*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| C249 - Malignant neoplasm of biliary tract, unspecified - as a primary diagnosis code | C249 - Malignant neoplasm of biliary tract, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.27 | |
| Readmission Rate (%) | 29.64 | |
| Unplanned Readmission Rate (%) | 17.5 | |
| Mortality Rate (%) | ||
| SNF Discharge Rate (%) | ||
| Home Discharge Rate (%) | ||
| PAYMENTS AND CHARGES | ||
| Total Medicare Payments | ||
| Payment Per Day | ||
| Payment Per Hospitalization | ||
| Total Medicare Charges | ||
| Avg. Charges | ||
| MARKET SIZING & INCIDENCE RATES | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - All) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations after Exclusion | ||
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 435: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 436: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 408: BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 437: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 40,116 | ||||
| Total Hospitalizations with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 362 | ||||
| DRG Share of Total Hospitalizations | 0.12 | ||||
| % of Total ICD C249 - Malignant neoplasm of biliary tract, unspecified in DRG | 56.04 | ||||
| Avg LOS at DRG | 6.14 | ||||
| Avg LOS with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 6.22 | ||||
| Readmission Rate at DRG | 26.88 | ||||
| Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 29.84 | ||||
| Unplanned Readmission Rate at DRG | 18.3 | ||||
| Unplanned Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 18.03 | ||||
| Total Medicare payments at DRG | $472,915,537 | ||||
| Total Medicare payments with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $4,168,666 | ||||
| Total Medicare payment per Day at DRG | $1,921 | ||||
| Total Medicare payment per Day with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $1,851 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,789 | ||||
| Total Medicare payment per Hospitalization with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $11,516 | ||||
| Total Medicare Charges at DRG | $2,356,079,688 | ||||
| Total Medicare Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $23,400,047 | ||||
| Avg Charges at DRG | $58,732 | ||||
| Avg Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $64,641 | ||||
| Mortality Rate at DRG | 10.79 | ||||
| Mortality Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 9.39 | ||||
| SNF Discharge Rate at DRG | 10.16 | ||||
| SNF Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 11.33 | ||||
| Home Discharge Rate at DRG | 35.89 | ||||
| Home Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 36.46 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 420: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 6,779 |
| Total Hospitalizations with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 14 |
| DRG Share of Total Hospitalizations | 0.02 |
| % of Total ICD C249 - Malignant neoplasm of biliary tract, unspecified in DRG | 2.17 |
| Avg LOS at DRG | 9.29 |
| Avg LOS with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 5.93 |
| Readmission Rate at DRG | 35.9 |
| Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA |
| Unplanned Readmission Rate at DRG | 25.82 |
| Unplanned Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA |
| Total Medicare payments at DRG | $181,778,856 |
| Total Medicare payments with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $323,107 |
| Total Medicare payment per Day at DRG | $2,886 |
| Total Medicare payment per Day with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $3,893 |
| Total Medicare payment per Hospitalization at DRG | $26,815 |
| Total Medicare payment per Hospitalization with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $23,079 |
| Total Medicare Charges at DRG | $661,562,226 |
| Total Medicare Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $1,101,824 |
| Avg Charges at DRG | $97,590 |
| Avg Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $78,702 |
| Mortality Rate at DRG | 10.8 |
| Mortality Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA |
| SNF Discharge Rate at DRG | 16.7 |
| SNF Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA |
| Home Discharge Rate at DRG | 36.13 |
| Home Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 435: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 436: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 445: DISORDERS OF THE BILIARY TRACT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 40,116 | ||||
| Total Hospitalizations with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 493 | ||||
| DRG Share of Total Hospitalizations | 0.12 | ||||
| % of Total ICD C249 - Malignant neoplasm of biliary tract, unspecified in DRG | 17.67 | ||||
| Avg LOS at DRG | 6.14 | ||||
| Avg LOS with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 6.57 | ||||
| Readmission Rate at DRG | 26.88 | ||||
| Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 27.05 | ||||
| Unplanned Readmission Rate at DRG | 18.3 | ||||
| Unplanned Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 17.15 | ||||
| Total Medicare payments at DRG | $472,915,537 | ||||
| Total Medicare payments with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $5,663,679 | ||||
| Total Medicare payment per Day at DRG | $1,921 | ||||
| Total Medicare payment per Day with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $1,748 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,789 | ||||
| Total Medicare payment per Hospitalization with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $11,488 | ||||
| Total Medicare Charges at DRG | $2,356,079,688 | ||||
| Total Medicare Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $33,809,574 | ||||
| Avg Charges at DRG | $58,732 | ||||
| Avg Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $68,579 | ||||
| Mortality Rate at DRG | 10.79 | ||||
