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I5040 - ICD 10 Diagnosis Code - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - Market Size, Prevalence, Incidence, Quality Outcomes, Top Hospitals & Physicians


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Key Statistics Related to I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure

*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.

I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code
OUTCOMES
Avg. LOS 7.48
Readmission Rate (%) 28.55
Unplanned Readmission Rate (%) 15.65
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

Top DRGs Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code

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Top 1 to 5 DRGs - Oct 2015 to Sep 2018

*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.

DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC)
Total Hospitalizations at DRG 422,757
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 641
DRG Share of Total Hospitalizations 1.29
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG 45.4
Avg LOS at DRG 4.14
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 5.09
Readmission Rate at DRG 24.43
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 23.74
Unplanned Readmission Rate at DRG 18.48
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 15.6
Total Medicare payments at DRG $2,636,135,714
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $5,157,372
Total Medicare payment per Day at DRG $1,507
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $1,582
Total Medicare payment per Hospitalization at DRG $6,236
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $8,046
Total Medicare Charges at DRG $11,980,955,733
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $16,002,354
Avg Charges at DRG $28,340
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $24,965
Mortality Rate at DRG 1.01
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 2.81
SNF Discharge Rate at DRG 16.05
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 12.79
Home Discharge Rate at DRG 47.18
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 41.03

Top 5 to 10 DRGs - Oct 2015 to Sep 2018

*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.

DRG 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC)
Total Hospitalizations at DRG 114,725
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 16
DRG Share of Total Hospitalizations 0.35
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG 1.13
Avg LOS at DRG 6.91
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 5.25
Readmission Rate at DRG 28.23
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure NA
Unplanned Readmission Rate at DRG 17.16
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure NA
Total Medicare payments at DRG $1,698,418,701
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $222,284
Total Medicare payment per Day at DRG $2,144
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $2,646
Total Medicare payment per Hospitalization at DRG $14,804
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $13,893
Total Medicare Charges at DRG $9,142,710,160
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $947,090
Avg Charges at DRG $79,692
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $59,193
Mortality Rate at DRG 3.27
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure NA
SNF Discharge Rate at DRG 10.66
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure NA
Home Discharge Rate at DRG 53.35
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure NA

Top Hospitals Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code

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Hospital Name Address City State Zip Code Total Hospitalizations ( Oct 2015 to Sep 2018 )
CUMBERLAND MEMORIAL HOSPITAL 1110 7TH AVE CUMBERLAND WI 54829 41
BAPTIST MEMORIAL REHABILITATION HOSPITAL 1240 SOUTH GERMANTOWN ROAD GERMANTOWN TN 38138 16
BARSTOW COMMUNITY HOSPITAL 820 E MOUNTAIN VIEW ST BARSTOW CA 92311 15

Top Attending Physicians Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code

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Physician Name Address City State Zip Code Total Hospitalizations ( Oct 2015 to Sep 2018 )
Dr. DALE P CUNNINGHAM 3265 W SARAZENS CIR MEMPHIS TN 38125 16
Dr. GREGORY J LEITHEISER 1475 WEBB ST CUMBERLAND WI 54829 16
Dr. BARBARA M ANKARLO 1475 WEBB ST CUMBERLAND WI 54829 11

Top DRGs Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code

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Top 1 to 5 DRGs - Oct 2015 to Sep 2018

*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.

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 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC)
Total Hospitalizations at DRG 1,808,415
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 2,621
DRG Share of Total Hospitalizations 5.5
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG 7.47
Avg LOS at DRG 6.34
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 7.37
Readmission Rate at DRG 24.2
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 30.7
Unplanned Readmission Rate at DRG 16.78
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 20.01
Total Medicare payments at DRG $21,288,214,047
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $33,497,544
Total Medicare payment per Day at DRG $1,857
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $1,734
Total Medicare payment per Hospitalization at DRG $11,772
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $12,780
Total Medicare Charges at DRG $107,155,481,388
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $194,388,928
Avg Charges at DRG $59,254
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $74,166
Mortality Rate at DRG 12.11
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 17.09
SNF Discharge Rate at DRG 27.18
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 28.31
Home Discharge Rate at DRG 25.81
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 19.42

