Hospital Costs > In Pennsylvania > Upmc Altoona, 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 | 217 | 299 / 25 | $34.881,20 | 1044 / 51 | $11.431,90 | 974 / 53 | $10.150,10 | 966 / 57 |
| Psychoses | 198 | 118 / 4 | $20.511,20 | 340 / 16 | $6.873,05 | 152 / 12 | $5.328,07 | 152 / 12 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 126 | 438 / 46 | $33.257,20 | 366 / 24 | $12.594,90 | 472 / 43 | $10.272,40 | 469 / 37 |
| Heart Failure & Shock W Cc | 106 | 172 / 27 | $21.277,00 | 1326 / 62 | $6.550,79 | 1335 / 66 | $5.585,36 | 1331 / 76 |
| G.I. Hemorrhage W Cc | 96 | 122 / 15 | $19.665,30 | 721 / 42 | $6.463,10 | 924 / 48 | $5.294,24 | 922 / 51 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 95 | 180 / 27 | $21.433,50 | 1550 / 70 | $5.572,01 | 1427 / 86 | $4.065,28 | 1416 / 81 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 92 | 96 / 10 | $26.741,90 | 366 / 21 | $7.156,85 | 762 / 29 | $5.834,14 | 760 / 37 |
| Heart Failure & Shock W Mcc | 90 | 194 / 27 | $32.247,30 | 1228 / 58 | $9.663,79 | 1079 / 66 | $8.408,80 | 1076 / 65 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 90 | 106 / 9 | $52.955,90 | 280 / 9 | $12.592,20 | 590 / 16 | $10.921,50 | 586 / 26 |
| Renal Failure W Mcc | 82 | 113 / 9 | $29.732,30 | 748 / 40 | $9.876,27 | 907 / 46 | $8.734,39 | 907 / 52 |
| Simple Pneumonia & Pleurisy W Mcc | 80 | 125 / 11 | $26.164,10 | 782 / 38 | $8.966,39 | 901 / 47 | $7.760,39 | 901 / 53 |
| Cellulitis W/O Mcc | 77 | 112 / 22 | $15.223,20 | 885 / 50 | $5.804,26 | 1116 / 69 | $4.362,00 | 1110 / 70 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 77 | 48 / 5 | $31.401,80 | 493 / 31 | $10.372,70 | 615 / 41 | $9.249,29 | 614 / 47 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 70 | 112 / 20 | $24.136,50 | 739 / 36 | $6.712,36 | 804 / 39 | $5.554,20 | 802 / 48 |
| Renal Failure W Cc | 64 | 157 / 29 | $23.197,00 | 1290 / 59 | $6.308,05 | 912 / 54 | $5.093,59 | 904 / 56 |
| Chronic Obstructive Pulmonary Disease W Cc | 64 | 115 / 21 | $19.415,30 | 944 / 47 | $6.222,05 | 700 / 60 | $4.725,89 | 698 / 49 |
| Simple Pneumonia & Pleurisy W Cc | 64 | 139 / 22 | $20.446,50 | 1171 / 52 | $6.259,78 | 924 / 53 | $5.022,92 | 921 / 59 |
| Respiratory Infections & Inflammations W Mcc | 60 | 76 / 5 | $31.912,00 | 459 / 24 | $11.438,50 | 296 / 26 | $10.013,80 | 296 / 21 |
| Transient Ischemia | 58 | 67 / 10 | $18.380,00 | 542 / 34 | $4.841,60 | 784 / 44 | $3.683,67 | 780 / 53 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 58 | 110 / 12 | $32.467,90 | 423 / 16 | $10.860,10 | 553 / 32 | $9.469,45 | 552 / 30 |
| G.I. Hemorrhage W Mcc | 57 | 64 / 7 | $29.842,10 | 322 / 19 | $10.728,90 | 429 / 29 | $9.461,77 | 430 / 28 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 57 | 74 / 9 | $45.939,60 | 512 / 26 | $14.051,10 | 453 / 33 | $12.332,00 | 448 / 32 |
| Kidney & Urinary Tract Infections W Mcc | 53 | 91 / 8 | $25.507,30 | 951 / 43 | $7.231,83 | 840 / 45 | $6.146,36 | 838 / 50 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 52 | 48 / 3 | $74.255,90 | 217 / 8 | $20.112,70 | 355 / 11 | $18.354,70 | 353 / 15 |
| Hip & Femur Procedures Except Major Joint W Cc | 50 | 93 / 14 | $32.506,70 | 313 / 20 | $11.454,90 | 655 / 25 | $10.354,90 | 652 / 38 |
