Hospital Costs > In Pennsylvania > Upmc Northwest, 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 | 84 | 432 / 65 | $26.367,60 | 606 / 35 | $9.845,46 | 176 / 10 | $8.870,45 | 176 / 15 |
Chronic Obstructive Pulmonary Disease W Cc | 75 | 104 / 17 | $13.417,20 | 361 / 16 | $5.184,53 | 373 / 14 | $4.394,93 | 372 / 31 |
Chronic Obstructive Pulmonary Disease W Mcc | 67 | 135 / 16 | $17.551,40 | 522 / 26 | $6.312,39 | 163 / 9 | $5.317,70 | 163 / 21 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 63 | 501 / 66 | $38.037,90 | 645 / 48 | $11.604,70 | 325 / 14 | $10.020,00 | 324 / 24 |
Heart Failure & Shock W Mcc | 56 | 228 / 50 | $22.557,10 | 568 / 34 | $8.369,84 | 106 / 17 | $6.985,62 | 106 / 15 |
Kidney & Urinary Tract Infections W/O Mcc | 54 | 179 / 38 | $10.025,50 | 299 / 21 | $4.397,56 | 229 / 17 | $3.340,15 | 229 / 20 |
Heart Failure & Shock W Cc | 53 | 225 / 62 | $11.745,00 | 249 / 17 | $5.304,25 | 228 / 9 | $4.585,83 | 228 / 19 |
Renal Failure W Cc | 53 | 168 / 38 | $12.269,50 | 236 / 19 | $5.405,94 | 245 / 18 | $4.462,74 | 244 / 21 |
Respiratory Infections & Inflammations W Cc | 50 | 38 / 4 | $24.188,30 | 433 / 19 | $7.561,24 | 169 / 7 | $6.688,76 | 168 / 14 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 49 | 226 / 58 | $11.346,60 | 320 / 19 | $4.333,37 | 265 / 16 | $3.193,98 | 265 / 28 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 47 | 73 / 10 | $9.296,70 | 175 / 8 | $4.187,00 | 262 / 18 | $3.100,62 | 262 / 28 |
Simple Pneumonia & Pleurisy W Cc | 45 | 158 / 39 | $16.398,00 | 727 / 39 | $5.625,60 | 49 / 22 | $3.977,13 | 49 / 6 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 45 | 162 / 39 | $13.406,30 | 242 / 17 | $5.973,02 | 61 / 13 | $4.516,33 | 61 / 6 |
Respiratory Infections & Inflammations W Mcc | 43 | 93 / 12 | $32.411,10 | 482 / 26 | $10.463,80 | 207 / 8 | $9.778,28 | 207 / 17 |
Cellulitis W/O Mcc | 42 | 147 / 46 | $9.477,12 | 202 / 20 | $4.698,38 | 200 / 15 | $3.557,62 | 199 / 20 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 38 | 128 / 32 | $7.668,05 | 118 / 7 | $3.974,47 | 127 / 15 | $2.883,13 | 127 / 17 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 37 | 124 / 31 | $11.403,40 | 198 / 14 | $4.560,19 | 115 / 14 | $3.329,08 | 115 / 15 |
G.I. Hemorrhage W Cc | 35 | 183 / 47 | $13.234,10 | 179 / 11 | $5.522,23 | 255 / 10 | $4.647,60 | 255 / 24 |
Simple Pneumonia & Pleurisy W Mcc | 35 | 170 / 37 | $19.434,30 | 356 / 20 | $7.564,34 | 129 / 6 | $6.661,37 | 129 / 12 |
Pulmonary Edema & Respiratory Failure | 34 | 169 / 32 | $17.795,70 | 270 / 18 | $6.744,32 | 68 / 11 | $5.572,21 | 68 / 11 |
Syncope & Collapse | 33 | 136 / 34 | $11.170,40 | 155 / 10 | $4.227,00 | 162 / 14 | $3.107,73 | 162 / 22 |
Transient Ischemia | 32 | 93 / 29 | $14.283,60 | 253 / 17 | $4.033,53 | 215 / 12 | $3.042,41 | 215 / 25 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 28 | 154 / 46 | $16.421,30 | 233 / 13 | $6.045,61 | 111 / 13 | $4.600,96 | 111 / 12 |
Chest Pain | 28 | 123 / 25 | $8.714,93 | 93 / 7 | $3.548,64 | 227 / 13 | $2.590,79 | 226 / 19 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 28 | 95 / 30 | $15.250,00 | 128 / 10 | $6.613,07 | 221 / 6 | $5.910,07 | 221 / 24 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 26 | 124 / 41 | $8.866,50 | 217 / 10 | $3.303,85 | 232 / 17 | $2.180,77 | 230 / 25 |
