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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.



ProcedureProvider StateTotal DischargesHospital Charge(s)Medicare Payment(s)Your Cost
Acute Myocardial Infarction Discharged Alive No Complications
 DC 50 $25146 $6872 $18274
Acute Myocardial Infarction Discharged Alive With Complications
 DC 117 $30906 $10167 $20739
Acute Myocardial Infarction Discharged Alive With Major Complications
 DC 181 $54932 $16341 $38591
Alcohol Drug Abuse No Rehabilitation Therapy No Major Complications
 DC 80 $19634 $6460 $13174
Atherosclerosis No Major Complications
 DC 52 $17188 $6156 $11032
Back And Neck Proc Exc Spinal Fusion No Complications
 DC 126 $27665 $7760 $19905
Bronchitis And Asthma No Complications
 DC 50 $16001 $5664 $10337
Bronchitis And Asthma With Complications
 DC 92 $20582 $7494 $13088
Cardiac Arrhythmia And Conduction Disorders No Complications
 DC 246 $15037 $4835 $10202
Cardiac Arrhythmia And Conduction Disorders With Complications
 DC 201 $24276 $7618 $16658
Cardiac Arrhythmia And Conduction Disorders With Major Complications
 DC 130 $41004 $12496 $28508
Cellulitis No Major Complications
 DC 368 $20432 $7158 $13274
Cellulitis With Major Complications
 DC 67 $35992 $12374 $23618
Cervical Spinal Fusion No Complications
 DC 71 $85475 $18332 $67143
Chest Pain
 DC 372 $16270 $5309 $10961
Chronic Obstructive Pulmonary Disease No Complications
 DC 297 $19111 $6580 $12531
Chronic Obstructive Pulmonary Disease With Complications
 DC 325 $25480 $8881 $16599
Chronic Obstructive Pulmonary Disease With Major Complications
 DC 269 $31823 $10629 $21194
Circulatory Disorders Except Ami With Card Cath No Major Complications
 DC 393 $34466 $9630 $24836
Circulatory Disorders Except Ami With Card Cath With Major Complications
 DC 126 $59859 $17269 $42590
Cranial And Peripheral Nerve Disorders No Major Complications
 DC 83 $24898 $8622 $16276
Degenerative Nervous System Disorders No Major Complications
 DC 109 $28468 $8792 $19676
Diabetes With Complications
 DC 194 $21544 $7576 $13968
Disorders Of Pancreas Except Malignancy With Complications
 DC 53 $25806 $9876 $15930
Dysequilibrium
 DC 62 $18321 $5917 $12404
Esophagitis Gastroent And Misc Digest Disorders No Major Complications
 DC 606 $19552 $6641 $12911
Esophagitis Gastroent And Misc Digest Disorders With Major Complications
 DC 177 $29895 $10846 $19049
Extracranial Procedures No Complications
 DC 47 $44919 $9242 $35677
Fractures Of Hip And Pelvis No Major Complications
 DC 42 $16927 $5053 $11874
Fx Sprn Strn And Disl Except Femur Hip Pelvis Thigh No Major Complications
 DC 43 $18316 $6093 $12223
Gi Hemorrhage No Complications
 DC 186 $16887 $6134 $10753
Gi Hemorrhage With Complications
 DC 354 $27979 $8900 $19079
Gi Hemorrhage With Major Complications
 DC 184 $51039 $16693 $34346
Gi Obstruction No Complications
 DC 124 $14378 $4838 $9540
Gi Obstruction With Complications
 DC 80 $25961 $8234 $17727
Heart Failure And Shock No Complications
 DC 372 $17665 $6032 $11633
Heart Failure And Shock With Complications
 DC 776 $25439 $9102 $16337
Heart Failure And Shock With Major Complications
 DC 525 $38984 $13625 $25359
Hip And Femur Procedures Except Major Joint No Complications
 DC 70 $42284 $12037 $30247
Hip And Femur Procedures Except Major Joint With Complications
 DC 99 $59230 $14916 $44314
Hip And Femur Procedures Except Major Joint With Major Complications
 DC 12 $71098 $23816 $47282
Hypertension No Major Complications
 DC 112 $15941 $6400 $9541
Infectious And Parasitic Diseases Or Procedure With Major Complications
 DC 133 $144050 $56096 $87954
Intracranial Hemorrhage Or Cerebral Infarction No Complications
 DC 209 $31375 $7915 $23460
Intracranial Hemorrhage Or Cerebral Infarction With Complications
 DC 385 $36913 $10567 $26346
Intracranial Hemorrhage Or Cerebral Infarction With Major Complications
 DC 277 $63280 $17980 $45300
Kidney And Urinary Tract Infections No Major Complications
 DC 594 $21712 $6901 $14811
Kidney And Urinary Tract Infections With Major Complications
 DC 179 $34866 $10781 $24085
Laparoscopic Cholecystectomy No Cde No Complications
 DC 37 $27914 $8355 $19559
Laparoscopic Cholecystectomy No Cde With Complications
