Hospital Costs > In Kentucky > University Of Louisville Hospital, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Psychoses | 292 | 68 / 2 | $17.455,30 | 254 / 11 | $11.162,10 | 532 / 13 | $8.778,39 | 532 / 14 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 148 | 39 / 3 | $68.099,30 | 1979 / 33 | $11.597,50 | 1950 / 33 | $9.567,68 | 1946 / 33 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 122 | 52 / 3 | $87.914,00 | 1423 / 24 | $16.988,80 | 1433 / 23 | $14.572,10 | 1426 / 24 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 80 | 436 / 28 | $85.236,50 | 2494 / 58 | $17.598,80 | 2517 / 58 | $15.379,70 | 2473 / 59 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 73 | 29 / 2 | $51.997,50 | 1513 / 24 | $8.559,71 | 1509 / 24 | $6.918,42 | 1505 / 24 |
| Seizures W/O Mcc | 71 | 37 / 2 | $30.549,00 | 974 / 21 | $8.441,00 | 1176 / 21 | $6.869,18 | 1174 / 22 |
| Medical Back Problems W/O Mcc | 54 | 67 / 3 | $33.382,40 | 1121 / 25 | $9.215,74 | 1361 / 24 | $7.250,33 | 1356 / 25 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 52 | 223 / 23 | $26.817,80 | 1988 / 52 | $8.392,52 | 2556 / 56 | $6.985,75 | 2541 / 57 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 45 | 10 / 1 | $108.644,00 | 599 / 11 | $17.405,10 | 541 / 10 | $15.079,60 | 537 / 11 |
| Red Blood Cell Disorders W/O Mcc | 45 | 98 / 8 | $29.774,50 | 1491 / 43 | $8.637,27 | 1874 / 44 | $7.699,49 | 1865 / 45 |
| Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 43 | 38 / 3 | $554.263,00 | 301 / 8 | $134.238,00 | 235 / 6 | $114.399,00 | 234 / 4 |
| Transient Ischemia | 42 | 83 / 11 | $44.708,00 | 1513 / 32 | $8.044,10 | 1574 / 31 | $6.569,64 | 1566 / 32 |
| Craniotomy & Endovascular Intracranial Procedures W Mcc | 42 | 56 / 3 | $167.326,00 | 390 / 12 | $35.501,80 | 364 / 11 | $32.595,50 | 364 / 12 |
| Major Small & Large Bowel Procedures W Cc | 38 | 70 / 8 | $139.923,00 | 1417 / 30 | $24.263,60 | 1357 / 30 | $19.931,80 | 1343 / 30 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 37 | 129 / 16 | $26.809,70 | 1986 / 57 | $8.054,38 | 2415 / 59 | $6.922,49 | 2406 / 60 |
| Heart Failure & Shock W Cc | 37 | 241 / 27 | $34.410,60 | 2155 / 54 | $9.918,43 | 2528 / 56 | $8.533,62 | 2522 / 57 |
| Renal Failure W Cc | 35 | 186 / 27 | $35.341,10 | 1910 / 47 | $9.743,20 | 2219 / 47 | $8.254,43 | 2209 / 48 |
| Degenerative Nervous System Disorders W/O Mcc | 34 | 44 / 2 | $36.302,10 | 619 / 14 | $10.072,20 | 758 / 14 | $8.610,06 | 758 / 15 |
| Hip & Femur Procedures Except Major Joint W Cc | 34 | 109 / 14 | $108.928,00 | 1942 / 36 | $17.207,20 | 1813 / 35 | $15.119,90 | 1794 / 36 |
| Kidney & Urinary Tract Infections W/O Mcc | 32 | 201 / 31 | $28.295,50 | 2145 / 58 | $8.616,69 | 2556 / 59 | $7.111,19 | 2545 / 60 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 31 | 41 / 5 | $93.455,30 | 944 / 20 | $14.740,10 | 874 / 19 | $12.396,50 | 871 / 20 |
| Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W/O Maj O.R. | 31 | 33 / 4 | $347.025,00 | 381 / 9 | $79.190,20 | 352 / 6 | $72.189,00 | 352 / 6 |
| G.I. Hemorrhage W Cc | 31 | 187 / 24 | $39.622,40 | 1944 / 50 | $10.181,90 | 2224 / 50 | $8.579,81 | 2220 / 51 |
| Chronic Obstructive Pulmonary Disease W Mcc | 30 | 172 / 32 | $39.612,20 | 1904 / 58 | $11.912,40 | 2307 / 60 | $9.451,67 | 2299 / 60 |
| Heart Failure & Shock W Mcc | 27 | 257 / 37 | $56.265,70 | 2129 / 53 | $14.338,40 | 2370 / 56 | $12.553,70 | 2360 / 56 |
| Syncope & Collapse | 27 | 142 / 20 | $33.117,10 | 1533 / 37 | $7.854,30 | 1699 / 37 | $6.129,33 | 1691 / 37 |
| Major Small & Large Bowel Procedures W Mcc | 27 | 58 / 8 | $188.754,00 | 1003 / 21 | $43.442,60 | 1027 / 20 | $38.310,70 | 1025 / 20 |
| Organic Disturbances & Mental Retardation | 26 | 33 / 1 | $32.261,70 | 372 / 10 | $11.313,60 | 485 / 10 | $8.917,65 | 485 / 11 |
| Other Digestive System Diagnoses W Cc | 26 | 71 / 6 | $29.673,50 | 851 / 23 | $10.163,10 | 1329 / 24 | $8.762,42 | 1325 / 25 |
| Chemotherapy W/O Acute Leukemia As Secondary Diagnosis W Cc | 26 | 65 / 2 | $60.090,80 | 350 / 9 | $10.710,80 | 326 / 8 | $9.763,96 | 326 / 9 |
| Simple Pneumonia & Pleurisy W Cc | 25 | 178 / 40 | $40.139,40 | 2330 / 64 | $9.492,64 | 2484 / 64 | $7.635,04 | 2475 / 65 |
| Diabetes W Cc | 25 | 67 / 11 | $31.263,60 | 1217 / 29 | $8.856,96 | 1462 / 29 | $7.436,20 | 1457 / 30 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 25 | 106 / 19 | $120.311,00 | 1680 / 43 | $22.556,80 | 1533 / 42 | $18.053,20 | 1519 / 42 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 25 | 41 / 2 | $48.128,60 | 410 / 6 | $11.381,20 | 456 / 6 | $9.181,52 | 455 / 7 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 25 | 36 / 3 | $24.821,20 | 644 / 14 | $7.699,56 | 829 / 15 | $6.248,44 | 828 / 16 |
| Chronic Obstructive Pulmonary Disease W Cc | 24 | 155 / 31 | $23.220,50 | 1321 / 46 | $9.746,62 | 2240 / 58 | $8.035,92 | 2233 / 58 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 23 | 103 / 18 | $31.490,40 | 1025 / 26 | $10.710,90 | 1486 / 29 | $9.321,39 | 1483 / 29 |
| Signs & Symptoms W/O Mcc | 23 | 68 / 8 | $34.292,00 | 1114 / 24 | $8.082,87 | 1236 / 24 | $6.710,78 | 1233 / 25 |
| Traumatic Stupor & Coma, Coma >1 Hr W Cc | 22 | 3 / 1 | $54.916,10 | 26 / 2 | $12.697,00 | 31 / 2 | $10.508,90 | 31 / 2 |
| Cranio W Major Dev Impl/Acute Complex Cns Pdx W Mcc Or Chemo Implant | 22 | 20 / 2 | $182.146,00 | 120 / 3 | $37.365,50 | 64 / 2 | $33.967,70 | 64 / 2 |
| Simple Pneumonia & Pleurisy W Mcc | 22 | 183 / 36 | $49.472,10 | 1900 / 54 | $12.732,90 | 2175 / 54 | $11.091,90 | 2170 / 54 |
| Traumatic Stupor & Coma, Coma <1 Hr W/O Cc/Mcc | 22 | 32 / 2 | $22.008,50 | 195 / 5 | $7.969,86 | 347 / 6 | $6.252,45 | 347 / 6 |
| Traumatic Stupor & Coma, Coma <1 Hr W Mcc | 22 | 29 / 1 | $68.718,10 | 237 / 7 | $18.480,00 | 278 / 6 | $16.341,00 | 278 / 7 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 21 | 543 / 36 | $107.031,00 | 2542 / 48 | $18.879,40 | 2433 / 48 | $16.601,50 | 2387 / 48 |
