Hospital Costs > In California > Scripps Memorial Hospital La Jolla, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 241 | 323 / 37 | $95.583,20 | 2419 / 144 | $14.848,30 | 1649 / 17 | $12.428,90 | 1612 / 16 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 193 | 323 / 82 | $80.407,50 | 2439 / 144 | $12.680,60 | 1775 / 15 | $11.683,20 | 1740 / 20 |
| Heart Failure & Shock W Mcc | 65 | 219 / 63 | $72.919,80 | 2386 / 142 | $10.457,70 | 1806 / 16 | $9.728,11 | 1801 / 22 |
| Simple Pneumonia & Pleurisy W Mcc | 61 | 144 / 32 | $61.834,50 | 2121 / 82 | $9.761,48 | 1646 / 9 | $9.003,87 | 1646 / 13 |
| Spinal Fusion Except Cervical W/O Mcc | 57 | 137 / 16 | $233.244,00 | 1325 / 81 | $31.219,90 | 1101 / 32 | $28.175,10 | 1096 / 34 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 57 | 150 / 58 | $37.524,70 | 1950 / 79 | $6.923,35 | 1262 / 7 | $5.940,91 | 1257 / 10 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 57 | 125 / 22 | $49.806,10 | 1737 / 73 | $7.194,09 | 1257 / 7 | $6.254,09 | 1254 / 12 |
| G.I. Hemorrhage W Cc | 57 | 161 / 38 | $36.904,90 | 1852 / 52 | $6.679,75 | 1319 / 5 | $5.719,23 | 1316 / 10 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 56 | 35 / 6 | $72.038,70 | 715 / 45 | $7.930,52 | 380 / 8 | $5.892,14 | 379 / 7 |
| Simple Pneumonia & Pleurisy W Cc | 53 | 150 / 37 | $34.841,20 | 2176 / 49 | $6.667,53 | 1246 / 10 | $5.258,91 | 1242 / 2 |
| Major Small & Large Bowel Procedures W Cc | 52 | 56 / 6 | $139.166,00 | 1415 / 69 | $28.321,80 | 1034 / 108 | $16.047,90 | 1022 / 14 |
| Traumatic Stupor & Coma, Coma <1 Hr W Cc | 52 | 15 / 1 | $80.004,20 | 515 / 27 | $8.348,00 | 262 / 6 | $6.614,23 | 262 / 4 |
| Hip & Femur Procedures Except Major Joint W Cc | 51 | 92 / 18 | $86.893,70 | 1784 / 68 | $13.785,40 | 1295 / 18 | $11.954,70 | 1278 / 10 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 46 | 229 / 64 | $31.272,60 | 2222 / 80 | $5.374,96 | 1122 / 14 | $3.840,50 | 1114 / 3 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 44 | 124 / 28 | $75.619,20 | 1325 / 63 | $14.319,50 | 1143 / 63 | $11.776,10 | 1137 / 26 |
| Medical Back Problems W/O Mcc | 43 | 78 / 16 | $40.978,80 | 1262 / 56 | $6.023,30 | 691 / 9 | $4.550,72 | 688 / 4 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 41 | 155 / 32 | $87.396,20 | 1012 / 23 | $15.099,40 | 788 / 16 | $11.610,40 | 783 / 3 |
| Kidney & Urinary Tract Infections W/O Mcc | 41 | 192 / 68 | $29.604,00 | 2202 / 64 | $5.068,83 | 1208 / 4 | $4.092,46 | 1199 / 8 |
| Heart Failure & Shock W Cc | 40 | 238 / 62 | $46.387,40 | 2493 / 129 | $6.772,55 | 1337 / 14 | $5.586,05 | 1333 / 10 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 38 | 128 / 42 | $27.035,10 | 1998 / 61 | $5.145,00 | 1142 / 16 | $3.759,11 | 1139 / 9 |