| Kidney & Urinary Tract Infections W/O Mcc | 44 | 189 / 48 | $15.852,80 | 1056 / 54 | $5.131,73 | 1006 / 60 | $3.966,23 | 998 / 58 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 43 | 164 / 40 | $19.714,30 | 755 / 41 | $6.836,47 | 967 / 51 | $5.632,79 | 964 / 57 |
| Chronic Obstructive Pulmonary Disease W Mcc | 42 | 160 / 33 | $21.423,80 | 852 / 46 | $7.244,33 | 825 / 47 | $6.072,38 | 820 / 52 |
| Syncope & Collapse | 38 | 131 / 32 | $19.696,90 | 827 / 44 | $5.000,92 | 837 / 50 | $3.882,61 | 833 / 57 |
| Pulmonary Edema & Respiratory Failure | 37 | 166 / 30 | $28.152,60 | 916 / 44 | $8.228,89 | 1066 / 58 | $7.037,97 | 1064 / 60 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 37 | 86 / 21 | $22.387,80 | 483 / 31 | $7.845,68 | 476 / 44 | $6.346,11 | 473 / 38 |
| Circulatory Disorders Except Ami, W Card Cath W Mcc | 36 | 57 / 8 | $33.387,10 | 71 / 6 | $12.646,10 | 327 / 9 | $11.694,00 | 322 / 12 |
| Medical Back Problems W/O Mcc | 35 | 86 / 21 | $19.713,30 | 498 / 24 | $5.391,31 | 362 / 25 | $4.051,89 | 362 / 27 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 35 | 89 / 19 | $85.406,00 | 305 / 13 | $31.437,60 | 537 / 32 | $29.820,50 | 533 / 36 |
| Heart Failure & Shock W/O Cc/Mcc | 34 | 76 / 25 | $18.137,60 | 1163 / 57 | $5.124,29 | 1066 / 77 | $3.804,76 | 1058 / 68 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 34 | 127 / 33 | $16.318,10 | 668 / 34 | $5.339,03 | 829 / 50 | $4.133,26 | 826 / 57 |
| Cellulitis W Mcc | 31 | 27 / 3 | $25.706,70 | 268 / 10 | $8.659,68 | 202 / 18 | $7.446,10 | 201 / 18 |
| Seizures W/O Mcc | 29 | 79 / 19 | $16.379,00 | 331 / 19 | $5.095,52 | 503 / 27 | $4.063,83 | 500 / 37 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 29 | 64 / 15 | $15.322,60 | 767 / 35 | $4.846,24 | 572 / 49 | $3.293,21 | 570 / 40 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 29 | 121 / 38 | $12.343,30 | 639 / 34 | $3.998,21 | 1098 / 55 | $2.909,31 | 1093 / 74 |
| Other Circulatory System Diagnoses W Mcc | 27 | 89 / 19 | $36.571,10 | 389 / 10 | $11.748,90 | 509 / 19 | $10.795,10 | 507 / 29 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 27 | 75 / 24 | $18.356,40 | 458 / 26 | $5.300,30 | 623 / 44 | $3.762,93 | 619 / 43 |
| Extracranial Procedures W/O Cc/Mcc | 27 | 71 / 8 | $20.114,00 | 138 / 10 | $6.669,04 | 437 / 13 | $5.575,19 | 436 / 21 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 26 | 75 / 17 | $21.544,50 | 154 / 6 | $8.908,19 | 38 / 8 | $7.100,31 | 38 / 5 |
| Permanent Cardiac Pacemaker Implant W Cc | 25 | 52 / 9 | $48.768,20 | 200 / 13 | $15.877,90 | 321 / 12 | $14.716,10 | 320 / 18 |
| Spinal Fusion Except Cervical W/O Mcc | 24 | 170 / 29 | $78.444,50 | 505 / 32 | $23.772,30 | 636 / 20 | $22.703,30 | 632 / 36 |
| Pulmonary Embolism W Mcc | 24 | 19 / 2 | $31.002,50 | 179 / 4 | $9.394,04 | 176 / 8 | $8.137,04 | 176 / 6 |
| Respiratory Infections & Inflammations W Cc | 24 | 64 / 19 | $25.383,80 | 487 / 21 | $8.177,42 | 376 / 20 | $7.119,25 | 373 / 21 |
| Major Small & Large Bowel Procedures W Cc | 24 | 84 / 23 | $38.623,30 | 165 / 8 | $15.024,80 | 529 / 12 | $13.713,80 | 523 / 26 |
| Diabetes W Cc | 23 | 69 / 17 | $19.716,10 | 676 / 28 | $5.832,22 | 845 / 37 | $4.794,52 | 841 / 49 |
| Major Small & Large Bowel Procedures W Mcc | 23 | 62 / 15 | $75.757,80 | 167 / 6 | $26.675,20 | 119 / 7 | $25.286,00 | 119 / 8 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 22 | 98 / 30 | $14.950,60 | 776 / 38 | $4.951,68 | 972 / 53 | $3.711,45 | 963 / 62 |
