*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J811 - Chronic pulmonary edema - as a primary diagnosis code | J811 - Chronic pulmonary edema - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 8.79 | |
| Readmission Rate (%) | 31.25 | |
| Unplanned Readmission Rate (%) | 21.44 | |
| 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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 539,642 | ||||
| Total Hospitalizations with ICD J811 - Chronic pulmonary edema | 3,740 | ||||
| DRG Share of Total Hospitalizations | 1.64 | ||||
| % of Total ICD J811 - Chronic pulmonary edema in DRG | 94.88 | ||||
| Avg LOS at DRG | 6.42 | ||||
| Avg LOS with ICD J811 - Chronic pulmonary edema | 3.29 | ||||
| Readmission Rate at DRG | 26.55 | ||||
| Readmission Rate with ICD J811 - Chronic pulmonary edema | 28.17 | ||||
| Unplanned Readmission Rate at DRG | 20.01 | ||||
| Unplanned Readmission Rate with ICD J811 - Chronic pulmonary edema | 21.29 | ||||
| Total Medicare payments at DRG | $5,267,842,463 | ||||
| Total Medicare payments with ICD J811 - Chronic pulmonary edema | $28,377,520 | ||||
| Total Medicare payment per Day at DRG | $1,520 | ||||
| Total Medicare payment per Day with ICD J811 - Chronic pulmonary edema | $2,305 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,762 | ||||
| Total Medicare payment per Hospitalization with ICD J811 - Chronic pulmonary edema | $7,588 | ||||
| Total Medicare Charges at DRG | $25,503,568,329 | ||||
| Total Medicare Charges with ICD J811 - Chronic pulmonary edema | $106,121,080 | ||||
| Avg Charges at DRG | $47,260 | ||||
| Avg Charges with ICD J811 - Chronic pulmonary edema | $28,375 | ||||
| Mortality Rate at DRG | 5.62 | ||||
| Mortality Rate with ICD J811 - Chronic pulmonary edema | 1.15 | ||||
| SNF Discharge Rate at DRG | 19.26 | ||||
| SNF Discharge Rate with ICD J811 - Chronic pulmonary edema | 12.67 | ||||
| Home Discharge Rate at DRG | 39.65 | ||||
| Home Discharge Rate with ICD J811 - Chronic pulmonary edema | 58.9 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|
| Total Hospitalizations at DRG | 36,636 |
| Total Hospitalizations with ICD J811 - Chronic pulmonary edema | 12 |
| DRG Share of Total Hospitalizations | 0.11 |
| % of Total ICD J811 - Chronic pulmonary edema in DRG | 0.3 |
| Avg LOS at DRG | 5.73 |
| Avg LOS with ICD J811 - Chronic pulmonary edema | 3.75 |
| Readmission Rate at DRG | 21.72 |
| Readmission Rate with ICD J811 - Chronic pulmonary edema | NA |
| Unplanned Readmission Rate at DRG | 14.08 |
| Unplanned Readmission Rate with ICD J811 - Chronic pulmonary edema | NA |
| Total Medicare payments at DRG | $448,734,039 |
| Total Medicare payments with ICD J811 - Chronic pulmonary edema | $138,972 |
| Total Medicare payment per Day at DRG | $2,137 |
| Total Medicare payment per Day with ICD J811 - Chronic pulmonary edema | $3,088 |
| Total Medicare payment per Hospitalization at DRG | $12,248 |
| Total Medicare payment per Hospitalization with ICD J811 - Chronic pulmonary edema | $11,581 |
| Total Medicare Charges at DRG | $2,388,208,589 |
| Total Medicare Charges with ICD J811 - Chronic pulmonary edema | $604,707 |
| Avg Charges at DRG | $65,187 |
| Avg Charges with ICD J811 - Chronic pulmonary edema | $50,392 |
| Mortality Rate at DRG | 0.77 |
| Mortality Rate with ICD J811 - Chronic pulmonary edema | NA |
| SNF Discharge Rate at DRG | 10.73 |
| SNF Discharge Rate with ICD J811 - Chronic pulmonary edema | NA |
| Home Discharge Rate at DRG | 59.85 |
| Home Discharge Rate with ICD J811 - Chronic pulmonary edema | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| METHODIST UNIVERSITY HOSPITAL | 1265 UNION AVE | MEMPHIS | TN | 38104 | 47 |
