*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M25461 - Effusion, right knee - as a primary diagnosis code | M25461 - Effusion, right knee - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.48 | |
| Readmission Rate (%) | 21.73 | |
| Unplanned Readmission Rate (%) | 10.35 | |
| 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 565: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 566: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 564: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES 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 489: KNEE PROCEDURES WITHOUT PDX OF INFECTION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 23,663 | ||||
| Total Hospitalizations with ICD M25461 - Effusion, right knee | 1,422 | ||||
| DRG Share of Total Hospitalizations | 0.07 | ||||
| % of Total ICD M25461 - Effusion, right knee in DRG | 54.21 | ||||
| Avg LOS at DRG | 4.81 | ||||
| Avg LOS with ICD M25461 - Effusion, right knee | 4.06 | ||||
| Readmission Rate at DRG | 21.07 | ||||
| Readmission Rate with ICD M25461 - Effusion, right knee | 18.34 | ||||
| Unplanned Readmission Rate at DRG | 11.02 | ||||
| Unplanned Readmission Rate with ICD M25461 - Effusion, right knee | 10.21 | ||||
| Total Medicare payments at DRG | $163,590,689 | ||||
| Total Medicare payments with ICD M25461 - Effusion, right knee | $8,847,617 | ||||
| Total Medicare payment per Day at DRG | $1,438 | ||||
| Total Medicare payment per Day with ICD M25461 - Effusion, right knee | $1,534 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,913 | ||||
| Total Medicare payment per Hospitalization with ICD M25461 - Effusion, right knee | $6,222 | ||||
| Total Medicare Charges at DRG | $779,108,044 | ||||
| Total Medicare Charges with ICD M25461 - Effusion, right knee | $38,864,638 | ||||
| Avg Charges at DRG | $32,925 | ||||
| Avg Charges with ICD M25461 - Effusion, right knee | $27,331 | ||||
| Mortality Rate at DRG | 0.29 | ||||
| Mortality Rate with ICD M25461 - Effusion, right knee | NA | ||||
| SNF Discharge Rate at DRG | 39.56 | ||||
| SNF Discharge Rate with ICD M25461 - Effusion, right knee | 41.84 | ||||
| Home Discharge Rate at DRG | 25.13 | ||||
| Home Discharge Rate with ICD M25461 - Effusion, right knee | 23.98 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 16 |
| BEAUMONT HOSPITAL TROY | 44201 DEQUINDRE RD | TROY | MI | 48085 | 12 |
| ST. PETER'S HOSPITAL | 315 SO. MANNING BLVD | ALBANY | NY | 12208 | 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 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 565: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 563: FRACTURE SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,522,684 | ||||
| Total Hospitalizations with ICD M25461 - Effusion, right knee | 2,495 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD M25461 - Effusion, right knee in DRG | 7.24 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD M25461 - Effusion, right knee | 2.68 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD M25461 - Effusion, right knee | 9.3 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD M25461 - Effusion, right knee | 3.29 | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD M25461 - Effusion, right knee | $28,357,407 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD M25461 - Effusion, right knee | $4,243 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD M25461 - Effusion, right knee | $11,366 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD M25461 - Effusion, right knee | $147,837,540 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD M25461 - Effusion, right knee | $59,254 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD M25461 - Effusion, right knee | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD M25461 - Effusion, right knee | 23.29 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD M25461 - Effusion, right knee | 31.18 |
*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 566: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES 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) | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 364,421 | ||||
| Total Hospitalizations with ICD M25461 - Effusion, right knee | 805 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD M25461 - Effusion, right knee in DRG | 2.34 | ||||
| Avg LOS at DRG | 3.97 | ||||
| Avg LOS with ICD M25461 - Effusion, right knee | 4.74 | ||||
| Readmission Rate at DRG | 16.14 | ||||
| Readmission Rate with ICD M25461 - Effusion, right knee | 15.8 | ||||
| Unplanned Readmission Rate at DRG | 10.98 | ||||
| Unplanned Readmission Rate with ICD M25461 - Effusion, right knee | 9.56 | ||||
| Total Medicare payments at DRG | $1,924,528,848 | ||||
| Total Medicare payments with ICD M25461 - Effusion, right knee | $4,216,357 | ||||
| Total Medicare payment per Day at DRG | $1,332 | ||||
| Total Medicare payment per Day with ICD M25461 - Effusion, right knee | $1,105 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,281 | ||||
