Range of Medicare Payments (Low-25th Percentile/High-75th Percentile) for Top Five Elective Inpatient Hospital Procedures, FY2006
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| Hip/Knee Replacement Low | Hip/Knee Replacement High | Gallbladder Removal By Laparoscope With Complications or Preexisting Conditions Low | Gallbladder Removal By Laparoscope With Complications or Preexisting Conditions High | Insertion of Heart Defibrillator Low | Insertion of Heart Defibrillator High | Back & Neck Operations Except Back or Neck Fusion Low | Back & Neck Operations Except Back or Neck Fusion High | Repair of Previous Hip or Knee Replacement Low | Repair of Previous Hip or Knee Replacement High | ||
| Hip/Knee Replacement Low | Hip/Knee Replacement High | Gallbladder Removal By Laparoscope With Complications or Preexisting Conditions Low | Gallbladder Removal By Laparoscope With Complications or Preexisting Conditions High | Insertion of Heart Defibrillator Low | Insertion of Heart Defibrillator High | Back & Neck Operations Except Back or Neck Fusion Low | Back & Neck Operations Except Back or Neck Fusion High | Repair of Previous Hip or Knee Replacement Low | Repair of Previous Hip or Knee Replacement High | ||
| United States | $10,085 | $12,257 | $9,474 | $11,378 | $29,410 | $37,779 | $7,258 | $9,010 | $12,763 | $16,228 | |
| Alabama | $9,448 | $10,487 | $8,896 | $9,889 | $26,788 | $30,855 | $6,695 | $7,475 | $11,785 | $13,244 | |
| Alaska | $14,150 | $16,600 | $13,798 | $15,565 | $41,548 | NA | $9,963 | $14,237 | $18,060 | $20,981 | |
| Arizona | $10,265 | $11,826 | $9,835 | $11,158 | $28,901 | $37,210 | $7,395 | $10,473 | $12,822 | $14,793 | |
| Arkansas | $9,509 | $10,554 | $9,070 | $9,844 | $26,993 | $30,041 | $6,780 | $7,678 | $12,228 | $13,783 | |
| California | $12,029 | $15,071 | $11,717 | $14,367 | $35,284 | $45,237 | $8,933 | $11,087 | $15,156 | $20,067 | |
| Colorado | $10,450 | $11,448 | $9,902 | $10,817 | $29,973 | $33,010 | $7,473 | $8,490 | $13,084 | $15,240 | |
| Connecticut | $12,062 | $14,020 | $11,262 | $13,246 | $39,450 | $43,395 | $9,250 | $9,994 | $15,265 | $17,607 | |
| Delaware | $10,607 | $12,392 | $9,906 | $11,708 | $34,912 | $35,256 | $7,953 | $8,833 | $13,213 | $15,701 | |
| District of Columbia | $10,913 | $14,583 | $10,189 | $13,977 | $38,954 | $43,124 | $9,760 | $10,533 | $13,798 | $18,907 | |
| Florida | $9,796 | $10,653 | $9,243 | $10,238 | $27,977 | $31,776 | $6,967 | $7,664 | $12,307 | $13,916 | |
| Georgia | $10,019 | $11,565 | $9,801 | $10,794 | $28,788 | $35,705 | $7,101 | $8,946 | $12,663 | $15,081 | |
| Hawaii | $12,259 | $14,832 | $11,505 | $13,553 | $33,821 | $42,624 | $8,473 | $10,443 | $15,210 | $18,746 | |
| Idaho | $10,107 | $10,956 | $9,603 | $10,339 | $30,212 | $30,346 | $7,116 | $7,714 | $12,712 | $13,647 | |
| Illinois | $10,574 | $12,106 | $9,944 | $11,424 | $30,102 | $36,761 | $7,542 | $9,210 | $13,373 | $16,532 | |
| Indiana | $10,089 | $10,853 | $9,539 | $10,193 | $28,355 | $32,108 | $7,108 | $7,783 | $12,520 | $14,184 | |
| Iowa | $9,761 | $10,662 | $9,168 | $9,900 | $28,091 | $30,517 | $6,916 | $7,847 | $12,052 | $13,724 | |
| Kansas | $9,593 | $10,637 | $9,108 | $10,055 | $26,961 | $30,278 | $6,755 | $7,565 | $11,982 | $13,617 | |
| Kentucky | $9,824 | $11,178 | $9,282 | $10,678 | $29,875 | $32,496 | $7,258 | $8,096 | $12,237 | $13,879 | |
| Louisiana | $9,750 | $10,866 | $9,100 | $10,267 | $27,419 | $30,916 | $7,051 | $7,867 | $12,331 | $14,121 | |
| Maine | $10,756 | $12,590 | $10,100 | $11,285 | $29,416 | $35,819 | $8,026 | $8,974 | $13,677 | $15,914 | |
| Maryland | $13,579 | $19,575 | $7,633 | $14,964 | $29,649 | $49,184 | $5,653 | $11,892 | $13,519 | $28,002 | |
| Massachusetts | $11,664 | $15,144 | $10,886 | $12,618 | $37,828 | $46,109 | $8,213 | $10,719 | $14,742 | $19,558 | |
| Michigan | $10,589 | $12,579 | $9,996 | $11,885 | $32,141 | $37,315 | $7,801 | $9,029 | $13,352 | $16,095 | |
| Minnesota | $10,896 | $11,667 | $10,199 | $10,889 | $31,860 | $37,310 | $7,967 | $9,399 | $13,819 | $16,756 | |
| Mississippi | $10,230 | $11,230 | $9,189 | $10,584 | $27,675 | $31,871 | $7,226 | $7,940 | $12,959 | $14,353 | |
| Missouri | $9,749 | $10,780 | $9,165 | $10,149 | $27,597 | $33,642 | $6,919 | $7,721 | $12,005 | $14,147 | |