| NASH GENERAL HOSPITAL | 2460 CURTIS ELLIS DR | ROCKY MOUNT | NC | 27804 | 44 |
| GRADY MEMORIAL HOSPITAL | 80 JESSE HILL JR DR, SE | ATLANTA | GA | 30303 | 21 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RAJA S TALLURI | 22080 LA HWY 20 | VACHERIE | LA | 70090 | 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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD J811 - Chronic pulmonary edema | 15,982 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD J811 - Chronic pulmonary edema in DRG | 10.39 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD J811 - Chronic pulmonary edema | 7.95 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD J811 - Chronic pulmonary edema | 27.84 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD J811 - Chronic pulmonary edema | 17.47 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD J811 - Chronic pulmonary edema | $206,377,172 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD J811 - Chronic pulmonary edema | $1,625 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD J811 - Chronic pulmonary edema | $12,913 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD J811 - Chronic pulmonary edema | $1,342,394,566 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD J811 - Chronic pulmonary edema | $83,994 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD J811 - Chronic pulmonary edema | 18.44 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD J811 - Chronic pulmonary edema | 24.51 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD J811 - Chronic pulmonary edema | 21.56 |
*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 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 443,386 | ||||
| Total Hospitalizations with ICD J811 - Chronic pulmonary edema | 4,395 | ||||
| DRG Share of Total Hospitalizations | 1.35 | ||||
| % of Total ICD J811 - Chronic pulmonary edema in DRG | 2.86 | ||||
| Avg LOS at DRG | 5.27 | ||||
| Avg LOS with ICD J811 - Chronic pulmonary edema | 6.24 | ||||
| Readmission Rate at DRG | 21.6 | ||||
| Readmission Rate with ICD J811 - Chronic pulmonary edema | 25.77 | ||||
| Unplanned Readmission Rate at DRG | 15.91 | ||||
| Unplanned Readmission Rate with ICD J811 - Chronic pulmonary edema | 18.89 | ||||
| Total Medicare payments at DRG | $3,812,834,208 | ||||
| Total Medicare payments with ICD J811 - Chronic pulmonary edema | $41,026,010 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD J811 - Chronic pulmonary edema | $1,495 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
| Total Medicare payment per Hospitalization with ICD J811 - Chronic pulmonary edema | $9,335 | ||||
| Total Medicare Charges at DRG | $18,110,468,211 | ||||
| Total Medicare Charges with ICD J811 - Chronic pulmonary edema | $238,023,327 | ||||
| Avg Charges at DRG | $40,846 | ||||
| Avg Charges with ICD J811 - Chronic pulmonary edema | $54,158 | ||||
| Mortality Rate at DRG | 3.59 | ||||
| Mortality Rate with ICD J811 - Chronic pulmonary edema | 5.44 | ||||
| SNF Discharge Rate at DRG | 22.57 | ||||
| SNF Discharge Rate with ICD J811 - Chronic pulmonary edema | 20.96 | ||||
| Home Discharge Rate at DRG | 40.95 | ||||
| Home Discharge Rate with ICD J811 - Chronic pulmonary edema | 41.23 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 535,322 | ||||
| Total Hospitalizations with ICD J811 - Chronic pulmonary edema | 2,340 | ||||
| DRG Share of Total Hospitalizations | 1.63 | ||||
| % of Total ICD J811 - Chronic pulmonary edema in DRG | 1.52 | ||||
| Avg LOS at DRG | 4.68 | ||||
| Avg LOS with ICD J811 - Chronic pulmonary edema | 5.5 | ||||
| Readmission Rate at DRG | 23.65 | ||||
| Readmission Rate with ICD J811 - Chronic pulmonary edema | 29.54 | ||||
