Hospital Costs > In Pennsylvania > Upmc Mercy, 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 | 122 | 394 / 49 | $51.926,00 | 1853 / 77 | $16.876,70 | 1937 / 116 | $12.154,00 | 1902 / 104 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 117 | 30 / 2 | $15.011,10 | 340 / 12 | $8.881,79 | 636 / 35 | $5.189,22 | 635 / 29 |
| Psychoses | 83 | 205 / 17 | $25.673,60 | 421 / 21 | $14.425,90 | 403 / 34 | $6.826,96 | 403 / 32 |
| Kidney & Urinary Tract Infections W/O Mcc | 71 | 162 / 29 | $17.770,20 | 1316 / 63 | $8.502,87 | 2317 / 119 | $5.827,24 | 2306 / 117 |
| Heart Failure & Shock W Cc | 70 | 208 / 47 | $25.662,70 | 1719 / 75 | $10.709,20 | 2282 / 124 | $7.260,91 | 2276 / 120 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 66 | 498 / 64 | $66.495,00 | 1902 / 92 | $18.237,90 | 1745 / 123 | $12.674,90 | 1705 / 104 |
| Renal Failure W Cc | 65 | 156 / 28 | $26.003,60 | 1490 / 69 | $10.545,50 | 2006 / 113 | $7.009,35 | 1996 / 110 |
| Simple Pneumonia & Pleurisy W Cc | 56 | 147 / 29 | $25.825,60 | 1683 / 73 | $9.989,29 | 2048 / 116 | $6.262,75 | 2040 / 111 |
| Renal Failure W Mcc | 48 | 147 / 22 | $33.013,20 | 947 / 51 | $13.613,70 | 1364 / 95 | $9.828,17 | 1364 / 83 |
| Heart Failure & Shock W Mcc | 42 | 242 / 58 | $37.545,10 | 1534 / 71 | $15.014,60 | 2105 / 120 | $10.773,70 | 2095 / 115 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 42 | 233 / 62 | $18.880,20 | 1260 / 60 | $8.153,14 | 2301 / 119 | $5.520,69 | 2286 / 116 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 41 | 120 / 27 | $23.803,80 | 1338 / 62 | $8.804,07 | 1792 / 105 | $5.809,00 | 1787 / 100 |
| Chronic Obstructive Pulmonary Disease W Cc | 41 | 138 / 34 | $24.522,30 | 1421 / 68 | $9.450,63 | 1965 / 114 | $6.573,10 | 1958 / 112 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 40 | 142 / 36 | $36.948,10 | 1422 / 63 | $10.842,50 | 1674 / 89 | $7.524,73 | 1670 / 88 |
| Medical Back Problems W/O Mcc | 39 | 82 / 18 | $26.301,60 | 886 / 44 | $9.032,54 | 1166 / 72 | $5.863,85 | 1162 / 70 |
| Chest Pain | 38 | 113 / 17 | $17.650,10 | 743 / 37 | $7.073,21 | 1478 / 81 | $5.112,71 | 1469 / 78 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 36 | 87 / 22 | $35.048,50 | 1164 / 58 | $13.134,90 | 1399 / 95 | $8.315,31 | 1396 / 87 |
| Alcohol/Drug Abuse Or Dependence, Left Ama | 35 | 15 / 2 | $9.824,29 | 73 / 6 | $5.797,66 | 57 / 7 | $3.477,63 | 56 / 5 |
| Cellulitis W/O Mcc | 35 | 154 / 53 | $17.167,10 | 1147 / 61 | $8.959,57 | 2196 / 118 | $6.086,40 | 2188 / 115 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 34 | 90 / 20 | $148.674,00 | 1015 / 40 | $43.677,00 | 871 / 61 | $33.495,80 | 865 / 53 |
| G.I. Hemorrhage W Cc | 32 | 186 / 49 | $26.110,20 | 1299 / 59 | $10.283,70 | 2023 / 109 | $7.353,59 | 2019 / 104 |
| Transient Ischemia | 31 | 94 / 30 | $32.596,50 | 1262 / 68 | $7.975,35 | 1345 / 88 | $5.006,87 | 1338 / 86 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 31 | 119 / 36 | $15.529,70 | 1059 / 51 | $6.558,58 | 1597 / 98 | $3.731,77 | 1591 / 94 |
