*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M25462 - Effusion, left knee - as a primary diagnosis code | M25462 - Effusion, left knee - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.49 | |
| Readmission Rate (%) | 22.26 | |
| Unplanned Readmission Rate (%) | 11.06 | |
| 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 M25462 - Effusion, left knee | 1,275 | ||||
| DRG Share of Total Hospitalizations | 0.07 | ||||
| % of Total ICD M25462 - Effusion, left knee in DRG | 52.95 | ||||
| Avg LOS at DRG | 4.81 | ||||
| Avg LOS with ICD M25462 - Effusion, left knee | 4.04 | ||||
| Readmission Rate at DRG | 21.07 | ||||
| Readmission Rate with ICD M25462 - Effusion, left knee | 20.02 | ||||
| Unplanned Readmission Rate at DRG | 11.02 | ||||
| Unplanned Readmission Rate with ICD M25462 - Effusion, left knee | 11.29 | ||||
| Total Medicare payments at DRG | $163,590,689 | ||||
| Total Medicare payments with ICD M25462 - Effusion, left knee | $8,073,371 | ||||
| Total Medicare payment per Day at DRG | $1,438 | ||||
| Total Medicare payment per Day with ICD M25462 - Effusion, left knee | $1,566 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,913 | ||||
| Total Medicare payment per Hospitalization with ICD M25462 - Effusion, left knee | $6,332 | ||||
| Total Medicare Charges at DRG | $779,108,044 | ||||
| Total Medicare Charges with ICD M25462 - Effusion, left knee | $34,921,790 | ||||
| Avg Charges at DRG | $32,925 | ||||
| Avg Charges with ICD M25462 - Effusion, left knee | $27,390 | ||||
| Mortality Rate at DRG | 0.29 | ||||
| Mortality Rate with ICD M25462 - Effusion, left knee | NA | ||||
| SNF Discharge Rate at DRG | 39.56 | ||||
| SNF Discharge Rate with ICD M25462 - Effusion, left knee | 39.84 | ||||
| Home Discharge Rate at DRG | 25.13 | ||||
| Home Discharge Rate with ICD M25462 - Effusion, left knee | 28.08 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 12 |
| JFK MEDICAL CENTER | 5301 S CONGRESS AVE | ATLANTIS | FL | 33462 | 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 M25462 - Effusion, left knee | 2,210 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD M25462 - Effusion, left knee in DRG | 7.14 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD M25462 - Effusion, left knee | 2.69 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD M25462 - Effusion, left knee | 8.86 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD M25462 - Effusion, left knee | 2.95 | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD M25462 - Effusion, left knee | $25,150,650 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD M25462 - Effusion, left knee | $4,237 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD M25462 - Effusion, left knee | $11,380 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD M25462 - Effusion, left knee | $131,265,098 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD M25462 - Effusion, left knee | $59,396 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD M25462 - Effusion, left knee | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD M25462 - Effusion, left knee | 23.12 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD M25462 - Effusion, left knee | 31.31 |
*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 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 364,421 | ||||
| Total Hospitalizations with ICD M25462 - Effusion, left knee | 737 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD M25462 - Effusion, left knee in DRG | 2.38 | ||||
| Avg LOS at DRG | 3.97 | ||||
| Avg LOS with ICD M25462 - Effusion, left knee | 4.88 | ||||
| Readmission Rate at DRG | 16.14 | ||||
| Readmission Rate with ICD M25462 - Effusion, left knee | 15.91 | ||||
| Unplanned Readmission Rate at DRG | 10.98 | ||||
| Unplanned Readmission Rate with ICD M25462 - Effusion, left knee | 9.52 | ||||
| Total Medicare payments at DRG | $1,924,528,848 | ||||
| Total Medicare payments with ICD M25462 - Effusion, left knee | $4,038,989 | ||||
| Total Medicare payment per Day at DRG | $1,332 | ||||
| Total Medicare payment per Day with ICD M25462 - Effusion, left knee | $1,122 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,281 | ||||
| Total Medicare payment per Hospitalization with ICD M25462 - Effusion, left knee | $5,480 | ||||
| Total Medicare Charges at DRG | $8,912,106,420 | ||||
| Total Medicare Charges with ICD M25462 - Effusion, left knee | $21,608,766 | ||||
| Avg Charges at DRG | $24,456 | ||||
