*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M069 - Rheumatoid arthritis, unspecified - as a primary diagnosis code | M069 - Rheumatoid arthritis, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.39 | |
| Readmission Rate (%) | 22.51 | |
| Unplanned Readmission Rate (%) | 10.75 | |
| 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 546: CONNECTIVE TISSUE DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 547: CONNECTIVE TISSUE DISORDERS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 545: CONNECTIVE TISSUE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 483: MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 14,526 | ||||
| Total Hospitalizations with ICD M069 - Rheumatoid arthritis, unspecified | 2,186 | ||||
| DRG Share of Total Hospitalizations | 0.04 | ||||
| % of Total ICD M069 - Rheumatoid arthritis, unspecified in DRG | 40.62 | ||||
| Avg LOS at DRG | 5.12 | ||||
| Avg LOS with ICD M069 - Rheumatoid arthritis, unspecified | 5.56 | ||||
| Readmission Rate at DRG | 23.17 | ||||
| Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 19.22 | ||||
| Unplanned Readmission Rate at DRG | 15.83 | ||||
| Unplanned Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 13.7 | ||||
| Total Medicare payments at DRG | $123,348,417 | ||||
| Total Medicare payments with ICD M069 - Rheumatoid arthritis, unspecified | $19,975,963 | ||||
| Total Medicare payment per Day at DRG | $1,658 | ||||
| Total Medicare payment per Day with ICD M069 - Rheumatoid arthritis, unspecified | $1,645 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,492 | ||||
| Total Medicare payment per Hospitalization with ICD M069 - Rheumatoid arthritis, unspecified | $9,138 | ||||
| Total Medicare Charges at DRG | $565,151,481 | ||||
| Total Medicare Charges with ICD M069 - Rheumatoid arthritis, unspecified | $64,522,291 | ||||
| Avg Charges at DRG | $38,906 | ||||
| Avg Charges with ICD M069 - Rheumatoid arthritis, unspecified | $29,516 | ||||
| Mortality Rate at DRG | 0.34 | ||||
| Mortality Rate with ICD M069 - Rheumatoid arthritis, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 16.01 | ||||
| SNF Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 23.24 | ||||
| Home Discharge Rate at DRG | 53.61 | ||||
| Home Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 40.39 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 469: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 462: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 505: FOOT PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 502: SOFT TISSUE PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 83,447 | ||||
| Total Hospitalizations with ICD M069 - Rheumatoid arthritis, unspecified | 31 | ||||
| DRG Share of Total Hospitalizations | 0.25 | ||||
| % of Total ICD M069 - Rheumatoid arthritis, unspecified in DRG | 0.58 | ||||
| Avg LOS at DRG | 6.32 | ||||
| Avg LOS with ICD M069 - Rheumatoid arthritis, unspecified | 4.94 | ||||
| Readmission Rate at DRG | 26.61 | ||||
| Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 10.75 | ||||
| Unplanned Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | NA | ||||
| Total Medicare payments at DRG | $1,636,094,359 | ||||
| Total Medicare payments with ICD M069 - Rheumatoid arthritis, unspecified | $660,340 | ||||
| Total Medicare payment per Day at DRG | $3,100 | ||||
| Total Medicare payment per Day with ICD M069 - Rheumatoid arthritis, unspecified | $4,316 | ||||
| Total Medicare payment per Hospitalization at DRG | $19,606 | ||||
| Total Medicare payment per Hospitalization with ICD M069 - Rheumatoid arthritis, unspecified | $21,301 | ||||
| Total Medicare Charges at DRG | $7,936,043,941 | ||||
| Total Medicare Charges with ICD M069 - Rheumatoid arthritis, unspecified | $3,583,056 | ||||
| Avg Charges at DRG | $95,103 | ||||
| Avg Charges with ICD M069 - Rheumatoid arthritis, unspecified | $115,582 | ||||
| Mortality Rate at DRG | 3.79 | ||||
| Mortality Rate with ICD M069 - Rheumatoid arthritis, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 52.83 | ||||
