Hospital Costs > In Tennessee > Regional One Health, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 37 | 44 / 4 | $602.247,00 | 321 / 15 | $144.044,00 | 313 / 15 | $132.694,00 | 312 / 15 |
| Full Thickness Burn W Skin Graft Or Inhal Inj W Cc/Mcc | 20 | 11 / 2 | $203.614,00 | 30 / 1 | $54.943,10 | 28 / 1 | $53.611,90 | 28 / 2 |
| Heart Failure & Shock W Cc | 16 | 262 / 50 | $36.132,50 | 2219 / 72 | $18.832,70 | 2765 / 77 | $18.230,70 | 2759 / 77 |
| Heart Failure & Shock W Mcc | 13 | 271 / 48 | $53.842,60 | 2086 / 72 | $22.513,90 | 2625 / 78 | $21.955,20 | 2614 / 78 |
| Hip & Femur Procedures Except Major Joint W Cc | 16 | 127 / 30 | $99.415,90 | 1887 / 49 | $25.828,40 | 2045 / 50 | $24.774,40 | 2023 / 50 |
| Hiv W Major Related Condition W Mcc | 18 | 19 / 2 | $75.797,80 | 44 / 2 | $30.665,70 | 77 / 3 | $29.933,20 | 77 / 3 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 12 | 43 / 10 | $103.834,00 | 588 / 17 | $26.452,20 | 636 / 17 | $24.608,20 | 632 / 17 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Mcc | 16 | 7 / 3 | $174.809,00 | 50 / 3 | $35.219,60 | 52 / 3 | $33.970,40 | 52 / 3 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 12 | 35 / 8 | $99.907,90 | 501 / 19 | $22.652,70 | 516 / 19 | $21.236,30 | 516 / 19 |
| Major Chest Trauma W Mcc | 15 | 4 / 2 | $78.450,60 | 18 / 3 | $23.531,50 | 21 / 3 | $21.169,90 | 21 / 3 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 44 | 520 / 43 | $58.890,00 | 1652 / 37 | $26.341,20 | 2674 / 59 | $25.326,70 | 2628 / 59 |
| Medical Back Problems W Mcc | 12 | 27 / 6 | $68.120,40 | 272 / 9 | $23.482,20 | 323 / 9 | $21.633,10 | 323 / 9 |
| Medical Back Problems W/O Mcc | 19 | 102 / 17 | $44.547,90 | 1337 / 35 | $19.501,00 | 1500 / 35 | $15.893,10 | 1495 / 35 |
| Non-Extensive Burns | 19 | 11 / 1 | $71.127,00 | 36 / 2 | $21.899,60 | 36 / 2 | $20.631,70 | 36 / 2 |
| Other Antepartum Diagnoses W Medical Complications | 18 | 7 / 1 | $36.593,30 | 30 / 2 | $17.111,30 | 35 / 2 | $16.694,40 | 35 / 2 |
| Other Multiple Significant Trauma W Mcc | 18 | 6 / 2 | $91.586,80 | 13 / 2 | $31.434,50 | 19 / 2 | $27.263,90 | 19 / 2 |
| Other O.R. Procedures For Multiple Significant Trauma W Mcc | 28 | 2 / 1 | $277.884,00 | 28 / 4 | $67.570,10 | 28 / 4 | $65.104,40 | 28 / 4 |
| Pneumothorax W Mcc | 11 | 7 / 2 | $71.261,50 | 14 / 3 | $24.748,50 | 15 / 3 | $23.651,70 | 15 / 3 |
| Red Blood Cell Disorders W/O Mcc | 26 | 117 / 17 | $53.528,80 | 1936 / 49 | $17.474,20 | 2006 / 49 | $16.343,50 | 1997 / 49 |
| Renal Failure W Mcc | 11 | 184 / 47 | $43.876,00 | 1411 / 45 | $22.763,60 | 2156 / 60 | $21.882,20 | 2152 / 60 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 38 | 478 / 54 | $68.990,20 | 2266 / 76 | $24.951,40 | 2806 / 82 | $24.108,50 | 2761 / 82 |
| Traumatic Stupor & Coma, Coma <1 Hr W Mcc | 18 | 33 / 6 | $90.679,70 | 289 / 8 | $26.833,30 | 345 / 8 | $25.893,00 | 345 / 8 |
| Vaginal Delivery W/O Complicating Diagnoses | 14 | 11 / 1 | $10.881,40 | 28 / 1 | $15.725,70 | 75 / 1 | $14.598,90 | 75 / 1 | Total 23 procedures | 451 | 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.