Hospital Costs > In Pennsylvania > Upmc East, 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 Mcc | 32 | 93 / 25 | $33.066,80 | 552 / 35 | $8.929,00 | 15 / 12 | $6.954,53 | 15 / 2 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 11 | 113 / 22 | $29.373,70 | 687 / 25 | $5.187,27 | 1 / 15 | $1.840,73 | 1 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 26 | 135 / 40 | $20.949,60 | 1121 / 47 | $4.572,62 | 10 / 15 | $2.911,19 | 10 / 1 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 12 | 111 / 45 | $22.494,90 | 491 / 32 | $6.724,67 | 17 / 12 | $5.205,33 | 17 / 5 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 18 | 132 / 47 | $15.255,80 | 1021 / 49 | $3.521,78 | 2 / 29 | $1.443,72 | 2 / 1 |
| Cellulitis W/O Mcc | 38 | 151 / 50 | $14.427,90 | 781 / 46 | $4.779,21 | 2 / 18 | $2.725,71 | 2 / 1 |
| Chest Pain | 19 | 132 / 33 | $16.610,60 | 648 / 32 | $3.353,21 | 5 / 6 | $1.879,32 | 5 / 1 |
| Chronic Obstructive Pulmonary Disease W Cc | 25 | 154 / 50 | $23.286,40 | 1329 / 65 | $5.154,76 | 1 / 11 | $3.159,32 | 1 / 1 |
| Chronic Obstructive Pulmonary Disease W Mcc | 20 | 182 / 54 | $31.007,70 | 1536 / 71 | $6.969,70 | 1 / 30 | $3.971,15 | 1 / 1 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 11 | 109 / 41 | $15.304,80 | 816 / 40 | $4.011,00 | 1 / 11 | $2.059,45 | 1 / 1 |
| Diabetes W Cc | 11 | 81 / 29 | $13.478,70 | 233 / 12 | $4.291,91 | 16 / 3 | $3.175,36 | 16 / 2 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 33 | 242 / 70 | $17.540,60 | 1068 / 53 | $4.357,09 | 8 / 17 | $2.540,24 | 8 / 2 |
| G.I. Hemorrhage W Cc | 30 | 188 / 51 | $24.383,80 | 1155 / 56 | $5.782,87 | 32 / 23 | $4.104,80 | 32 / 5 |
| Heart Failure & Shock W Cc | 48 | 230 / 65 | $25.609,10 | 1716 / 74 | $5.944,00 | 6 / 36 | $3.813,02 | 6 / 1 |
| Heart Failure & Shock W Mcc | 37 | 247 / 63 | $31.405,10 | 1180 / 56 | $8.547,22 | 2 / 24 | $5.451,54 | 2 / 1 |
| Heart Failure & Shock W/O Cc/Mcc | 11 | 99 / 45 | $16.933,30 | 1052 / 53 | $4.085,64 | 2 / 32 | $2.221,55 | 2 / 1 |
| Hip & Femur Procedures Except Major Joint W Cc | 13 | 130 / 42 | $59.159,00 | 1328 / 57 | $10.397,80 | 15 / 5 | $8.553,00 | 15 / 1 |
| Hip & Femur Procedures Except Major Joint W Mcc | 12 | 50 / 14 | $85.855,90 | 586 / 15 | $16.383,60 | 13 / 3 | $13.643,40 | 13 / 2 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 14 | 168 / 58 | $28.842,90 | 1075 / 50 | $5.343,21 | 2 / 1 | $3.924,14 | 2 / 1 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 14 | 154 / 36 | $30.413,60 | 354 / 12 | $9.287,79 | 1 / 9 | $6.301,93 | 1 / 1 |
| Kidney & Urinary Tract Infections W Mcc | 11 | 133 / 41 | $28.755,60 | 1124 / 49 | $6.846,18 | 18 / 32 | $4.594,00 | 18 / 4 |