| Syncope & Collapse | 31 | 138 / 36 | $21.849,10 | 1022 / 50 | $7.978,23 | 1540 / 95 | $5.284,58 | 1533 / 92 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 31 | 137 / 24 | $65.697,50 | 1215 / 46 | $17.534,40 | 1293 / 62 | $12.927,30 | 1287 / 62 |
| Simple Pneumonia & Pleurisy W Mcc | 30 | 175 / 42 | $42.572,70 | 1659 / 65 | $14.168,30 | 1847 / 107 | $9.535,27 | 1847 / 98 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 29 | 167 / 42 | $62.644,00 | 509 / 24 | $16.916,60 | 750 / 57 | $11.401,70 | 746 / 37 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 29 | 102 / 25 | $65.295,40 | 1047 / 44 | $20.544,00 | 1289 / 73 | $15.654,60 | 1276 / 68 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 28 | 160 / 40 | $33.529,90 | 686 / 33 | $10.452,10 | 1310 / 65 | $7.526,11 | 1307 / 66 |
| Chronic Obstructive Pulmonary Disease W Mcc | 27 | 175 / 48 | $27.848,70 | 1337 / 64 | $11.315,10 | 1802 / 109 | $7.437,56 | 1794 / 103 |
| Hip & Femur Procedures Except Major Joint W Cc | 25 | 118 / 32 | $56.666,40 | 1266 / 55 | $17.450,30 | 1611 / 87 | $13.403,20 | 1592 / 87 |
| G.I. Hemorrhage W Mcc | 25 | 96 / 26 | $41.593,70 | 753 / 35 | $15.766,70 | 1191 / 74 | $12.165,80 | 1183 / 71 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 24 | 96 / 28 | $17.038,30 | 1019 / 44 | $7.755,75 | 1834 / 98 | $5.498,62 | 1823 / 98 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 24 | 102 / 24 | $28.154,20 | 864 / 26 | $10.777,00 | 1278 / 64 | $8.000,79 | 1275 / 65 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 23 | 143 / 45 | $17.807,20 | 1300 / 58 | $7.814,13 | 2073 / 106 | $5.072,83 | 2065 / 104 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 23 | 38 / 10 | $18.964,30 | 477 / 15 | $8.230,48 | 770 / 38 | $5.348,22 | 769 / 35 |
| Other Digestive System Diagnoses W Cc | 22 | 75 / 22 | $24.579,80 | 653 / 29 | $10.082,50 | 1157 / 61 | $7.175,59 | 1153 / 61 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 22 | 185 / 59 | $31.481,70 | 1702 / 73 | $12.118,70 | 1928 / 114 | $7.085,59 | 1920 / 105 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Cc | 19 | 25 / 8 | $70.012,10 | 179 / 9 | $24.232,20 | 60 / 20 | $14.346,30 | 59 / 6 |
| Non-Extensive Burns | 19 | 11 / 3 | $54.410,90 | 26 / 3 | $15.793,90 | 13 / 3 | $10.491,20 | 13 / 3 |
| Degenerative Nervous System Disorders W/O Mcc | 18 | 60 / 18 | $24.502,40 | 371 / 18 | $9.615,22 | 598 / 43 | $6.657,22 | 598 / 42 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 18 | 78 / 23 | $44.059,80 | 1051 / 39 | $13.422,90 | 1155 / 62 | $8.983,50 | 1150 / 59 |
| Diabetes W Cc | 18 | 74 / 22 | $24.925,90 | 992 / 39 | $10.745,60 | 1380 / 72 | $6.667,67 | 1375 / 69 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 17 | 55 / 14 | $42.075,80 | 601 / 15 | $14.260,80 | 718 / 29 | $9.923,18 | 716 / 27 |