 DC 12 $63610 $14558 $49052
Major Cardiovasc Procedures No Major Complications
 DC 136 $93155 $26861 $66294
Major Gastrointestinal Disorders And Peritoneal Infections With Complications
 DC 71 $25931 $10433 $15498
Major Joint Replacement Of Lower Extremity No Major Complications
 DC 1013 $44858 $15744 $29114
Major Joint Replacement Of Lower Extremity With Major Complications
 DC 23 $81129 $24124 $57005
Major Small And Large Bowel Procedures With Complications
 DC 166 $67712 $21635 $46077
Major Small And Large Bowel Procedures With Major Complications
 DC 143 $153583 $48487 $105096
Medical Back Problems No Major Complications
 DC 151 $21194 $7281 $13913
Misc Disorders Of Metabolism Fluids Electrolytes No Major Complications
 DC 512 $19201 $6460 $12741
Misc Disorders Of Metabolism Fluids Electrolytes With Major Complications
 DC 309 $33542 $11497 $22045
Other Circulatory System Diagnoses With Complications
 DC 97 $31791 $9375 $22416
Other Circulatory System Diagnoses With Major Complications
 DC 294 $54924 $17257 $37667
Other Digestive System Diagnoses With Complications
 DC 108 $23957 $8806 $15151
Other Kidney And Urinary Tract Diagnoses With Complications
 DC 127 $36489 $9534 $26955
Other Kidney And Urinary Tract Diagnoses With Major Complications
 DC 85 $53372 $14899 $38473
Other Vascular Procedures No Complications
 DC 107 $52371 $14132 $38239
Other Vascular Procedures With Complications
 DC 167 $77852 $21610 $56242
Other Vascular Procedures With Major Complications
 DC 265 $79056 $28106 $50950
Perc Cardiovasc Proc No Coronary Artery Stent No Major Complications
 DC 267 $57520 $14987 $42533
Perc Cardiovasc Proc With Drug Eluting Stent No Major Complications
 DC 307 $64079 $16252 $47827
Perc Cardiovasc Proc With Drug Eluting Stent With Major Complications
 DC 129 $86472 $26324 $60148
Perc Cardiovasc Proc With Nondrug Eluting Stent No Major Complications
 DC 147 $59296 $14895 $44401
Peripheral Vascular Disorders No Complications
 DC 80 $17491 $5692 $11799
Peripheral Vascular Disorders With Complications
 DC 190 $24480 $8814 $15666
Permanent Cardiac Pacemaker Implant No Complications
 DC 80 $44150 $15797 $28353
Permanent Cardiac Pacemaker Implant With Complications
 DC 82 $72724 $22170 $50554
Poisoning And Toxic Effects Of Drugs No Major Complications
 DC 61 $18229 $6236 $11993
Poisoning And Toxic Effects Of Drugs With Major Complications
 DC 23 $36325 $12275 $24050
Psychoses
 DC 360 $14452 $9444 $5008
Pulmonary Edema And Respiratory Failure
 DC 136 $37492 $12399 $25093
Pulmonary Embolism No Major Complications
 DC 157 $27751 $9403 $18348
Red Blood Cell Disorders No Major Complications
 DC 444 $20334 $7460 $12874
Red Blood Cell Disorders With Major Complications
 DC 102 $32742 $11775 $20967
Renal Failure No Complications
 DC 94 $14783 $5461 $9322
Renal Failure With Complications
 DC 590 $25402 $9053 $16349
Renal Failure With Major Complications
 DC 427 $40825 $15541 $25284
Respiratory Infections And Inflammations With Complications
 DC 69 $33836 $11277 $22559
Respiratory Infections And Inflammations With Major Complications
 DC 49 $54800 $17122 $37678
Respiratory System Diagnosis With Ventilator Support 96 Plus Hrs
 DC 130 $159064 $49004 $110060
Respiratory System Diagnosis With Ventilator Support Less 96 Hrs
 DC 187 $69937 $20888 $49049
Seizures No Major Complications
 DC 170 $26781 $7792 $18989
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs No Major Complications
 DC 183 $31627 $10213 $21414
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs With Major Complications
 DC 498 $54713 $17738 $36975
Septicemia Or Severe Sepsis With Mv 96 Plus Hrs
 DC 92 $152433 $52222 $100211
Signs And Symptoms No Major Complications
 DC 179 $19792 $6473 $13319
Simple Pneumonia And Pleurisy No Complications
 DC 165 $17252 $6030 $11222
Simple Pneumonia And Pleurisy With Complications
 DC 393 $28864 $9037 $19827
Simple Pneumonia And Pleurisy With Major Complications
 DC 223 $41583 $13415 $28168
Spinal Fusion Except Cervical No Major Complications
 DC 252 $111638 $33609 $78029
Syncope And Collapse
 DC 366 $18488 $6557 $11931
Transient Ischemia
 DC 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.

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