| Pulmonary Embolism W/O Mcc | 22 | 52 / 18 | $18.692,30 | 324 / 14 | $5.891,41 | 427 / 14 | $5.047,41 | 426 / 27 |
| Hip & Femur Procedures Except Major Joint W Mcc | 22 | 40 / 7 | $50.397,70 | 166 / 5 | $17.588,90 | 185 / 4 | $15.784,10 | 184 / 7 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 22 | 70 / 13 | $102.520,00 | 197 / 7 | $33.546,20 | 235 / 9 | $32.166,50 | 234 / 14 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 21 | 70 / 20 | $22.552,00 | 398 / 23 | $6.940,29 | 649 / 41 | $5.761,38 | 647 / 47 |
| Other Digestive System Diagnoses W Cc | 21 | 76 / 23 | $22.265,10 | 528 / 24 | $6.386,62 | 527 / 26 | $5.245,19 | 524 / 39 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 21 | 32 / 6 | $19.676,20 | 287 / 15 | $5.643,76 | 186 / 33 | $3.539,90 | 185 / 13 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 21 | 75 / 20 | $21.777,90 | 291 / 9 | $7.221,81 | 226 / 14 | $6.061,62 | 225 / 20 |
| G.I. Obstruction W/O Cc/Mcc | 21 | 50 / 15 | $11.804,80 | 267 / 10 | $4.366,29 | 610 / 30 | $3.105,24 | 609 / 32 |
| Permanent Cardiac Pacemaker Implant W Mcc | 20 | 32 / 6 | $56.229,90 | 61 / 3 | $22.311,60 | 218 / 11 | $21.093,20 | 218 / 12 |
| Bronchitis & Asthma W Cc/Mcc | 20 | 56 / 18 | $19.623,10 | 367 / 13 | $5.952,10 | 374 / 26 | $4.494,35 | 370 / 31 |
| G.I. Obstruction W Cc | 20 | 72 / 26 | $14.142,80 | 231 / 13 | $6.025,25 | 811 / 37 | $4.820,65 | 809 / 42 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 19 | 147 / 49 | $18.631,10 | 1404 / 65 | $4.700,37 | 1204 / 48 | $3.814,21 | 1200 / 64 |
| Degenerative Nervous System Disorders W/O Mcc | 19 | 59 / 17 | $31.409,50 | 533 / 27 | $8.253,42 | 572 / 37 | $6.557,42 | 572 / 39 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 19 | 47 / 12 | $24.511,90 | 153 / 5 | $7.127,84 | 136 / 6 | $5.805,26 | 136 / 8 |
| Major Cardiovasc Procedures W/O Mcc | 18 | 83 / 19 | $80.531,60 | 381 / 16 | $22.219,50 | 232 / 25 | $18.043,10 | 232 / 9 |
| Major Cardiovasc Procedures W Mcc | 17 | 51 / 10 | $126.551,00 | 240 / 8 | $38.228,00 | 407 / 17 | $36.311,20 | 406 / 22 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Mcc | 17 | 23 / 2 | $39.155,50 | 38 / 3 | $14.886,80 | 134 / 3 | $13.587,20 | 133 / 4 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 17 | 46 / 11 | $80.128,00 | 99 / 6 | $27.687,00 | 114 / 6 | $25.568,10 | 114 / 3 |
| Traumatic Stupor & Coma, Coma <1 Hr W/O Cc/Mcc | 17 | 37 / 12 | $16.955,30 | 117 / 3 | $4.939,12 | 119 / 5 | $3.822,47 | 119 / 10 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 16 | 40 / 8 | $33.830,20 | 157 / 5 | $10.471,30 | 269 / 10 | $8.582,75 | 269 / 13 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 16 | 108 / 18 | $16.000,40 | 383 / 14 | $4.880,56 | 234 / 11 | $3.618,44 | 234 / 12 |
| Other Vascular Procedures W Mcc | 16 | 81 / 21 | $66.076,90 | 218 / 9 | $19.255,60 | 268 / 8 | $18.424,00 | 267 / 12 |
| Disorders Of The Biliary Tract W Cc | 16 | 38 / 9 | $18.777,60 | 56 / 1 | $6.521,75 | 108 / 6 | $5.553,00 | 108 / 8 |
| Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 15 | 23 / 5 | $17.206,20 | 182 / 6 | $4.911,67 | 141 / 10 | $3.128,00 | 141 / 4 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 15 | 56 / 14 | $88.693,60 | 168 / 6 | $29.266,30 | 203 / 6 | $27.979,10 | 203 / 11 |
| Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 15 | 42 / 14 | $36.104,50 | 99 / 7 | $13.159,10 | 149 / 15 | $11.048,30 | 148 / 6 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 15 | 111 / 32 | $20.848,10 | 450 / 17 | $7.196,93 | 525 / 28 | $6.059,47 | 522 / 28 |
| Acute Myocardial Infarction, Expired W Mcc | 14 | 16 / 5 | $30.185,70 | 38 / 2 | $10.304,70 | 40 / 2 | $9.287,07 | 40 / 3 |
| Peripheral Vascular Disorders W Cc | 14 | 70 / 20 | $19.005,40 | 360 / 21 | $6.512,50 | 458 / 34 | $5.216,50 | 456 / 34 |
| Other Vascular Procedures W Cc | 14 | 88 / 24 | $51.622,20 | 227 / 7 | $15.430,40 | 356 / 12 | $14.172,40 | 354 / 19 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 14 | 50 / 14 | $29.522,40 | 127 / 4 | $10.319,60 | 217 / 6 | $8.141,71 | 217 / 6 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 14 | 47 / 17 | $19.734,60 | 506 / 18 | $4.604,43 | 372 / 12 | $3.527,36 | 371 / 19 |
| Organic Disturbances & Mental Retardation | 13 | 46 / 13 | $17.101,80 | 131 / 5 | $6.055,23 | 84 / 4 | $5.003,15 | 84 / 5 |
| Hypertension W/O Mcc | 13 | 52 / 17 | $18.691,40 | 365 / 11 | $4.444,15 | 324 / 9 | $3.217,08 | 322 / 13 |
| G.I. Hemorrhage W/O Cc/Mcc | 13 | 55 / 20 | $14.262,50 | 293 / 18 | $4.774,62 | 441 / 27 | $3.641,00 | 437 / 29 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 13 | 59 / 18 | $41.014,70 | 588 / 14 | $8.716,08 | 265 / 8 | $7.552,62 | 264 / 12 |
| Chest Pain | 13 | 138 / 39 | $13.642,90 | 364 / 15 | $4.364,23 | 556 / 40 | $2.976,31 | 552 / 37 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 13 | 42 / 13 | $32.753,50 | 65 / 1 | $12.099,30 | 253 / 3 | $10.930,20 | 253 / 13 |
| Renal Failure W/O Cc/Mcc | 13 | 43 / 13 | $16.081,90 | 417 / 14 | $4.479,46 | 303 / 16 | $3.147,62 | 302 / 14 |
| Transurethral Procedures W Cc | 13 | 28 / 9 | $22.396,60 | 43 / 2 | $8.105,69 | 149 / 4 | $6.913,00 | 149 / 9 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 13 | 43 / 15 | $27.013,50 | 128 / 7 | $9.679,38 | 272 / 10 | $8.384,92 | 271 / 11 |
| Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 12 | 35 / 11 | $30.949,40 | 174 / 6 | $7.975,67 | 156 / 9 | $5.951,42 | 156 / 10 |
| Red Blood Cell Disorders W/O Mcc | 12 | 131 / 40 | $17.046,40 | 629 / 33 | $5.400,25 | 554 / 52 | $4.038,50 | 552 / 46 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 12 | 84 / 15 | $50.428,20 | 347 / 13 | $13.260,00 | 391 / 10 | $12.125,90 | 388 / 19 |
| Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 12 | 83 / 22 | $49.977,80 | 104 / 3 | $11.983,60 | 183 / 6 | $10.728,50 | 181 / 6 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 11 | 36 / 12 | $26.384,40 | 66 / 4 | $9.165,45 | 147 / 7 | $7.521,27 | 147 / 10 |
| Other Vascular Procedures W/O Cc/Mcc | 11 | 45 / 16 | $29.568,80 | 59 / 2 | $11.037,50 | 91 / 8 | $8.394,27 | 91 / 4 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 11 | 58 / 14 | $57.404,40 | 172 / 5 | $16.677,40 | 110 / 2 | $13.692,90 | 110 / 7 |
| Uterine & Adnexa Proc For Non-Malignancy W/O Cc/Mcc | 11 | 35 / 9 | $18.597,00 | 39 / 2 | $6.841,45 | 20 / 3 | $4.173,82 | 20 / 3 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 27 | $23.728,90 | 354 / 14 | $6.763,91 | 344 / 16 | $5.658,00 | 344 / 20 | Total 102 procedures | 3.750 | 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.