| Cellulitis W/O Mcc | 36 | 153 / 50 | $33.889,20 | 2266 / 99 | $5.869,94 | 1243 / 11 | $4.463,67 | 1237 / 7 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Cc | 35 | 83 / 11 | $301.194,00 | 505 / 23 | $37.168,10 | 377 / 4 | $36.124,50 | 377 / 5 |
| Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 34 | 32 / 6 | $129.824,00 | 556 / 36 | $14.516,80 | 441 / 9 | $13.298,40 | 438 / 14 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 34 | 90 / 32 | $269.719,00 | 1457 / 91 | $41.338,30 | 1135 / 47 | $37.536,00 | 1127 / 35 |
| Chronic Obstructive Pulmonary Disease W Mcc | 33 | 169 / 57 | $50.699,20 | 2202 / 86 | $7.588,06 | 1215 / 4 | $6.479,21 | 1209 / 5 |
| Other Digestive System Diagnoses W Cc | 29 | 68 / 14 | $43.489,40 | 1181 / 57 | $6.457,10 | 814 / 2 | $5.822,66 | 810 / 9 |
| Degenerative Nervous System Disorders W/O Mcc | 28 | 50 / 5 | $32.959,60 | 563 / 14 | $6.310,50 | 382 / 3 | $5.569,89 | 382 / 5 |
| Respiratory Infections & Inflammations W Mcc | 26 | 110 / 46 | $68.765,20 | 1394 / 43 | $12.521,60 | 1033 / 7 | $11.806,90 | 1020 / 8 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 25 | 136 / 41 | $40.722,30 | 1919 / 93 | $5.269,60 | 1003 / 3 | $4.300,56 | 1000 / 6 |
| G.I. Obstruction W Cc | 25 | 67 / 27 | $30.661,50 | 1221 / 24 | $5.893,80 | 766 / 3 | $4.774,36 | 764 / 3 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 24 | 40 / 9 | $88.568,80 | 704 / 30 | $11.806,60 | 435 / 7 | $9.446,33 | 435 / 4 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 23 | 42 / 10 | $131.786,00 | 790 / 26 | $20.820,90 | 540 / 6 | $19.761,50 | 537 / 7 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 23 | 165 / 38 | $69.680,20 | 1495 / 77 | $9.190,70 | 1049 / 44 | $6.491,22 | 1046 / 9 |
| Fractures Of Hip & Pelvis W/O Mcc | 22 | 39 / 9 | $27.442,40 | 701 / 16 | $4.685,32 | 350 / 3 | $3.576,95 | 351 / 3 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 22 | 101 / 32 | $51.277,60 | 1554 / 54 | $8.466,14 | 1170 / 7 | $7.529,82 | 1167 / 8 |
| Renal Failure W Cc | 22 | 199 / 66 | $34.687,20 | 1889 / 49 | $6.509,77 | 964 / 9 | $5.147,00 | 956 / 3 |
| Hip & Femur Procedures Except Major Joint W Mcc | 22 | 40 / 7 | $131.438,00 | 830 / 36 | $20.300,40 | 606 / 3 | $19.361,10 | 603 / 7 |
| Chronic Obstructive Pulmonary Disease W Cc | 21 | 158 / 52 | $37.077,40 | 1990 / 60 | $6.002,14 | 1118 / 2 | $5.074,48 | 1114 / 4 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 21 | 81 / 27 | $33.093,70 | 1190 / 23 | $5.069,67 | 784 / 4 | $3.975,29 | 780 / 7 |
