CostGrade

All published prices at Good Samaritan Medical Center

84 procedures, each showing what the hospital billed, what that care was actually paid for, and how the charge compares with the national middle for the same coded work.

F
Procedure Patients Charged Actually paid vs national
Level 5 Musculoskeletal Procedures

APC 5115 · Hospital outpatient visit

501 $175,801 $10,942 +181%
Comprehensive Observation Services

APC 8011 · Hospital outpatient visit

451 $49,777 $2,401 +156%
Sepsis (severe)

MS-DRG 871 · Inpatient stay

205 $182,045 $13,347 +179%
Level 2 Excision/ Biopsy/ Incision and Drainage

APC 5072 · Hospital outpatient visit

165 $28,335 $1,337 +181%
Level 1 Laparoscopy and Related Services

APC 5361 · Hospital outpatient visit

112 $84,720 $5,041 +141%
Level 4 Musculoskeletal Procedures

APC 5114 · Hospital outpatient visit

109 $159,162 $5,580 +299%
Level 2 Breast/lymphatic Surgery and Related Procedures

APC 5092 · Hospital outpatient visit

80 $121,165 $4,968 +207%
Heart Failure (severe)

MS-DRG 291 · Inpatient stay

77 $109,874 $8,922 +153%
Level 1 Breast/lymphatic Surgery and Related Procedures

APC 5091 · Hospital outpatient visit

68 $73,741 $3,089 +209%
Level 6 Musculoskeletal Procedures

APC 5116 · Hospital outpatient visit

58 $209,691 $13,702 +153%
Level 3 Vascular Procedures

APC 5183 · Hospital outpatient visit

56 $47,113 $2,764 +147%
Digestive Disorder (without major complications)

MS-DRG 392 · Inpatient stay

55 $88,040 $6,252 +173%
Pneumonia (severe)

MS-DRG 193 · Inpatient stay

54 $140,343 $9,340 +201%
Heart Attack (severe)

MS-DRG 280 · Inpatient stay

54 $125,066 $10,337 +104%
Level 3 Endovascular Procedures

APC 5193 · Hospital outpatient visit

41 $134,627 $9,348 +99%
Level 2 Laparoscopy and Related Services

APC 5362 · Hospital outpatient visit

41 $123,875 $8,757 +107%
Respiratory Infection (severe)

MS-DRG 177 · Inpatient stay

40 $115,572 $11,962 +110%
Urinary Tract Infection (without major complications)

MS-DRG 690 · Inpatient stay

39 $92,031 $6,197 +209%
Infection Needing Surgery (severe)

MS-DRG 853 · Inpatient stay

39 $479,593 $35,903 +170%
Level 3 Excision/ Biopsy/ Incision and Drainage

APC 5073 · Hospital outpatient visit

37 $63,385 $2,518 +258%
Hip or Knee Replacement (without major complications)

MS-DRG 470 · Inpatient stay

36 $223,206 $12,838 +179%
Major Small and Large Bowel Procedures with Complications

MS-DRG 330 · Inpatient stay

35 $286,247 $18,596 +185%
Gastrointestinal Bleeding (with complications)

MS-DRG 378 · Inpatient stay

32 $121,019 $7,863 +193%
Urinary Tract Infection (severe)

MS-DRG 689 · Inpatient stay

32 $117,562 $8,111 +188%
Level 4 Gynecologic Procedures

APC 5414 · Hospital outpatient visit

32 $56,227 $2,761 +210%
Level 3 Lower GI Procedures

APC 5313 · Hospital outpatient visit

32 $63,262 $2,227 +282%
Level 3 Urology and Related Services

APC 5373 · Hospital outpatient visit

31 $24,599 $1,845 +90%
Kidney or Urinary Disorder (severe)

MS-DRG 698 · Inpatient stay

28 $126,678 $11,040 +123%
Level 4 Vascular Procedures

APC 5184 · Hospital outpatient visit

28 $107,500 $4,978 +197%
Level 1 Endovascular Procedures

APC 5191 · Hospital outpatient visit

27 $44,682 $2,878 +77%
Irregular Heartbeat (with complications)

MS-DRG 309 · Inpatient stay

26 $73,728 $5,969 +141%
Skin Infection (without major complications)

MS-DRG 603 · Inpatient stay

26 $75,198 $6,985 +146%
Red Blood Cell Disorders without Major Complications

MS-DRG 812 · Inpatient stay

26 $61,583 $6,951 +66%
Sepsis (without major complications)

MS-DRG 872 · Inpatient stay

26 $118,958 $7,905 +203%
Kidney Failure (with complications)

MS-DRG 683 · Inpatient stay

25 $89,853 $7,053 +173%
Respiratory Failure

MS-DRG 189 · Inpatient stay

24 $139,067 $9,505 +187%
Kidney Failure (severe)

MS-DRG 682 · Inpatient stay

24 $144,842 $10,302 +174%
Revision of Hip or Knee Replacement with Complications

MS-DRG 467 · Inpatient stay

23 $417,797 $23,571 +221%
Level 2 Endovascular Procedures

APC 5192 · Hospital outpatient visit

23 $65,158 $4,819 +88%
Level 5 ENT Procedures

APC 5165 · Hospital outpatient visit

23 $108,978 $5,129 +217%
Fluid and Electrolyte Disorder (without major complications)

MS-DRG 641 · Inpatient stay

22 $88,491 $5,872 +190%
Major Small and Large Bowel Procedures with Major Complications

MS-DRG 329 · Inpatient stay

21 $481,248 $34,255 +168%
Back Problems (without major complications)

