The Price of Medicare Procedures in Virginia



This table shows the 100 most frequently charged procedures/diagnosis in Virginia 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
 Virginia 680 $19748 $5290 $14458
Acute Myocardial Infarction Discharged Alive With Complications
 Virginia 1231 $24489 $7575 $16914
Acute Myocardial Infarction Discharged Alive With Major Complications
 Virginia 1682 $36558 $11483 $25075
Alcohol Drug Abuse No Rehabilitation Therapy No Major Complications
 Virginia 389 $14537 $4835 $9702
Atherosclerosis No Major Complications
 Virginia 762 $13265 $3621 $9644
Back And Neck Proc Exc Spinal Fusion No Complications
 Virginia 901 $26397 $6948 $19449
Bronchitis And Asthma No Complications
 Virginia 473 $12999 $3720 $9279
Bronchitis And Asthma With Complications
 Virginia 929 $17068 $5290 $11778
Cardiac Arrhythmia And Conduction Disorders No Complications
 Virginia 3206 $11985 $3674 $8311
Cardiac Arrhythmia And Conduction Disorders With Complications
 Virginia 2816 $16713 $5355 $11358
Cardiac Arrhythmia And Conduction Disorders With Major Complications
 Virginia 1784 $24425 $7960 $16465
Cellulitis No Major Complications
 Virginia 3629 $16080 $5268 $10812
Cellulitis With Major Complications
 Virginia 513 $29617 $9378 $20239
Cervical Spinal Fusion No Complications
 Virginia 684 $50697 $14483 $36214
Chest Pain
 Virginia 3907 $13309 $3508 $9801
Chronic Obstructive Pulmonary Disease No Complications
 Virginia 2997 $14677 $4562 $10115
Chronic Obstructive Pulmonary Disease With Complications
 Virginia 4034 $18712 $6003 $12709
Chronic Obstructive Pulmonary Disease With Major Complications
 Virginia 3894 $22971 $7375 $15596
Circulatory Disorders Except Ami With Card Cath No Major Complications
 Virginia 2714 $31351 $7532 $23819
Circulatory Disorders Except Ami With Card Cath With Major Complications
 Virginia 676 $51481 $15382 $36099
Cranial And Peripheral Nerve Disorders No Major Complications
 Virginia 549 $19317 $5894 $13423
Degenerative Nervous System Disorders No Major Complications
 Virginia 770 $19236 $6159 $13077
Diabetes With Complications
 Virginia 1411 $16675 $5442 $11233
Disorders Of Pancreas Except Malignancy With Complications
 Virginia 543 $21185 $7102 $14083
Dysequilibrium
 Virginia 577 $14526 $4129 $10397
Esophagitis Gastroent And Misc Digest Disorders No Major Complications
 Virginia 6447 $16267 $4677 $11590
Esophagitis Gastroent And Misc Digest Disorders With Major Complications
 Virginia 1059 $26117 $7657 $18460
Extracranial Procedures No Complications
 Virginia 827 $26379 $6764 $19615
Fractures Of Hip And Pelvis No Major Complications
 Virginia 662 $12895 $4245 $8650
Fx Sprn Strn And Disl Except Femur Hip Pelvis Thigh No Major Complications
 Virginia 417 $14268 $4502 $9766
Gi Hemorrhage No Complications
 Virginia 814 $14928 $4663 $10265
Gi Hemorrhage With Complications
 Virginia 4193 $19562 $6368 $13194
Gi Hemorrhage With Major Complications
 Virginia 1517 $33327 $11053 $22274
Gi Obstruction No Complications
 Virginia 878 $13520 $4289 $9231
Gi Obstruction With Complications
 Virginia 1271 $19150 $6043 $13107
Heart Failure And Shock No Complications
 Virginia 2261 $13642 $4360 $9282
Heart Failure And Shock With Complications
 Virginia 6264 $18524 $6409 $12115
Heart Failure And Shock With Major Complications
 Virginia 5832 $27627 $9254 $18373
Hip And Femur Procedures Except Major Joint No Complications
 Virginia 537 $37395 $9595 $27800
Hip And Femur Procedures Except Major Joint With Complications
 Virginia 2162 $42571 $11742 $30829
Hip And Femur Procedures Except Major Joint With Major Complications
 Virginia 543 $63084 $18968 $44116
Hypertension No Major Complications
 Virginia 547 $12824 $3971 $8853
Infectious And Parasitic Diseases Or Procedure With Major Complications
 Virginia 999 $118155 $37863 $80292
Intracranial Hemorrhage Or Cerebral Infarction No Complications
 Virginia 1843 $19084 $5409 $13675
Intracranial Hemorrhage Or Cerebral Infarction With Complications
 Virginia 3388 $23909 $7314 $16595
Intracranial Hemorrhage Or Cerebral Infarction With Major Complications
 Virginia 2094 $35480 $12363 $23117
Kidney And Urinary Tract Infections No Major Complications
 Virginia 5615 $15209 $4914 $10295
Kidney And Urinary Tract Infections With Major Complications
 Virginia 2036 $20337 $7368 $12969
Laparoscopic Cholecystectomy No Cde No Complications
 Virginia 436 $31423 $7258 $24165
Laparoscopic Cholecystectomy No Cde With Complications
 Virginia 436 $41350 $10985 $30365
Major Cardiovasc Procedures No Major Complications