| Pulmonary Edema & Respiratory Failure | 21 | 182 / 54 | $48.318,10 | 1722 / 42 | $8.142,24 | 1354 / 2 | $7.505,19 | 1350 / 7 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W/O Card Cath W Mcc | 20 | 96 / 18 | $429.104,00 | 450 / 27 | $61.694,10 | 376 / 8 | $61.061,20 | 376 / 15 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W Mcc Or 4+ Vessels/Stents | 20 | 80 / 22 | $141.127,00 | 782 / 29 | $21.613,90 | 610 / 1 | $20.945,80 | 606 / 5 |
| Cervical Spinal Fusion W/O Cc/Mcc | 19 | 85 / 19 | $152.843,00 | 865 / 54 | $18.516,90 | 696 / 26 | $14.911,00 | 693 / 15 |
| Poisoning & Toxic Effects Of Drugs W Mcc | 19 | 53 / 16 | $95.252,20 | 949 / 70 | $12.461,70 | 834 / 43 | $11.502,10 | 831 / 48 |
| Major Small & Large Bowel Procedures W Mcc | 19 | 66 / 21 | $291.518,00 | 1227 / 65 | $41.209,90 | 1082 / 32 | $40.218,00 | 1080 / 39 |
| Stomach, Esophageal & Duodenal Proc W/O Cc/Mcc | 19 | 29 / 6 | $79.446,30 | 217 / 13 | $9.869,11 | 105 / 1 | $8.665,26 | 105 / 2 |
| Uterine & Adnexa Proc For Non-Malignancy W/O Cc/Mcc | 19 | 27 / 6 | $69.379,00 | 248 / 24 | $7.341,00 | 80 / 3 | $5.142,53 | 80 / 2 |
| Permanent Cardiac Pacemaker Implant W Cc | 19 | 58 / 16 | $102.721,00 | 787 / 32 | $17.224,90 | 554 / 1 | $16.335,40 | 553 / 5 |
| Other Disorders Of Nervous System W Cc | 18 | 38 / 9 | $36.697,10 | 463 / 12 | $5.831,94 | 302 / 2 | $5.293,50 | 302 / 4 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Cc | 18 | 26 / 6 | $137.529,00 | 393 / 15 | $18.401,60 | 215 / 3 | $17.389,70 | 214 / 3 |
| Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O.R. | 18 | 63 / 11 | $1.135.000,00 | 436 / 25 | $177.601,00 | 420 / 21 | $175.218,00 | 419 / 23 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 18 | 74 / 37 | $377.870,00 | 1058 / 119 | $51.512,20 | 951 / 88 | $49.700,10 | 950 / 93 |
| Craniotomy & Endovascular Intracranial Procedures W Mcc | 17 | 81 / 16 | $282.067,00 | 486 / 32 | $55.273,20 | 336 / 41 | $31.127,80 | 336 / 8 |
| Renal Failure W Mcc | 17 | 178 / 69 | $64.587,30 | 1823 / 89 | $10.614,80 | 1361 / 13 | $9.819,12 | 1361 / 15 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 17 | 45 / 14 | $35.267,80 | 670 / 24 | $7.808,47 | 198 / 41 | $3.598,82 | 198 / 2 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 17 | 38 / 10 | $121.483,00 | 617 / 32 | $16.719,80 | 560 / 25 | $15.574,10 | 556 / 29 |
| Other Musculoskelet Sys & Conn Tiss O.R. Proc W Cc | 17 | 23 / 4 | $99.780,10 | 199 / 10 | $13.162,40 | 127 / 1 | $12.089,30 | 127 / 2 |
| Traumatic Stupor & Coma, Coma <1 Hr W/O Cc/Mcc | 16 | 38 / 12 | $55.238,90 | 385 / 12 | $4.923,06 | 129 / 1 | $3.856,38 | 129 / 1 |
| Cardiac Valve & Oth Maj Cardiothoracic Proc W Card Cath W Mcc | 16 | 53 / 8 | $499.055,00 | 270 / 12 | $70.923,90 | 204 / 3 | $70.213,40 | 204 / 4 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 16 | 109 / 36 | $93.369,40 | 1665 / 97 | $13.869,40 | 1530 / 58 | $13.191,20 | 1517 / 69 |
