The Price of Medicare Procedures in Dc

This table shows the 100 most frequently charged procedures/diagnosis in Dc to the Inpatient Prospective Payment System (IPPS). This table will give a basic idea of the cost of medicare for hospital procedures. Hospitals determine what they bill according to a "chargemaster". The charge master serves as a price point for the beginning of negotiations between you and the health care provider.

Procedure

Provider State

Total Discharges

Hospital Charge(s)

Medicare Payment(s)

Your Cost

Acute Myocardial Infarction Discharged Alive No Complications

$25146

$6872

$18274

Acute Myocardial Infarction Discharged Alive With Complications

117

$30906

$10167

$20739

Acute Myocardial Infarction Discharged Alive With Major Complications

181

$54932

$16341

$38591

Alcohol Drug Abuse No Rehabilitation Therapy No Major Complications

$19634

$6460

$13174

Atherosclerosis No Major Complications

$17188

$6156

$11032

Back And Neck Proc Exc Spinal Fusion No Complications

126

$27665

$7760

$19905

Bronchitis And Asthma No Complications

$16001

$5664

$10337

Bronchitis And Asthma With Complications

$20582

$7494

$13088

Cardiac Arrhythmia And Conduction Disorders No Complications

246

$15037

$4835

$10202

Cardiac Arrhythmia And Conduction Disorders With Complications

201

$24276

$7618

$16658

Cardiac Arrhythmia And Conduction Disorders With Major Complications

130

$41004

$12496

$28508

Cellulitis No Major Complications

368

$20432

$7158

$13274

Cellulitis With Major Complications

$35992

$12374

$23618

Cervical Spinal Fusion No Complications

$85475

$18332

$67143

Chest Pain

372

$16270

$5309

$10961

Chronic Obstructive Pulmonary Disease No Complications

297

$19111

$6580

$12531

Chronic Obstructive Pulmonary Disease With Complications

325

$25480

$8881

$16599

Chronic Obstructive Pulmonary Disease With Major Complications

269

$31823

$10629

$21194

Circulatory Disorders Except Ami With Card Cath No Major Complications

393

$34466

$9630

$24836

Circulatory Disorders Except Ami With Card Cath With Major Complications

126

$59859

$17269

$42590

Cranial And Peripheral Nerve Disorders No Major Complications

$24898

$8622

$16276

Degenerative Nervous System Disorders No Major Complications

109

$28468

$8792

$19676

Diabetes With Complications

194

$21544

$7576

$13968

Disorders Of Pancreas Except Malignancy With Complications

$25806

$9876

$15930

Dysequilibrium

$18321

$5917

$12404

Esophagitis Gastroent And Misc Digest Disorders No Major Complications

606

$19552

$6641

$12911

Esophagitis Gastroent And Misc Digest Disorders With Major Complications

177

$29895

$10846

$19049

Extracranial Procedures No Complications

$44919

$9242

$35677

Fractures Of Hip And Pelvis No Major Complications

$16927

$5053

$11874

Fx Sprn Strn And Disl Except Femur Hip Pelvis Thigh No Major Complications

$18316

$6093

$12223

Gi Hemorrhage No Complications

186

$16887

$6134

$10753

Gi Hemorrhage With Complications

354

$27979

$8900

$19079

Gi Hemorrhage With Major Complications

184

$51039

$16693

$34346

Gi Obstruction No Complications

124

$14378

$4838

$9540

Gi Obstruction With Complications

$25961

$8234

$17727

Heart Failure And Shock No Complications

372

$17665

$6032

$11633

Heart Failure And Shock With Complications

776

$25439

$9102

$16337

Heart Failure And Shock With Major Complications

525

$38984

$13625

$25359

Hip And Femur Procedures Except Major Joint No Complications

$42284

$12037

$30247

Hip And Femur Procedures Except Major Joint With Complications

$59230

$14916

$44314

Hip And Femur Procedures Except Major Joint With Major Complications

$71098

$23816

$47282

Hypertension No Major Complications

112

$15941

$6400

$9541

Infectious And Parasitic Diseases Or Procedure With Major Complications

133

$144050

$56096

$87954

Intracranial Hemorrhage Or Cerebral Infarction No Complications

209

$31375

$7915

$23460

Intracranial Hemorrhage Or Cerebral Infarction With Complications

385

$36913

$10567

$26346

Intracranial Hemorrhage Or Cerebral Infarction With Major Complications

277

$63280

$17980

$45300

Kidney And Urinary Tract Infections No Major Complications

594

$21712

$6901

$14811

Kidney And Urinary Tract Infections With Major Complications

179

$34866

$10781

$24085

Laparoscopic Cholecystectomy No Cde No Complications

$27914

$8355

$19559

