*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| D480 - Neoplasm of uncertain behavior of bone and articular cartilage - as a primary diagnosis code | D480 - Neoplasm of uncertain behavior of bone and articular cartilage - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.46 | |
| Readmission Rate (%) | 21.03 | |
| Unplanned Readmission Rate (%) | 8.25 | |
| 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 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 478: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 479: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 47,199 | ||||
| Total Hospitalizations with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 30 | ||||
| DRG Share of Total Hospitalizations | 0.14 | ||||
| % of Total ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage in DRG | 13.45 | ||||
| Avg LOS at DRG | 4.61 | ||||
| Avg LOS with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 6.13 | ||||
| Readmission Rate at DRG | 24.6 | ||||
| Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Unplanned Readmission Rate at DRG | 15.23 | ||||
| Unplanned Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Total Medicare payments at DRG | $344,528,731 | ||||
| Total Medicare payments with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $249,949 | ||||
| Total Medicare payment per Day at DRG | $1,583 | ||||
| Total Medicare payment per Day with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $1,358 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,299 | ||||
| Total Medicare payment per Hospitalization with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $8,332 | ||||
| Total Medicare Charges at DRG | $1,680,848,591 | ||||
| Total Medicare Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $1,269,916 | ||||
| Avg Charges at DRG | $35,612 | ||||
| Avg Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $42,331 | ||||
| Mortality Rate at DRG | 0.94 | ||||
| Mortality Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| SNF Discharge Rate at DRG | 39.23 | ||||
| SNF Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Home Discharge Rate at DRG | 22.76 | ||||
| Home Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 36.67 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 544: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 42,559 | |
| Total Hospitalizations with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 14 | |
| DRG Share of Total Hospitalizations | 0.13 | |
| % of Total ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage in DRG | 6.28 | |
| Avg LOS at DRG | 4.67 | |
| Avg LOS with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 3.14 | |
| Readmission Rate at DRG | 23.96 | |
| Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| Unplanned Readmission Rate at DRG | 9.89 | |
| Unplanned Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| Total Medicare payments at DRG | $524,182,097 | |
| Total Medicare payments with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $151,611 | |
| Total Medicare payment per Day at DRG | $2,636 | |
| Total Medicare payment per Day with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $3,446 | |
| Total Medicare payment per Hospitalization at DRG | $12,317 | |
| Total Medicare payment per Hospitalization with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $10,829 | |
| Total Medicare Charges at DRG | $2,765,571,309 | |
| Total Medicare Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $873,152 | |
| Avg Charges at DRG | $64,982 | |
| Avg Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $62,368 | |
| Mortality Rate at DRG | 0.11 | |
| Mortality Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| SNF Discharge Rate at DRG | 33.62 | |
| SNF Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| Home Discharge Rate at DRG | 31.52 | |
| Home Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 78.57 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 483: MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | DRG 478: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,522,684 | ||||
| Total Hospitalizations with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 141 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage in DRG | 13.36 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 3.0 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 12.32 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $1,787,061 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $4,225 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $12,674 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $9,714,441 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $68,897 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 20.57 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 26.24 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 479: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 6,181 | ||||
| Total Hospitalizations with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 27 | ||||
| DRG Share of Total Hospitalizations | 0.02 | ||||
| % of Total ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage in DRG | 2.56 | ||||
| Avg LOS at DRG | 4.04 | ||||
| Avg LOS with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 2.3 | ||||
| Readmission Rate at DRG | 19.49 | ||||
| Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Unplanned Readmission Rate at DRG | 8.69 | ||||
| Unplanned Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Total Medicare payments at DRG | $63,351,723 | ||||
| Total Medicare payments with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $210,850 | ||||
| Total Medicare payment per Day at DRG | $2,539 | ||||
| Total Medicare payment per Day with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $3,401 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,249 | ||||
| Total Medicare payment per Hospitalization with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $7,809 | ||||
| Total Medicare Charges at DRG | $367,012,549 | ||||
| Total Medicare Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $1,208,109 | ||||
| Avg Charges at DRG | $59,378 | ||||
| Avg Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $44,745 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| SNF Discharge Rate at DRG | 26.11 | ||||
| SNF Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Home Discharge Rate at DRG | 40.66 | ||||
| Home Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 62.96 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 544: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 15,043 | ||||
| Total Hospitalizations with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 14 | ||||
| DRG Share of Total Hospitalizations | 0.05 | ||||
| % of Total ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage in DRG | 1.33 | ||||
| Avg LOS at DRG | 3.37 | ||||
| Avg LOS with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 2.93 | ||||
| Readmission Rate at DRG | 19.32 | ||||
| Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Unplanned Readmission Rate at DRG | 9.33 | ||||
| Unplanned Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Total Medicare payments at DRG | $73,311,923 | ||||
| Total Medicare payments with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $81,063 | ||||
| Total Medicare payment per Day at DRG | $1,448 | ||||
| Total Medicare payment per Day with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $1,977 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,873 | ||||
| Total Medicare payment per Hospitalization with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $5,790 | ||||
| Total Medicare Charges at DRG | $380,530,132 | ||||
| Total Medicare Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $286,568 | ||||
| Avg Charges at DRG | $25,296 | ||||
| Avg Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $20,469 | ||||
| Mortality Rate at DRG | 0.37 | ||||
| Mortality Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| SNF Discharge Rate at DRG | 42.09 | ||||
| SNF Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | ||||
| Home Discharge Rate at DRG | 24.51 | ||||
| Home Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 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 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 477: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 240,618 | |
| Total Hospitalizations with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 11 | |
| DRG Share of Total Hospitalizations | 0.73 | |
| % of Total ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage in DRG | 1.04 | |
| Avg LOS at DRG | 4.81 | |
| Avg LOS with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | 3.18 | |
| Readmission Rate at DRG | 26.3 | |
| Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| Unplanned Readmission Rate at DRG | 7.83 | |
| Unplanned Readmission Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| Total Medicare payments at DRG | $2,989,116,299 | |
| Total Medicare payments with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $145,653 | |
| Total Medicare payment per Day at DRG | $2,581 | |
| Total Medicare payment per Day with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $4,162 | |
| Total Medicare payment per Hospitalization at DRG | $12,423 | |
| Total Medicare payment per Hospitalization with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $13,241 | |
| Total Medicare Charges at DRG | $15,603,027,471 | |
| Total Medicare Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $574,560 | |
| Avg Charges at DRG | $64,846 | |
| Avg Charges with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | $52,233 | |
| Mortality Rate at DRG | 0.4 | |
| Mortality Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| SNF Discharge Rate at DRG | 66.28 | |
| SNF Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA | |
| Home Discharge Rate at DRG | 3.84 | |
| Home Discharge Rate with ICD D480 - Neoplasm of uncertain behavior of bone and articular cartilage | NA |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | I10 | Essential (primary) hypertension |
| 2 | E785 | Hyperlipidemia, unspecified |
| 3 | K219 | Gastro-esophageal reflux disease without esophagitis |
| 4 | Z87891 | Personal history of nicotine dependence |