*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| K605 - Anorectal fistula - as a primary diagnosis code | K605 - Anorectal fistula - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 7.86 | |
| Readmission Rate (%) | 27.62 | |
| Unplanned Readmission Rate (%) | 11.29 | |
| 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 330: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 348: ANAL AND STOMAL PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|
| Total Hospitalizations at DRG | 130,303 | |||
| Total Hospitalizations with ICD K605 - Anorectal fistula | 31 | |||
| DRG Share of Total Hospitalizations | 0.4 | |||
| % of Total ICD K605 - Anorectal fistula in DRG | 23.66 | |||
| Avg LOS at DRG | 3.94 | |||
| Avg LOS with ICD K605 - Anorectal fistula | 4.0 | |||
| Readmission Rate at DRG | 20.31 | |||
| Readmission Rate with ICD K605 - Anorectal fistula | NA | |||
| Unplanned Readmission Rate at DRG | 14.61 | |||
| Unplanned Readmission Rate with ICD K605 - Anorectal fistula | NA | |||
| Total Medicare payments at DRG | $778,992,768 | |||
| Total Medicare payments with ICD K605 - Anorectal fistula | $166,180 | |||
| Total Medicare payment per Day at DRG | $1,517 | |||
| Total Medicare payment per Day with ICD K605 - Anorectal fistula | $1,340 | |||
| Total Medicare payment per Hospitalization at DRG | $5,978 | |||
| Total Medicare payment per Hospitalization with ICD K605 - Anorectal fistula | $5,361 | |||
| Total Medicare Charges at DRG | $4,222,655,144 | |||
| Total Medicare Charges with ICD K605 - Anorectal fistula | $1,070,324 | |||
| Avg Charges at DRG | $32,406 | |||
| Avg Charges with ICD K605 - Anorectal fistula | $34,527 | |||
| Mortality Rate at DRG | 0.93 | |||
| Mortality Rate with ICD K605 - Anorectal fistula | NA | |||
| SNF Discharge Rate at DRG | 14.17 | |||
| SNF Discharge Rate with ICD K605 - Anorectal fistula | NA | |||
| Home Discharge Rate at DRG | 60.3 | |||
| Home Discharge Rate with ICD K605 - Anorectal fistula | 58.06 |
*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 330: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 329: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD K605 - Anorectal fistula | 59 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD K605 - Anorectal fistula in DRG | 7.5 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD K605 - Anorectal fistula | 8.15 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD K605 - Anorectal fistula | 32.56 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD K605 - Anorectal fistula | 27.91 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD K605 - Anorectal fistula | $781,565 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD K605 - Anorectal fistula | $1,625 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD K605 - Anorectal fistula | $13,247 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD K605 - Anorectal fistula | $4,073,235 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD K605 - Anorectal fistula | $69,038 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD K605 - Anorectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD K605 - Anorectal fistula | 27.12 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD K605 - Anorectal fistula | 20.34 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 348: ANAL AND STOMAL PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 386: INFLAMMATORY BOWEL DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 331: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 8,316 | ||||
| Total Hospitalizations with ICD K605 - Anorectal fistula | 33 | ||||
| DRG Share of Total Hospitalizations | 0.03 | ||||
| % of Total ICD K605 - Anorectal fistula in DRG | 4.19 | ||||
| Avg LOS at DRG | 4.9 | ||||
| Avg LOS with ICD K605 - Anorectal fistula | 3.88 | ||||
| Readmission Rate at DRG | 17.02 | ||||
| Readmission Rate with ICD K605 - Anorectal fistula | NA | ||||
| Unplanned Readmission Rate at DRG | 12.32 | ||||
| Unplanned Readmission Rate with ICD K605 - Anorectal fistula | NA | ||||
| Total Medicare payments at DRG | $76,401,122 | ||||
| Total Medicare payments with ICD K605 - Anorectal fistula | $297,793 | ||||
| Total Medicare payment per Day at DRG | $1,873 | ||||
| Total Medicare payment per Day with ICD K605 - Anorectal fistula | $2,327 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,187 | ||||
| Total Medicare payment per Hospitalization with ICD K605 - Anorectal fistula | $9,024 | ||||
| Total Medicare Charges at DRG | $416,769,489 | ||||
| Total Medicare Charges with ICD K605 - Anorectal fistula | $1,471,084 | ||||
| Avg Charges at DRG | $50,117 | ||||
| Avg Charges with ICD K605 - Anorectal fistula | $44,578 | ||||
| Mortality Rate at DRG | 0.26 | ||||
| Mortality Rate with ICD K605 - Anorectal fistula | NA | ||||
| SNF Discharge Rate at DRG | 11.22 | ||||
| SNF Discharge Rate with ICD K605 - Anorectal fistula | NA | ||||
| Home Discharge Rate at DRG | 64.53 | ||||
| Home Discharge Rate with ICD K605 - Anorectal fistula | 72.73 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 854: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|
| Total Hospitalizations at DRG | 408,103 | ||
| Total Hospitalizations with ICD K605 - Anorectal fistula | 13 | ||
| DRG Share of Total Hospitalizations | 1.24 | ||
| % of Total ICD K605 - Anorectal fistula in DRG | 1.65 | ||
| Avg LOS at DRG | 3.52 | ||
| Avg LOS with ICD K605 - Anorectal fistula | 3.69 | ||
| Readmission Rate at DRG | 17.83 | ||
| Readmission Rate with ICD K605 - Anorectal fistula | NA | ||
| Unplanned Readmission Rate at DRG | 13.81 | ||
| Unplanned Readmission Rate with ICD K605 - Anorectal fistula | NA | ||
| Total Medicare payments at DRG | $2,416,862,532 | ||
| Total Medicare payments with ICD K605 - Anorectal fistula | $70,942 | ||
| Total Medicare payment per Day at DRG | $1,682 | ||
| Total Medicare payment per Day with ICD K605 - Anorectal fistula | $1,478 | ||
| Total Medicare payment per Hospitalization at DRG | $5,922 | ||
| Total Medicare payment per Hospitalization with ICD K605 - Anorectal fistula | $5,457 | ||
| Total Medicare Charges at DRG | $13,267,744,847 | ||
| Total Medicare Charges with ICD K605 - Anorectal fistula | $396,431 | ||
| Avg Charges at DRG | $32,511 | ||
| Avg Charges with ICD K605 - Anorectal fistula | $30,495 | ||
| Mortality Rate at DRG | 0.72 | ||
| Mortality Rate with ICD K605 - Anorectal fistula | NA | ||
| SNF Discharge Rate at DRG | 14.1 | ||
| SNF Discharge Rate with ICD K605 - Anorectal fistula | NA | ||
| Home Discharge Rate at DRG | 62.97 | ||
| Home Discharge Rate with ICD K605 - Anorectal fistula | NA |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | Z87891 | Personal history of nicotine dependence |
| 2 | K219 | Gastro-esophageal reflux disease without esophagitis |