| Mortality Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 10.34 | ||||
| SNF Discharge Rate at DRG | 10.16 | ||||
| SNF Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 11.97 | ||||
| Home Discharge Rate at DRG | 35.89 | ||||
| Home Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 33.27 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 919: COMPLICATIONS OF TREATMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 408: BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 444: DISORDERS OF THE BILIARY TRACT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 44,227 | ||||
| Total Hospitalizations with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 60 | ||||
| DRG Share of Total Hospitalizations | 0.13 | ||||
| % of Total ICD C249 - Malignant neoplasm of biliary tract, unspecified in DRG | 2.15 | ||||
| Avg LOS at DRG | 8.02 | ||||
| Avg LOS with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 7.32 | ||||
| Readmission Rate at DRG | 30.44 | ||||
| Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 40.0 | ||||
| Unplanned Readmission Rate at DRG | 20.14 | ||||
| Unplanned Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 27.27 | ||||
| Total Medicare payments at DRG | $641,315,623 | ||||
| Total Medicare payments with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $779,004 | ||||
| Total Medicare payment per Day at DRG | $1,808 | ||||
| Total Medicare payment per Day with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $1,774 | ||||
| Total Medicare payment per Hospitalization at DRG | $14,501 | ||||
| Total Medicare payment per Hospitalization with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $12,983 | ||||
| Total Medicare Charges at DRG | $3,055,824,019 | ||||
| Total Medicare Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $3,760,302 | ||||
| Avg Charges at DRG | $69,094 | ||||
| Avg Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $62,672 | ||||
| Mortality Rate at DRG | 3.89 | ||||
| Mortality Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 16.17 | ||||
| SNF Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Home Discharge Rate at DRG | 45.86 | ||||
| Home Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 46.67 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 420: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 374: DIGESTIVE MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 6,779 | ||||
| Total Hospitalizations with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 32 | ||||
| DRG Share of Total Hospitalizations | 0.02 | ||||
| % of Total ICD C249 - Malignant neoplasm of biliary tract, unspecified in DRG | 1.15 | ||||
| Avg LOS at DRG | 9.29 | ||||
| Avg LOS with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 9.16 | ||||
| Readmission Rate at DRG | 35.9 | ||||
| Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 25.82 | ||||
| Unplanned Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Total Medicare payments at DRG | $181,778,856 | ||||
| Total Medicare payments with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $769,722 | ||||
| Total Medicare payment per Day at DRG | $2,886 | ||||
| Total Medicare payment per Day with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $2,627 | ||||
| Total Medicare payment per Hospitalization at DRG | $26,815 | ||||
| Total Medicare payment per Hospitalization with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $24,054 | ||||
| Total Medicare Charges at DRG | $661,562,226 | ||||
| Total Medicare Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $2,723,351 | ||||
| Avg Charges at DRG | $97,590 | ||||
| Avg Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $85,105 | ||||
| Mortality Rate at DRG | 10.8 | ||||
| Mortality Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 16.7 | ||||
| SNF Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Home Discharge Rate at DRG | 36.13 | ||||
| Home Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 375: DIGESTIVE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 442: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 522,791 | ||||
| Total Hospitalizations with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 26 | ||||
| DRG Share of Total Hospitalizations | 1.59 | ||||
| % of Total ICD C249 - Malignant neoplasm of biliary tract, unspecified in DRG | 0.93 | ||||
| Avg LOS at DRG | 3.14 | ||||
| Avg LOS with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 3.58 | ||||
| Readmission Rate at DRG | 17.1 | ||||
| Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 12.62 | ||||
| Unplanned Readmission Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Total Medicare payments at DRG | $2,290,151,156 | ||||
| Total Medicare payments with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $104,792 | ||||
| Total Medicare payment per Day at DRG | $1,394 | ||||
| Total Medicare payment per Day with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $1,127 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,381 | ||||
| Total Medicare payment per Hospitalization with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $4,030 | ||||
| Total Medicare Charges at DRG | $13,619,287,561 | ||||
| Total Medicare Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $670,236 | ||||
| Avg Charges at DRG | $26,051 | ||||
| Avg Charges with ICD C249 - Malignant neoplasm of biliary tract, unspecified | $25,778 | ||||
| Mortality Rate at DRG | 0.18 | ||||
| Mortality Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 8.57 | ||||
| SNF Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | NA | ||||
| Home Discharge Rate at DRG | 72.49 | ||||
| Home Discharge Rate with ICD C249 - Malignant neoplasm of biliary tract, unspecified | 50.0 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MASSACHUSETTS GENERAL HOSPITAL | 55 FRUIT ST | BOSTON | MA | 02114 | 18 |
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 18 |
| NUVANCE HEALTH - NORWALK HOSPITAL | 34 MAPLE ST | NORWALK | CT | 06850 | 13 |