*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M25519 - Pain in unspecified shoulder - as a primary diagnosis code | M25519 - Pain in unspecified shoulder - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.68 | |
| Readmission Rate (%) | 21.46 | |
| Unplanned Readmission Rate (%) | NA | |
| 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 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 43,543 |
| Total Hospitalizations with ICD M25519 - Pain in unspecified shoulder | 51 |
| DRG Share of Total Hospitalizations | 0.13 |
| % of Total ICD M25519 - Pain in unspecified shoulder in DRG | 80.95 |
| Avg LOS at DRG | 4.54 |
| Avg LOS with ICD M25519 - Pain in unspecified shoulder | 1.71 |
| Readmission Rate at DRG | 18.05 |
| Readmission Rate with ICD M25519 - Pain in unspecified shoulder | NA |
| Unplanned Readmission Rate at DRG | 10.73 |
| Unplanned Readmission Rate with ICD M25519 - Pain in unspecified shoulder | NA |
| Total Medicare payments at DRG | $293,427,765 |
| Total Medicare payments with ICD M25519 - Pain in unspecified shoulder | $210,097 |
| Total Medicare payment per Day at DRG | $1,485 |
| Total Medicare payment per Day with ICD M25519 - Pain in unspecified shoulder | $2,415 |
| Total Medicare payment per Hospitalization at DRG | $6,739 |
| Total Medicare payment per Hospitalization with ICD M25519 - Pain in unspecified shoulder | $4,120 |
| Total Medicare Charges at DRG | $1,161,067,318 |
| Total Medicare Charges with ICD M25519 - Pain in unspecified shoulder | $1,237,999 |
| Avg Charges at DRG | $26,665 |
| Avg Charges with ICD M25519 - Pain in unspecified shoulder | $24,274 |
| Mortality Rate at DRG | 0.19 |
| Mortality Rate with ICD M25519 - Pain in unspecified shoulder | NA |
| SNF Discharge Rate at DRG | 27.91 |
| SNF Discharge Rate with ICD M25519 - Pain in unspecified shoulder | NA |
| Home Discharge Rate at DRG | 35.39 |
| Home Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 64.71 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 885: PSYCHOSES | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,100,860 | ||||
| Total Hospitalizations with ICD M25519 - Pain in unspecified shoulder | 1,975 | ||||
| DRG Share of Total Hospitalizations | 3.35 | ||||
| % of Total ICD M25519 - Pain in unspecified shoulder in DRG | 9.03 | ||||
| Avg LOS at DRG | 11.86 | ||||
| Avg LOS with ICD M25519 - Pain in unspecified shoulder | 12.35 | ||||
| Readmission Rate at DRG | 27.58 | ||||
| Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 27.34 | ||||
| Unplanned Readmission Rate at DRG | 13.34 | ||||
| Unplanned Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 12.63 | ||||
| Total Medicare payments at DRG | $9,312,828,663 | ||||
| Total Medicare payments with ICD M25519 - Pain in unspecified shoulder | $17,458,011 | ||||
| Total Medicare payment per Day at DRG | $713 | ||||
| Total Medicare payment per Day with ICD M25519 - Pain in unspecified shoulder | $716 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,460 | ||||
| Total Medicare payment per Hospitalization with ICD M25519 - Pain in unspecified shoulder | $8,839 | ||||
| Total Medicare Charges at DRG | $32,341,464,302 | ||||
| Total Medicare Charges with ICD M25519 - Pain in unspecified shoulder | $59,531,199 | ||||
| Avg Charges at DRG | $29,378 | ||||
| Avg Charges with ICD M25519 - Pain in unspecified shoulder | $30,142 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD M25519 - Pain in unspecified shoulder | NA | ||||
| SNF Discharge Rate at DRG | 5.83 | ||||
| SNF Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 3.65 | ||||
| Home Discharge Rate at DRG | 79.47 | ||||
| Home Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 84.35 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 167,575 | ||||
| Total Hospitalizations with ICD M25519 - Pain in unspecified shoulder | 402 | ||||
| DRG Share of Total Hospitalizations | 0.51 | ||||
| % of Total ICD M25519 - Pain in unspecified shoulder in DRG | 1.84 | ||||
| Avg LOS at DRG | 5.54 | ||||
| Avg LOS with ICD M25519 - Pain in unspecified shoulder | 6.72 | ||||
| Readmission Rate at DRG | 28.6 | ||||
| Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 27.97 | ||||
| Unplanned Readmission Rate at DRG | 14.22 | ||||
| Unplanned Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 14.25 | ||||
| Total Medicare payments at DRG | $830,329,176 | ||||
| Total Medicare payments with ICD M25519 - Pain in unspecified shoulder | $2,056,498 | ||||
| Total Medicare payment per Day at DRG | $895 | ||||
| Total Medicare payment per Day with ICD M25519 - Pain in unspecified shoulder | $761 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,955 | ||||
| Total Medicare payment per Hospitalization with ICD M25519 - Pain in unspecified shoulder | $5,116 | ||||
| Total Medicare Charges at DRG | $3,314,158,261 | ||||
| Total Medicare Charges with ICD M25519 - Pain in unspecified shoulder | $7,611,941 | ||||
