*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts - as a primary diagnosis code | D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.78 | |
| Readmission Rate (%) | 26.43 | |
| Unplanned Readmission Rate (%) | 20.28 | |
| 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 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 437: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 40,116 | ||||
| Total Hospitalizations with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 80 | ||||
| DRG Share of Total Hospitalizations | 0.12 | ||||
| % of Total ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts in DRG | 33.06 | ||||
| Avg LOS at DRG | 6.14 | ||||
| Avg LOS with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 4.44 | ||||
| Readmission Rate at DRG | 26.88 | ||||
| Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 40.0 | ||||
| Unplanned Readmission Rate at DRG | 18.3 | ||||
| Unplanned Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 28.57 | ||||
| Total Medicare payments at DRG | $472,915,537 | ||||
| Total Medicare payments with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $865,103 | ||||
| Total Medicare payment per Day at DRG | $1,921 | ||||
| Total Medicare payment per Day with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $2,437 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,789 | ||||
| Total Medicare payment per Hospitalization with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $10,814 | ||||
| Total Medicare Charges at DRG | $2,356,079,688 | ||||
| Total Medicare Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $3,729,406 | ||||
| Avg Charges at DRG | $58,732 | ||||
| Avg Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $46,618 | ||||
| Mortality Rate at DRG | 10.79 | ||||
| Mortality Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| SNF Discharge Rate at DRG | 10.16 | ||||
| SNF Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 13.75 | ||||
| Home Discharge Rate at DRG | 35.89 | ||||
| Home Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 50.0 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 5,745 |
| Total Hospitalizations with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 12 |
| DRG Share of Total Hospitalizations | 0.02 |
| % of Total ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts in DRG | 4.96 |
| Avg LOS at DRG | 4.57 |
| Avg LOS with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 6.17 |
| Readmission Rate at DRG | 12.33 |
| Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA |
| Unplanned Readmission Rate at DRG | 8.29 |
| Unplanned Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA |
| Total Medicare payments at DRG | $80,007,154 |
| Total Medicare payments with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $174,784 |
| Total Medicare payment per Day at DRG | $3,048 |
| Total Medicare payment per Day with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $2,362 |
| Total Medicare payment per Hospitalization at DRG | $13,926 |
| Total Medicare payment per Hospitalization with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $14,565 |
| Total Medicare Charges at DRG | $449,200,078 |
| Total Medicare Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $979,833 |
| Avg Charges at DRG | $78,190 |
| Avg Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $81,653 |
| Mortality Rate at DRG | NA |
| Mortality Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA |
| SNF Discharge Rate at DRG | 4.16 |
| SNF Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA |
| Home Discharge Rate at DRG | 74.73 |
| Home Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 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 436: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 40,116 | ||||
| Total Hospitalizations with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 92 | ||||
| DRG Share of Total Hospitalizations | 0.12 | ||||
| % of Total ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts in DRG | 8.65 | ||||
| Avg LOS at DRG | 6.14 | ||||
| Avg LOS with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 4.41 | ||||
| Readmission Rate at DRG | 26.88 | ||||
| Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 38.75 | ||||
| Unplanned Readmission Rate at DRG | 18.3 | ||||
| Unplanned Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 27.5 | ||||
| Total Medicare payments at DRG | $472,915,537 | ||||
| Total Medicare payments with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $1,018,490 | ||||
| Total Medicare payment per Day at DRG | $1,921 | ||||
| Total Medicare payment per Day with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $2,509 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,789 | ||||
| Total Medicare payment per Hospitalization with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $11,071 | ||||
| Total Medicare Charges at DRG | $2,356,079,688 | ||||
| Total Medicare Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $4,447,486 | ||||
| Avg Charges at DRG | $58,732 | ||||
| Avg Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $48,342 | ||||
| Mortality Rate at DRG | 10.79 | ||||
| Mortality Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| SNF Discharge Rate at DRG | 10.16 | ||||
| SNF Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 11.96 | ||||
| Home Discharge Rate at DRG | 35.89 | ||||
| Home Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 52.17 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 445: DISORDERS OF THE BILIARY TRACT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 437: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 444: DISORDERS OF THE BILIARY TRACT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 56,656 | ||||
