Hospital Costs > In Massachusetts > Hallmark Health System, 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 Cc | 23 | 68 / 15 | $9.878,00 | 35 / 5 | $8.236,87 | 818 / 17 | $6.172,65 | 816 / 5 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 46 | 79 / 13 | $13.380,20 | 30 / 4 | $12.018,30 | 1092 / 14 | $10.620,40 | 1087 / 12 |
| Acute Myocardial Infarction, Discharged Alive W/O Cc/Mcc | 19 | 34 / 9 | $8.278,53 | 28 / 6 | $5.841,21 | 563 / 10 | $4.529,32 | 559 / 5 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 33 | 91 / 16 | $9.020,70 | 100 / 13 | $5.803,94 | 484 / 21 | $4.399,52 | 483 / 10 |
| Atherosclerosis W/O Mcc | 20 | 38 / 6 | $7.301,95 | 15 / 3 | $4.992,85 | / 6 | $3.622,90 | / |
| Biopsies Of Musculoskeletal System & Connective Tissue W Cc | 13 | 19 / 5 | $46.159,10 | 28 / 4 | $17.046,50 | 88 / 4 | $15.049,20 | 88 / 1 |
| Biopsies Of Musculoskeletal System & Connective Tissue W/O Cc/Mcc | 11 | 7 / 2 | $45.238,50 | 8 / 2 | $15.056,60 | 16 / 2 | $13.554,10 | 16 / 2 |
| Bone Diseases & Arthropathies W/O Mcc | 19 | 25 / 3 | $7.908,21 | 21 / 5 | $5.922,11 | 140 / 5 | $4.432,84 | 140 / 3 |
| Bronchitis & Asthma W Cc/Mcc | 12 | 64 / 22 | $6.833,75 | 8 / 2 | $6.793,92 | 713 / 9 | $5.523,42 | 709 / 9 |
| Bronchitis & Asthma W/O Cc/Mcc | 13 | 32 / 9 | $7.920,08 | 27 / 2 | $5.286,38 | 244 / 2 | $4.001,92 | 244 / 3 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 60 | 101 / 15 | $9.237,13 | 79 / 11 | $6.225,27 | 1520 / 22 | $5.023,40 | 1515 / 18 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 47 | 76 / 14 | $12.565,10 | 57 / 10 | $9.229,36 | 1223 / 19 | $7.675,83 | 1220 / 10 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 52 | 98 / 7 | $6.430,77 | 55 / 6 | $4.643,37 | 1354 / 18 | $3.231,50 | 1349 / 13 |
| Cellulitis W Mcc | 18 | 40 / 12 | $9.842,72 | 5 / 3 | $10.888,00 | 477 / 12 | $8.635,17 | 475 / 4 |
| Cellulitis W/O Mcc | 84 | 105 / 19 | $7.548,00 | 72 / 10 | $6.776,31 | 1724 / 31 | $5.012,19 | 1716 / 16 |
| Chest Pain | 35 | 116 / 13 | $7.992,43 | 73 / 9 | $4.849,97 | 1026 / 14 | $3.603,66 | 1020 / 7 |
| Chronic Obstructive Pulmonary Disease W Cc | 79 | 100 / 10 | $9.764,83 | 87 / 14 | $7.485,11 | 1632 / 29 | $5.731,38 | 1625 / 10 |
| Chronic Obstructive Pulmonary Disease W Mcc | 121 | 81 / 5 | $10.817,50 | 66 / 8 | $8.932,07 | 1756 / 28 | $7.338,92 | 1748 / 15 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 66 | 54 / 7 | $7.368,71 | 67 / 13 | $5.781,77 | 1499 / 20 | $4.421,67 | 1488 / 15 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 18 | 170 / 23 | $17.803,10 | 64 / 8 | $8.379,94 | 1140 / 8 | $6.817,39 | 1137 / 4 |
| Cirrhosis & Alcoholic Hepatitis W Mcc | 13 | 29 / 8 | $14.140,10 | 1 / 1 | $12.951,30 | 157 / 2 | $11.688,00 | 157 / 1 |
| Diabetes W Cc | 31 | 61 / 12 | $9.164,77 | 62 / 16 | $6.469,55 | 1013 / 13 | $5.171,68 | 1009 / 12 |
| Diabetes W Mcc | 14 | 43 / 10 | $12.407,30 | 16 / 4 | $10.397,80 | 418 / 6 | $8.799,29 | 418 / 3 |
| Disorders Of Pancreas Except Malignancy W Cc | 11 | 50 / 22 | $14.884,10 | 116 / 20 | $7.554,91 | 394 / 14 | $5.002,91 | 393 / 3 |