| Seizures W/O Mcc | 16 | 92 / 29 | $22.783,60 | 684 / 33 | $8.664,44 | 1052 / 62 | $5.881,38 | 1050 / 61 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 16 | 73 / 19 | $39.385,10 | 456 / 19 | $9.524,44 | 539 / 28 | $6.809,75 | 538 / 26 |
| Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W/O Maj O.R. | 16 | 48 / 11 | $301.289,00 | 328 / 10 | $82.069,40 | 312 / 18 | $67.809,10 | 312 / 18 |
| Spinal Fusion Except Cervical W/O Mcc | 16 | 178 / 34 | $105.763,00 | 801 / 41 | $29.472,70 | 881 / 50 | $24.826,30 | 877 / 52 |
| Cellulitis W Mcc | 16 | 42 / 12 | $39.703,90 | 590 / 25 | $14.733,10 | 742 / 45 | $10.352,90 | 740 / 41 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 16 | 75 / 25 | $33.462,00 | 863 / 46 | $11.193,50 | 1108 / 73 | $7.130,94 | 1106 / 68 |
| Pulmonary Edema & Respiratory Failure | 16 | 187 / 48 | $45.200,70 | 1650 / 72 | $12.154,90 | 1531 / 96 | $7.908,56 | 1526 / 86 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 16 | 50 / 14 | $40.243,40 | 346 / 11 | $10.824,60 | 383 / 19 | $7.809,75 | 382 / 21 |
| Signs & Symptoms W/O Mcc | 16 | 75 / 28 | $20.866,10 | 691 / 26 | $7.711,44 | 1103 / 50 | $5.464,81 | 1100 / 50 |
| Kidney & Urinary Tract Infections W Mcc | 15 | 129 / 37 | $17.885,70 | 419 / 19 | $10.683,90 | 1551 / 82 | $7.809,33 | 1547 / 81 |
| Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 15 | 66 / 15 | $486.153,00 | 262 / 9 | $127.026,00 | 190 / 13 | $106.973,00 | 190 / 12 |
| Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 15 | 51 / 13 | $69.348,40 | 407 / 11 | $15.731,30 | 363 / 16 | $11.954,90 | 360 / 17 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 15 | 110 / 41 | $49.358,80 | 1125 / 60 | $15.990,70 | 1311 / 90 | $11.550,40 | 1301 / 82 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 15 | 48 / 13 | $159.245,00 | 511 / 20 | $41.962,30 | 454 / 25 | $32.113,30 | 454 / 21 |
| Dysequilibrium | 14 | 51 / 13 | $22.747,80 | 300 / 14 | $7.228,64 | 449 / 30 | $4.636,79 | 449 / 29 |
| Other Resp System O.R. Procedures W Mcc | 14 | 49 / 11 | $114.847,00 | 400 / 10 | $32.750,50 | 439 / 17 | $25.958,60 | 438 / 17 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 14 | 55 / 17 | $64.390,90 | 301 / 16 | $15.188,70 | 317 / 26 | $10.716,10 | 317 / 20 |
| Peripheral Vascular Disorders W Cc | 14 | 70 / 20 | $24.680,40 | 628 / 32 | $9.348,07 | 833 / 60 | $6.323,93 | 830 / 57 |
| Other Circulatory System Diagnoses W Mcc | 14 | 102 / 30 | $51.502,90 | 782 / 28 | $17.846,00 | 873 / 51 | $12.540,40 | 867 / 44 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 13 | 89 / 36 | $46.172,80 | 1442 / 72 | $8.855,77 | 1314 / 78 | $5.266,15 | 1310 / 75 |
| Major Chest Trauma W Cc | 13 | 23 / 8 | $40.023,70 | 98 / 7 | $10.562,20 | 114 / 10 | $7.126,46 | 114 / 12 |
| Red Blood Cell Disorders W/O Mcc | 13 | 130 / 39 | $18.898,80 | 795 / 42 | $8.355,69 | 1593 / 92 | $5.811,92 | 1584 / 90 |