Laparoscopic Cholecystectomy No Cde With Complications

$63610

$14558

$49052

Major Cardiovasc Procedures No Major Complications

136

$93155

$26861

$66294

Major Gastrointestinal Disorders And Peritoneal Infections With Complications

$25931

$10433

$15498

Major Joint Replacement Of Lower Extremity No Major Complications

1013

$44858

$15744

$29114

Major Joint Replacement Of Lower Extremity With Major Complications

$81129

$24124

$57005

Major Small And Large Bowel Procedures With Complications

166

$67712

$21635

$46077

Major Small And Large Bowel Procedures With Major Complications

143

$153583

$48487

$105096

Medical Back Problems No Major Complications

151

$21194

$7281

$13913

Misc Disorders Of Metabolism Fluids Electrolytes No Major Complications

512

$19201

$6460

$12741

Misc Disorders Of Metabolism Fluids Electrolytes With Major Complications

309

$33542

$11497

$22045

Other Circulatory System Diagnoses With Complications

$31791

$9375

$22416

Other Circulatory System Diagnoses With Major Complications

294

$54924

$17257

$37667

Other Digestive System Diagnoses With Complications

108

$23957

$8806

$15151

Other Kidney And Urinary Tract Diagnoses With Complications

127

$36489

$9534

$26955

Other Kidney And Urinary Tract Diagnoses With Major Complications

$53372

$14899

$38473

Other Vascular Procedures No Complications

107

$52371

$14132

$38239

Other Vascular Procedures With Complications

167

$77852

$21610

$56242

Other Vascular Procedures With Major Complications

265

$79056

$28106

$50950

Perc Cardiovasc Proc No Coronary Artery Stent No Major Complications

267

$57520

$14987

$42533

Perc Cardiovasc Proc With Drug Eluting Stent No Major Complications

307

$64079

$16252

$47827

Perc Cardiovasc Proc With Drug Eluting Stent With Major Complications

129

$86472

$26324

$60148

Perc Cardiovasc Proc With Nondrug Eluting Stent No Major Complications

147

$59296

$14895

$44401

Peripheral Vascular Disorders No Complications

$17491

$5692

$11799

Peripheral Vascular Disorders With Complications

190

$24480

$8814

$15666

Permanent Cardiac Pacemaker Implant No Complications

$44150

$15797

$28353

Permanent Cardiac Pacemaker Implant With Complications

$72724

$22170

$50554

Poisoning And Toxic Effects Of Drugs No Major Complications

$18229

$6236

$11993

Poisoning And Toxic Effects Of Drugs With Major Complications

$36325

$12275

$24050

Psychoses

360

$14452

$9444

$5008

Pulmonary Edema And Respiratory Failure

136

$37492

$12399

$25093

Pulmonary Embolism No Major Complications

157

$27751

$9403

$18348

Red Blood Cell Disorders No Major Complications

444

$20334

$7460

$12874

Red Blood Cell Disorders With Major Complications

102

$32742

$11775

$20967

Renal Failure No Complications

$14783

$5461

$9322

Renal Failure With Complications

590

$25402

$9053

$16349

Renal Failure With Major Complications

427

$40825

$15541

$25284

Respiratory Infections And Inflammations With Complications

$33836

$11277

$22559

Respiratory Infections And Inflammations With Major Complications

$54800

$17122

$37678

Respiratory System Diagnosis With Ventilator Support 96 Plus Hrs

130

$159064

$49004

$110060

Respiratory System Diagnosis With Ventilator Support Less 96 Hrs

187

$69937

$20888

$49049

Seizures No Major Complications

170

$26781

$7792

$18989

Septicemia Or Severe Sepsis No Mv 96 Plus Hrs No Major Complications

183

$31627

$10213

$21414

Septicemia Or Severe Sepsis No Mv 96 Plus Hrs With Major Complications

498

$54713

$17738

$36975

Septicemia Or Severe Sepsis With Mv 96 Plus Hrs

$152433

$52222

$100211

Signs And Symptoms No Major Complications

179

$19792

$6473

$13319

Simple Pneumonia And Pleurisy No Complications

165

$17252

$6030

$11222

Simple Pneumonia And Pleurisy With Complications

393

$28864

$9037

$19827

Simple Pneumonia And Pleurisy With Major Complications

223

$41583

$13415

$28168

Spinal Fusion Except Cervical No Major Complications

252

$111638

$33609

$78029

Syncope And Collapse

366

$18488

$6557

$11931

Transient Ischemia

152

$19864

$6130

$13734

Source: CMS

As part of the Obama administration’s goal to make our healthcare more accountable, transparent and affordable the CMS.gov has released data from more then 3000 hospitals that receive payments for the 100 highest frequently billed charges under Medicare. For more information visit CMS.gov.