DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS


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Jan 2017 to Dec 2017   |   Jan 2013 to Dec 2017

Table of Contents

No.Quality Metric
1CHARGE CAPTURE ANALYSIS FOR DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) GROUP BASED ON MEDICARE
2DEMOGRAPHIC DETAILS OF DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)
3TOP ICD DIAGNOSIS CODES FOR DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)
4TOP ICD PROCEDURE CODES FOR DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)
5TOP HOSPITALS ASSOCIATED WITH DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)
6TOP ATTENDING PHYSICIAN ASSOCIATED WITH DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)
7TOP OPERATING PHYSICIAN ASSOCIATED WITH DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)
8DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) SUMMARY TABLE

CHARGE CAPTURE ANALYSIS FOR DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) GROUP BASED ON MEDICARE

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DRG Code DRG Description Category Sub Category DRG Group Surgical Category Case Mix Level Total National Projected Hospitalizations - Annualized Total Medicare Hospitalizations - Jan 2017 to Dec 2017 Total Medicare Hospitalizations - Jan 2013 to Dec 2017 Total Medicare Hospitalizations After Exclusion Avg. LOS GMLOS All Cause Readmission Rate (%) Unplanned Readmission Rate (%) Total Medicare Payments Payment per Day Payment per Discharge Total Medicare Charges Avg. Charges Mortality Rate (%) SNF Discharge Rate (%) Home Discharge Rate (%)
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Surgical 38.71 NA 13,810 83,124 82,649
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Surgical 14.29 NA 6,294 30,698 29,367
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH COMPLICATION OR COMORBIDITY (CC) Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Surgical 47.00 NA 19,365 100,940 100,060

DEMOGRAPHIC DETAILS OF DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)

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Race Total Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
White 74,012 89.04
Black 5,012 6.03
Hispanic 1,235 1.49
Age Group ( Years ) Total Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
65 to 69 20,913 25.16
Less than 65 17,195 20.69
70 to 74 15,927 19.16

TOP ICD DIAGNOSIS CODES FOR DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)

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ICD Code ICD Description Total ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
4019 Unspecified essential hypertension 28,445 34.22
2724 Other and unspecified hyperlipidemia 15,773 18.98
53081 Esophageal reflux 11,321 13.62

TOP ICD PROCEDURE CODES FOR DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)

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TOP HOSPITALS ASSOCIATED WITH DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)

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Hospital Name Address City State Zip Code Total Hospital & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
Florida Hospital Orlando 601 E ROLLINS ST Orlando FL 32803 551 0.66
Massachusetts General Hospital 55 FRUIT ST Boston MA 02114 249 0.3
Beaumont Hospital, Royal Oak 3601 W 13 MILE RD Royal Oak MI 48073 219 0.26

TOP ATTENDING PHYSICIAN ASSOCIATED WITH DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)

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Physician Name Address City State Zip Code Total Physician & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
DR. GLEEN JOHN LIM GO 601 E ROLLINS AVE ORLANDO FL 32803 125 0.15
DR. MICHAEL P SWORDS 2815 S PENNSYLVANIA AVE LANSING MI 48910 77 0.09
DR. NABIL A EBRAHEIM 3000 ARLINGTON AVE TOLEDO OH 43614 72 0.09

TOP OPERATING PHYSICIAN ASSOCIATED WITH DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC)

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Physician Name Address City State Zip Code Total Physician & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
DR. BRIAN KEITH VICKARYOUS 2501 N ORANGE AVE ORLANDO FL 32804 133 0.16
DR. MICHAEL ANTHONY HAWKS 2501 N ORANGE AVE ORLANDO FL 32804 115 0.14
DR. ROBERT J MEURET 2501 N ORANGE AVE ORLANDO FL 32804 96 0.12

DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) SUMMARY TABLE

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Category Sub Category DRG Group ICD Codes ICD Description National Projected Hospitalizations (Present on Admission - All) Jan 2016 to Dec 2016 Medicare Hospitalizations (Present on Admission - All) Jan 2013 to Dec 2017 National Projected Hospitalizations(Present on Admission - Yes) Jan 2016 to Dec 2016 Medicare Hospitalizations (Present on Admission - Yes) Jan 2013 to Dec 2017 National Projected Hospitalizations (Present on Admission - Not Y) Jan 2016 to Dec 2016 Medicare Hospitalizations (Present on Admission - Not Y) Jan 2013 to Dec 2017 Total Discharges After Exclusion Avg. LOS GMLOS All Cause Readmission Rate (%) Unplanned Readmission Rate (%) Total Medicare Payments Payment per Day Payment per Discharge Total Medicare Charges Avg. Charges Mortality Rate (%) SNF Discharge Rate (%) Home Discharge Rate (%)
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 4019 Unspecified essential hypertension NA 28,445
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur I10 Essential (primary) hypertension 23,838 18,706
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 2724 Other and unspecified hyperlipidemia NA 15,773
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 53081 Esophageal reflux NA 11,321
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur E785 Hyperlipidemia, unspecified 11,190 10,539
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 25000 Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled NA 9,418
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 2449 Unspecified acquired hypothyroidism NA 8,722
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 8244 Bimalleolar fracture, closed NA 8,291
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur 8246 Trimalleolar fracture, closed NA 7,844
Orthopedics Lower Extremity And Humerus Procedures Except Hip,Foot,Femur Lower Extremity And Humerus Procedures Except Hip, Foot And Femur K219 Gastro-esophageal reflux disease without esophagitis 7,985 7,836