | 1298 / 29 | $3.968,60 | 1287 / 36 |
Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 12 | 51 / 10 | $76.712,00 | 81 / 1 | $25.643,80 | 62 / 1 | $24.260,40 | 62 / 2 |
Fractures Of Hip & Pelvis W/O Mcc | 12 | 49 / 7 | $13.655,00 | 229 / 3 | $4.812,75 | 387 / 12 | $3.672,08 | 388 / 12 |
G.I. Hemorrhage W Cc | 89 | 129 / 11 | $14.380,20 | 255 / 4 | $6.427,30 | 1005 / 24 | $5.368,18 | 1003 / 28 |
G.I. Hemorrhage W Mcc | 38 | 83 / 10 | $24.154,10 | 150 / 2 | $10.642,20 | 435 / 14 | $9.478,34 | 436 / 13 |
G.I. Obstruction W Cc | 19 | 73 / 13 | $21.779,90 | 779 / 6 | $5.888,05 | 605 / 13 | $4.586,16 | 604 / 10 |
G.I. Obstruction W Mcc | 16 | 26 / 4 | $21.602,70 | 43 / 1 | $9.806,31 | 123 / 4 | $8.640,81 | 123 / 3 |
G.I. Obstruction W/O Cc/Mcc | 16 | 55 / 10 | $10.333,60 | 159 / 1 | $4.304,50 | 553 / 18 | $3.024,19 | 552 / 18 |
Heart Failure & Shock W Cc | 89 | 189 / 16 | $13.747,60 | 437 / 4 | $6.377,35 | 1151 / 28 | $5.403,96 | 1148 / 31 |
Heart Failure & Shock W Mcc | 166 | 118 / 4 | $21.217,70 | 492 / 5 | $9.261,44 | 1018 / 29 | $8.320,05 | 1016 / 28 |
Heart Failure & Shock W/O Cc/Mcc | 21 | 89 / 13 | $11.066,80 | 367 / 4 | $4.597,33 | 1070 / 19 | $3.807,05 | 1062 / 28 |
Hip & Femur Procedures Except Major Joint W Cc | 31 | 112 / 16 | $51.454,10 | 1095 / 16 | $11.593,60 | 668 / 18 | $10.380,70 | 665 / 19 |
Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 25 | 99 / 12 | $85.998,00 | 310 / 2 | $30.308,40 | 248 / 6 | $27.352,00 | 248 / 5 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 60 | 122 / 13 | $13.987,10 | 109 / 1 | $6.853,55 | 693 / 21 | $5.424,97 | 692 / 18 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 33 | 135 / 14 | $17.996,50 | 56 / 1 | $9.702,58 | 261 / 4 | $8.673,00 | 260 / 5 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 25 | 77 / 15 | $11.865,20 | 94 / 1 | $5.041,00 | 663 / 12 | $3.813,16 | 659 / 18 |
Kidney & Urinary Tract Infections W Mcc | 32 | 112 / 15 | $15.222,50 | 262 / 1 | $7.147,50 | 903 / 19 | $6.228,62 | 901 / 20 |
Kidney & Urinary Tract Infections W/O Mcc | 79 | 154 / 11 | $13.651,30 | 744 / 8 | $5.248,33 | 1318 / 28 | $4.181,78 | 1309 / 32 |
Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 11 | 45 / 11 | $52.060,40 | 494 / 7 | $11.873,70 | 335 / 11 | $8.802,36 | 335 / 11 |
Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 11 | 44 / 11 | $63.413,30 | 389 / 4 | $14.400,30 | 466 / 8 | $13.094,90 | 462 / 10 |
Major Cardiovasc Procedures W/O Mcc | 11 | 90 / 15 | $67.556,40 | 227 / 2 | $20.021,90 | 335 / 3 | $18.867,40 | 335 / 8 |
Major Hematol/Immun Diag Exc Sickle Cell Crisis & Coagul W Cc | 16 | 37 / 5 | $17.766,00 | 44 / 1 | $7.480,31 | 167 / 4 | $6.732,06 | 167 / 6 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 123 | 441 / 25 | $66.385,00 | 1899 / 31 | $12.894,00 | 1215 / 18 | $11.416,00 | 1185 / 31 |
