*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J948 - Other specified pleural conditions - as a primary diagnosis code | J948 - Other specified pleural conditions - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 10.47 | |
| Readmission Rate (%) | 32.19 | |
| Unplanned Readmission Rate (%) | 22.36 | |
| 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 186: PLEURAL EFFUSION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 187: PLEURAL EFFUSION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 163: MAJOR CHEST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 188: PLEURAL EFFUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 33,602 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 1,477 | ||||
| DRG Share of Total Hospitalizations | 0.1 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 40.91 | ||||
| Avg LOS at DRG | 5.81 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 7.14 | ||||
| Readmission Rate at DRG | 32.29 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | 32.11 | ||||
| Unplanned Readmission Rate at DRG | 23.93 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | 23.93 | ||||
| Total Medicare payments at DRG | $334,298,246 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $16,235,021 | ||||
| Total Medicare payment per Day at DRG | $1,713 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $1,540 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,949 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $10,992 | ||||
| Total Medicare Charges at DRG | $1,633,515,935 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $81,456,729 | ||||
| Avg Charges at DRG | $48,614 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $55,150 | ||||
| Mortality Rate at DRG | 3.24 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | 5.08 | ||||
| SNF Discharge Rate at DRG | 19.31 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | 16.32 | ||||
| Home Discharge Rate at DRG | 40.36 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 35.68 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 164: MAJOR CHEST PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 982: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 49,331 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 81 | ||||
| DRG Share of Total Hospitalizations | 0.15 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 2.24 | ||||
| Avg LOS at DRG | 5.76 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 8.96 | ||||
| Readmission Rate at DRG | 13.39 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | 25.0 | ||||
| Unplanned Readmission Rate at DRG | 8.11 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | 15.0 | ||||
| Total Medicare payments at DRG | $830,506,314 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $1,343,964 | ||||
| Total Medicare payment per Day at DRG | $2,922 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $1,851 | ||||
| Total Medicare payment per Hospitalization at DRG | $16,835 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $16,592 | ||||
| Total Medicare Charges at DRG | $4,394,247,481 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $6,846,148 | ||||
| Avg Charges at DRG | $89,077 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $84,520 | ||||
| Mortality Rate at DRG | 0.32 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | NA | ||||
| SNF Discharge Rate at DRG | 6.7 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | NA | ||||
| Home Discharge Rate at DRG | 62.23 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 55.56 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 988: NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 168: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 165: MAJOR CHEST PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 987: NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 28,142 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 21 | ||||
| DRG Share of Total Hospitalizations | 0.09 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 0.58 | ||||
| Avg LOS at DRG | 5.88 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 6.05 | ||||
| Readmission Rate at DRG | 23.6 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | NA | ||||
| Unplanned Readmission Rate at DRG | 15.33 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | NA | ||||
| Total Medicare payments at DRG | $317,761,689 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $270,535 | ||||
| Total Medicare payment per Day at DRG | $1,919 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $2,130 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,291 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $12,883 | ||||
| Total Medicare Charges at DRG | $1,612,718,515 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $1,053,222 | ||||
| Avg Charges at DRG | $57,306 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $50,153 | ||||
| Mortality Rate at DRG | 0.56 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | NA | ||||
| SNF Discharge Rate at DRG | 18.42 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | NA | ||||
| Home Discharge Rate at DRG | 50.45 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 66.67 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL | 3635 VISTA AVE | SAINT LOUIS | MO | 63110 | 24 |
| INDIANA UNIVERSITY HEALTH | 1701 N SENATE | INDIANAPOLIS | IN | 46202 | 22 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 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 186: PLEURAL EFFUSION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 164: MAJOR CHEST PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 163: MAJOR CHEST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 187: PLEURAL EFFUSION WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 33,602 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 2,126 | ||||
| DRG Share of Total Hospitalizations | 0.1 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 7.18 | ||||
| Avg LOS at DRG | 5.81 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 7.57 | ||||
| Readmission Rate at DRG | 32.29 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | 32.46 | ||||
| Unplanned Readmission Rate at DRG | 23.93 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | 23.62 | ||||
| Total Medicare payments at DRG | $334,298,246 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $23,312,178 | ||||
