*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| L89154 - Pressure ulcer of sacral region, stage 4 - as a primary diagnosis code | L89154 - Pressure ulcer of sacral region, stage 4 - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 14.04 | |
| Readmission Rate (%) | 37.84 | |
| Unplanned Readmission Rate (%) | 19.33 | |
| 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 592: SKIN ULCERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 570: SKIN DEBRIDEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 573: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 24,286 | ||||
| Total Hospitalizations with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 9,096 | ||||
| DRG Share of Total Hospitalizations | 0.07 | ||||
| % of Total ICD L89154 - Pressure ulcer of sacral region, stage 4 in DRG | 39.87 | ||||
| Avg LOS at DRG | 12.57 | ||||
| Avg LOS with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 14.87 | ||||
| Readmission Rate at DRG | 30.43 | ||||
| Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 32.54 | ||||
| Unplanned Readmission Rate at DRG | 19.44 | ||||
| Unplanned Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 21.17 | ||||
| Total Medicare payments at DRG | $340,052,154 | ||||
| Total Medicare payments with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $139,069,377 | ||||
| Total Medicare payment per Day at DRG | $1,114 | ||||
| Total Medicare payment per Day with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $1,028 | ||||
| Total Medicare payment per Hospitalization at DRG | $14,002 | ||||
| Total Medicare payment per Hospitalization with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $15,289 | ||||
| Total Medicare Charges at DRG | $1,599,050,306 | ||||
| Total Medicare Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $700,531,854 | ||||
| Avg Charges at DRG | $65,842 | ||||
| Avg Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $77,015 | ||||
| Mortality Rate at DRG | 4.97 | ||||
| Mortality Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 6.49 | ||||
| SNF Discharge Rate at DRG | 39.28 | ||||
| SNF Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 41.62 | ||||
| Home Discharge Rate at DRG | 11.17 | ||||
| Home Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 8.29 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 987: NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 003: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE | DRG 004: TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE | |
|---|---|---|---|
| Total Hospitalizations at DRG | 33,583 | ||
| Total Hospitalizations with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 169 | ||
| DRG Share of Total Hospitalizations | 0.1 | ||
| % of Total ICD L89154 - Pressure ulcer of sacral region, stage 4 in DRG | 0.74 | ||
| Avg LOS at DRG | 11.44 | ||
| Avg LOS with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 15.3 | ||
| Readmission Rate at DRG | 33.65 | ||
| Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 26.14 | ||
| Unplanned Readmission Rate at DRG | 21.15 | ||
| Unplanned Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 9.15 | ||
| Total Medicare payments at DRG | $802,022,870 | ||
| Total Medicare payments with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $4,126,250 | ||
| Total Medicare payment per Day at DRG | $2,088 | ||
| Total Medicare payment per Day with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $1,596 | ||
| Total Medicare payment per Hospitalization at DRG | $23,882 | ||
| Total Medicare payment per Hospitalization with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $24,416 | ||
| Total Medicare Charges at DRG | $3,957,485,422 | ||
| Total Medicare Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $15,483,721 | ||
| Avg Charges at DRG | $117,842 | ||
| Avg Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $91,620 | ||
| Mortality Rate at DRG | 8.73 | ||
| Mortality Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | NA | ||
| SNF Discharge Rate at DRG | 24.87 | ||
| SNF Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 36.09 | ||
| Home Discharge Rate at DRG | 28.69 | ||
| Home Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 8.88 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| RUSH HEALTH SYSTEMS | 1314 19TH AVE | MERIDIAN | MS | 39301 | 146 |
| TRIUMPH HOSPITAL OF NORTH HOUSTON | 505 GRAHAM DR | TOMBALL | TX | 77375 | 113 |
| CALVARY HOSPITAL | 1740 EASTCHESTER RD | BRONX | NY | 10461 | 102 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. NAJI KAMAL BADDOURA | 14434 BRUCE B DOWNS BLVD | TAMPA | FL | 33613 | 120 |
| Dr. JAMES C. MATTHEWS | 1800 12TH ST | MERIDIAN | MS | 39301 | 81 |
| Dr. MONIQUE LEONA CONSOER | 46 LOUIS PRIMA DR | COVINGTON | LA | 70433 | 77 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MICHAEL RUSSO | 1111 MEDICAL CENTER BLVD | MARRERO | LA | 70072 | 46 |
| Dr. GUTTI J RAO | 1604 LEFLORE AVE | GREENWOOD | MS | 38930 | 46 |
| Dr. KARTHIK KRISHNA REDDY | 3600 FLORIDA BLVD | BATON ROUGE | LA | 70806 | 44 |
*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 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 592: SKIN ULCERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 31,464 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD L89154 - Pressure ulcer of sacral region, stage 4 in DRG | 19.7 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 8.71 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 35.94 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 23.71 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $394,572,446 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $1,440 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $12,540 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $2,308,161,204 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $73,359 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 13.7 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 37.1 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 6.73 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 570: SKIN DEBRIDEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | DRG 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 539: OSTEOMYELITIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 19,663 | ||||