| Total Hospitalizations with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 24 | ||||
| DRG Share of Total Hospitalizations | 0.17 | ||||
| % of Total ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts in DRG | 2.26 | ||||
| Avg LOS at DRG | 3.7 | ||||
| Avg LOS with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 3.38 | ||||
| Readmission Rate at DRG | 21.0 | ||||
| Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Unplanned Readmission Rate at DRG | 14.31 | ||||
| Unplanned Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Total Medicare payments at DRG | $374,740,838 | ||||
| Total Medicare payments with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $155,420 | ||||
| Total Medicare payment per Day at DRG | $1,786 | ||||
| Total Medicare payment per Day with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $1,919 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,614 | ||||
| Total Medicare payment per Hospitalization with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $6,476 | ||||
| Total Medicare Charges at DRG | $2,130,704,945 | ||||
| Total Medicare Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $715,304 | ||||
| Avg Charges at DRG | $37,608 | ||||
| Avg Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $29,804 | ||||
| Mortality Rate at DRG | 0.43 | ||||
| Mortality Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| SNF Discharge Rate at DRG | 11.12 | ||||
| SNF Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Home Discharge Rate at DRG | 60.3 | ||||
| Home Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 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 441: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 439: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 375: DIGESTIVE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 418: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 56,884 | ||||
| Total Hospitalizations with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 14 | ||||
| DRG Share of Total Hospitalizations | 0.17 | ||||
| % of Total ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts in DRG | 1.32 | ||||
| Avg LOS at DRG | 6.43 | ||||
| Avg LOS with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 7.43 | ||||
| Readmission Rate at DRG | 37.66 | ||||
| Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Unplanned Readmission Rate at DRG | 28.76 | ||||
| Unplanned Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Total Medicare payments at DRG | $726,233,427 | ||||
| Total Medicare payments with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $194,360 | ||||
| Total Medicare payment per Day at DRG | $1,987 | ||||
| Total Medicare payment per Day with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $1,869 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,767 | ||||
| Total Medicare payment per Hospitalization with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $13,883 | ||||
| Total Medicare Charges at DRG | $3,363,541,067 | ||||
| Total Medicare Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $956,518 | ||||
| Avg Charges at DRG | $59,130 | ||||
| Avg Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $68,323 | ||||
| Mortality Rate at DRG | 9.48 | ||||
| Mortality Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| SNF Discharge Rate at DRG | 18.8 | ||||
| SNF Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Home Discharge Rate at DRG | 33.97 | ||||
| Home Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 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 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 432: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 438: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 5,745 | ||||
| Total Hospitalizations with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 13 | ||||
| DRG Share of Total Hospitalizations | 0.02 | ||||
| % of Total ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts in DRG | 1.22 | ||||
| Avg LOS at DRG | 4.57 | ||||
| Avg LOS with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 5.85 | ||||
| Readmission Rate at DRG | 12.33 | ||||
| Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Unplanned Readmission Rate at DRG | 8.29 | ||||
| Unplanned Readmission Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Total Medicare payments at DRG | $80,007,154 | ||||
| Total Medicare payments with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $186,559 | ||||
| Total Medicare payment per Day at DRG | $3,048 | ||||
| Total Medicare payment per Day with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $2,455 | ||||
| Total Medicare payment per Hospitalization at DRG | $13,926 | ||||
| Total Medicare payment per Hospitalization with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $14,351 | ||||
| Total Medicare Charges at DRG | $449,200,078 | ||||
| Total Medicare Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $1,057,173 | ||||
| Avg Charges at DRG | $78,190 | ||||
| Avg Charges with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | $81,321 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| SNF Discharge Rate at DRG | 4.16 | ||||
| SNF Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | NA | ||||
| Home Discharge Rate at DRG | 74.73 | ||||
| Home Discharge Rate with ICD D376 - Neoplasm of uncertain behavior of liver, gallbladder and bile ducts | 84.62 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | K831 | Obstruction of bile duct |
| 2 | E119 | Type 2 diabetes mellitus without complications |
| 3 | I10 | Essential (primary) hypertension |
| 4 | Z87891 | Personal history of nicotine dependence |
| 5 | E785 | Hyperlipidemia, unspecified |