*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| K604 - Rectal fistula - as a primary diagnosis code | K604 - Rectal fistula - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 8.68 | |
| Readmission Rate (%) | 29.55 | |
| Unplanned Readmission Rate (%) | 11.68 | |
| 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 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 330: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 329: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 331: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 130,303 | ||||
| Total Hospitalizations with ICD K604 - Rectal fistula | 93 | ||||
| DRG Share of Total Hospitalizations | 0.4 | ||||
| % of Total ICD K604 - Rectal fistula in DRG | 21.73 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD K604 - Rectal fistula | 4.94 | ||||
| Readmission Rate at DRG | 20.31 | ||||
| Readmission Rate with ICD K604 - Rectal fistula | 26.44 | ||||
| Unplanned Readmission Rate at DRG | 14.61 | ||||
| Unplanned Readmission Rate with ICD K604 - Rectal fistula | 14.94 | ||||
| Total Medicare payments at DRG | $778,992,768 | ||||
| Total Medicare payments with ICD K604 - Rectal fistula | $590,172 | ||||
| Total Medicare payment per Day at DRG | $1,517 | ||||
| Total Medicare payment per Day with ICD K604 - Rectal fistula | $1,286 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,978 | ||||
| Total Medicare payment per Hospitalization with ICD K604 - Rectal fistula | $6,346 | ||||
| Total Medicare Charges at DRG | $4,222,655,144 | ||||
| Total Medicare Charges with ICD K604 - Rectal fistula | $3,138,325 | ||||
| Avg Charges at DRG | $32,406 | ||||
| Avg Charges with ICD K604 - Rectal fistula | $33,745 | ||||
| Mortality Rate at DRG | 0.93 | ||||
| Mortality Rate with ICD K604 - Rectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 14.17 | ||||
| SNF Discharge Rate with ICD K604 - Rectal fistula | 13.98 | ||||
| Home Discharge Rate at DRG | 60.3 | ||||
| Home Discharge Rate with ICD K604 - Rectal fistula | 44.09 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 395: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 39,606 |
| Total Hospitalizations with ICD K604 - Rectal fistula | 19 |
| DRG Share of Total Hospitalizations | 0.12 |
| % of Total ICD K604 - Rectal fistula in DRG | 4.44 |
| Avg LOS at DRG | 2.67 |
| Avg LOS with ICD K604 - Rectal fistula | 2.68 |
| Readmission Rate at DRG | 13.3 |
| Readmission Rate with ICD K604 - Rectal fistula | NA |
| Unplanned Readmission Rate at DRG | 8.72 |
| Unplanned Readmission Rate with ICD K604 - Rectal fistula | NA |
| Total Medicare payments at DRG | $152,080,579 |
| Total Medicare payments with ICD K604 - Rectal fistula | $64,805 |
| Total Medicare payment per Day at DRG | $1,436 |
| Total Medicare payment per Day with ICD K604 - Rectal fistula | $1,271 |
| Total Medicare payment per Hospitalization at DRG | $3,840 |
| Total Medicare payment per Hospitalization with ICD K604 - Rectal fistula | $3,411 |
| Total Medicare Charges at DRG | $921,857,813 |
| Total Medicare Charges with ICD K604 - Rectal fistula | $358,892 |
| Avg Charges at DRG | $23,276 |
| Avg Charges with ICD K604 - Rectal fistula | $18,889 |
| Mortality Rate at DRG | 0.54 |
| Mortality Rate with ICD K604 - Rectal fistula | NA |
| SNF Discharge Rate at DRG | 7.46 |
| SNF Discharge Rate with ICD K604 - Rectal fistula | NA |
| Home Discharge Rate at DRG | 75.53 |
| Home Discharge Rate with ICD K604 - Rectal fistula | 57.89 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 330: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 329: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 169,880 | ||||
| Total Hospitalizations with ICD K604 - Rectal fistula | 216 | ||||
| DRG Share of Total Hospitalizations | 0.52 | ||||
| % of Total ICD K604 - Rectal fistula in DRG | 7.3 | ||||
| Avg LOS at DRG | 7.24 | ||||
| Avg LOS with ICD K604 - Rectal fistula | 8.5 | ||||
| Readmission Rate at DRG | 16.58 | ||||
| Readmission Rate with ICD K604 - Rectal fistula | 27.75 | ||||
| Unplanned Readmission Rate at DRG | 10.87 | ||||
| Unplanned Readmission Rate with ICD K604 - Rectal fistula | 18.18 | ||||
| Total Medicare payments at DRG | $2,683,693,576 | ||||
| Total Medicare payments with ICD K604 - Rectal fistula | $3,528,362 | ||||
| Total Medicare payment per Day at DRG | $2,183 | ||||
| Total Medicare payment per Day with ICD K604 - Rectal fistula | $1,921 | ||||
| Total Medicare payment per Hospitalization at DRG | $15,798 | ||||
| Total Medicare payment per Hospitalization with ICD K604 - Rectal fistula | $16,335 | ||||
| Total Medicare Charges at DRG | $13,978,014,634 | ||||
| Total Medicare Charges with ICD K604 - Rectal fistula | $19,521,433 | ||||
| Avg Charges at DRG | $82,282 | ||||
| Avg Charges with ICD K604 - Rectal fistula | $90,377 | ||||
| Mortality Rate at DRG | 0.35 | ||||
| Mortality Rate with ICD K604 - Rectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 14.58 | ||||
| SNF Discharge Rate with ICD K604 - Rectal fistula | 18.98 | ||||
| Home Discharge Rate at DRG | 53.56 | ||||
