Hospital Costs > In Pennsylvania > Upmc St Margaret, 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 | 14 | 77 / 27 | $28.046,10 | 654 / 35 | $7.050,64 | 111 / 43 | $4.733,64 | 111 / 13 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 17 | 108 / 39 | $38.620,80 | 753 / 45 | $11.790,10 | 36 / 64 | $7.288,82 | 36 / 5 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 14 | 110 / 20 | $30.192,40 | 695 / 26 | $5.587,93 | 2 / 17 | $1.973,43 | 2 / 2 |
| Bone Diseases & Arthropathies W/O Mcc | 13 | 31 / 9 | $11.813,10 | 69 / 1 | $4.930,15 | 16 / 6 | $3.019,15 | 16 / 2 |
| Bronchitis & Asthma W Cc/Mcc | 13 | 63 / 23 | $23.320,60 | 514 / 22 | $6.685,31 | 34 / 39 | $3.568,00 | 34 / 5 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 43 | 118 / 25 | $21.226,40 | 1143 / 50 | $5.649,02 | 158 / 67 | $3.419,37 | 158 / 19 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 40 | 83 / 19 | $28.877,80 | 903 / 44 | $8.638,75 | 206 / 71 | $5.871,58 | 206 / 23 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 39 | 111 / 28 | $14.264,30 | 899 / 40 | $4.027,23 | 103 / 56 | $1.938,03 | 103 / 15 |
| Cellulitis W Mcc | 16 | 42 / 12 | $30.892,90 | 400 / 13 | $10.318,00 | 210 / 27 | $7.491,88 | 209 / 19 |
| Cellulitis W/O Mcc | 62 | 127 / 30 | $18.121,50 | 1258 / 65 | $6.263,50 | 257 / 92 | $3.636,42 | 255 / 24 |
| Chest Pain | 20 | 131 / 32 | $17.805,80 | 752 / 39 | $4.195,85 | 147 / 36 | $2.451,65 | 146 / 13 |
| Chronic Obstructive Pulmonary Disease W Cc | 48 | 131 / 28 | $29.629,90 | 1702 / 78 | $7.109,60 | 22 / 95 | $3.635,35 | 22 / 5 |
| Chronic Obstructive Pulmonary Disease W Mcc | 44 | 158 / 32 | $33.984,30 | 1690 / 78 | $8.789,48 | 47 / 96 | $4.955,14 | 47 / 10 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 12 | 108 / 40 | $20.339,20 | 1289 / 61 | $5.358,00 | 241 / 71 | $3.075,83 | 241 / 27 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 13 | 175 / 50 | $35.430,70 | 779 / 37 | $8.781,77 | 232 / 59 | $5.023,54 | 232 / 17 |
| Degenerative Nervous System Disorders W/O Mcc | 18 | 60 / 18 | $19.047,30 | 194 / 10 | $6.705,39 | 77 / 21 | $4.409,56 | 77 / 7 |
| Diabetes W Cc | 12 | 80 / 28 | $15.797,50 | 389 / 20 | $5.675,42 | 131 / 29 | $3.677,00 | 131 / 12 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 71 | 204 / 41 | $23.360,90 | 1748 / 78 | $5.644,90 | 284 / 89 | $3.216,34 | 284 / 29 |
| Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W/O Mcc | 17 | 45 / 15 | $16.420,60 | 241 / 7 | $5.108,12 | 42 / 15 | $3.008,41 | 42 / 5 |
| G.I. Hemorrhage W Cc | 36 | 182 / 46 | $29.693,00 | 1535 / 68 | $7.623,14 | 236 / 88 | $4.617,14 | 236 / 20 |
| G.I. Hemorrhage W Mcc | 17 | 104 / 34 | $54.967,60 | 1110 / 48 | $13.250,40 | 385 / 62 | $9.365,82 | 385 / 25 |
| G.I. Obstruction W Cc | 24 | 68 / 22 | $29.120,60 | 1169 / 47 | $7.138,08 | 174 / 56 | $4.011,00 | 173 / 14 |
| Heart Failure & Shock W Cc | 106 | 172 / 27 | $26.051,20 | 1748 / 77 | $7.728,74 | 432 / 104 | $4.819,72 | 432 / 32 |
