*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M109 - Gout, unspecified - as a primary diagnosis code | M109 - Gout, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.61 | |
| Readmission Rate (%) | 23.44 | |
| Unplanned Readmission Rate (%) | 12.45 | |
| 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 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 553: BONE DISEASES AND ARTHROPATHIES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 488: KNEE PROCEDURES WITHOUT PDX OF INFECTION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 506: MAJOR THUMB OR JOINT PROCEDURES | DRG 513: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 51,757 | ||||
| Total Hospitalizations with ICD M109 - Gout, unspecified | 7,892 | ||||
| DRG Share of Total Hospitalizations | 0.16 | ||||
| % of Total ICD M109 - Gout, unspecified in DRG | 80.22 | ||||
| Avg LOS at DRG | 4.41 | ||||
| Avg LOS with ICD M109 - Gout, unspecified | 3.44 | ||||
| Readmission Rate at DRG | 17.16 | ||||
| Readmission Rate with ICD M109 - Gout, unspecified | 16.54 | ||||
| Unplanned Readmission Rate at DRG | 9.0 | ||||
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | 11.4 | ||||
| Total Medicare payments at DRG | $332,400,259 | ||||
| Total Medicare payments with ICD M109 - Gout, unspecified | $39,720,788 | ||||
| Total Medicare payment per Day at DRG | $1,455 | ||||
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $1,465 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,422 | ||||
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $5,033 | ||||
| Total Medicare Charges at DRG | $1,234,809,519 | ||||
| Total Medicare Charges with ICD M109 - Gout, unspecified | $180,037,510 | ||||
| Avg Charges at DRG | $23,858 | ||||
| Avg Charges with ICD M109 - Gout, unspecified | $22,813 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD M109 - Gout, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 25.37 | ||||
| SNF Discharge Rate with ICD M109 - Gout, unspecified | 19.84 | ||||
| Home Discharge Rate at DRG | 42.31 | ||||
| Home Discharge Rate with ICD M109 - Gout, unspecified | 52.38 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 489: KNEE PROCEDURES WITHOUT PDX OF INFECTION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 501: SOFT TISSUE PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 982: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 464: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS 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 | 8,316 | ||||
| Total Hospitalizations with ICD M109 - Gout, unspecified | 23 | ||||
| DRG Share of Total Hospitalizations | 0.03 | ||||
| % of Total ICD M109 - Gout, unspecified in DRG | 0.23 | ||||
| Avg LOS at DRG | 2.38 | ||||
| Avg LOS with ICD M109 - Gout, unspecified | 3.83 | ||||
| Readmission Rate at DRG | 9.79 | ||||
| Readmission Rate with ICD M109 - Gout, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 3.56 | ||||
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | NA | ||||
| Total Medicare payments at DRG | $60,167,626 | ||||
| Total Medicare payments with ICD M109 - Gout, unspecified | $170,216 | ||||
| Total Medicare payment per Day at DRG | $3,044 | ||||
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $1,934 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,235 | ||||
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $7,401 | ||||
| Total Medicare Charges at DRG | $348,193,427 | ||||
| Total Medicare Charges with ICD M109 - Gout, unspecified | $771,757 | ||||
| Avg Charges at DRG | $41,870 | ||||
| Avg Charges with ICD M109 - Gout, unspecified | $33,555 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD M109 - Gout, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 17.4 | ||||
| SNF Discharge Rate with ICD M109 - Gout, unspecified | NA | ||||
| Home Discharge Rate at DRG | 41.37 | ||||
| Home Discharge Rate with ICD M109 - Gout, unspecified | 60.87 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 478: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|
| Total Hospitalizations at DRG | 21,107 |
| Total Hospitalizations with ICD M109 - Gout, unspecified | 11 |