| Kidney & Urinary Tract Infections W/O Mcc | 29 | 204 / 61 | $18.565,00 | 1416 / 67 | $4.492,28 | 2 / 19 | $2.519,52 | 2 / 1 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 13 | 60 / 23 | $24.449,80 | 458 / 25 | $6.847,54 | 8 / 13 | $4.756,77 | 8 / 4 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 77 | 487 / 62 | $71.281,80 | 2025 / 96 | $11.563,40 | 5 / 11 | $8.018,29 | 5 / 1 |
| Medical Back Problems W/O Mcc | 15 | 106 / 36 | $16.661,70 | 312 / 18 | $4.622,40 | 1 / 8 | $2.565,67 | 1 / 1 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 21 | 145 / 47 | $14.291,10 | 873 / 44 | $3.739,57 | 29 / 6 | $2.605,86 | 29 / 2 |
| Other Digestive System Diagnoses W Cc | 13 | 84 / 31 | $26.640,80 | 743 / 33 | $6.028,46 | 1 / 22 | $3.435,46 | 1 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 27 | $19.955,50 | 245 / 7 | $5.728,27 | 1 / 7 | $3.716,36 | 1 / 1 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 12 | 89 / 29 | $43.140,60 | 688 / 23 | $9.325,83 | 6 / 13 | $6.421,00 | 6 / 1 |
| Peripheral Vascular Disorders W Cc | 15 | 69 / 19 | $14.998,70 | 179 / 15 | $5.169,53 | 7 / 5 | $3.555,07 | 7 / 3 |
| Pulmonary Edema & Respiratory Failure | 33 | 170 / 33 | $37.302,40 | 1398 / 58 | $7.435,21 | 11 / 32 | $5.140,64 | 11 / 2 |
| Red Blood Cell Disorders W/O Mcc | 23 | 120 / 29 | $16.975,10 | 621 / 32 | $4.533,39 | 25 / 11 | $3.096,48 | 25 / 4 |
| Renal Failure W Cc | 25 | 196 / 59 | $23.374,60 | 1301 / 60 | $5.710,48 | 1 / 28 | $3.284,56 | 1 / 1 |
| Renal Failure W Mcc | 29 | 166 / 37 | $37.197,10 | 1161 / 55 | $8.777,83 | 4 / 18 | $6.226,28 | 4 / 1 |
| Respiratory Infections & Inflammations W Cc | 21 | 67 / 22 | $27.100,10 | 574 / 25 | $7.769,43 | 6 / 11 | $5.699,24 | 6 / 3 |
| Respiratory Infections & Inflammations W Mcc | 19 | 117 / 33 | $42.073,00 | 856 / 36 | $10.509,10 | 3 / 9 | $8.013,53 | 3 / 1 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 16 | 115 / 37 | $61.469,40 | 941 / 39 | $13.569,30 | 3 / 25 | $9.014,62 | 3 / 1 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 51 | 465 / 79 | $50.172,70 | 1789 / 75 | $11.479,70 | 11 / 55 | $7.783,22 | 11 / 3 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 14 | 193 / 66 | $23.974,40 | 1157 / 55 | $6.194,64 | 1 / 18 | $3.342,86 | 1 / 1 |
| Signs & Symptoms W/O Mcc | 12 | 79 / 32 | $17.089,70 | 480 / 21 | $3.985,58 | 5 / 4 | $2.473,83 | 5 / 2 |
| Simple Pneumonia & Pleurisy W Cc | 28 | 175 / 53 | $25.590,10 | 1662 / 70 | $5.821,11 | 1 / 29 | $3.384,89 | 1 / 1 |
| Simple Pneumonia & Pleurisy W Mcc | 24 | 181 / 48 | $47.365,20 | 1827 / 75 | $8.859,04 | 15 / 42 | $5.944,46 | 15 / 2 |
| Syncope & Collapse | 15 | 154 / 50 | $20.552,10 | 909 / 46 | $4.238,47 | 1 / 15 | $2.056,47 | 1 / 1 |
| Transient Ischemia | 16 | 109 / 41 | $22.469,30 | 825 / 41 | $3.858,50 | 8 / 7 | $2.422,94 | 8 / 1 | Total 44 procedures | 978 | 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.