| Renal Failure W Mcc | 21 | 174 / 30 | $54.008,00 | 1659 / 43 | $14.680,90 | 1902 / 44 | $12.745,20 | 1898 / 45 |
| Traumatic Stupor & Coma, Coma >1 Hr W/O Cc/Mcc | 21 | 2 / 1 | $28.464,50 | 15 / 1 | $9.139,38 | 14 / 1 | $7.265,52 | 14 / 1 |
| Major Chest Trauma W Cc | 20 | 16 / 2 | $37.606,20 | 89 / 1 | $12.091,40 | 55 / 1 | $5.363,80 | 55 / 1 |
| Nervous System Neoplasms W Mcc | 20 | 28 / 3 | $50.477,90 | 217 / 6 | $12.934,20 | 254 / 5 | $11.174,30 | 254 / 6 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 19 | 105 / 10 | $25.065,50 | 619 / 14 | $8.050,53 | 762 / 13 | $6.736,63 | 761 / 14 |
| Postoperative & Post-Traumatic Infections W/O Mcc | 19 | 35 / 3 | $35.824,60 | 339 / 8 | $10.208,30 | 404 / 8 | $8.937,68 | 404 / 8 |
| Traumatic Stupor & Coma, Coma >1 Hr W Mcc | 19 | 8 / 2 | $78.908,80 | 44 / 1 | $18.071,20 | 36 / 1 | $15.906,20 | 36 / 1 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 19 | 72 / 16 | $37.954,30 | 982 / 27 | $10.917,20 | 1289 / 28 | $8.576,05 | 1287 / 29 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 18 | 74 / 8 | $275.177,00 | 955 / 20 | $52.440,10 | 921 / 18 | $48.094,60 | 920 / 19 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 18 | 29 / 5 | $87.679,90 | 488 / 14 | $14.841,20 | 488 / 13 | $13.145,60 | 488 / 14 |
| Other O.R. Procedures For Multiple Significant Trauma W Cc | 17 | 4 / 2 | $189.826,00 | 9 / 2 | $33.953,10 | 3 / 1 | $27.553,60 | 3 / 1 |
| Red Blood Cell Disorders W Mcc | 17 | 54 / 11 | $70.950,80 | 1036 / 22 | $13.240,40 | 1004 / 21 | $11.385,90 | 1000 / 22 |
| Non-Extensive Burns | 17 | 12 / 1 | $57.430,50 | 29 / 1 | $13.888,80 | 16 / 1 | $11.535,20 | 16 / 1 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 17 | 54 / 12 | $209.716,00 | 777 / 21 | $43.429,40 | 775 / 20 | $39.353,80 | 774 / 20 |
| Medical Back Problems W Mcc | 17 | 22 / 4 | $58.518,90 | 247 / 3 | $16.342,50 | 238 / 3 | $11.302,50 | 238 / 4 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 17 | 47 / 7 | $72.262,50 | 648 / 14 | $14.557,20 | 620 / 13 | $11.562,30 | 620 / 14 |
| G.I. Hemorrhage W Mcc | 17 | 104 / 19 | $86.930,40 | 1492 / 26 | $17.011,20 | 1481 / 25 | $14.905,20 | 1471 / 26 |
| Acute Ischemic Stroke W Use Of Thrombolytic Agent W Cc | 16 | 15 / 3 | $85.923,40 | 121 / 4 | $16.587,60 | 129 / 3 | $14.641,80 | 129 / 4 |
| Cranial & Peripheral Nerve Disorders W/O Mcc | 16 | 52 / 7 | $42.108,60 | 631 / 10 | $9.186,31 | 643 / 8 | $7.455,38 | 643 / 9 |
| Chest Pain | 16 | 135 / 23 | $22.523,90 | 1087 / 34 | $7.107,31 | 1574 / 38 | $5.893,62 | 1565 / 38 |
| Cellulitis W/O Mcc | 15 | 174 / 34 | $41.682,50 | 2446 / 57 | $8.716,47 | 2401 / 57 | $7.158,20 | 2393 / 58 |
| Other Disorders Of Nervous System W/O Cc/Mcc | 15 | 20 / 1 | $37.463,30 | 129 / 3 | $7.741,47 | 134 / 3 | $6.279,00 | 134 / 3 |