| Unplanned Readmission Rate at DRG | 18.66 | ||||
| Unplanned Readmission Rate with ICD J811 - Chronic pulmonary edema | 22.59 | ||||
| Total Medicare payments at DRG | $3,844,806,408 | ||||
| Total Medicare payments with ICD J811 - Chronic pulmonary edema | $17,893,508 | ||||
| Total Medicare payment per Day at DRG | $1,536 | ||||
| Total Medicare payment per Day with ICD J811 - Chronic pulmonary edema | $1,390 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,182 | ||||
| Total Medicare payment per Hospitalization with ICD J811 - Chronic pulmonary edema | $7,647 | ||||
| Total Medicare Charges at DRG | $19,258,468,078 | ||||
| Total Medicare Charges with ICD J811 - Chronic pulmonary edema | $109,109,768 | ||||
| Avg Charges at DRG | $35,975 | ||||
| Avg Charges with ICD J811 - Chronic pulmonary edema | $46,628 | ||||
| Mortality Rate at DRG | 1.27 | ||||
| Mortality Rate with ICD J811 - Chronic pulmonary edema | 2.52 | ||||
| SNF Discharge Rate at DRG | 14.61 | ||||
| SNF Discharge Rate with ICD J811 - Chronic pulmonary edema | 16.28 | ||||
| Home Discharge Rate at DRG | 52.12 | ||||
| Home Discharge Rate with ICD J811 - Chronic pulmonary edema | 46.28 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 003: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE | DRG 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 48,449 | ||||
| Total Hospitalizations with ICD J811 - Chronic pulmonary edema | 1,644 | ||||
| DRG Share of Total Hospitalizations | 0.15 | ||||
| % of Total ICD J811 - Chronic pulmonary edema in DRG | 1.07 | ||||
| Avg LOS at DRG | 29.97 | ||||
| Avg LOS with ICD J811 - Chronic pulmonary edema | 33.5 | ||||
| Readmission Rate at DRG | 76.3 | ||||
| Readmission Rate with ICD J811 - Chronic pulmonary edema | 80.2 | ||||
| Unplanned Readmission Rate at DRG | 6.46 | ||||
| Unplanned Readmission Rate with ICD J811 - Chronic pulmonary edema | 5.53 | ||||
| Total Medicare payments at DRG | $6,190,071,785 | ||||
| Total Medicare payments with ICD J811 - Chronic pulmonary edema | $237,710,401 | ||||
| Total Medicare payment per Day at DRG | $4,263 | ||||
| Total Medicare payment per Day with ICD J811 - Chronic pulmonary edema | $4,317 | ||||
| Total Medicare payment per Hospitalization at DRG | $127,765 | ||||
| Total Medicare payment per Hospitalization with ICD J811 - Chronic pulmonary edema | $144,593 | ||||
| Total Medicare Charges at DRG | $28,754,600,069 | ||||
| Total Medicare Charges with ICD J811 - Chronic pulmonary edema | $1,162,125,802 | ||||
| Avg Charges at DRG | $593,502 | ||||
| Avg Charges with ICD J811 - Chronic pulmonary edema | $706,889 | ||||
| Mortality Rate at DRG | 20.61 | ||||
| Mortality Rate with ICD J811 - Chronic pulmonary edema | 21.29 | ||||
| SNF Discharge Rate at DRG | 12.46 | ||||
| SNF Discharge Rate with ICD J811 - Chronic pulmonary edema | 10.34 | ||||
| Home Discharge Rate at DRG | 2.36 | ||||
| Home Discharge Rate with ICD J811 - Chronic pulmonary edema | 2.07 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| BARNES JEWISH HOSPITAL | 1 BARNES-JEWISH HOSPITAL PLZ | SAINT LOUIS | MO | 63110 | 789 |
| METHODIST HOSPITAL | 7700 FLOYD CURL DRIVE | SAN ANTONIO | TX | 78229 | 658 |
| MASSACHUSETTS GENERAL HOSPITAL | 55 FRUIT ST | BOSTON | MA | 02114 | 653 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. NYAN WAI PHYO | 4717 S SUGAR RD | EDINBURG | TX | 78539 | 44 |
| Dr. HANY M HABASHY | 1325 EASTMORELAND AVE | MEMPHIS | TN | 38104 | 40 |
| Dr. WILLIAM RESTREPO | 409 LINDBERG AVE | MCALLEN | TX | 78501 | 36 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 127 |
| Dr. KHURSHEED ALAM | 1021 N MAIN ST | MCALLEN | TX | 78501 | 112 |
| Dr. KALYAN AKKINENI | 1001 TOWSON AVE | FORT SMITH | AR | 72901 | 105 |