| Total Medicare payment per Hospitalization with ICD M25461 - Effusion, right knee | $5,238 | ||||
| Total Medicare Charges at DRG | $8,912,106,420 | ||||
| Total Medicare Charges with ICD M25461 - Effusion, right knee | $23,917,670 | ||||
| Avg Charges at DRG | $24,456 | ||||
| Avg Charges with ICD M25461 - Effusion, right knee | $29,711 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD M25461 - Effusion, right knee | NA | ||||
| SNF Discharge Rate at DRG | 15.72 | ||||
| SNF Discharge Rate with ICD M25461 - Effusion, right knee | 24.1 | ||||
| Home Discharge Rate at DRG | 53.33 | ||||
| Home Discharge Rate with ICD M25461 - Effusion, right knee | 43.11 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 564: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 488: KNEE PROCEDURES WITHOUT PDX OF INFECTION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 14,748 | ||||
| Total Hospitalizations with ICD M25461 - Effusion, right knee | 513 | ||||
| DRG Share of Total Hospitalizations | 0.04 | ||||
| % of Total ICD M25461 - Effusion, right knee in DRG | 1.49 | ||||
| Avg LOS at DRG | 7.44 | ||||
| Avg LOS with ICD M25461 - Effusion, right knee | 4.99 | ||||
| Readmission Rate at DRG | 28.16 | ||||
| Readmission Rate with ICD M25461 - Effusion, right knee | 23.89 | ||||
| Unplanned Readmission Rate at DRG | 16.34 | ||||
| Unplanned Readmission Rate with ICD M25461 - Effusion, right knee | 16.91 | ||||
| Total Medicare payments at DRG | $168,559,396 | ||||
| Total Medicare payments with ICD M25461 - Effusion, right knee | $5,496,379 | ||||
| Total Medicare payment per Day at DRG | $1,536 | ||||
| Total Medicare payment per Day with ICD M25461 - Effusion, right knee | $2,145 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,429 | ||||
| Total Medicare payment per Hospitalization with ICD M25461 - Effusion, right knee | $10,714 | ||||
| Total Medicare Charges at DRG | $809,829,979 | ||||
| Total Medicare Charges with ICD M25461 - Effusion, right knee | $20,039,001 | ||||
| Avg Charges at DRG | $54,911 | ||||
| Avg Charges with ICD M25461 - Effusion, right knee | $39,062 | ||||
| Mortality Rate at DRG | 3.86 | ||||
| Mortality Rate with ICD M25461 - Effusion, right knee | NA | ||||
| SNF Discharge Rate at DRG | 41.09 | ||||
| SNF Discharge Rate with ICD M25461 - Effusion, right knee | 42.5 | ||||
| Home Discharge Rate at DRG | 17.98 | ||||
| Home Discharge Rate with ICD M25461 - Effusion, right knee | 27.88 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 553: BONE DISEASES AND ARTHROPATHIES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 312: SYNCOPE AND COLLAPSE | DRG 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 269,064 | ||||
| Total Hospitalizations with ICD M25461 - Effusion, right knee | 381 | ||||
| DRG Share of Total Hospitalizations | 0.82 | ||||
| % of Total ICD M25461 - Effusion, right knee in DRG | 1.11 | ||||
| Avg LOS at DRG | 13.18 | ||||
| Avg LOS with ICD M25461 - Effusion, right knee | 13.26 | ||||
| Readmission Rate at DRG | 37.51 | ||||
| Readmission Rate with ICD M25461 - Effusion, right knee | 35.4 | ||||
| Unplanned Readmission Rate at DRG | 18.15 | ||||
| Unplanned Readmission Rate with ICD M25461 - Effusion, right knee | 17.4 | ||||
| Total Medicare payments at DRG | $9,344,186,034 | ||||
| Total Medicare payments with ICD M25461 - Effusion, right knee | $11,950,393 | ||||
| Total Medicare payment per Day at DRG | $2,635 | ||||
| Total Medicare payment per Day with ICD M25461 - Effusion, right knee | $2,365 | ||||
| Total Medicare payment per Hospitalization at DRG | $34,728 | ||||
| Total Medicare payment per Hospitalization with ICD M25461 - Effusion, right knee | $31,366 | ||||
| Total Medicare Charges at DRG | $44,371,117,432 | ||||
| Total Medicare Charges with ICD M25461 - Effusion, right knee | $53,929,332 | ||||
| Avg Charges at DRG | $164,909 | ||||
| Avg Charges with ICD M25461 - Effusion, right knee | $141,547 | ||||
| Mortality Rate at DRG | 14.37 | ||||
| Mortality Rate with ICD M25461 - Effusion, right knee | 6.3 | ||||
| SNF Discharge Rate at DRG | 31.8 | ||||
| SNF Discharge Rate with ICD M25461 - Effusion, right knee | 48.03 | ||||
| Home Discharge Rate at DRG | 14.61 | ||||
| Home Discharge Rate with ICD M25461 - Effusion, right knee | 8.66 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| NORTH SHORE UNIVERSITY HOSPITAL | 300 COMMUNITY DRIVE | MANHASSET | NY | 11030 | 134 |
| CHRISTIANA CARE WILMINGTON HOSPITAL | 501 W 14TH ST | WILMINGTON | DE | 19801 | 99 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 89 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 48 |
| Dr. EUGENE S KRAUSS | 833 NORTHERN BLVD | GREAT NECK | NY | 11021 | 46 |
| Dr. PAUL BRIAN JACOB | 9800 BROADWAY EXTENSION | OKLAHOMA CITY | OK | 73114 | 42 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 47 |
| Dr. PAUL BRIAN JACOB | 9800 BROADWAY EXTENSION | OKLAHOMA CITY | OK | 73114 | 42 |
| Dr. THOMAS G. WULLER | 511 S WINDSOR DR | STILLWATER | OK | 74074 | 41 |