| Home Discharge Rate with ICD K604 - Rectal fistula | 31.48 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 386: INFLAMMATORY BOWEL DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 331: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 77,444 | ||||
| Total Hospitalizations with ICD K604 - Rectal fistula | 134 | ||||
| DRG Share of Total Hospitalizations | 0.24 | ||||
| % of Total ICD K604 - Rectal fistula in DRG | 4.53 | ||||
| Avg LOS at DRG | 6.72 | ||||
| Avg LOS with ICD K604 - Rectal fistula | 8.57 | ||||
| Readmission Rate at DRG | 28.36 | ||||
| Readmission Rate with ICD K604 - Rectal fistula | 31.58 | ||||
| Unplanned Readmission Rate at DRG | 20.29 | ||||
| Unplanned Readmission Rate with ICD K604 - Rectal fistula | 17.54 | ||||
| Total Medicare payments at DRG | $929,345,247 | ||||
| Total Medicare payments with ICD K604 - Rectal fistula | $1,928,286 | ||||
| Total Medicare payment per Day at DRG | $1,786 | ||||
| Total Medicare payment per Day with ICD K604 - Rectal fistula | $1,680 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,000 | ||||
| Total Medicare payment per Hospitalization with ICD K604 - Rectal fistula | $14,390 | ||||
| Total Medicare Charges at DRG | $4,453,573,782 | ||||
| Total Medicare Charges with ICD K604 - Rectal fistula | $8,219,383 | ||||
| Avg Charges at DRG | $57,507 | ||||
| Avg Charges with ICD K604 - Rectal fistula | $61,339 | ||||
| Mortality Rate at DRG | 5.64 | ||||
| Mortality Rate with ICD K604 - Rectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 22.62 | ||||
| SNF Discharge Rate with ICD K604 - Rectal fistula | 23.13 | ||||
| Home Discharge Rate at DRG | 38.94 | ||||
| Home Discharge Rate with ICD K604 - Rectal fistula | 32.09 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 372: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 854: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 364,421 | ||||
| Total Hospitalizations with ICD K604 - Rectal fistula | 37 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD K604 - Rectal fistula in DRG | 1.25 | ||||
| Avg LOS at DRG | 3.97 | ||||
| Avg LOS with ICD K604 - Rectal fistula | 5.41 | ||||
| Readmission Rate at DRG | 16.14 | ||||
| Readmission Rate with ICD K604 - Rectal fistula | NA | ||||
| Unplanned Readmission Rate at DRG | 10.98 | ||||
| Unplanned Readmission Rate with ICD K604 - Rectal fistula | NA | ||||
| Total Medicare payments at DRG | $1,924,528,848 | ||||
| Total Medicare payments with ICD K604 - Rectal fistula | $228,562 | ||||
| Total Medicare payment per Day at DRG | $1,332 | ||||
| Total Medicare payment per Day with ICD K604 - Rectal fistula | $1,143 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,281 | ||||
| Total Medicare payment per Hospitalization with ICD K604 - Rectal fistula | $6,177 | ||||
| Total Medicare Charges at DRG | $8,912,106,420 | ||||
| Total Medicare Charges with ICD K604 - Rectal fistula | $1,557,134 | ||||
| Avg Charges at DRG | $24,456 | ||||
| Avg Charges with ICD K604 - Rectal fistula | $42,085 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD K604 - Rectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 15.72 | ||||
| SNF Discharge Rate with ICD K604 - Rectal fistula | NA | ||||
| Home Discharge Rate at DRG | 53.33 | ||||
| Home Discharge Rate with ICD K604 - Rectal fistula | 32.43 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 862: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 172,705 | ||||
| Total Hospitalizations with ICD K604 - Rectal fistula | 30 | ||||
| DRG Share of Total Hospitalizations | 0.53 | ||||
| % of Total ICD K604 - Rectal fistula in DRG | 1.01 | ||||
| Avg LOS at DRG | 6.21 | ||||
| Avg LOS with ICD K604 - Rectal fistula | 8.3 | ||||
| Readmission Rate at DRG | 27.27 | ||||
| Readmission Rate with ICD K604 - Rectal fistula | NA | ||||
| Unplanned Readmission Rate at DRG | 20.51 | ||||
| Unplanned Readmission Rate with ICD K604 - Rectal fistula | NA | ||||
| Total Medicare payments at DRG | $1,773,015,083 | ||||
| Total Medicare payments with ICD K604 - Rectal fistula | $327,221 | ||||
| Total Medicare payment per Day at DRG | $1,652 | ||||
| Total Medicare payment per Day with ICD K604 - Rectal fistula | $1,314 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,266 | ||||
| Total Medicare payment per Hospitalization with ICD K604 - Rectal fistula | $10,907 | ||||
| Total Medicare Charges at DRG | $8,667,227,667 | ||||
| Total Medicare Charges with ICD K604 - Rectal fistula | $1,710,035 | ||||
| Avg Charges at DRG | $50,185 | ||||
| Avg Charges with ICD K604 - Rectal fistula | $57,001 | ||||
| Mortality Rate at DRG | 2.92 | ||||
| Mortality Rate with ICD K604 - Rectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 33.71 | ||||
| SNF Discharge Rate with ICD K604 - Rectal fistula | NA | ||||
| Home Discharge Rate at DRG | 25.53 | ||||
| Home Discharge Rate with ICD K604 - Rectal fistula | 36.67 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| CLEVELAND CLINIC | 9500 EUCLID AVE | CLEVELAND | OH | 44195 | 15 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 15 |
| VANDERBILT UNIVERSITY MEDICAL CENTER | 1211 MEDICAL CENTER DRIVE | NASHVILLE | TN | 37232 | 14 |