| Disorders Of Pancreas Except Malignancy W/O Cc/Mcc | 11 | 27 / 11 | $7.335,64 | 16 / 2 | $5.367,18 | 288 / 3 | $3.793,45 | 287 / 2 |
| Disorders Of The Biliary Tract W Cc | 11 | 43 / 17 | $12.606,70 | 19 / 3 | $7.961,00 | 289 / 6 | $6.862,09 | 289 / 4 |
| Dysequilibrium | 17 | 48 / 11 | $10.865,60 | 51 / 11 | $5.079,06 | 325 / 6 | $3.704,24 | 325 / 4 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 16 | 80 / 25 | $13.243,90 | 53 / 13 | $9.644,88 | 886 / 20 | $7.725,19 | 881 / 9 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 124 | 151 / 19 | $9.111,24 | 154 / 13 | $6.046,28 | 1836 / 27 | $4.534,84 | 1823 / 16 |
| Fractures Of Hip & Pelvis W/O Mcc | 39 | 22 / 2 | $7.706,90 | 31 / 6 | $5.728,87 | 628 / 13 | $4.318,54 | 628 / 10 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 50 | 14 / 1 | $8.921,72 | 45 / 8 | $6.178,92 | 468 / 14 | $4.473,32 | 466 / 7 |
| G.I. Hemorrhage W Cc | 80 | 138 / 15 | $13.731,40 | 206 / 23 | $7.845,58 | 1669 / 26 | $6.295,71 | 1665 / 15 |
| G.I. Hemorrhage W Mcc | 35 | 86 / 12 | $22.006,50 | 110 / 18 | $12.429,80 | 797 / 10 | $10.535,60 | 794 / 3 |
| G.I. Hemorrhage W/O Cc/Mcc | 24 | 44 / 7 | $9.025,25 | 71 / 9 | $5.632,75 | 644 / 9 | $4.182,42 | 640 / 8 |
| G.I. Obstruction W Cc | 31 | 61 / 14 | $9.937,61 | 54 / 11 | $7.174,48 | 1178 / 21 | $5.487,55 | 1175 / 11 |
| G.I. Obstruction W/O Cc/Mcc | 29 | 42 / 9 | $6.929,93 | 34 / 5 | $5.316,86 | 823 / 18 | $3.487,34 | 820 / 9 |
| Heart Failure & Shock W Cc | 171 | 108 / 11 | $9.294,36 | 88 / 8 | $7.642,11 | 1786 / 25 | $6.119,91 | 1781 / 10 |
| Heart Failure & Shock W Mcc | 113 | 171 / 20 | $13.914,20 | 107 / 14 | $11.272,90 | 1775 / 28 | $9.649,38 | 1770 / 16 |
| Heart Failure & Shock W/O Cc/Mcc | 71 | 39 / 4 | $7.290,28 | 73 / 7 | $5.435,63 | 1310 / 23 | $4.101,86 | 1300 / 12 |
| Hip & Femur Procedures Except Major Joint W Cc | 43 | 100 / 17 | $22.085,10 | 50 / 7 | $14.790,20 | 1550 / 20 | $13.059,70 | 1532 / 17 |
| Hip & Femur Procedures Except Major Joint W Mcc | 15 | 47 / 12 | $37.045,10 | 36 / 8 | $22.870,60 | 711 / 12 | $20.712,30 | 708 / 6 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 12 | 44 / 12 | $20.119,00 | 35 / 5 | $12.384,50 | 706 / 7 | $10.747,60 | 703 / 7 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 14 | 110 / 21 | $64.483,70 | 137 / 17 | $44.959,10 | 577 / 25 | $30.147,30 | 572 / 1 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 46 | 136 / 15 | $13.662,10 | 98 / 14 | $7.855,59 | 1359 / 20 | $6.495,76 | 1356 / 16 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 22 | 146 / 21 | $16.931,50 | 46 / 9 | $12.623,90 | 893 / 15 | $10.599,90 | 891 / 6 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 26 | 76 / 17 | $14.712,60 | 235 / 24 | $6.352,27 | 943 / 19 | $4.211,88 | 939 / 7 |
| Kidney & Urinary Tract Infections W Mcc | 44 | 100 / 16 | $10.317,80 | 53 / 10 | $8.739,18 | 1349 / 24 | $7.151,80 | 1345 / 16 |
| Kidney & Urinary Tract Infections W/O Mcc | 143 | 90 / 8 | $7.312,83 | 62 / 2 | $6.191,13 | 1701 / 29 | $4.550,45 | 1690 / 9 |
| Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 11 | 36 / 10 | $20.001,80 | 34 / 5 | $9.347,82 | 448 / 4 | $7.828,73 | 447 / 4 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 11 | 36 / 10 | $18.648,00 | 14 / 1 | $11.438,40 | 391 / 2 | $9.790,64 | 391 / 3 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 29 | 44 / 8 | $10.193,30 | 27 / 4 | $9.305,52 | 811 / 19 | $7.859,79 | 809 / 12 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 11 | 45 / 11 | $15.758,00 | 16 / 4 | $14.090,20 | 404 / 8 | $12.286,70 | 403 / 4 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 102 | 462 / 30 | $26.394,90 | 112 / 10 | $16.595,50 | 1838 / 30 | $12.988,90 | 1797 / 4 |
| Major Small & Large Bowel Procedures W Cc | 28 | 80 / 14 | $31.133,50 | 62 / 8 | $19.042,50 | 1111 / 13 | $16.697,40 | 1098 / 11 |
| Major Small & Large Bowel Procedures W Mcc | 16 | 69 / 18 | $55.385,40 | 50 / 8 | $36.680,40 | 801 / 11 | $33.593,80 | 799 / 6 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 14 | 50 / 14 | $20.870,20 | 29 / 6 | $12.641,40 | 567 / 5 | $10.597,90 | 567 / 3 |
| Medical Back Problems W/O Mcc | 30 | 91 / 18 | $10.020,00 | 54 / 7 | $6.728,13 | 982 / 15 | $5.203,17 | 979 / 11 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 21 | 105 / 15 | $12.171,60 | 64 / 11 | $8.976,33 | 1159 / 18 | $7.515,29 | 1156 / 11 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 88 | 78 / 9 | $7.611,14 | 115 / 10 | $5.713,44 | 1550 / 28 | $4.127,32 | 1545 / 11 |
| Other Circulatory System Diagnoses W Cc | 11 | 55 / 17 | $14.471,30 | 72 / 9 | $7.308,00 | 340 / 5 | $5.730,45 | 339 / 1 |
| Other Digestive System Diagnoses W Cc | 14 | 83 / 25 | $11.228,60 | 51 / 12 | $8.014,50 | 848 / 22 | $5.915,21 | 844 / 6 |
| Other Disorders Of Nervous System W Cc | 11 | 45 / 19 | $9.418,36 | 25 / 9 | $7.090,45 | 352 / 12 | $5.576,45 | 352 / 8 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 12 | 91 / 18 | $9.657,67 | 28 / 6 | $7.660,33 | 518 / 9 | $6.401,83 | 518 / 5 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 13 | 88 / 20 | $11.746,50 | 13 / 4 | $11.045,00 | 618 / 8 | $9.604,85 | 616 / 2 |
| Other Respiratory System Diagnoses W/O Mcc | 14 | 32 / 10 | $8.834,36 | 10 / 2 | $6.389,71 | 177 / 5 | $5.057,43 | 177 / 5 |
| Other Vascular Procedures W Cc | 12 | 90 / 18 | $35.968,80 | 60 / 5 | $18.816,20 | 756 / 4 | $16.870,10 | 751 / 4 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 12 | 184 / 22 | $42.220,60 | 87 / 5 | $15.283,80 | 1178 / 2 | $13.810,40 | 1171 / 4 |
| Peripheral Vascular Disorders W Cc | 14 | 70 / 18 | $8.211,21 | 15 / 3 | $7.348,29 | 715 / 9 | $5.894,21 | 712 / 5 |
| Peripheral Vascular Disorders W Mcc | 14 | 35 / 9 | $13.631,70 | 14 / 4 | $11.975,20 | 218 / 9 | $7.816,57 | 218 / 1 |
| Permanent Cardiac Pacemaker Implant W Cc | 11 | 66 / 18 | $31.102,70 | 27 / 2 | $19.601,80 | 690 / 6 | $17.706,80 | 689 / 3 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 17 | 55 / 14 | $19.552,10 | 102 / 17 | $10.984,80 | 683 / 13 | $9.702,76 | 681 / 7 |
| Poisoning & Toxic Effects Of Drugs W/O Mcc | 16 | 45 / 16 | $7.093,00 | 23 / 3 | $5.198,88 | 555 / 11 | $4.041,31 | 554 / 12 |