Major Small & Large Bowel Procedures W Cc | 18 | 90 / 16 | $70.269,20 | 863 / 9 | $16.555,40 | 870 / 12 | $15.078,10 | 862 / 16 |
Major Small & Large Bowel Procedures W Mcc | 18 | 67 / 11 | $108.066,00 | 463 / 4 | $33.700,40 | 685 / 9 | $32.073,30 | 683 / 12 |
Major Small & Large Bowel Procedures W/O Cc/Mcc | 11 | 53 / 13 | $61.966,80 | 586 / 15 | $10.422,10 | 405 / 12 | $9.231,91 | 405 / 16 |
Malignancy Of Hepatobiliary System Or Pancreas W Cc | 11 | 20 / 3 | $32.406,60 | 85 / 1 | $8.403,82 | 33 / 3 | $5.928,55 | 33 / 1 |
Medical Back Problems W/O Mcc | 11 | 110 / 17 | $17.423,50 | 356 / 4 | $5.639,00 | 659 / 12 | $4.498,64 | 657 / 16 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 58 | 68 / 4 | $16.495,70 | 223 / 2 | $7.062,40 | 443 / 13 | $5.951,57 | 440 / 10 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 88 | 78 / 6 | $11.100,40 | 433 / 5 | $4.936,93 | 1294 / 29 | $3.884,25 | 1290 / 31 |
Organic Disturbances & Mental Retardation | 11 | 48 / 8 | $14.413,00 | 81 / 1 | $6.281,82 | 179 / 5 | $5.566,18 | 179 / 8 |
Other Circulatory System Diagnoses W Mcc | 35 | 81 / 10 | $22.433,30 | 80 / 1 | $11.156,80 | 236 / 8 | $9.722,80 | 236 / 6 |
Other Circulatory System O.R. Procedures | 15 | 40 / 5 | $53.748,90 | 118 / 4 | $15.963,70 | 88 / 5 | $14.823,10 | 88 / 6 |
Other Digestive System Diagnoses W Cc | 38 | 59 / 3 | $14.797,30 | 144 / 1 | $6.322,03 | 498 / 12 | $5.191,63 | 495 / 11 |
Other Digestive System Diagnoses W Mcc | 21 | 41 / 3 | $22.613,00 | 65 / 1 | $10.028,40 | 173 / 4 | $9.233,38 | 173 / 5 |
Other Kidney & Urinary Tract Diagnoses W Cc | 19 | 84 / 6 | $12.973,60 | 68 / 1 | $6.403,21 | 371 / 5 | $5.753,32 | 371 / 8 |
Other Kidney & Urinary Tract Diagnoses W Mcc | 22 | 79 / 7 | $31.766,40 | 436 / 2 | $11.279,10 | 657 / 9 | $9.867,32 | 655 / 11 |
Other Kidney & Urinary Tract Procedures W Mcc | 11 | 27 / 6 | $46.881,70 | 19 / 1 | $18.535,00 | 8 / 4 | $15.476,70 | 8 / 1 |
Other Resp System O.R. Procedures W Mcc | 11 | 52 / 10 | $84.463,20 | 247 / 4 | $25.128,90 | 179 / 9 | $20.303,50 | 179 / 4 |
Other Vascular Procedures W Mcc | 13 | 84 / 12 | $54.690,30 | 113 / 3 | $18.548,20 | 168 / 5 | $17.628,80 | 168 / 8 |
Peripheral Vascular Disorders W Cc | 23 | 61 / 5 | $16.429,50 | 241 / 1 | $6.217,22 | 395 / 7 | $5.096,35 | 393 / 9 |
Peripheral Vascular Disorders W Mcc | 17 | 32 / 3 | $18.815,90 | 52 / 2 | $8.320,53 | 132 / 6 | $7.211,82 | 132 / 7 |
Pulmonary Edema & Respiratory Failure | 44 | 159 / 21 | $22.828,60 | 589 / 4 | $8.462,00 | 1287 / 33 | $7.380,89 | 1284 / 36 |