| Heart Failure & Shock W Mcc | 68 | 216 / 40 | $46.562,50 | 1896 / 86 | $11.560,80 | 602 / 106 | $7.818,37 | 602 / 36 |
| Heart Failure & Shock W/O Cc/Mcc | 35 | 75 / 24 | $19.477,30 | 1260 / 61 | $5.272,11 | 128 / 82 | $2.843,66 | 126 / 17 |
| Hip & Femur Procedures Except Major Joint W Cc | 40 | 103 / 20 | $56.141,40 | 1245 / 53 | $13.342,50 | 514 / 68 | $10.083,50 | 513 / 30 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 14 | 110 / 39 | $108.181,00 | 589 / 26 | $32.876,20 | 305 / 39 | $28.051,80 | 305 / 21 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 25 | 157 / 49 | $29.383,00 | 1111 / 52 | $7.718,48 | 106 / 68 | $4.595,04 | 106 / 11 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 14 | 154 / 36 | $43.170,10 | 784 / 31 | $11.851,20 | 181 / 41 | $8.438,71 | 180 / 14 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 15 | 87 / 34 | $25.751,70 | 939 / 38 | $5.477,07 | 63 / 49 | $2.874,67 | 62 / 8 |
| Kidney & Urinary Tract Infections W Mcc | 16 | 128 / 36 | $35.118,60 | 1363 / 55 | $9.291,06 | 792 / 74 | $6.087,44 | 791 / 47 |
| Kidney & Urinary Tract Infections W/O Mcc | 76 | 157 / 26 | $21.642,80 | 1737 / 79 | $5.919,25 | 237 / 94 | $3.348,18 | 237 / 21 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 12 | 44 / 12 | $51.577,30 | 482 / 14 | $10.180,40 | 79 / 8 | $7.714,00 | 79 / 4 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W Cc | 12 | 43 / 14 | $72.316,90 | 444 / 16 | $14.813,80 | 61 / 17 | $9.561,42 | 61 / 5 |
| Lower Extrem & Humer Proc Except Hip,Foot,Femur W/O Cc/Mcc | 12 | 35 / 11 | $56.554,80 | 374 / 17 | $9.844,25 | 22 / 13 | $6.269,50 | 22 / 1 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 13 | 60 / 23 | $23.288,50 | 414 / 21 | $8.268,92 | 47 / 35 | $5.329,62 | 47 / 7 |
| Major Joint & Limb Reattachment Proc Of Upper Extremity W/O Cc/Mcc | 11 | 85 / 16 | $88.784,60 | 707 / 30 | $14.648,90 | 4 / 25 | $8.639,91 | 4 / 2 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 189 | 375 / 33 | $71.698,60 | 2037 / 98 | $13.712,50 | 288 / 72 | $9.931,98 | 288 / 22 |
| Major Small & Large Bowel Procedures W Cc | 12 | 96 / 35 | $89.197,40 | 1104 / 39 | $18.217,40 | 502 / 44 | $13.621,20 | 497 / 21 |
| Medical Back Problems W Mcc | 11 | 28 / 11 | $45.163,80 | 185 / 7 | $11.714,50 | 13 / 7 | $7.316,36 | 13 / 1 |
| Medical Back Problems W/O Mcc | 55 | 66 / 12 | $18.282,00 | 406 / 23 | $5.813,82 | 150 / 39 | $3.656,64 | 150 / 16 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 13 | 113 / 34 | $23.985,00 | 646 / 22 | $7.882,23 | 177 / 44 | $5.484,15 | 175 / 11 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 31 | 135 / 37 | $17.883,80 | 1310 / 59 | $5.603,32 | 33 / 87 | $2.635,45 | 33 / 3 |
| Other Circulatory System Diagnoses W Mcc | 11 | 105 / 33 | $38.280,90 | 438 / 12 | $13.471,50 | 5 / 36 | $7.819,36 | 5 / 1 |
