Hospital Costs > In Kentucky > Pineville Community Hospital, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Cellulitis W/O Mcc | 30 | 159 / 22 | $6.249,60 | 18 / 1 | $4.913,10 | 232 / 7 | $3.603,83 | 230 / 6 |
| Chest Pain | 22 | 129 / 19 | $5.843,55 | 21 / 1 | $3.753,14 | 429 / 9 | $2.857,09 | 427 / 16 |
| Chronic Obstructive Pulmonary Disease W Cc | 40 | 139 / 21 | $8.051,27 | 24 / 1 | $5.648,92 | 259 / 16 | $4.267,52 | 259 / 9 |
| Chronic Obstructive Pulmonary Disease W Mcc | 47 | 155 / 25 | $9.428,77 | 26 / 1 | $6.911,45 | 253 / 16 | $5.509,04 | 252 / 8 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 27 | 93 / 24 | $7.009,11 | 43 / 1 | $4.314,81 | 445 / 9 | $3.277,74 | 444 / 17 |
| Diabetes W Cc | 11 | 81 / 25 | $5.811,55 | 2 / 1 | $4.919,36 | 177 / 7 | $3.784,55 | 177 / 4 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 54 | 221 / 21 | $8.244,48 | 108 / 1 | $4.604,96 | 376 / 16 | $3.309,02 | 375 / 11 |
| G.I. Hemorrhage W Cc | 18 | 200 / 34 | $10.895,50 | 81 / 3 | $5.718,89 | 355 / 6 | $4.765,06 | 355 / 12 |
| Heart Failure & Shock W Cc | 29 | 249 / 32 | $8.797,07 | 68 / 1 | $5.555,86 | 191 / 6 | $4.513,59 | 191 / 5 |
| Heart Failure & Shock W Mcc | 54 | 230 / 26 | $11.757,10 | 44 / 1 | $8.362,24 | 125 / 10 | $7.054,17 | 125 / 3 |
| Heart Failure & Shock W/O Cc/Mcc | 13 | 97 / 28 | $6.517,00 | 40 / 1 | $4.123,15 | 341 / 10 | $3.149,15 | 339 / 10 |
| Hypertension W/O Mcc | 11 | 54 / 12 | $5.940,45 | 16 / 1 | $3.792,27 | 180 / 4 | $2.845,73 | 178 / 7 |
| Kidney & Urinary Tract Infections W Mcc | 26 | 118 / 16 | $14.729,50 | 230 / 5 | $7.166,50 | 123 / 27 | $5.074,19 | 123 / 4 |
| Kidney & Urinary Tract Infections W/O Mcc | 41 | 192 / 27 | $7.059,17 | 55 / 1 | $4.630,02 | 318 / 12 | $3.456,80 | 318 / 7 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 20 | 146 / 27 | $7.435,30 | 97 / 2 | $4.372,85 | 331 / 20 | $3.167,60 | 331 / 9 |
| Respiratory Infections & Inflammations W Cc | 11 | 77 / 20 | $11.526,70 | 26 / 1 | $8.045,18 | 162 / 13 | $6.670,18 | 162 / 5 |
| Respiratory Infections & Inflammations W Mcc | 31 | 105 / 14 | $17.562,90 | 50 / 2 | $10.815,30 | 63 / 10 | $9.188,26 | 63 / 4 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 11 | 505 / 53 | $18.176,50 | 178 / 2 | $10.190,50 | 301 / 12 | $9.174,27 | 301 / 13 |
| Simple Pneumonia & Pleurisy W Cc | 32 | 171 / 37 | $10.365,90 | 132 / 1 | $5.784,91 | 233 / 13 | $4.378,41 | 233 / 6 |
| Simple Pneumonia & Pleurisy W Mcc | 45 | 160 / 27 | $11.360,00 | 20 / 1 | $7.833,71 | 81 / 3 | $6.533,04 | 81 / 3 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 14 | 79 / 26 | $7.634,64 | 73 / 1 | $4.272,50 | 413 / 12 | $3.155,14 | 411 / 15 |
| Syncope & Collapse | 17 | 152 / 24 | $7.040,29 | 18 / 1 | $4.468,35 | 386 / 10 | $3.433,47 | 384 / 10 |
| Transient Ischemia | 11 | 114 / 23 | $7.271,09 | 23 / 1 | $4.244,09 | 580 / 4 | $3.451,64 | 577 / 16 | Total 23 procedures | 615 | 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.