Pulmonary Embolism W Mcc | 13 | 30 / 7 | $24.093,90 | 88 / 2 | $9.106,23 | 157 / 4 | $8.038,23 | 157 / 3 |
Pulmonary Embolism W/O Mcc | 22 | 52 / 11 | $11.777,20 | 67 / 1 | $6.382,36 | 556 / 10 | $5.284,00 | 553 / 13 |
Red Blood Cell Disorders W Mcc | 49 | 22 / 1 | $16.756,40 | 86 / 1 | $7.797,43 | 391 / 9 | $7.089,75 | 389 / 13 |
Red Blood Cell Disorders W/O Mcc | 103 | 43 / 5 | $13.227,20 | 287 / 4 | $5.533,33 | 671 / 25 | $4.159,13 | 667 / 16 |
Renal Failure W Cc | 112 | 109 / 9 | $15.456,60 | 503 / 3 | $6.240,89 | 1045 / 27 | $5.231,56 | 1037 / 28 |
Renal Failure W Mcc | 97 | 98 / 10 | $26.218,70 | 533 / 8 | $9.821,30 | 968 / 22 | $8.857,09 | 968 / 28 |
Renal Failure W/O Cc/Mcc | 19 | 37 / 8 | $9.679,42 | 104 / 1 | $4.371,00 | 424 / 11 | $3.385,11 | 423 / 12 |
Respiratory Infections & Inflammations W Cc | 20 | 68 / 9 | $32.528,60 | 773 / 8 | $8.757,00 | 496 / 14 | $7.335,40 | 493 / 13 |
Respiratory Infections & Inflammations W Mcc | 40 | 96 / 9 | $33.131,70 | 520 / 3 | $11.945,10 | 750 / 16 | $11.029,90 | 742 / 18 |
Respiratory Neoplasms W Mcc | 12 | 40 / 8 | $35.164,60 | 178 / 2 | $10.342,20 | 130 / 5 | $9.071,83 | 130 / 5 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 34 | 97 / 14 | $39.847,80 | 323 / 2 | $13.213,00 | 401 / 11 | $12.148,70 | 397 / 11 |
Seizures W/O Mcc | 13 | 95 / 16 | $12.415,20 | 151 / 1 | $5.142,92 | 529 / 10 | $4.102,92 | 526 / 10 |
Septicemia Or Severe Sepsis W Mv 96+ Hours | 13 | 79 / 11 | $81.538,20 | 92 / 1 | $33.005,60 | 208 / 3 | $31.912,70 | 208 / 5 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 159 | 357 / 19 | $32.181,40 | 898 / 9 | $11.399,50 | 1066 / 30 | $10.278,60 | 1053 / 29 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 36 | 171 / 24 | $16.101,10 | 446 / 3 | $6.813,36 | 979 / 25 | $5.643,47 | 976 / 24 |
Signs & Symptoms W/O Mcc | 13 | 78 / 17 | $17.286,10 | 490 / 2 | $4.852,54 | 641 / 13 | $3.930,38 | 640 / 16 |
Simple Pneumonia & Pleurisy W Cc | 39 | 164 / 22 | $15.930,20 | 675 / 10 | $6.767,97 | 1046 / 37 | $5.119,46 | 1043 / 27 |
Simple Pneumonia & Pleurisy W Mcc | 63 | 142 / 13 | $25.688,30 | 749 / 6 | $9.097,87 | 968 / 22 | $7.843,41 | 968 / 23 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 22 | 71 / 12 | $9.856,18 | 201 / 3 | $4.760,27 | 955 / 18 | $3.637,36 | 950 / 24 |
Spinal Fusion Except Cervical W/O Mcc | 15 | 179 / 25 | $92.484,70 | 660 / 9 | $23.684,50 | 314 / 9 | $20.659,80 | 313 / 8 |
Syncope & Collapse | 25 | 144 / 20 | $12.134,40 | 205 / 1 | $4.961,88 | 934 / 19 | $3.983,64 | 928 / 24 |
Transient Ischemia | 20 | 105 / 18 | $12.614,00 | 149 / 1 | $4.863,35 | 577 / 19 | $3.450,45 | 574 / 14 | Total 87 procedures | 3.055 | 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.