 Virginia 949 $83998 $22787 $61211
Major Gastrointestinal Disorders And Peritoneal Infections With Complications
 Virginia 899 $23295 $8191 $15104
Major Joint Replacement Of Lower Extremity No Major Complications
 Virginia 12410 $47709 $13248 $34461
Major Joint Replacement Of Lower Extremity With Major Complications
 Virginia 561 $73373 $20573 $52800
Major Small And Large Bowel Procedures With Complications
 Virginia 1390 $57851 $17353 $40498
Major Small And Large Bowel Procedures With Major Complications
 Virginia 950 $126902 $37200 $89702
Medical Back Problems No Major Complications
 Virginia 1567 $17476 $5447 $12029
Misc Disorders Of Metabolism Fluids Electrolytes No Major Complications
 Virginia 4001 $14229 $4420 $9809
Misc Disorders Of Metabolism Fluids Electrolytes With Major Complications
 Virginia 1485 $22123 $7532 $14591
Other Circulatory System Diagnoses With Complications
 Virginia 441 $24848 $7690 $17158
Other Circulatory System Diagnoses With Major Complications
 Virginia 1353 $40408 $12949 $27459
Other Digestive System Diagnoses With Complications
 Virginia 984 $21528 $6787 $14741
Other Kidney And Urinary Tract Diagnoses With Complications
 Virginia 599 $24781 $7618 $17163
Other Kidney And Urinary Tract Diagnoses With Major Complications
 Virginia 722 $34114 $11409 $22705
Other Vascular Procedures No Complications
 Virginia 518 $43591 $11297 $32294
Other Vascular Procedures With Complications
 Virginia 976 $64086 $17034 $47052
Other Vascular Procedures With Major Complications
 Virginia 849 $77691 $22345 $55346
Perc Cardiovasc Proc No Coronary Artery Stent No Major Complications
 Virginia 528 $53314 $12766 $40548
Perc Cardiovasc Proc With Drug Eluting Stent No Major Complications
 Virginia 2147 $62066 $14262 $47804
Perc Cardiovasc Proc With Drug Eluting Stent With Major Complications
 Virginia 570 $88422 $22578 $65844
Perc Cardiovasc Proc With Nondrug Eluting Stent No Major Complications
 Virginia 803 $55802 $12356 $43446
Peripheral Vascular Disorders No Complications
 Virginia 369 $14604 $4384 $10220
Peripheral Vascular Disorders With Complications
 Virginia 964 $19498 $6264 $13234
Permanent Cardiac Pacemaker Implant No Complications
 Virginia 660 $48134 $13133 $35001
Permanent Cardiac Pacemaker Implant With Complications
 Virginia 676 $57978 $17416 $40562
Poisoning And Toxic Effects Of Drugs No Major Complications
 Virginia 641 $13329 $4159 $9170
Poisoning And Toxic Effects Of Drugs With Major Complications
 Virginia 345 $28696 $10188 $18508
Psychoses
 Virginia 1944 $13670 $5851 $7819
Pulmonary Edema And Respiratory Failure
 Virginia 3672 $25878 $8160 $17718
Pulmonary Embolism No Major Complications
 Virginia 1045 $20805 $6859 $13946
Red Blood Cell Disorders No Major Complications
 Virginia 2333 $16210 $5305 $10905
Red Blood Cell Disorders With Major Complications
 Virginia 686 $27406 $8783 $18623
Renal Failure No Complications
 Virginia 596 $14169 $4300 $9869
Renal Failure With Complications
 Virginia 4756 $19940 $6384 $13556
Renal Failure With Major Complications
 Virginia 3244 $30290 $10421 $19869
Respiratory Infections And Inflammations With Complications
 Virginia 1481 $26604 $9105 $17499
Respiratory Infections And Inflammations With Major Complications
 Virginia 1991 $37946 $12347 $25599
Respiratory System Diagnosis With Ventilator Support 96 Plus Hrs
 Virginia 647 $118211 $37165 $81046
Respiratory System Diagnosis With Ventilator Support Less 96 Hrs
 Virginia 1648 $51609 $15311 $36298
Seizures No Major Complications
 Virginia 1286 $17714 $5190 $12524
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs No Major Complications
 Virginia 3573 $22569 $7309 $15260
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs With Major Complications
 Virginia 9884 $36847 $12110 $24737
Septicemia Or Severe Sepsis With Mv 96 Plus Hrs
 Virginia 565 $129339 $41249 $88090
Signs And Symptoms No Major Complications
 Virginia 1251 $15097 $4461 $10636
Simple Pneumonia And Pleurisy No Complications
 Virginia 1982 $14202 $4467 $9735
Simple Pneumonia And Pleurisy With Complications
 Virginia 4994 $19305 $6423 $12882
Simple Pneumonia And Pleurisy With Major Complications
 Virginia 3800 $27841 $9090 $18751
Spinal Fusion Except Cervical No Major Complications
 Virginia 2110 $87261 $27270 $59991
Syncope And Collapse
 Virginia 4142 $15506 $4539 $10967
Transient Ischemia
 Virginia 2583 $16483 $4621 $11862


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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