i need help to determine what the outlier payment is on this problem i cant seem to get it...

IPPS: High cost devices are used in many inpatient surgery cases. The Safe-Cross, radio frequency total occlusion crossing system, is such a device. The Safe-Cross guidewire is present on the following claim. First, complete an inpatient payment calculation to determine whether this claim would qualify for a high cost outlier add-on payment. Second, calculate the total reimbursement for this claim, including the additional amount that the facility would receive for the high cost outlier if applicable. Does this facility have a profit or loss for this encounter? The 2015 IPPS high-cost outlier threshold is $24,758; the hospital specific CCR is: 0.429; the hospital base rate is $6,200.00. Admit Date: January 1, 2015 Inpatient Claim Discharge January 10, Date: 2015 Length of Stay: 9 days Principal 410.71 Subendocardial infarction, initial episode of care Diagnosis*: Secondary 414.01 Coronary atherosclerosis of native coronary artery Diagnosis: Secondary 427.1 Paroxysmal ventricular tachycardia Diagnosis: Secondary 272.0 Pure hypercholesterolemia Diagnosis: Principal 00.66 Percutaneous transluminal coronary angioplasty Procedure: Secondary 36.07 Insertion of drug-eluting coronary artery stent Procedure: Secondary 39.29 Other vascular shunt or bypass Procedure: Secondary 37.22 Left heart cardiac catheterization Procedure: MS-DRG: Percutaneous cardiovascular procedure with drug-eluting stent with major 246 complication/comorbidity or 4+vessels/stents RW: 3.2368 *Diagnosis and procedures not converted to ICD-10-CM/PCS because service dates for this claim are prior to implementation of ICD-10-CM/PCS Revenue Code 110 120 200 206 250 255 258 259 270 272 272 278 301 302 305 323 360 361 370 390 410 420 430 480 481 483 710 730 921 Claim Detail Revenue Code Description Charge Room & board - private Room & board - semi private Intensive care - general Intensive care - intermediate ICU Pharmacy - general Pharmacy - drugs incident to radiology Pharmacy - IV solutions Pharmacy - other pharmacy Medical/surgical supplies - general Medical/surgical supplies - sterile supply The Safe-Cross guidewire Medical/surgical supplies - other implants Laboratory -chemistry Laboratory - Immunology Laboratory - Hematology Laboratory - Arteriography Operating room - general Operating room - minor surgery Anesthesia - general Blood and blood component admin, process, storage - gen Respiratory services - general Physical therapy - general Occupational therapy - general Cardiology - general Cardiology - cardiac cath lab Cardiology - echocardiology Recovery room - general EKG/ECG - general Other diagnostic services - peripheral vascular lab TOTAL CHARGE: $8,375.00 $3,700.00 $5,910.00 $2,780.00 $1,486.66 $728.13 $1,583.60 $7,766.18 $8,256.00 $8,366.25 $15,000.00 $28,623.00 $2,739.00 $648.00 $2,335.00 $2,491.00 $23,875.00 $517.00 $209.00 $668.00 $21.00 $314.00 $441.00 $5,629.00 $6,249.00 $1,786.00 $1,648.00 $1,098.00 $359.00 $143,601.80 IPPS Outlier: If the cost of the case is greater than the fixed-loss cost threshold then an outlier add-on payment is warranted. The fixed-loss cost threshold equals the MS-DRG payment + the HC outlier threshold amount for the applicable year. Outlier Add-on Amount is equal to 80% of the difference between the cost of the case and the fixed-loss cost threshold. Outlier paid if: cost of claim > reimbursement of claim + threshold Cost = charge * hospital specific cost to charge ratio Cost = 143,601.80*0.429 Cost = $61,605.17 Claim reimbursement = MS-DRG relative weight * hospital base rate Claim reimbursement = 3.2368*6,200.00 Claim reimbursement = $20,068.16 Outlier = 24,758+20,068.16 Outlier = 44,826.16 Does this claim qualify for a high cost outlier payment? N0 HC outlier payment = 80% * (cost - (claim reimbursement + threshold)) HC outlier payment = 0.8*(61,605.17-(20,068.16+24,758) HC outlier payment = 0.8*61,605.17-44,826.16 HC outlier payment = 13,423.21 TOTAL reimbursement for claim = claim reimbursement + HC outlier payment TOTAL reimbursement for claim = 20,068.16+13,423.21 TOTAL reimbursement for claim = 33,491.37 LOSS = Cost - Total payment LOSS = 61,605.17Outlier payment reduces loss from $ --------- to $