| Total Medicare payment per Day at DRG | $1,713 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $1,448 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,949 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $10,965 | ||||
| Total Medicare Charges at DRG | $1,633,515,935 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $126,499,623 | ||||
| Avg Charges at DRG | $48,614 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $59,501 | ||||
| Mortality Rate at DRG | 3.24 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | 4.94 | ||||
| SNF Discharge Rate at DRG | 19.31 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | 17.22 | ||||
| Home Discharge Rate at DRG | 40.36 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 35.18 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 432: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 269,064 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 923 | ||||
| DRG Share of Total Hospitalizations | 0.82 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 3.12 | ||||
| Avg LOS at DRG | 13.18 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 19.11 | ||||
| Readmission Rate at DRG | 37.51 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | 35.85 | ||||
| Unplanned Readmission Rate at DRG | 18.15 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | 15.13 | ||||
| Total Medicare payments at DRG | $9,344,186,034 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $41,223,189 | ||||
| Total Medicare payment per Day at DRG | $2,635 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $2,337 | ||||
| Total Medicare payment per Hospitalization at DRG | $34,728 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $44,662 | ||||
| Total Medicare Charges at DRG | $44,371,117,432 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $240,481,115 | ||||
| Avg Charges at DRG | $164,909 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $260,543 | ||||
| Mortality Rate at DRG | 14.37 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | 17.88 | ||||
| SNF Discharge Rate at DRG | 31.8 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | 25.68 | ||||
| Home Discharge Rate at DRG | 14.61 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 13.98 |
*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 433: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 180: RESPIRATORY NEOPLASMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 56,884 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 657 | ||||
| DRG Share of Total Hospitalizations | 0.17 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 2.22 | ||||
| Avg LOS at DRG | 6.43 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 8.87 | ||||
| Readmission Rate at DRG | 37.66 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | 40.0 | ||||
| Unplanned Readmission Rate at DRG | 28.76 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | 27.38 | ||||
| Total Medicare payments at DRG | $726,233,427 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $9,887,456 | ||||
| Total Medicare payment per Day at DRG | $1,987 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $1,697 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,767 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $15,049 | ||||
| Total Medicare Charges at DRG | $3,363,541,067 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $57,020,183 | ||||
| Avg Charges at DRG | $59,130 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $86,789 | ||||
| Mortality Rate at DRG | 9.48 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | 15.07 | ||||
| SNF Discharge Rate at DRG | 18.8 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | 14.61 | ||||
| Home Discharge Rate at DRG | 33.97 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 24.66 |
*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 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 199: PNEUMOTHORAX WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 200: PNEUMOTHORAX WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 48,449 | ||||
| Total Hospitalizations with ICD J948 - Other specified pleural conditions | 453 | ||||
| DRG Share of Total Hospitalizations | 0.15 | ||||
| % of Total ICD J948 - Other specified pleural conditions in DRG | 1.53 | ||||
| Avg LOS at DRG | 29.97 | ||||
| Avg LOS with ICD J948 - Other specified pleural conditions | 41.27 | ||||
| Readmission Rate at DRG | 76.3 | ||||
| Readmission Rate with ICD J948 - Other specified pleural conditions | 78.36 | ||||
| Unplanned Readmission Rate at DRG | 6.46 | ||||
| Unplanned Readmission Rate with ICD J948 - Other specified pleural conditions | 6.43 | ||||
| Total Medicare payments at DRG | $6,190,071,785 | ||||
| Total Medicare payments with ICD J948 - Other specified pleural conditions | $73,137,726 | ||||
| Total Medicare payment per Day at DRG | $4,263 | ||||
| Total Medicare payment per Day with ICD J948 - Other specified pleural conditions | $3,912 | ||||
| Total Medicare payment per Hospitalization at DRG | $127,765 | ||||
| Total Medicare payment per Hospitalization with ICD J948 - Other specified pleural conditions | $161,452 | ||||
| Total Medicare Charges at DRG | $28,754,600,069 | ||||
| Total Medicare Charges with ICD J948 - Other specified pleural conditions | $366,788,529 | ||||
| Avg Charges at DRG | $593,502 | ||||
| Avg Charges with ICD J948 - Other specified pleural conditions | $809,688 | ||||
| Mortality Rate at DRG | 20.61 | ||||
| Mortality Rate with ICD J948 - Other specified pleural conditions | 21.85 | ||||
| SNF Discharge Rate at DRG | 12.46 | ||||
| SNF Discharge Rate with ICD J948 - Other specified pleural conditions | 7.95 | ||||
| Home Discharge Rate at DRG | 2.36 | ||||
| Home Discharge Rate with ICD J948 - Other specified pleural conditions | 2.65 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 275 |
| BRIGHAM AND WOMEN'S HOSPITAL | 75 FRANCIS ST | BOSTON | MA | 02115 | 180 |
| UPMC PRESBYTERIAN SHADYSIDE | 200 LOTHROP ST | PITTSBURGH | PA | 15213 | 162 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. PRASHANT C. SHAH | 2401 S 31ST ST | TEMPLE | TX | 76508 | 57 |
| Dr. VALERIE W RUSCH | 1275 YORK AVE | NEW YORK | NY | 10021 | 43 |
| Dr. PAUL ANTHONY VESCO | 1540 S TAMIAMI TRL | SARASOTA | FL | 34239 | 37 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. PRASHANT C. SHAH | 2401 S 31ST ST | TEMPLE | TX | 76508 | 60 |
| Dr. VALERIE W RUSCH | 1275 YORK AVE | NEW YORK | NY | 10021 | 44 |
| Dr. PAUL ANTHONY VESCO | 1540 S TAMIAMI TRL | SARASOTA | FL | 34239 | 29 |