| DRG Share of Total Hospitalizations | 0.06 |
| % of Total ICD M109 - Gout, unspecified in DRG | 0.11 |
| Avg LOS at DRG | 6.49 |
| Avg LOS with ICD M109 - Gout, unspecified | 6.09 |
| Readmission Rate at DRG | 26.91 |
| Readmission Rate with ICD M109 - Gout, unspecified | NA |
| Unplanned Readmission Rate at DRG | 14.11 |
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | NA |
| Total Medicare payments at DRG | $299,258,488 |
| Total Medicare payments with ICD M109 - Gout, unspecified | $158,315 |
| Total Medicare payment per Day at DRG | $2,183 |
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $2,363 |
| Total Medicare payment per Hospitalization at DRG | $14,178 |
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $14,392 |
| Total Medicare Charges at DRG | $1,625,982,661 |
| Total Medicare Charges with ICD M109 - Gout, unspecified | $569,446 |
| Avg Charges at DRG | $77,035 |
| Avg Charges with ICD M109 - Gout, unspecified | $51,768 |
| Mortality Rate at DRG | 0.28 |
| Mortality Rate with ICD M109 - Gout, unspecified | NA |
| SNF Discharge Rate at DRG | 35.38 |
| SNF Discharge Rate with ICD M109 - Gout, unspecified | NA |
| Home Discharge Rate at DRG | 25.84 |
| Home Discharge Rate with ICD M109 - Gout, unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 51 |
| MEDSTAR WASHINGTON HOSPITAL CENTER | 110 IRVING ST NW | WASHINGTON | DC | 20010 | 47 |
| YALE NEW HAVEN HOSPITAL | 20 YORK ST | NEW HAVEN | CT | 06504 | 45 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ADNAN M DAHDUL | 14 CHESTNUT PL | LUDLOW | MA | 01056 | 13 |
*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 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 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD M109 - Gout, unspecified | 84,569 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD M109 - Gout, unspecified in DRG | 6.16 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD M109 - Gout, unspecified | 5.53 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD M109 - Gout, unspecified | 28.51 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | 21.89 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD M109 - Gout, unspecified | $805,051,082 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $1,721 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $9,519 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD M109 - Gout, unspecified | $3,631,572,058 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD M109 - Gout, unspecified | $42,942 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD M109 - Gout, unspecified | 3.08 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD M109 - Gout, unspecified | 19.25 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD M109 - Gout, unspecified | 39.88 |
*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 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 365,119 | ||||
| Total Hospitalizations with ICD M109 - Gout, unspecified | 24,739 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD M109 - Gout, unspecified in DRG | 1.8 | ||||
| Avg LOS at DRG | 5.91 | ||||
| Avg LOS with ICD M109 - Gout, unspecified | 6.15 | ||||
| Readmission Rate at DRG | 27.73 | ||||
| Readmission Rate with ICD M109 - Gout, unspecified | 27.03 | ||||
| Unplanned Readmission Rate at DRG | 20.3 | ||||
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | 19.26 | ||||
| Total Medicare payments at DRG | $3,552,910,533 | ||||
| Total Medicare payments with ICD M109 - Gout, unspecified | $242,844,764 | ||||
| Total Medicare payment per Day at DRG | $1,646 | ||||
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $1,597 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,731 | ||||
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $9,816 | ||||
| Total Medicare Charges at DRG | $16,860,985,198 | ||||
| Total Medicare Charges with ICD M109 - Gout, unspecified | $1,168,157,535 | ||||
| Avg Charges at DRG | $46,179 | ||||
| Avg Charges with ICD M109 - Gout, unspecified | $47,219 | ||||
| Mortality Rate at DRG | 5.06 | ||||
| Mortality Rate with ICD M109 - Gout, unspecified | 4.45 | ||||
