Health Costs

Procedure Count

The procedure count on CompareMaine represents the number of times a facility located in Maine performed the particular service or procedure as reported in MHDO’s APCD. The procedure counts include claims for both commercial and public payers – it does not include counts of services received by those without insurance and other covered members not reported in the APCD.

We had to use two different methodologies to calculate full year count estimates for complex vs. non-complex procedures, and then used the most recent data available, which varied by payer. To count non-complex procedures, each unique combination of APCD member ID, facility ID, service or procedure code, and service date receives a count of 1. For commercial and Medicaid (MaineCare), the claims counts are for January 1, 2017 – December 31, 2017 and for October 1, 2016 – September 30, 2017 for Medicare. To count complex procedures, each unique combination of episode and procedure ID receives a count of 1. For commercial and Medicaid (MaineCare), the claims counts are for July 1, 2016 – June 30, 2017 and for Medicare, we created a full year estimate by doubling the counts from July 1, 2016 – December 31, 2016.

Counts are rounded to the highest multiple of 10 before they are displayed on the site (for example, 12, 15, and 19 are all rounded to 20).