MS-DRG 552 · Inpatient stay

21 $89,437 $7,009 +129%
Pneumonia (with complications)

MS-DRG 194 · Inpatient stay

20 $88,544 $6,517 +179%
Level 3 Musculoskeletal Procedures

APC 5113 · Hospital outpatient visit

20 $105,566 $2,932 +418%
Level 2 Upper GI Procedures

APC 5302 · Hospital outpatient visit

20 $28,681 $1,723 +144%
Level 4 Airway Endoscopy

APC 5154 · Hospital outpatient visit

19 $80,065 $3,392 +253%
Gastrointestinal Obstruction with Complications

MS-DRG 389 · Inpatient stay

18 $97,208 $6,249 +211%
Level 1 Abdominal/peritoneal/biliary and Related Procedures

APC 5341 · Hospital outpatient visit

18 $57,596 $2,856 +148%
Fluid and Electrolyte Disorder (severe)

MS-DRG 640 · Inpatient stay

17 $107,886 $8,922 +122%
Level 4 Endovascular Procedures

APC 5194 · Hospital outpatient visit

17 $174,464 $11,285 +83%
Fainting

MS-DRG 312 · Inpatient stay

16 $70,842 $6,365 +93%
Chest Pain

MS-DRG 313 · Inpatient stay

16 $72,732 $5,540 +116%
Other Digestive System Diagnoses with Complications

MS-DRG 394 · Inpatient stay

16 $115,133 $7,396 +196%
Hip or Thigh Bone Surgery (with complications)

MS-DRG 481 · Inpatient stay

16 $235,526 $14,666 +183%
Level 4 Urology and Related Services

APC 5374 · Hospital outpatient visit

16 $65,458 $3,001 +217%
Level 5 Urology and Related Services

APC 5375 · Hospital outpatient visit

16 $81,794 $4,687 +198%
Level 2 Musculoskeletal Procedures

APC 5112 · Hospital outpatient visit

16 $39,084 $1,384 +248%
Heart Catheter Procedure (severe)

MS-DRG 321 · Inpatient stay

15 $291,977 $21,406 +103%
Kidney or Urinary Disorder (with complications)

MS-DRG 699 · Inpatient stay

15 $98,083 $7,707 +160%
Combined Anterior and Posterior Spinal Fusion without Complications/mcc

MS-DRG 455 · Inpatient stay

15 $471,708 $33,582 +167%
Other Vascular Procedures with Major Complications

MS-DRG 252 · Inpatient stay

14 $328,007 $24,850 +126%
Other Circulatory System Diagnoses with Major Complications

MS-DRG 314 · Inpatient stay

14 $231,058 $14,359 +195%
Revision of Hip or Knee Replacement without Complications/mcc

MS-DRG 468 · Inpatient stay

14 $286,761 $17,886 +164%
Major Chest Procedures with Major Complications

MS-DRG 163 · Inpatient stay

13 $426,846 $31,282 +142%
Permanent Cardiac Pacemaker Implant with Complications

MS-DRG 243 · Inpatient stay

13 $207,122 $15,248 +121%
Heart Catheter Procedure (without major complications)

MS-DRG 322 · Inpatient stay

13 $201,683 $12,347 +98%
Hip Replacement with Principal Diagnosis of Hip Fracture without Major Complications

MS-DRG 522 · Inpatient stay

13 $242,823 $14,669 +183%
Major Chest Procedures with Complications

MS-DRG 164 · Inpatient stay

13 $190,674 $14,461 +75%
Stroke (severe)

MS-DRG 064 · Inpatient stay

12 $141,804 $11,258 +86%
Respiratory Infection (with complications)

MS-DRG 178 · Inpatient stay

12 $115,953 $6,985 +212%
Irregular Heartbeat (severe)

MS-DRG 308 · Inpatient stay

12 $117,576 $9,185 +148%
Digestive Disorder (severe)

MS-DRG 391 · Inpatient stay

12 $83,449 $9,612 +63%
Diabetes (with complications)

MS-DRG 638 · Inpatient stay

12 $76,140 $7,381 +120%
Other Major Cardiovascular Procedures with Major Complications

MS-DRG 270 · Inpatient stay

12 $419,733 $35,395 +87%
Level 2 Vascular Procedures

APC 5182 · Hospital outpatient visit

12 $18,252 $1,354 +113%
COPD (severe)

MS-DRG 190 · Inpatient stay

11 $123,185 $8,200 +194%
Heart Attack (with complications)

MS-DRG 281 · Inpatient stay

11 $87,665 $7,733 +100%
Gastrointestinal Bleeding (severe)

MS-DRG 377 · Inpatient stay

11 $161,586 $12,410 +127%
Fractures of Hip and Pelvis without Major Complications

MS-DRG 536 · Inpatient stay

11 $77,365 $6,015 +136%
Diabetes with Major Complications

MS-DRG 637 · Inpatient stay

11 $120,521 $10,244 +114%
Red Blood Cell Disorders with Major Complications

MS-DRG 811 · Inpatient stay

11 $135,869 $10,589 +141%
Combined Anterior and Posterior Spinal Fusion with Complications

MS-DRG 454 · Inpatient stay

11 $492,671 $38,839 +122%
Trauma to the Skin, Subcutaneous Tissue and Breast without Major Complications

MS-DRG 605 · Inpatient stay

11 $75,297 $7,072 +84%

These figures are averages across this hospital's Medicare patients in the most recent federal data year. They are not a quote and not your bill. For your own case, ask the hospital for a written good-faith estimate and check its published machine-readable price file.