| SNF Discharge Rate at DRG | 28.7 | ||||
| SNF Discharge Rate with ICD M109 - Gout, unspecified | 29.14 | ||||
| Home Discharge Rate at DRG | 32.16 | ||||
| Home Discharge Rate with ICD M109 - Gout, unspecified | 32.67 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 539,642 | ||||
| Total Hospitalizations with ICD M109 - Gout, unspecified | 18,563 | ||||
| DRG Share of Total Hospitalizations | 1.64 | ||||
| % of Total ICD M109 - Gout, unspecified in DRG | 1.35 | ||||
| Avg LOS at DRG | 6.42 | ||||
| Avg LOS with ICD M109 - Gout, unspecified | 6.53 | ||||
| Readmission Rate at DRG | 26.55 | ||||
| Readmission Rate with ICD M109 - Gout, unspecified | 27.58 | ||||
| Unplanned Readmission Rate at DRG | 20.01 | ||||
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | 20.67 | ||||
| Total Medicare payments at DRG | $5,267,842,463 | ||||
| Total Medicare payments with ICD M109 - Gout, unspecified | $187,939,074 | ||||
| Total Medicare payment per Day at DRG | $1,520 | ||||
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $1,550 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,762 | ||||
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $10,124 | ||||
| Total Medicare Charges at DRG | $25,503,568,329 | ||||
| Total Medicare Charges with ICD M109 - Gout, unspecified | $907,947,523 | ||||
| Avg Charges at DRG | $47,260 | ||||
| Avg Charges with ICD M109 - Gout, unspecified | $48,912 | ||||
| Mortality Rate at DRG | 5.62 | ||||
| Mortality Rate with ICD M109 - Gout, unspecified | 5.24 | ||||
| SNF Discharge Rate at DRG | 19.26 | ||||
| SNF Discharge Rate with ICD M109 - Gout, unspecified | 21.06 | ||||
| Home Discharge Rate at DRG | 39.65 | ||||
| Home Discharge Rate with ICD M109 - Gout, unspecified | 37.84 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS | DRG 885: PSYCHOSES | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 292,335 | ||||
| Total Hospitalizations with ICD M109 - Gout, unspecified | 14,582 | ||||
| DRG Share of Total Hospitalizations | 0.89 | ||||
| % of Total ICD M109 - Gout, unspecified in DRG | 1.06 | ||||
| Avg LOS at DRG | 2.96 | ||||
| Avg LOS with ICD M109 - Gout, unspecified | 3.11 | ||||
| Readmission Rate at DRG | 19.18 | ||||
| Readmission Rate with ICD M109 - Gout, unspecified | 20.65 | ||||
| Unplanned Readmission Rate at DRG | 13.96 | ||||
| Unplanned Readmission Rate with ICD M109 - Gout, unspecified | 15.15 | ||||
| Total Medicare payments at DRG | $1,347,436,356 | ||||
| Total Medicare payments with ICD M109 - Gout, unspecified | $69,225,543 | ||||
| Total Medicare payment per Day at DRG | $1,557 | ||||
| Total Medicare payment per Day with ICD M109 - Gout, unspecified | $1,528 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,609 | ||||
| Total Medicare payment per Hospitalization with ICD M109 - Gout, unspecified | $4,747 | ||||
| Total Medicare Charges at DRG | $7,385,462,160 | ||||
| Total Medicare Charges with ICD M109 - Gout, unspecified | $382,288,811 | ||||
| Avg Charges at DRG | $25,264 | ||||
| Avg Charges with ICD M109 - Gout, unspecified | $26,216 | ||||
| Mortality Rate at DRG | 0.57 | ||||
| Mortality Rate with ICD M109 - Gout, unspecified | 0.44 | ||||
| SNF Discharge Rate at DRG | 11.55 | ||||
| SNF Discharge Rate with ICD M109 - Gout, unspecified | 10.94 | ||||
| Home Discharge Rate at DRG | 63.79 | ||||
| Home Discharge Rate with ICD M109 - Gout, unspecified | 63.84 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| YALE NEW HAVEN HOSPITAL | 20 YORK ST | NEW HAVEN | CT | 06504 | 4,616 |
| MASSACHUSETTS GENERAL HOSPITAL | 55 FRUIT ST | BOSTON | MA | 02114 | 4,260 |
| VIDANT MEDICAL CENTER | 2100 STANTONSBURG RD | GREENVILLE | NC | 27834 | 4,133 |
| 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 | 197 |
| Dr. EDITH NEBUWA ANIEDOBE | 1500 FOREST GLEN RD | SILVER SPRING | MD | 20910 | 168 |
| Dr. DAVID MARK GORDON | 28455 HAGGERTY RD | NOVI | MI | 48377 | 133 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 569 |
| Dr. RAJESH AGARWAL | 6770 MAYFIELD RD | MAYFIELD HEIGHTS | OH | 44124 | 324 |
| Dr. PADMAJA KONDAMURI | 8840 CALUMET AVE | MUNSTER | IN | 46321 | 310 |