| Montana | $9,820 | $10,508 | $9,185 | $10,033 | $27,659 | $28,328 | $6,978 | $7,425 | $12,439 | $13,372 | |
| Nebraska | $10,035 | $11,130 | $9,555 | $10,419 | $28,203 | $33,431 | $7,066 | $7,933 | $12,939 | $16,420 | |
| Nevada | $10,707 | $11,810 | $10,359 | $11,206 | $33,745 | $36,213 | $7,966 | $9,073 | $13,275 | $15,033 | |
| New Hampshire | $11,226 | $12,037 | $10,484 | $10,895 | $31,571 | $44,948 | $7,899 | $8,475 | $14,178 | $20,214 | |
| New Jersey | $11,658 | $13,726 | $10,983 | $12,956 | $36,420 | $41,761 | $8,324 | $9,928 | $14,630 | $17,717 | |
| New Mexico | $10,279 | $11,954 | $10,007 | $11,545 | $28,658 | $35,884 | $7,373 | $8,991 | $13,552 | $15,908 | |
| New York | $10,443 | $15,245 | $10,070 | $15,467 | $35,036 | $50,933 | $7,607 | $11,712 | $14,172 | $20,946 | |
| North Carolina | $10,269 | $11,489 | $9,708 | $10,825 | $30,882 | $38,668 | $7,535 | $8,763 | $12,774 | $14,672 | |
| North Dakota | $9,540 | $10,563 | $8,891 | $9,858 | $28,294 | $31,345 | $6,708 | $7,153 | $12,282 | $13,373 | |
| Ohio | $9,737 | $11,050 | $9,198 | $10,291 | $29,622 | $34,652 | $7,352 | $8,641 | $12,447 | $15,200 | |
| Oklahoma | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Oregon | $11,109 | $12,220 | $10,610 | $11,545 | $31,518 | $34,766 | $8,102 | $8,803 | $13,971 | $16,074 | |
| Pennsylvania | $9,946 | $11,618 | $9,289 | $10,715 | $30,157 | $35,426 | $7,330 | $8,756 | $12,765 | $15,932 | |
| Rhode Island | $11,279 | $15,327 | $10,328 | $12,169 | $43,607 | $44,646 | $8,412 | $11,186 | $13,987 | $18,963 | |
| South Carolina | $10,142 | $11,412 | $9,500 | $10,596 | $28,504 | $36,623 | $7,242 | $8,671 | $12,819 | $15,619 | |
| South Dakota | $9,718 | $10,856 | $9,767 | $10,229 | $27,743 | $30,509 | $7,497 | $7,644 | $12,937 | $13,722 | |
| Tennessee | $9,829 | $11,445 | $9,174 | $10,561 | $29,040 | $33,327 | $7,269 | $8,003 | $12,323 | $14,303 | |
| Texas | $10,106 | $11,826 | $9,610 | $11,173 | $29,006 | $34,598 | $7,216 | $8,429 | $12,932 | $15,302 | |
| Utah | $9,923 | $11,347 | $9,483 | $10,648 | $30,631 | $39,481 | $7,275 | $8,249 | $12,330 | $16,611 | |
| Vermont | $11,145 | $15,373 | $9,856 | $10,624 | $43,204 | NA | $7,847 | $10,824 | $14,355 | $19,430 | |
| Virginia | $9,601 | $10,822 | $9,076 | $10,154 | $29,213 | $34,703 | $7,045 | $8,244 | $12,135 | $14,878 | |
| Washington | $11,719 | $13,112 | $11,010 | $12,120 | $35,291 | $37,638 | $8,412 | $9,330 | $14,812 | $16,630 | |
| West Virginia | $9,497 | $10,964 | $8,997 | $10,232 | $27,448 | $30,925 | $6,926 | $7,748 | $11,951 | $13,860 | |
| Wisconsin | $10,116 | $11,412 | $9,482 | $10,447 | $29,711 | $33,605 | $7,092 | $8,040 | $12,731 | $14,492 | |
| Wyoming | $10,357 | $11,466 | $10,187 | $10,701 | $30,786 | $31,590 | $7,292 | $7,716 | $13,079 | $13,848 | |
| Guam | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Puerto Rico | $6,167 | $6,571 | $5,988 | $6,482 | $17,546 | NA | $4,396 | $4,997 | $7,891 | $8,395 | |
| Virgin Islands | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
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| Notes: |
Each payment is the sum of Medicare payments for the DRG including DRG, Teaching, Disproportionate Share, Capital, and Outlier payments for all cases. Also included in Medicare Payments are co-payments and deductibles paid by patients. |
| Sources: | The Centers for Medicare and Medicaid Services (CMS) Health Care Consumer Initiatives, Top 31 Elective Inpatient Hospital DRGs, Fiscal Year 2006, from the Medicare Provider Analysis and Review File (MedPAR), Centers for Medicare and Medicaid Services, Office of Information Services, the Medicare Decision Support Access Facility. Available at: http://www.cms.hhs.gov/HealthCareConInit/02_Hospital.asp#TopOfPage; accessed November 2007. |
| Definitions: | DRGs: Diagnosis Related Groups. National Average Payments: The sum of the total payments of all hospitals in the nation divided by the number of cases in the nation for the DRG. National Average Charges: The sum of the covered charges of all hospitals in the nation divided by the number of cases in the nation for the DRG. NA: Data excluded because payments were unusually low. |
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