Hospital Costs > In Texas > Wise Regional Health System, 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 | 74 | 442 / 98 | $50.897,90 | 1825 / 107 | $10.725,70 | 549 / 41 | $9.592,32 | 548 / 38 |
Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 73 | 491 / 97 | $85.933,70 | 2308 / 171 | $12.528,20 | 707 / 40 | $10.634,50 | 697 / 84 |
Pulmonary Edema & Respiratory Failure | 66 | 137 / 23 | $47.378,00 | 1701 / 88 | $7.849,92 | 549 / 57 | $6.391,06 | 549 / 30 |
Chronic Obstructive Pulmonary Disease W Mcc | 39 | 163 / 54 | $33.158,50 | 1653 / 83 | $6.330,72 | 162 / 5 | $5.311,49 | 162 / 9 |
Simple Pneumonia & Pleurisy W Mcc | 36 | 169 / 60 | $32.413,00 | 1191 / 47 | $7.660,28 | 100 / 3 | $6.587,47 | 100 / 7 |
Renal Failure W Mcc | 34 | 161 / 63 | $30.640,10 | 797 / 31 | $8.304,74 | 118 / 7 | $7.321,03 | 118 / 9 |
Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 32 | 243 / 79 | $22.188,00 | 1646 / 77 | $4.248,34 | 100 / 9 | $2.938,38 | 100 / 9 |
Simple Pneumonia & Pleurisy W Cc | 29 | 174 / 78 | $26.747,30 | 1751 / 88 | $5.966,62 | 94 / 51 | $4.135,59 | 94 / 7 |
Heart Failure & Shock W Mcc | 27 | 257 / 94 | $45.563,60 | 1861 / 113 | $8.609,26 | 278 / 34 | $7.384,85 | 278 / 13 |
Kidney & Urinary Tract Infections W/O Mcc | 26 | 207 / 83 | $19.233,90 | 1484 / 75 | $4.181,62 | 57 / 5 | $3.044,62 | 57 / 5 |
Renal Failure W Cc | 25 | 196 / 81 | $23.280,70 | 1296 / 51 | $5.477,84 | 295 / 18 | $4.531,88 | 293 / 21 |
Acute Myocardial Infarction, Discharged Alive W Mcc | 24 | 101 / 38 | $40.125,20 | 807 / 23 | $9.248,12 | 134 / 4 | $8.058,21 | 134 / 4 |
Kidney & Urinary Tract Infections W Mcc | 24 | 120 / 52 | $23.370,60 | 811 / 30 | $6.096,25 | 24 / 6 | $4.646,96 | 24 / 1 |
Hip & Femur Procedures Except Major Joint W Cc | 23 | 120 / 49 | $57.682,70 | 1292 / 68 | $10.801,40 | 6 / 13 | $8.345,65 | 6 / 1 |
Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 21 | 145 / 65 | $13.746,00 | 795 / 26 | $3.856,14 | 54 / 6 | $2.721,38 | 54 / 6 |
Chronic Obstructive Pulmonary Disease W Cc | 21 | 158 / 54 | $22.925,00 | 1294 / 37 | $5.263,81 | 79 / 12 | $3.946,95 | 79 / 6 |
Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 20 | 187 / 71 | $31.910,30 | 1725 / 98 | $6.304,00 | 114 / 22 | $4.672,00 | 114 / 10 |
Chest Pain | 19 | 132 / 47 | $23.972,90 | 1159 / 56 | $3.445,26 | 243 / 4 | $2.610,42 | 242 / 15 |
O.R. Procedures For Obesity W/O Cc/Mcc | 17 | 60 / 26 | $43.839,80 | 211 / 11 | $10.815,40 | 14 / 14 | $6.670,29 | 14 / 1 |
Respiratory System Diagnosis W Ventilator Support <96 Hours | 17 | 114 / 49 | $54.620,40 | 754 / 29 | $12.790,00 | 256 / 19 | $11.753,00 | 254 / 21 |
Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 17 | 179 / 57 | $66.058,40 | 597 / 28 | $11.825,80 | 140 / 12 | $9.611,29 | 140 / 20 |
Heart Failure & Shock W Cc | 16 | 262 / 96 | $21.027,80 | 1298 / 43 | $5.212,38 | 117 / 4 | $4.386,38 | 117 / 8 |
Simple Pneumonia & Pleurisy W/O Cc/Mcc | 16 | 77 / 38 | $18.340,90 | 1059 / 49 | $3.859,19 | 142 / 4 | $2.801,19 | 141 / 7 |
Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 16 | 172 / 58 | $42.526,90 | 1014 / 62 | $8.016,00 | 4 / 86 | $4.102,75 | 4 / 1 |
Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 16 | 166 / 67 | $27.873,50 | 992 / 25 | $5.942,00 | 288 / 8 | $4.958,00 | 287 / 22 |
Extracranial Procedures W/O Cc/Mcc | 15 | 83 / 33 | $33.526,10 | 512 / 35 | $5.754,47 | 92 / 3 | $4.632,33 | 92 / 5 |
Other Vascular Procedures W Cc | 15 | 87 / 39 | $49.689,50 | 202 / 9 | $15.968,30 | 25 / 41 | $11.947,10 | 25 / 4 |
Cardiac Arrhythmia & Conduction Disorders W Cc | 15 | 146 / 58 | $24.053,70 | 1355 / 63 | $5.272,27 | 122 / 70 | $3.342,93 | 122 / 12 |
Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 14 | 136 / 51 | $15.467,90 | 1049 / 35 | $3.936,14 | 30 / 59 | $1.788,57 | 30 / 5 |
Cellulitis W/O Mcc | 14 | 175 / 75 | $26.029,60 | 1929 / 126 | $5.581,79 | 751 / 89 | $4.086,71 | 747 / 63 |
G.I. Obstruction W/O Cc/Mcc | 13 | 58 / 24 | $16.568,70 | 630 / 20 | $3.338,08 | 140 / 2 | $2.410,08 | 140 / 13 |
G.I. Hemorrhage W Cc | 13 | 205 / 76 | $28.936,50 | 1493 / 66 | $5.377,38 | 1 / 3 | $3.134,62 | 1 / 1 |
Cardiac Arrhythmia & Conduction Disorders W Mcc | 13 | 110 / 50 | $41.196,50 | 1356 / 75 | $7.325,46 | 427 / 38 | $6.261,85 | 425 / 37 |
Coronary Bypass W Cardiac Cath W Mcc | 12 | 44 / 16 | $181.897,00 | 199 / 13 | $42.557,50 | 135 / 16 | $39.752,80 | 135 / 18 |
Acute Myocardial Infarction, Discharged Alive W Cc | 12 | 79 / 33 | $43.922,60 | 1099 / 59 | $5.614,17 | 41 / 1 | $4.472,50 | 41 / 3 |
Spinal Fusion Except Cervical W/O Mcc | 12 | 182 / 61 | $153.447,00 | 1129 / 89 | $29.129,80 | 1073 / 92 | $27.709,30 | 1068 / 111 |
Syncope & Collapse | 12 | 157 / 53 | $20.819,20 | 930 / 25 | $3.939,00 | 103 / 3 | $2.989,42 | 103 / 7 |
Major Small & Large Bowel Procedures W Cc | 11 | 97 / 39 | $64.812,60 | 744 / 33 | $14.198,90 | 225 / 13 | $12.573,40 | 223 / 23 |
Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 11 | 109 / 45 | $18.991,90 | 1184 / 41 | $3.918,64 | 154 / 2 | $2.929,55 | 154 / 8 |
Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 11 | 45 / 22 | $46.724,80 | 524 / 36 | $8.965,45 | 17 / 5 | $7.109,27 | 17 / 1 | Total 40 procedures | 921 | 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.