| Pulmonary Edema & Respiratory Failure | 24 | 179 / 31 | $14.347,00 | 120 / 20 | $9.612,42 | 1634 / 24 | $8.232,33 | 1629 / 12 |
| Pulmonary Embolism W/O Mcc | 15 | 59 / 20 | $10.374,50 | 35 / 7 | $7.611,20 | 918 / 15 | $6.174,80 | 915 / 14 |
| Red Blood Cell Disorders W Mcc | 19 | 52 / 10 | $15.539,50 | 74 / 13 | $10.146,60 | 578 / 15 | $7.719,53 | 576 / 4 |
| Red Blood Cell Disorders W/O Mcc | 39 | 104 / 15 | $10.836,50 | 145 / 20 | $6.299,97 | 1339 / 16 | $5.072,64 | 1330 / 14 |
| Renal Failure W Cc | 97 | 124 / 14 | $8.652,02 | 34 / 6 | $7.384,34 | 1685 / 25 | $6.090,72 | 1676 / 18 |
| Renal Failure W Mcc | 73 | 122 / 10 | $13.196,00 | 31 / 9 | $11.417,80 | 1236 / 22 | $9.516,55 | 1236 / 5 |
| Renal Failure W/O Cc/Mcc | 11 | 45 / 12 | $5.406,27 | 9 / 1 | $4.974,00 | 457 / 5 | $3.468,36 | 456 / 2 |
| Respiratory Infections & Inflammations W Cc | 50 | 38 / 5 | $11.990,90 | 29 / 9 | $10.501,80 | 1081 / 19 | $9.003,48 | 1076 / 14 |
| Respiratory Infections & Inflammations W Mcc | 26 | 110 / 26 | $15.878,50 | 29 / 7 | $14.481,30 | 1280 / 20 | $12.844,70 | 1265 / 13 |
| Respiratory Neoplasms W Mcc | 15 | 37 / 7 | $12.421,30 | 8 / 2 | $12.974,30 | 424 / 4 | $11.523,50 | 422 / 5 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 23 | 108 / 18 | $27.567,00 | 93 / 10 | $16.389,50 | 1114 / 9 | $14.651,00 | 1102 / 5 |
| Seizures W/O Mcc | 21 | 87 / 20 | $9.002,43 | 52 / 11 | $6.380,00 | 722 / 22 | $4.531,43 | 719 / 5 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 212 | 304 / 21 | $16.797,80 | 127 / 8 | $14.160,50 | 1832 / 31 | $11.818,50 | 1797 / 16 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 59 | 148 / 21 | $11.864,80 | 138 / 18 | $9.028,07 | 1812 / 34 | $6.813,98 | 1804 / 16 |
| Signs & Symptoms Of Musculoskeletal System & Conn Tissue W/O Mcc | 18 | 29 / 8 | $8.345,44 | 18 / 3 | $5.822,56 | 172 / 6 | $4.248,67 | 172 / 3 |
| Signs & Symptoms W/O Mcc | 28 | 63 / 11 | $8.304,68 | 50 / 5 | $5.562,18 | 787 / 14 | $4.253,71 | 784 / 8 |
| Simple Pneumonia & Pleurisy W Cc | 115 | 88 / 10 | $9.396,93 | 78 / 14 | $7.761,84 | 1989 / 30 | $6.144,44 | 1981 / 19 |
| Simple Pneumonia & Pleurisy W Mcc | 71 | 134 / 17 | $12.568,00 | 47 / 6 | $10.835,40 | 1715 / 25 | $9.185,38 | 1715 / 13 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 43 | 50 / 7 | $6.852,23 | 39 / 7 | $5.661,40 | 1304 / 20 | $4.053,53 | 1297 / 9 |
| Syncope & Collapse | 38 | 131 / 26 | $9.643,13 | 93 / 18 | $5.777,39 | 1212 / 20 | $4.407,03 | 1205 / 9 |
| Tendonitis, Myositis & Bursitis W/O Mcc | 15 | 27 / 7 | $7.912,53 | 12 / 1 | $6.621,27 | 201 / 6 | $5.020,87 | 201 / 4 |
| Transient Ischemia | 15 | 110 / 25 | $11.369,50 | 111 / 13 | $5.597,87 | 1137 / 14 | $4.340,13 | 1131 / 12 |
| Trauma To The Skin, Subcut Tiss & Breast W/O Mcc | 12 | 32 / 8 | $8.490,17 | 17 / 4 | $5.901,92 | 173 / 5 | $4.622,25 | 173 / 3 |
| Urinary Stones W/O Esw Lithotripsy W/O Mcc | 14 | 32 / 7 | $10.195,80 | 21 / 5 | $5.671,36 | 277 / 6 | $4.321,00 | 276 / 6 | Total 96 procedures | 3.630 | 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.