| G.I. Obstruction W/O Cc/Mcc | 15 | 56 / 26 | $27.084,90 | 1061 / 33 | $4.059,73 | 654 / 3 | $3.163,73 | 652 / 9 |
| Other Circulatory System Diagnoses W Mcc | 15 | 101 / 35 | $116.477,00 | 1331 / 109 | $13.355,50 | 871 / 10 | $12.529,90 | 865 / 12 |
| Nonspecific Cerebrovascular Disorders W Cc | 15 | 41 / 11 | $44.311,40 | 393 / 18 | $6.570,60 | 194 / 3 | $5.429,67 | 194 / 1 |
| Respiratory Infections & Inflammations W Cc | 15 | 73 / 33 | $56.860,30 | 1225 / 48 | $8.803,40 | 832 / 5 | $8.074,33 | 827 / 6 |
| Major Chest Trauma W Cc | 15 | 21 / 2 | $55.141,80 | 125 / 2 | $6.583,47 | 64 / 1 | $5.530,80 | 64 / 1 |
| Other Skin, Subcut Tiss & Breast Proc W/O Cc/Mcc | 14 | 13 / 3 | $72.428,10 | 56 / 4 | $7.909,14 | 27 / 1 | $6.870,21 | 27 / 1 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 14 | 49 / 16 | $272.014,00 | 710 / 36 | $40.229,70 | 627 / 27 | $38.956,90 | 627 / 30 |
| Red Blood Cell Disorders W/O Mcc | 14 | 129 / 42 | $33.777,40 | 1636 / 56 | $5.341,21 | 1091 / 3 | $4.645,07 | 1084 / 10 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 14 | 87 / 34 | $103.903,00 | 1071 / 68 | $13.771,20 | 966 / 41 | $13.157,40 | 962 / 51 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 14 | 112 / 45 | $57.697,90 | 1583 / 111 | $8.767,64 | 1267 / 34 | $7.973,36 | 1264 / 42 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 14 | 33 / 8 | $81.305,00 | 476 / 15 | $13.603,90 | 169 / 17 | $7.681,64 | 169 / 1 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 14 | 117 / 39 | $197.957,00 | 1832 / 129 | $22.641,30 | 1748 / 103 | $21.699,90 | 1734 / 113 |
| Stomach, Esophageal & Duodenal Proc W Cc | 14 | 36 / 10 | $144.979,00 | 209 / 9 | $28.320,30 | 45 / 7 | $14.456,50 | 45 / 1 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 14 | 82 / 30 | $65.490,60 | 1330 / 86 | $10.043,40 | 1193 / 53 | $9.253,29 | 1188 / 58 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 14 | 42 / 16 | $72.329,20 | 672 / 17 | $11.057,00 | 546 / 1 | $9.842,29 | 544 / 4 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 14 | 57 / 19 | $324.541,00 | 937 / 64 | $42.621,40 | 826 / 39 | $41.512,30 | 825 / 43 |
| Concussion W Cc | 14 | 6 / 3 | $84.455,60 | 18 / 2 | $6.853,07 | 10 / 1 | $5.895,79 | 10 / 1 |
| Transient Ischemia | 14 | 111 / 42 | $40.077,20 | 1441 / 71 | $5.211,79 | 661 / 10 | $3.540,07 | 657 / 2 |
| Kidney & Urinary Tract Infections W Mcc | 13 | 131 / 53 | $30.418,00 | 1194 / 17 | $7.526,38 | 1102 / 9 | $6.579,62 | 1098 / 10 |
| Hernia Procedures Except Inguinal & Femoral W/O Cc/Mcc | 13 | 19 / 6 | $56.185,70 | 113 / 5 | $7.885,62 | 63 / 1 | $6.671,62 | 63 / 1 |
