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Montana Hospitals
June 1, 2004 through June 30, 2005
Average Inpatient Hospital Charges for Common Diagnoses

DRG Description Cases Avg. Days/Stay Avg. Charge Average Charge Range Low - High
14 Stroke 1,288 4.36 $11,981 $4,262 - $21,996
88 COPD (Emphysema) 1,905 4.07 $8,414 $3,118 - $15,433
89 Pneumonia Age > 17 3,071 4.5 $9,492 $3,512 -  $17,518
127 Heart Failure 2,319 4.15 $9,049 $3,143 - $16,922
138 Abnormal Heartbeat with complications 899 2.78 $7,862 $2,536 - $14,925
143 Chest Pain 1,789 1.44 $4,713 $2,050 - $8,097
148 Major Small & Large Bowel Procedures w/cc 887 10 $33,747 $13,587 - $69,638
167 Appendectomy without cc 625 1.56 $8,145 $4,966 - $11,693
174 Gastro-Intestinal Hemorrhage 1,341 3.43 $9,180 $3,269 - $17,313
182 Digestive Disorders 2,041 3.27 $6,869 $2,161 - $12,766
183 Esophogitis 1,095 2.18 $5,047 $1,831 - $8,887
209 Joint Replace Reattach 3,995 3.91 $24,170 $16,156 - $33,450
243 Medical Back Problems 1,153 3.31 $6,920 $2,307 - $12,722
294 Diabetes over age 35 502 3.37 $7,138 $2,407 - $13,260
320 Kidney & Urinary Tract Infections w/c 962 3.78 $6,879 $2,547 - $12,228
359 Hysterectomy 1,656 1.81 $8,394 $5,460 - $11,793
371 Delivery by Cesarean Section 2,316 3.35 $7,828 $5,585 - $10,101
372 Normal Delivery with complications 1,198 2.46 $4,813 $2,669 - $6,869
373 Normal Delivery 6,735 1.86 $3,835 $2,319 - $5213
390 Newborn with Sig. problems 1,282 2.52 $2,400 $794 - $4,728
391 Normal Newborn (Baby’s Bill) 9,521 1.89 $1,234 $647 - $1,841
430 Psychoses 3,226 5.74 $7,216 $2,178 - $13,795
The data presented above comes from the MHA COMPdata Program, for the period of June 1, 2004 through June 30, 2005. Average charges are for a DRG category which can include multiple patient diagnoses. “Average Charge Range from Low to High” is the 10th Percentile Average Charge (low) and the 90th Percentile Average Charge (high). Individual patient charges will vary, but will probably fall within the reported range.



Diagnosis Category Definitions

DRG 14: Stroke. Stroke and related conditions, such as bleeding in the brain and sudden obstruction or blockage of blood vessels in the brain.

DRG 88 Chronic Obstructive Pulmonary Disease (COPD). Chronic Bronchitis and emphysema.

DRG 89 Pneumonia Age 17 or older with complications. Bacterial, viral, and bronchial pneumonia, pleurisy, and tuberculosis.

DRG 127: Heart Failure and Shock. Conditions related to weakening heart muscles as a result of high blood pressure, rheumatic heart disease, and congestive heart failure.

DRG 138: Abnormal Heartbeat with complications. Abnormal heart rate or rhythm including tachycardia, bradycardia, fibrillation, flutter and heart block. Does not include heart attack, congenital heart defects, or heart valve disorders.

DRG 143: Chest Pain. Severe pain related to a heart condition.

DRG 148: Major Small and Large Bowel Procedures. With medical complications.

DRG 174: Gastro-intestinal bleeding. Bleeding from the stomach or intestinal track. May require insertion of a tube or a scope.

DRG 182: Digestive Disorders Age 17 or older with Complications. conditions related to the esophogus, stomach, and intestines, sucn as salmonella, food poisoning, infectious diarrhea, intestinal parasites, persistent vomiting, heartburn, gas and abdominal pain.

DRG 183: Esophogitis. Upper abdominal pain or chest pain related to the esophagus. Pain may be due to diverticulitis, reflux, or an unknown origin.

DRG 209: Joint Replacement and Limb Reattachment. Major joint replacements such as knees, hips, ankles; and major limb reattachments, sucn as hand, foot, forearm, and lower leg.

DRG 243: Medical Back Problems. (no definition)

DRG 294: Diabetes over 35. Hospitalized for control of blood sugar. Conditions include coma, ketoacidosis, and fluid imbalances. Kidney, eye, nervous system, or circulatory complications related to diabetes are not included.

DRG 320: Kidney & Urinary Tract Infections w/c. Acute and chronic infections of the kidney and urinary tract. Does not include urinary stone(s) or urinary symptoms such as frequency, bleeding or pain.

DRG 359: Hysterectomy. Surgical removal of the uterus through either a vaginal approach or an abdominal incision. May include a bladder repair for stress urinary incontinence. May include the biopsy and/or removal of the fallopian tubes, ovaries.

DRG 371: Cesarean Section. Hospital charges for the mother. Normal delivery of a baby or babies through incisions made in the mother’s abdomen.

DRG 372: Normal delivery with complications. Hospital charges for the mother. The delivery is complicated by conditions such as excessive bleeding, high blood pressure.

DRG 373: Normal Childbirth. Hospital charges for the mother. Normal delivery of a baby or babies without surgery.

DRG 390: Neonate with Significant problems. Hospital charges for the newborn. Baby has complications such as skin disorders, low temperature, feeding problems, cyst. Complications do not require extended hospital stays or intensive care.

DRG 391: Normal newborn. Hospital charges for the newborn. Newly delivered babies without significant health problems.

DRG 430: Psychoses. Major personality disorders such schizophrenia, catatonia, manic disorders, bipolar affective disorders, and paranoia.

Note: These figures are averages for items and services provided by hospitals. Doctor fees are not included. Figures include charges for the hospital room, hospital services ordered by the doctor such as x-rays and laboratory tests, and personal care items, such as hospital gowns. The charges include anesthesia provided by Certified Registered Nurses, but not MD anesthesiologists. Data source: MHA COMPdata Program.

 

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