| Endocrine Disorders W Cc | 14 | 24 / 3 | $35.299,10 | 213 / 2 | $10.597,50 | 270 / 3 | $9.194,29 | 270 / 3 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 14 | 174 / 23 | $54.604,60 | 1306 / 30 | $10.924,40 | 1500 / 29 | $9.247,36 | 1497 / 29 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 14 | 111 / 24 | $75.683,90 | 1515 / 33 | $16.076,90 | 1587 / 32 | $13.889,60 | 1574 / 32 |
| Respiratory Neoplasms W Mcc | 14 | 38 / 9 | $73.925,90 | 523 / 17 | $15.517,60 | 539 / 17 | $13.393,80 | 536 / 18 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 14 | 48 / 6 | $32.119,40 | 631 / 13 | $10.033,50 | 679 / 14 | $5.744,00 | 677 / 14 |
| G.I. Obstruction W Cc | 14 | 78 / 19 | $23.934,10 | 920 / 30 | $8.641,64 | 1556 / 34 | $7.061,00 | 1551 / 34 |
| Hip & Femur Procedures Except Major Joint W Mcc | 14 | 48 / 13 | $194.531,00 | 945 / 17 | $30.011,40 | 904 / 17 | $26.899,30 | 901 / 17 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 14 | 49 / 8 | $199.958,00 | 630 / 14 | $41.491,50 | 620 / 11 | $38.653,10 | 620 / 13 |
| Other Multiple Significant Trauma W Cc | 13 | 12 / 2 | $88.006,80 | 42 / 2 | $14.584,20 | 29 / 1 | $10.795,20 | 29 / 2 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 13 | 107 / 36 | $16.568,20 | 976 / 42 | $7.804,69 | 1990 / 56 | $6.660,54 | 1979 / 57 |
| Pulmonary Edema & Respiratory Failure | 13 | 190 / 39 | $50.160,40 | 1761 / 51 | $12.208,10 | 2060 / 51 | $10.756,10 | 2054 / 52 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 13 | 111 / 20 | $286.769,00 | 1490 / 24 | $51.725,60 | 1449 / 22 | $47.587,20 | 1439 / 23 |
| Pulmonary Embolism W/O Mcc | 13 | 61 / 11 | $28.278,10 | 780 / 14 | $9.966,23 | 1220 / 16 | $8.819,15 | 1217 / 17 |
| Headaches W/O Mcc | 13 | 30 / 4 | $28.436,50 | 158 / 7 | $7.652,00 | 210 / 7 | $5.868,23 | 210 / 7 |
| Limb Reattachment, Hip & Femur Proc For Multiple Significant Trauma | 13 | 9 / 2 | $275.664,00 | 59 / 2 | $39.255,70 | 52 / 1 | $34.723,20 | 52 / 2 |
| Signs & Symptoms W Mcc | 13 | 28 / 5 | $89.249,90 | 278 / 6 | $12.633,50 | 252 / 5 | $11.114,20 | 252 / 6 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 13 | 83 / 16 | $65.412,70 | 1329 / 26 | $12.594,80 | 1326 / 25 | $10.732,90 | 1321 / 26 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 13 | 148 / 33 | $34.080,60 | 1776 / 41 | $8.578,77 | 1998 / 40 | $7.029,00 | 1993 / 41 |
| Kidney & Ureter Procedures For Neoplasm W Cc | 13 | 31 / 2 | $108.375,00 | 160 / 6 | $18.257,60 | 133 / 5 | $15.927,80 | 133 / 5 |
| Other Resp System O.R. Procedures W Mcc | 13 | 50 / 11 | $165.515,00 | 506 / 13 | $31.105,00 | 478 / 12 | $27.953,50 | 477 / 13 |
| Depressive Neuroses | 13 | 37 / 6 | $21.315,20 | 120 / 10 | $8.436,08 | 121 / 10 | $6.472,38 | 121 / 10 |
| Craniotomy & Endovascular Intracranial Procedures W Cc | 12 | 43 / 4 | $171.476,00 | 216 / 5 | $28.467,50 | 198 / 5 | $26.064,10 | 198 / 5 |