Top 5 to 10 DRGs - Oct 2015 to Sep 2018

*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 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC) DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC)
Total Hospitalizations at DRG 434,264
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 737
DRG Share of Total Hospitalizations 1.32
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG 2.1
Avg LOS at DRG 3.94
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 4.14
Readmission Rate at DRG 22.76
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 27.9
Unplanned Readmission Rate at DRG 16.46
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 21.32
Total Medicare payments at DRG $2,472,138,198
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $4,647,312
Total Medicare payment per Day at DRG $1,444
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $1,522
Total Medicare payment per Hospitalization at DRG $5,693
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $6,306
Total Medicare Charges at DRG $12,478,361,060
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $21,438,158
Avg Charges at DRG $28,735
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $29,088
Mortality Rate at DRG 0.91
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 1.63
SNF Discharge Rate at DRG 22.02
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 23.74
Home Discharge Rate at DRG 46.68
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 44.91

Top 10 to 15 DRGs - Oct 2015 to Sep 2018

*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.

DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS
Total Hospitalizations at DRG 443,386
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 578
DRG Share of Total Hospitalizations 1.35
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG 1.65
Avg LOS at DRG 5.27
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 6.29
Readmission Rate at DRG 21.6
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 25.58
Unplanned Readmission Rate at DRG 15.91
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 16.92
Total Medicare payments at DRG $3,812,834,208
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $5,489,674
Total Medicare payment per Day at DRG $1,632
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $1,509
Total Medicare payment per Hospitalization at DRG $8,599
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $9,498
Total Medicare Charges at DRG $18,110,468,211
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $28,112,844
Avg Charges at DRG $40,846
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $48,638
Mortality Rate at DRG 3.59
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 6.75
SNF Discharge Rate at DRG 22.57
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 26.64
Home Discharge Rate at DRG 40.95
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 33.22

Top 15 to 20 DRGs - Oct 2015 to Sep 2018

*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.

DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC)
Total Hospitalizations at DRG 101,617
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 442
DRG Share of Total Hospitalizations 0.31
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG 1.26
Avg LOS at DRG 9.5
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 12.02
Readmission Rate at DRG 26.88
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 34.57
Unplanned Readmission Rate at DRG 19.26
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 29.71
Total Medicare payments at DRG $1,599,186,807
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $8,226,488
Total Medicare payment per Day at DRG $1,656
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $1,548
Total Medicare payment per Hospitalization at DRG $15,737
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $18,612
Total Medicare Charges at DRG $4,836,538,333
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $19,261,130
Avg Charges at DRG $47,596
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure $43,577
Mortality Rate at DRG 2.8
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure NA
SNF Discharge Rate at DRG 20.21
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 15.84
Home Discharge Rate at DRG 20.17
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 16.97

Top Hospitals Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code

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Hospital Name Address City State Zip Code Total Hospitalizations ( Oct 2015 to Sep 2018 )
METHODIST UNIVERSITY HOSPITAL 1265 UNION AVE MEMPHIS TN 38104 136
BAPTIST MEMORIAL REHABILITATION HOSPITAL 1240 SOUTH GERMANTOWN ROAD GERMANTOWN TN 38138 135
CUMBERLAND MEMORIAL HOSPITAL 1110 7TH AVE CUMBERLAND WI 54829 131

Top Operating Physicians Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code

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Physician Name Address City State Zip Code Total Hospitalizations ( Oct 2015 to Sep 2018 )
Dr. DAVID MARK GORDON 28455 HAGGERTY RD NOVI MI 48377 30
Dr. BALJIT K SHARMA 602 N. 39TH AVE. YAKIMA WA 98902 27
Dr. ARASH KIARASH 25500 GODDARD RD. TAYLOR MI 48180 15

Top Attending Physicians Associated With I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code

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Physician Name Address City State Zip Code Total Hospitalizations ( Oct 2015 to Sep 2018 )
Dr. DALE P CUNNINGHAM 3265 W SARAZENS CIR MEMPHIS TN 38125 112
Dr. GREGORY J LEITHEISER 1475 WEBB ST CUMBERLAND WI 54829 55
Dr. RAKESH R PATEL 2005 VALLEY VIEW BLVD ALTOONA PA 16602 47