| Avg Charges at DRG | $19,777 | ||||
| Avg Charges with ICD M25519 - Pain in unspecified shoulder | $18,935 | ||||
| Mortality Rate at DRG | 0.03 | ||||
| Mortality Rate with ICD M25519 - Pain in unspecified shoulder | NA | ||||
| SNF Discharge Rate at DRG | 5.67 | ||||
| SNF Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 4.73 | ||||
| Home Discharge Rate at DRG | 80.01 | ||||
| Home Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 81.09 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 408,103 | ||||
| Total Hospitalizations with ICD M25519 - Pain in unspecified shoulder | 310 | ||||
| DRG Share of Total Hospitalizations | 1.24 | ||||
| % of Total ICD M25519 - Pain in unspecified shoulder in DRG | 1.42 | ||||
| Avg LOS at DRG | 3.52 | ||||
| Avg LOS with ICD M25519 - Pain in unspecified shoulder | 3.48 | ||||
| Readmission Rate at DRG | 17.83 | ||||
| Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 19.66 | ||||
| Unplanned Readmission Rate at DRG | 13.81 | ||||
| Unplanned Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 15.25 | ||||
| Total Medicare payments at DRG | $2,416,862,532 | ||||
| Total Medicare payments with ICD M25519 - Pain in unspecified shoulder | $1,782,499 | ||||
| Total Medicare payment per Day at DRG | $1,682 | ||||
| Total Medicare payment per Day with ICD M25519 - Pain in unspecified shoulder | $1,652 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,922 | ||||
| Total Medicare payment per Hospitalization with ICD M25519 - Pain in unspecified shoulder | $5,750 | ||||
| Total Medicare Charges at DRG | $13,267,744,847 | ||||
| Total Medicare Charges with ICD M25519 - Pain in unspecified shoulder | $10,022,595 | ||||
| Avg Charges at DRG | $32,511 | ||||
| Avg Charges with ICD M25519 - Pain in unspecified shoulder | $32,331 | ||||
| Mortality Rate at DRG | 0.72 | ||||
| Mortality Rate with ICD M25519 - Pain in unspecified shoulder | NA | ||||
| SNF Discharge Rate at DRG | 14.1 | ||||
| SNF Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 10.32 | ||||
| Home Discharge Rate at DRG | 62.97 | ||||
| Home Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 65.48 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 895: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | DRG 313: CHEST PAIN | DRG 312: SYNCOPE AND COLLAPSE | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 195,476 | ||||
| Total Hospitalizations with ICD M25519 - Pain in unspecified shoulder | 262 | ||||
| DRG Share of Total Hospitalizations | 0.59 | ||||
| % of Total ICD M25519 - Pain in unspecified shoulder in DRG | 1.2 | ||||
| Avg LOS at DRG | 4.48 | ||||
| Avg LOS with ICD M25519 - Pain in unspecified shoulder | 4.92 | ||||
| Readmission Rate at DRG | 20.57 | ||||
| Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 20.08 | ||||
| Unplanned Readmission Rate at DRG | 9.88 | ||||
| Unplanned Readmission Rate with ICD M25519 - Pain in unspecified shoulder | 11.24 | ||||
| Total Medicare payments at DRG | $1,320,662,237 | ||||
| Total Medicare payments with ICD M25519 - Pain in unspecified shoulder | $1,956,846 | ||||
| Total Medicare payment per Day at DRG | $1,508 | ||||
| Total Medicare payment per Day with ICD M25519 - Pain in unspecified shoulder | $1,519 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,756 | ||||
| Total Medicare payment per Hospitalization with ICD M25519 - Pain in unspecified shoulder | $7,469 | ||||
| Total Medicare Charges at DRG | $6,024,639,461 | ||||
| Total Medicare Charges with ICD M25519 - Pain in unspecified shoulder | $8,634,844 | ||||
| Avg Charges at DRG | $30,820 | ||||
| Avg Charges with ICD M25519 - Pain in unspecified shoulder | $32,957 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD M25519 - Pain in unspecified shoulder | NA | ||||
| SNF Discharge Rate at DRG | 33.36 | ||||
| SNF Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 26.34 | ||||
| Home Discharge Rate at DRG | 30.98 | ||||
| Home Discharge Rate with ICD M25519 - Pain in unspecified shoulder | 36.64 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| TURNING POINT HOSPITAL | 3015 VETERANS PKWY S | MOULTRIE | GA | 31788 | 86 |
| LIGHTHOUSE BEHAVIORAL HEALTH HOSPITAL | 152 WACCAMAW MEDICAL PARK DR | CONWAY | SC | 29526 | 86 |
| BAYSTATE MEDICAL CENTER | 759 CHESTNUT ST | SPRINGFIELD | MA | 01199 | 59 |
| 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 | 70 |
| Dr. THEODORE V PARRAN | 2351 E 22ND ST | CLEVELAND | OH | 44115 | 32 |
| Dr. ADEDAPO M ODUWOLE | 1203 48TH AVE N | MYRTLE BEACH | SC | 29577 | 24 |
| 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 | 80 |
| Dr. ADEDAPO M ODUWOLE | 1203 48TH AVE N | MYRTLE BEACH | SC | 29577 | 35 |
| Dr. THEODORE V PARRAN | 2351 E 22ND ST | CLEVELAND | OH | 44115 | 31 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | E785 | Hyperlipidemia, unspecified |
| 2 | I10 | Essential (primary) hypertension |