| Coronary Bypass W Cardiac Cath W/O Mcc | 13 | 63 / 15 | $311.039,00 | 590 / 22 | $35.835,60 | 536 / 9 | $34.993,50 | 536 / 16 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 13 | 90 / 26 | $47.928,20 | 729 / 27 | $6.547,15 | 357 / 3 | $5.701,00 | 357 / 3 |
| G.I. Hemorrhage W Mcc | 13 | 108 / 43 | $53.805,10 | 1082 / 29 | $11.443,10 | 765 / 4 | $10.459,10 | 763 / 3 |
| Medical Back Problems W Mcc | 13 | 26 / 7 | $44.310,70 | 177 / 4 | $10.075,80 | 105 / 3 | $8.949,54 | 105 / 3 |
| Combined Anterior/Posterior Spinal Fusion W/O Cc/Mcc | 13 | 34 / 10 | $272.517,00 | 100 / 8 | $43.064,60 | 84 / 2 | $41.845,20 | 84 / 6 |
| Cervical Spinal Fusion W Cc | 13 | 40 / 14 | $190.705,00 | 377 / 25 | $22.246,50 | 299 / 9 | $21.025,90 | 298 / 10 |
| Pulmonary Embolism W/O Mcc | 12 | 62 / 18 | $34.820,50 | 967 / 14 | $6.510,83 | 793 / 1 | $5.803,25 | 790 / 9 |
| Other Disorders Of Nervous System W Mcc | 12 | 28 / 11 | $51.939,00 | 218 / 6 | $10.487,80 | 141 / 2 | $9.868,92 | 141 / 2 |
| Hip & Femur Procedures Except Major Joint W/O Cc/Mcc | 12 | 44 / 22 | $71.408,80 | 800 / 31 | $12.854,40 | 422 / 27 | $8.880,58 | 420 / 1 |
| Peritoneal Adhesiolysis W Cc | 12 | 27 / 10 | $98.894,20 | 248 / 7 | $15.696,10 | 174 / 2 | $14.795,80 | 174 / 3 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 12 | 57 / 20 | $129.863,00 | 471 / 25 | $17.929,10 | 338 / 1 | $16.726,40 | 337 / 4 |
| Disorders Of Pancreas Except Malignancy W Cc | 12 | 49 / 13 | $32.633,20 | 680 / 10 | $6.127,08 | 543 / 2 | $5.418,50 | 541 / 4 |
| Acute Myocardial Infarction, Discharged Alive W Cc | 12 | 79 / 24 | $35.817,90 | 929 / 14 | $6.425,50 | 463 / 1 | $5.414,17 | 462 / 1 |
| Trauma To The Skin, Subcut Tiss & Breast W/O Mcc | 12 | 32 / 12 | $41.874,00 | 277 / 16 | $4.947,17 | 82 / 1 | $3.828,25 | 82 / 1 |
| Peritoneal Adhesiolysis W/O Cc/Mcc | 11 | 13 / 4 | $61.686,50 | 67 / 2 | $12.401,50 | 20 / 3 | $8.677,36 | 20 / 1 |
| Perc Cardiovasc Proc W/O Coronary Artery Stent W/O Mcc | 11 | 84 / 19 | $130.133,00 | 552 / 28 | $15.884,30 | 255 / 16 | $11.475,90 | 253 / 2 |
| Infectious & Parasitic Diseases W O.R. Procedure W Cc | 11 | 25 / 11 | $111.219,00 | 314 / 13 | $20.502,60 | 316 / 17 | $19.503,50 | 315 / 17 |
| Major Cardiovasc Procedures W Mcc | 11 | 57 / 19 | $316.498,00 | 622 / 38 | $58.393,60 | 458 / 40 | $38.375,50 | 457 / 9 |
| Permanent Cardiac Pacemaker Implant W/O Cc/Mcc | 11 | 46 / 15 | $115.319,00 | 683 / 40 | $14.903,40 | 501 / 7 | $13.808,50 | 500 / 9 |
| Periph/Cranial Nerve & Other Nerv Syst Proc W Cc Or Periph Neurostim | 11 | 18 / 3 | $133.703,00 | 73 / 2 | $16.002,50 | 42 / 1 | $14.987,20 | 42 / 2 | Total 100 procedures | 2.753 | 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.