*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| I099 - Rheumatic heart disease, unspecified - as a primary diagnosis code | I099 - Rheumatic heart disease, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.9 | |
| Readmission Rate (%) | 23.23 | |
| Unplanned Readmission Rate (%) | NA | |
| 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 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD I099 - Rheumatic heart disease, unspecified | 381 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD I099 - Rheumatic heart disease, unspecified in DRG | 5.45 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD I099 - Rheumatic heart disease, unspecified | 5.9 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | 30.41 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | 23.68 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD I099 - Rheumatic heart disease, unspecified | $3,876,303 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD I099 - Rheumatic heart disease, unspecified | $1,724 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD I099 - Rheumatic heart disease, unspecified | $10,174 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD I099 - Rheumatic heart disease, unspecified | $18,196,792 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD I099 - Rheumatic heart disease, unspecified | $47,761 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD I099 - Rheumatic heart disease, unspecified | 4.72 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | 19.16 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | 39.11 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 310: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 221,460 | ||||
| Total Hospitalizations with ICD I099 - Rheumatic heart disease, unspecified | 152 | ||||
| DRG Share of Total Hospitalizations | 0.67 | ||||
| % of Total ICD I099 - Rheumatic heart disease, unspecified in DRG | 2.17 | ||||
| Avg LOS at DRG | 2.1 | ||||
| Avg LOS with ICD I099 - Rheumatic heart disease, unspecified | 2.42 | ||||
| Readmission Rate at DRG | 11.15 | ||||
| Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | 11.27 | ||||
| Unplanned Readmission Rate at DRG | 7.88 | ||||
| Unplanned Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| Total Medicare payments at DRG | $635,922,710 | ||||
| Total Medicare payments with ICD I099 - Rheumatic heart disease, unspecified | $548,161 | ||||
| Total Medicare payment per Day at DRG | $1,367 | ||||
| Total Medicare payment per Day with ICD I099 - Rheumatic heart disease, unspecified | $1,490 | ||||
| Total Medicare payment per Hospitalization at DRG | $2,872 | ||||
| Total Medicare payment per Hospitalization with ICD I099 - Rheumatic heart disease, unspecified | $3,606 | ||||
| Total Medicare Charges at DRG | $4,179,979,444 | ||||
| Total Medicare Charges with ICD I099 - Rheumatic heart disease, unspecified | $3,483,394 | ||||
| Avg Charges at DRG | $18,875 | ||||
| Avg Charges with ICD I099 - Rheumatic heart disease, unspecified | $22,917 | ||||
| Mortality Rate at DRG | 0.21 | ||||
| Mortality Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 4.01 | ||||
| SNF Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| Home Discharge Rate at DRG | 82.23 | ||||
| Home Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | 84.21 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 209,527 | ||||
| Total Hospitalizations with ICD I099 - Rheumatic heart disease, unspecified | 100 | ||||
| DRG Share of Total Hospitalizations | 0.64 | ||||
| % of Total ICD I099 - Rheumatic heart disease, unspecified in DRG | 1.43 | ||||
| Avg LOS at DRG | 2.98 | ||||
| Avg LOS with ICD I099 - Rheumatic heart disease, unspecified | 4.98 | ||||
| Readmission Rate at DRG | 15.34 | ||||
| Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | 18.89 | ||||
| Unplanned Readmission Rate at DRG | 8.56 | ||||
| Unplanned Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| Total Medicare payments at DRG | $1,394,352,541 | ||||
| Total Medicare payments with ICD I099 - Rheumatic heart disease, unspecified | $897,245 | ||||
| Total Medicare payment per Day at DRG | $2,234 | ||||
| Total Medicare payment per Day with ICD I099 - Rheumatic heart disease, unspecified | $1,802 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,655 | ||||
| Total Medicare payment per Hospitalization with ICD I099 - Rheumatic heart disease, unspecified | $8,972 | ||||
| Total Medicare Charges at DRG | $9,726,714,225 | ||||
| Total Medicare Charges with ICD I099 - Rheumatic heart disease, unspecified | $5,757,695 | ||||
| Avg Charges at DRG | $46,422 | ||||
| Avg Charges with ICD I099 - Rheumatic heart disease, unspecified | $57,577 | ||||
| Mortality Rate at DRG | 0.17 | ||||
| Mortality Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 3.41 | ||||
| SNF Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| Home Discharge Rate at DRG | 79.22 | ||||
| Home Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | 69.0 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | 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) | DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 434,264 | ||||
| Total Hospitalizations with ICD I099 - Rheumatic heart disease, unspecified | 93 | ||||
| DRG Share of Total Hospitalizations | 1.32 | ||||
| % of Total ICD I099 - Rheumatic heart disease, unspecified in DRG | 1.33 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD I099 - Rheumatic heart disease, unspecified | 3.66 | ||||
| Readmission Rate at DRG | 22.76 | ||||
| Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | 17.44 | ||||
| Unplanned Readmission Rate at DRG | 16.46 | ||||
| Unplanned Readmission Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| Total Medicare payments at DRG | $2,472,138,198 | ||||
| Total Medicare payments with ICD I099 - Rheumatic heart disease, unspecified | $529,892 | ||||
| Total Medicare payment per Day at DRG | $1,444 | ||||
| Total Medicare payment per Day with ICD I099 - Rheumatic heart disease, unspecified | $1,559 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,693 | ||||
| Total Medicare payment per Hospitalization with ICD I099 - Rheumatic heart disease, unspecified | $5,698 | ||||
| Total Medicare Charges at DRG | $12,478,361,060 | ||||
| Total Medicare Charges with ICD I099 - Rheumatic heart disease, unspecified | $2,573,449 | ||||
| Avg Charges at DRG | $28,735 | ||||
| Avg Charges with ICD I099 - Rheumatic heart disease, unspecified | $27,671 | ||||
| Mortality Rate at DRG | 0.91 | ||||
| Mortality Rate with ICD I099 - Rheumatic heart disease, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 22.02 | ||||
| SNF Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | 26.88 | ||||
| Home Discharge Rate at DRG | 46.68 | ||||
| Home Discharge Rate with ICD I099 - Rheumatic heart disease, unspecified | 41.94 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 66 |
| NEWYORK PRESBYTERIAN - COLUMBIA UNIVERSITY MEDICAL CENTER | 622 W 168TH ST | NEW YORK | NY | 10032 | 40 |
| NEWYORK PRESBYTERIAN - WEILL CORNELL MEDICAL CENTER | 525 E 68TH ST | NEW YORK | NY | 10021 | 38 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RALPH NIMCHAN | 6801 MCPHERSON AVE | LAREDO | TX | 78041 | 12 |