| Other Disorders Of Nervous System W Mcc | 12 | 28 / 5 | $79.807,80 | 285 / 5 | $17.353,70 | 280 / 5 | $13.667,10 | 280 / 5 |
| Other Multiple Significant Trauma W Mcc | 12 | 11 / 2 | $101.905,00 | 15 / 1 | $23.475,60 | 9 / 1 | $19.242,80 | 9 / 1 |
| Non-Extensive O.R. Proc Unrelated To Principal Diagnosis W Cc | 12 | 15 / 4 | $75.408,30 | 57 / 5 | $16.151,30 | 62 / 5 | $14.080,10 | 62 / 5 |
| Uterine & Adnexa Proc For Ovarian Or Adnexal Malignancy W Cc | 12 | 14 / 2 | $112.734,00 | 57 / 2 | $18.971,20 | 45 / 2 | $16.344,90 | 45 / 2 |
| Other O.R. Procedures For Multiple Significant Trauma W Mcc | 12 | 11 / 2 | $269.633,00 | 26 / 2 | $55.837,20 | 21 / 1 | $51.396,70 | 21 / 2 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 12 | 195 / 32 | $52.672,80 | 2308 / 49 | $11.130,10 | 2417 / 48 | $9.579,58 | 2407 / 49 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Mcc | 12 | 11 / 1 | $155.606,00 | 49 / 1 | $28.400,20 | 41 / 1 | $24.458,10 | 41 / 1 |
| Trauma To The Skin, Subcut Tiss & Breast W/O Mcc | 12 | 32 / 2 | $30.563,90 | 197 / 3 | $8.233,25 | 195 / 3 | $4.951,75 | 195 / 3 |
| Kidney & Urinary Tract Infections W Mcc | 12 | 132 / 29 | $39.007,80 | 1473 / 35 | $10.536,50 | 1757 / 38 | $9.220,17 | 1753 / 38 |
| Uterine & Adnexa Proc For Non-Malignancy W/O Cc/Mcc | 12 | 34 / 3 | $68.481,40 | 246 / 3 | $10.218,80 | 230 / 2 | $8.485,75 | 230 / 3 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 12 | 64 / 7 | $86.733,90 | 464 / 9 | $16.977,70 | 430 / 9 | $14.948,70 | 430 / 9 |
| Other Ear, Nose, Mouth & Throat O.R. Procedures W/O Cc/Mcc | 12 | 7 / 1 | $61.492,90 | 14 / 1 | $9.864,17 | 10 / 1 | $8.371,50 | 10 / 1 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Cc | 11 | 33 / 6 | $136.455,00 | 389 / 9 | $25.422,50 | 371 / 8 | $22.990,20 | 369 / 9 |
| Spinal Fusion Except Cervical W/O Mcc | 11 | 183 / 14 | $193.197,00 | 1254 / 14 | $35.098,60 | 1255 / 14 | $32.945,80 | 1250 / 14 |
| Revision Of Hip Or Knee Replacement W Cc | 11 | 75 / 9 | $171.284,00 | 634 / 13 | $27.417,80 | 582 / 12 | $25.719,70 | 580 / 13 |
| Seizures W Mcc | 11 | 55 / 10 | $67.450,30 | 623 / 12 | $14.217,80 | 615 / 13 | $12.503,10 | 615 / 13 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 11 | 62 / 15 | $52.762,00 | 969 / 19 | $11.468,90 | 1021 / 18 | $9.880,55 | 1019 / 19 |
| Other Digestive System Diagnoses W Mcc | 11 | 51 / 9 | $63.549,60 | 585 / 10 | $15.582,70 | 574 / 11 | $12.749,80 | 573 / 11 |
| Other Circulatory System Diagnoses W Mcc | 11 | 105 / 14 | $134.921,00 | 1360 / 24 | $23.390,60 | 1350 / 24 | $20.836,60 | 1342 / 24 |
| Heart Failure & Shock W/O Cc/Mcc | 11 | 99 / 30 | $18.676,10 | 1202 / 39 | $7.608,73 | 1887 / 45 | $6.338,09 | 1874 / 45 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 10 | $27.316,00 | 459 / 11 | $9.828,73 | 762 / 13 | $8.755,09 | 762 / 14 | Total 109 procedures | 2.891 | 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.