| Disorders Of Liver Except Malig,Cirr,Alc Hepa W Mcc | 13 | 63 / 11 | $64.832,20 | 388 / 9 | $18.647,50 | 254 / 12 | $11.635,10 | 254 / 9 |
| Disorders Of Pancreas Except Malignancy W Cc | 13 | 48 / 17 | $24.454,90 | 456 / 16 | $9.996,54 | 657 / 33 | $5.883,23 | 654 / 29 |
| Other Disorders Of Nervous System W Cc | 12 | 44 / 20 | $28.509,50 | 351 / 11 | $9.288,50 | 441 / 34 | $6.203,00 | 441 / 32 |
| Organic Disturbances & Mental Retardation | 12 | 47 / 14 | $23.606,50 | 255 / 10 | $11.435,10 | 397 / 27 | $7.291,50 | 397 / 25 |
| Full Thickness Burn W Skin Graft Or Inhal Inj W Cc/Mcc | 12 | 19 / 4 | $115.568,00 | 12 / 2 | $45.627,00 | 5 / 2 | $34.772,90 | 5 / 1 |
| Uterine,Adnexa Proc For Non-Ovarian/Adnexal Malig W Cc | 12 | 16 / 2 | $53.982,60 | 26 / 1 | $14.140,90 | 22 / 3 | $10.757,70 | 22 / 3 |
| Major Small & Large Bowel Procedures W Mcc | 12 | 73 / 25 | $150.838,00 | 812 / 28 | $43.266,20 | 643 / 46 | $31.398,00 | 641 / 37 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 12 | 61 / 24 | $26.547,10 | 545 / 30 | $11.576,50 | 826 / 49 | $7.967,50 | 824 / 48 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W Mcc | 12 | 15 / 3 | $19.675,80 | 18 / 1 | $13.187,80 | 43 / 3 | $9.412,17 | 43 / 3 |
| G.I. Obstruction W Cc | 11 | 81 / 34 | $24.688,60 | 976 / 38 | $9.579,91 | 1362 / 71 | $6.071,45 | 1357 / 68 |
| Circulatory Disorders Except Ami, W Card Cath W Mcc | 11 | 82 / 25 | $49.282,30 | 307 / 12 | $18.370,50 | 664 / 33 | $14.602,70 | 657 / 32 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 11 | 45 / 11 | $48.047,00 | 395 / 11 | $16.636,50 | 310 / 17 | $11.326,70 | 309 / 11 |
| Hip & Femur Procedures Except Major Joint W Mcc | 11 | 51 / 15 | $93.085,10 | 653 / 16 | $26.352,90 | 686 / 27 | $20.260,60 | 683 / 27 |
| Pulmonary Embolism W/O Mcc | 11 | 63 / 29 | $22.443,20 | 517 / 21 | $10.115,80 | 1086 / 58 | $7.102,18 | 1083 / 57 |
| Other Vascular Procedures W Cc | 11 | 91 / 27 | $74.456,70 | 581 / 28 | $20.259,10 | 390 / 51 | $14.344,00 | 388 / 24 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 11 | 81 / 22 | $130.579,00 | 392 / 14 | $41.905,80 | 214 / 25 | $31.940,50 | 214 / 13 |
| Respiratory Infections & Inflammations W Mcc | 11 | 125 / 40 | $44.297,60 | 917 / 40 | $17.344,10 | 1306 / 78 | $12.970,50 | 1291 / 76 |
| Other Vascular Procedures W Mcc | 11 | 86 / 26 | $75.877,90 | 330 / 15 | $24.715,00 | 542 / 35 | $21.160,40 | 539 / 32 |
| Craniotomy & Endovascular Intracranial Procedures W Cc | 11 | 44 / 8 | $88.102,40 | 114 / 3 | $24.041,60 | 82 / 6 | $18.321,10 | 82 / 5 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 11 | 60 / 18 | $154.059,00 | 581 / 21 | $41.414,90 | 332 / 30 | $29.582,20 | 332 / 17 |
| Transurethral Procedures W Cc | 11 | 30 / 11 | $49.618,00 | 279 / 15 | $13.736,50 | 295 / 22 | $8.510,55 | 295 / 22 | Total 87 procedures | 2.287 | 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.