| Total Hospitalizations with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 5,518 | ||||
| DRG Share of Total Hospitalizations | 0.06 | ||||
| % of Total ICD L89154 - Pressure ulcer of sacral region, stage 4 in DRG | 3.45 | ||||
| Avg LOS at DRG | 13.89 | ||||
| Avg LOS with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 17.58 | ||||
| Readmission Rate at DRG | 32.63 | ||||
| Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 35.06 | ||||
| Unplanned Readmission Rate at DRG | 18.18 | ||||
| Unplanned Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 19.37 | ||||
| Total Medicare payments at DRG | $387,130,602 | ||||
| Total Medicare payments with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $121,973,428 | ||||
| Total Medicare payment per Day at DRG | $1,417 | ||||
| Total Medicare payment per Day with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $1,257 | ||||
| Total Medicare payment per Hospitalization at DRG | $19,688 | ||||
| Total Medicare payment per Hospitalization with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $22,105 | ||||
| Total Medicare Charges at DRG | $1,865,858,139 | ||||
| Total Medicare Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $614,585,421 | ||||
| Avg Charges at DRG | $94,892 | ||||
| Avg Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $111,378 | ||||
| Mortality Rate at DRG | 3.29 | ||||
| Mortality Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 4.62 | ||||
| SNF Discharge Rate at DRG | 40.65 | ||||
| SNF Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 48.02 | ||||
| Home Discharge Rate at DRG | 12.36 | ||||
| Home Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 6.16 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 463: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 365,119 | ||||
| Total Hospitalizations with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 2,358 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD L89154 - Pressure ulcer of sacral region, stage 4 in DRG | 1.48 | ||||
| Avg LOS at DRG | 5.91 | ||||
| Avg LOS with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 7.8 | ||||
| Readmission Rate at DRG | 27.73 | ||||
| Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 36.05 | ||||
| Unplanned Readmission Rate at DRG | 20.3 | ||||
| Unplanned Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 27.13 | ||||
| Total Medicare payments at DRG | $3,552,910,533 | ||||
| Total Medicare payments with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $23,751,389 | ||||
| Total Medicare payment per Day at DRG | $1,646 | ||||
| Total Medicare payment per Day with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $1,291 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,731 | ||||
| Total Medicare payment per Hospitalization with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $10,073 | ||||
| Total Medicare Charges at DRG | $16,860,985,198 | ||||
| Total Medicare Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $129,449,130 | ||||
| Avg Charges at DRG | $46,179 | ||||
| Avg Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $54,898 | ||||
| Mortality Rate at DRG | 5.06 | ||||
| Mortality Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 7.42 | ||||
| SNF Discharge Rate at DRG | 28.7 | ||||
| SNF Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 44.7 | ||||
| Home Discharge Rate at DRG | 32.16 | ||||
| Home Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 8.44 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 1,933 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD L89154 - Pressure ulcer of sacral region, stage 4 in DRG | 1.21 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 7.75 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 37.77 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 28.78 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $19,167,516 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $1,280 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $9,916 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $121,423,859 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD L89154 - Pressure ulcer of sacral region, stage 4 | $62,816 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 8.9 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 38.39 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD L89154 - Pressure ulcer of sacral region, stage 4 | 8.69 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 673 |
| MAIMONIDES MEDICAL CENTER | 4802 10TH AVE | BROOKLYN | NY | 11219 | 630 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 555 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. NAJI KAMAL BADDOURA | 14434 BRUCE B DOWNS BLVD | TAMPA | FL | 33613 | 364 |
| Dr. JOSEPH A RACANELLI | 9 MADISON ST | MORRISTOWN | NJ | 07960 | 188 |
| Dr. ALBERTO RENE MALDONADO | 3 AUDUBON PLAZA DR | LOUISVILLE | KY | 40217 | 123 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ELIE FTEHA | 359 AVENUE U | BROOKLYN | NY | 11223 | 230 |
| Dr. PHILIP ATIGRE | 5112 N HABANA AVE | TAMPA | FL | 33614 | 174 |
| Dr. DANIEL LIND CROCKER | 1041 NOELL LN | ROCKY MOUNT | NC | 27804 | 157 |