| Other Digestive System Diagnoses W Cc | 18 | 79 / 26 | $25.567,30 | 706 / 31 | $7.198,78 | 186 / 46 | $4.623,94 | 184 / 20 |
| Other Vascular Procedures W Cc | 15 | 87 / 23 | $65.668,50 | 457 / 21 | $16.143,60 | 266 / 22 | $13.735,80 | 265 / 15 |
| Peripheral Vascular Disorders W Cc | 13 | 71 / 21 | $20.774,40 | 446 / 24 | $7.330,15 | 1 / 49 | $3.102,38 | 1 / 1 |
| Pulmonary Edema & Respiratory Failure | 16 | 187 / 48 | $41.908,50 | 1567 / 68 | $9.148,50 | 174 / 78 | $5.863,50 | 174 / 19 |
| Pulmonary Embolism W/O Mcc | 15 | 59 / 25 | $32.919,30 | 916 / 35 | $7.582,27 | 10 / 43 | $3.716,93 | 10 / 2 |
| Red Blood Cell Disorders W Mcc | 12 | 59 / 20 | $26.400,10 | 352 / 9 | $9.081,33 | 150 / 32 | $6.339,00 | 150 / 9 |
| Red Blood Cell Disorders W/O Mcc | 11 | 132 / 41 | $19.357,30 | 844 / 43 | $7.079,18 | 44 / 85 | $3.200,73 | 44 / 8 |
| Renal Failure W Cc | 56 | 165 / 35 | $24.304,60 | 1375 / 63 | $7.275,88 | 282 / 91 | $4.516,86 | 280 / 23 |
| Renal Failure W Mcc | 37 | 158 / 31 | $37.849,30 | 1196 / 57 | $11.713,90 | 279 / 83 | $7.695,62 | 279 / 22 |
| Respiratory Infections & Inflammations W Cc | 28 | 60 / 15 | $32.659,80 | 779 / 28 | $9.868,82 | 161 / 49 | $6.666,21 | 161 / 13 |
| Respiratory Infections & Inflammations W Mcc | 31 | 105 / 21 | $51.918,50 | 1116 / 48 | $13.725,50 | 58 / 59 | $9.159,03 | 58 / 10 |
| Respiratory Neoplasms W Cc | 13 | 34 / 13 | $29.013,20 | 178 / 6 | $8.139,46 | 33 / 6 | $5.521,69 | 32 / 1 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 17 | 114 / 36 | $55.252,50 | 774 / 33 | $15.455,50 | 88 / 48 | $11.042,00 | 88 / 12 |
| Seizures W/O Mcc | 12 | 96 / 33 | $22.126,30 | 654 / 30 | $5.534,08 | 80 / 38 | $3.249,33 | 80 / 9 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 85 | 431 / 64 | $53.285,50 | 1898 / 81 | $14.193,30 | 593 / 103 | $9.659,78 | 592 / 37 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 22 | 185 / 59 | $35.087,80 | 1865 / 80 | $8.317,86 | 500 / 93 | $5.207,77 | 498 / 32 |
| Signs & Symptoms Of Musculoskeletal System & Conn Tissue W/O Mcc | 13 | 34 / 11 | $21.027,10 | 180 / 5 | $5.334,31 | 44 / 7 | $3.402,69 | 44 / 3 |
| Signs & Symptoms W/O Mcc | 11 | 80 / 33 | $15.287,70 | 353 / 15 | $4.473,73 | 83 / 16 | $2.934,91 | 83 / 7 |
| Simple Pneumonia & Pleurisy W Cc | 56 | 147 / 29 | $31.311,60 | 2025 / 83 | $7.641,82 | 366 / 101 | $4.531,98 | 364 / 32 |
| Simple Pneumonia & Pleurisy W Mcc | 23 | 182 / 49 | $44.127,40 | 1722 / 67 | $11.314,20 | 297 / 94 | $7.015,09 | 297 / 18 |
| Spinal Fusion Except Cervical W/O Mcc | 41 | 153 / 20 | $166.700,00 | 1182 / 54 | $28.255,60 | 303 / 46 | $20.565,40 | 302 / 17 |
| Syncope & Collapse | 25 | 144 / 42 | $21.924,20 | 1033 / 51 | $5.272,96 | 117 / 60 | $3.017,68 | 117 / 18 |
| Transient Ischemia | 21 | 104 / 36 | $25.491,80 | 985 / 49 | $4.844,86 | 167 / 45 | $2.956,86 | 167 / 21 | Total 67 procedures | 1.985 | 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.