| Avg Charges with ICD M25462 - Effusion, left knee | $29,320 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD M25462 - Effusion, left knee | NA | ||||
| SNF Discharge Rate at DRG | 15.72 | ||||
| SNF Discharge Rate with ICD M25462 - Effusion, left knee | 24.69 | ||||
| Home Discharge Rate at DRG | 53.33 | ||||
| Home Discharge Rate with ICD M25462 - Effusion, left knee | 44.37 |
*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 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 488: KNEE PROCEDURES WITHOUT PDX OF INFECTION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 553: BONE DISEASES AND ARTHROPATHIES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 14,748 | ||||
| Total Hospitalizations with ICD M25462 - Effusion, left knee | 448 | ||||
| DRG Share of Total Hospitalizations | 0.04 | ||||
| % of Total ICD M25462 - Effusion, left knee in DRG | 1.45 | ||||
| Avg LOS at DRG | 7.44 | ||||
| Avg LOS with ICD M25462 - Effusion, left knee | 5.08 | ||||
| Readmission Rate at DRG | 28.16 | ||||
| Readmission Rate with ICD M25462 - Effusion, left knee | 23.76 | ||||
| Unplanned Readmission Rate at DRG | 16.34 | ||||
| Unplanned Readmission Rate with ICD M25462 - Effusion, left knee | 16.47 | ||||
| Total Medicare payments at DRG | $168,559,396 | ||||
| Total Medicare payments with ICD M25462 - Effusion, left knee | $4,447,923 | ||||
| Total Medicare payment per Day at DRG | $1,536 | ||||
| Total Medicare payment per Day with ICD M25462 - Effusion, left knee | $1,953 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,429 | ||||
| Total Medicare payment per Hospitalization with ICD M25462 - Effusion, left knee | $9,928 | ||||
| Total Medicare Charges at DRG | $809,829,979 | ||||
| Total Medicare Charges with ICD M25462 - Effusion, left knee | $16,967,824 | ||||
| Avg Charges at DRG | $54,911 | ||||
| Avg Charges with ICD M25462 - Effusion, left knee | $37,875 | ||||
| Mortality Rate at DRG | 3.86 | ||||
| Mortality Rate with ICD M25462 - Effusion, left knee | NA | ||||
| SNF Discharge Rate at DRG | 41.09 | ||||
| SNF Discharge Rate with ICD M25462 - Effusion, left knee | 41.29 | ||||
| Home Discharge Rate at DRG | 17.98 | ||||
| Home Discharge Rate with ICD M25462 - Effusion, left knee | 27.01 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 240,618 | ||||
| Total Hospitalizations with ICD M25462 - Effusion, left knee | 335 | ||||
| DRG Share of Total Hospitalizations | 0.73 | ||||
| % of Total ICD M25462 - Effusion, left knee in DRG | 1.08 | ||||
| Avg LOS at DRG | 4.81 | ||||
| Avg LOS with ICD M25462 - Effusion, left knee | 5.33 | ||||
| Readmission Rate at DRG | 26.3 | ||||
| Readmission Rate with ICD M25462 - Effusion, left knee | 24.92 | ||||
| Unplanned Readmission Rate at DRG | 7.83 | ||||
| Unplanned Readmission Rate with ICD M25462 - Effusion, left knee | 7.48 | ||||
| Total Medicare payments at DRG | $2,989,116,299 | ||||
| Total Medicare payments with ICD M25462 - Effusion, left knee | $4,285,546 | ||||
| Total Medicare payment per Day at DRG | $2,581 | ||||
| Total Medicare payment per Day with ICD M25462 - Effusion, left knee | $2,402 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,423 | ||||
| Total Medicare payment per Hospitalization with ICD M25462 - Effusion, left knee | $12,793 | ||||
| Total Medicare Charges at DRG | $15,603,027,471 | ||||
| Total Medicare Charges with ICD M25462 - Effusion, left knee | $22,578,764 | ||||
| Avg Charges at DRG | $64,846 | ||||
| Avg Charges with ICD M25462 - Effusion, left knee | $67,399 | ||||
| Mortality Rate at DRG | 0.4 | ||||
| Mortality Rate with ICD M25462 - Effusion, left knee | NA | ||||
| SNF Discharge Rate at DRG | 66.28 | ||||
| SNF Discharge Rate with ICD M25462 - Effusion, left knee | 71.04 | ||||
| Home Discharge Rate at DRG | 3.84 | ||||
| Home Discharge Rate with ICD M25462 - Effusion, left knee | 3.58 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| NORTH SHORE UNIVERSITY HOSPITAL | 300 COMMUNITY DRIVE | MANHASSET | NY | 11030 | 131 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 92 |
| RUSH HEALTH SYSTEMS | 1314 19TH AVE | MERIDIAN | MS | 39301 | 80 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 59 |
| Dr. PAUL BRIAN JACOB | 9800 BROADWAY EXTENSION | OKLAHOMA CITY | OK | 73114 | 47 |
| Dr. EUGENE S KRAUSS | 833 NORTHERN BLVD | GREAT NECK | NY | 11021 | 46 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 58 |
| Dr. PAUL BRIAN JACOB | 9800 BROADWAY EXTENSION | OKLAHOMA CITY | OK | 73114 | 47 |
| Dr. GUSTAVUS A. RUSH | 1800 12TH ST | MERIDIAN | MS | 39301 | 37 |