Red Blood Cell Disorders W/O Mcc | 24 | 119 / 28 | $11.328,80 | 179 / 10 | $4.585,58 | 148 / 15 | $3.521,42 | 148 / 17 |
G.I. Obstruction W Cc | 23 | 69 / 23 | $11.244,80 | 88 / 3 | $5.033,96 | 352 / 12 | $4.280,04 | 351 / 25 |
Peripheral Vascular Disorders W Cc | 22 | 62 / 13 | $11.579,40 | 71 / 5 | $5.007,36 | 69 / 3 | $4.278,82 | 69 / 11 |
Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 22 | 146 / 30 | $21.318,70 | 125 / 4 | $9.231,00 | 142 / 8 | $8.274,09 | 141 / 12 |
Renal Failure W Mcc | 22 | 173 / 44 | $22.220,80 | 327 / 16 | $8.387,64 | 192 / 11 | $7.525,27 | 192 / 20 |
Heart Failure & Shock W/O Cc/Mcc | 21 | 89 / 35 | $8.865,10 | 175 / 12 | $3.957,48 | 167 / 19 | $2.924,67 | 165 / 20 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 20 | 111 / 33 | $33.171,20 | 169 / 12 | $11.242,70 | 34 / 1 | $10.489,50 | 34 / 6 |
Hip & Femur Procedures Except Major Joint W Cc | 20 | 123 / 35 | $28.442,10 | 180 / 15 | $10.545,90 | 182 / 9 | $9.439,30 | 181 / 12 |
Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 19 | 83 / 30 | $14.056,20 | 197 / 10 | $4.555,89 | 129 / 16 | $3.066,42 | 127 / 15 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 19 | 106 / 37 | $16.324,20 | 78 / 6 | $7.726,37 | 17 / 2 | $7.012,26 | 17 / 3 |
Diabetes W Cc | 17 | 75 / 23 | $9.365,06 | 66 / 4 | $4.470,41 | 71 / 6 | $3.535,59 | 71 / 7 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 17 | 76 / 27 | $9.737,94 | 198 / 13 | $4.072,18 | 216 / 15 | $2.928,88 | 214 / 17 |
Medical Back Problems W/O Mcc | 16 | 105 / 35 | $12.444,40 | 117 / 6 | $4.630,62 | 178 / 9 | $3.711,88 | 178 / 19 |
Cellulitis W Mcc | 15 | 43 / 13 | $23.133,20 | 189 / 8 | $7.925,93 | 91 / 8 | $6.948,33 | 91 / 12 |
Renal Failure W/O Cc/Mcc | 15 | 41 / 11 | $7.789,53 | 53 / 1 | $3.658,20 | 196 / 5 | $2.924,33 | 195 / 9 |
Seizures W/O Mcc | 14 | 94 / 31 | $8.617,86 | 45 / 1 | $4.300,14 | 26 / 5 | $2.966,93 | 26 / 4 |
Kidney & Urinary Tract Infections W Mcc | 14 | 130 / 38 | $17.925,80 | 422 / 20 | $6.344,64 | 384 / 15 | $5.547,79 | 383 / 26 |
Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 13 | 83 / 28 | $17.741,90 | 133 / 4 | $6.618,38 | 125 / 5 | $5.758,38 | 125 / 13 |
G.I. Hemorrhage W/O Cc/Mcc | 13 | 55 / 20 | $6.810,62 | 26 / 2 | $4.039,46 | 90 / 9 | $2.912,38 | 90 / 9 |
Headaches W/O Mcc | 13 | 30 / 9 | $12.625,90 | 25 / 2 | $3.894,77 | 35 / 1 | $2.957,23 | 35 / 3 |
Bronchitis & Asthma W Cc/Mcc | 12 | 64 / 24 | $11.925,70 | 94 / 5 | $4.945,75 | 70 / 6 | $3.721,42 | 70 / 9 |
Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 12 | 61 / 24 | $11.627,60 | 47 / 4 | $6.329,83 | 159 / 7 | $5.813,83 | 159 / 16 |
G.I. Hemorrhage W Mcc | 12 | 109 / 38 | $24.161,80 | 152 / 13 | $9.461,33 | 138 / 10 | $8.626,33 | 138 / 13 |
Disorders Of Pancreas Except Malignancy W Cc | 12 | 49 / 18 | $13.976,40 | 96 / 2 | $5.193,50 | 191 / 4 | $4.476,83 | 191 / 10 |
Pulmonary Embolism W/O Mcc | 12 | 62 / 28 | $17.144,60 | 244 / 10 | $5.575,17 | 223 / 7 | $4.650,83 | 223 / 16 |
Other Circulatory System Diagnoses W Mcc | 11 | 105 / 33 | $23.250,50 | 87 / 2 | $10.050,50 | 8 / 6 | $8.011,18 | 8 / 3 |
Degenerative Nervous System Disorders W/O Mcc | 11 | 67 / 25 | $11.091,30 | 39 / 2 | $5.547,09 | 137 / 7 | $4.762,36 | 137 / 11 | Total 53 procedures | 1.621 | 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.