| SNF Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | NA | ||||
| Home Discharge Rate at DRG | 9.28 | ||||
| Home Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| METHODIST UNIVERSITY HOSPITAL | 1265 UNION AVE | MEMPHIS | TN | 38104 | 23 |
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W 13 MILE RD | ROYAL OAK | MI | 48073 | 20 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 20 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MOHAMMED S ADEEL | 4100 COVERT AVE | EVANSVILLE | IN | 47714 | 13 |
| Dr. BRADLEY MARK SHORT | 3905 BROOKEN HILL DR | FORT SMITH | AR | 72908 | 12 |
| Dr. JOHN A. KLINE | 150 MUNDY ST | WILKES BARRE | PA | 18702 | 12 |
*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 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT 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 | 1,808,415 | ||||
| Total Hospitalizations with ICD M069 - Rheumatoid arthritis, unspecified | 54,752 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD M069 - Rheumatoid arthritis, unspecified in DRG | 6.4 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD M069 - Rheumatoid arthritis, unspecified | 6.27 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 25.31 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 17.78 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD M069 - Rheumatoid arthritis, unspecified | $624,847,549 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD M069 - Rheumatoid arthritis, unspecified | $1,821 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD M069 - Rheumatoid arthritis, unspecified | $11,412 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD M069 - Rheumatoid arthritis, unspecified | $3,156,218,480 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD M069 - Rheumatoid arthritis, unspecified | $57,646 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD M069 - Rheumatoid arthritis, unspecified | 10.28 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 26.75 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 27.95 |
*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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 535,322 | ||||
| Total Hospitalizations with ICD M069 - Rheumatoid arthritis, unspecified | 15,962 | ||||
| DRG Share of Total Hospitalizations | 1.63 | ||||
| % of Total ICD M069 - Rheumatoid arthritis, unspecified in DRG | 1.87 | ||||
| Avg LOS at DRG | 4.68 | ||||
| Avg LOS with ICD M069 - Rheumatoid arthritis, unspecified | 4.82 | ||||
| Readmission Rate at DRG | 23.65 | ||||
| Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 23.83 | ||||
| Unplanned Readmission Rate at DRG | 18.66 | ||||
| Unplanned Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 18.35 | ||||
| Total Medicare payments at DRG | $3,844,806,408 | ||||
| Total Medicare payments with ICD M069 - Rheumatoid arthritis, unspecified | $113,586,505 | ||||
| Total Medicare payment per Day at DRG | $1,536 | ||||
| Total Medicare payment per Day with ICD M069 - Rheumatoid arthritis, unspecified | $1,475 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,182 | ||||
| Total Medicare payment per Hospitalization with ICD M069 - Rheumatoid arthritis, unspecified | $7,116 | ||||
| Total Medicare Charges at DRG | $19,258,468,078 | ||||
| Total Medicare Charges with ICD M069 - Rheumatoid arthritis, unspecified | $586,058,318 | ||||
| Avg Charges at DRG | $35,975 | ||||
| Avg Charges with ICD M069 - Rheumatoid arthritis, unspecified | $36,716 | ||||
| Mortality Rate at DRG | 1.27 | ||||
| Mortality Rate with ICD M069 - Rheumatoid arthritis, unspecified | 1.15 | ||||
| SNF Discharge Rate at DRG | 14.61 | ||||
| SNF Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 15.15 | ||||
| Home Discharge Rate at DRG | 52.12 | ||||
| Home Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 50.99 |
*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 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 885: PSYCHOSES | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 443,386 | ||||
| Total Hospitalizations with ICD M069 - Rheumatoid arthritis, unspecified | 13,132 | ||||
| DRG Share of Total Hospitalizations | 1.35 | ||||
| % of Total ICD M069 - Rheumatoid arthritis, unspecified in DRG | 1.54 | ||||
| Avg LOS at DRG | 5.27 | ||||
| Avg LOS with ICD M069 - Rheumatoid arthritis, unspecified | 5.44 | ||||
| Readmission Rate at DRG | 21.6 | ||||
| Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 22.41 | ||||
| Unplanned Readmission Rate at DRG | 15.91 | ||||
| Unplanned Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 16.4 | ||||
| Total Medicare payments at DRG | $3,812,834,208 | ||||
| Total Medicare payments with ICD M069 - Rheumatoid arthritis, unspecified | $111,377,409 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD M069 - Rheumatoid arthritis, unspecified | $1,559 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
| Total Medicare payment per Hospitalization with ICD M069 - Rheumatoid arthritis, unspecified | $8,481 | ||||
| Total Medicare Charges at DRG | $18,110,468,211 | ||||
| Total Medicare Charges with ICD M069 - Rheumatoid arthritis, unspecified | $554,953,716 | ||||
| Avg Charges at DRG | $40,846 | ||||
| Avg Charges with ICD M069 - Rheumatoid arthritis, unspecified | $42,260 | ||||
| Mortality Rate at DRG | 3.59 | ||||
| Mortality Rate with ICD M069 - Rheumatoid arthritis, unspecified | 3.21 | ||||
| SNF Discharge Rate at DRG | 22.57 | ||||
| SNF Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 22.68 | ||||
| Home Discharge Rate at DRG | 40.95 | ||||
| Home Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 39.71 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 483: MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 286,456 | ||||
| Total Hospitalizations with ICD M069 - Rheumatoid arthritis, unspecified | 8,655 | ||||
| DRG Share of Total Hospitalizations | 0.87 | ||||
| % of Total ICD M069 - Rheumatoid arthritis, unspecified in DRG | 1.01 | ||||
| Avg LOS at DRG | 3.75 | ||||
| Avg LOS with ICD M069 - Rheumatoid arthritis, unspecified | 3.98 | ||||
| Readmission Rate at DRG | 22.9 | ||||
| Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 22.65 | ||||
| Unplanned Readmission Rate at DRG | 18.29 | ||||
| Unplanned Readmission Rate with ICD M069 - Rheumatoid arthritis, unspecified | 17.97 | ||||
| Total Medicare payments at DRG | $1,641,467,496 | ||||
| Total Medicare payments with ICD M069 - Rheumatoid arthritis, unspecified | $49,251,737 | ||||
| Total Medicare payment per Day at DRG | $1,526 | ||||
| Total Medicare payment per Day with ICD M069 - Rheumatoid arthritis, unspecified | $1,430 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,730 | ||||
| Total Medicare payment per Hospitalization with ICD M069 - Rheumatoid arthritis, unspecified | $5,691 | ||||
| Total Medicare Charges at DRG | $8,050,963,680 | ||||
| Total Medicare Charges with ICD M069 - Rheumatoid arthritis, unspecified | $257,938,501 | ||||
| Avg Charges at DRG | $28,105 | ||||
| Avg Charges with ICD M069 - Rheumatoid arthritis, unspecified | $29,802 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD M069 - Rheumatoid arthritis, unspecified | 0.16 | ||||
| SNF Discharge Rate at DRG | 10.84 | ||||
| SNF Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 11.2 | ||||
| Home Discharge Rate at DRG | 59.73 | ||||
| Home Discharge Rate with ICD M069 - Rheumatoid arthritis, unspecified | 58.83 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| COVENANT MEDICAL CENTER | 3615 19TH ST | LUBBOCK | TX | 79410 | 2,533 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 2,505 |
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W 13 MILE RD | ROYAL OAK | MI | 48073 | 2,374 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 226 |
| Dr. AAMIR HASHMAT | 2024 15TH ST FL 2 | MERIDIAN | MS | 39301 | 134 |
| Dr. WILLIAM TIMOTHY BALLARD | 2415 MCCALLIE AVE | CHATTANOOGA | TN | 37404 | 119 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 366 |
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 260 |
| Dr. ARASH MILANI | 12830 HESPERIA RD STE D | VICTORVILLE | CA | 92395 | 208 |