*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M25561 - Pain in right knee - as a primary diagnosis code | M25561 - Pain in right knee - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.92 | |
| Readmission Rate (%) | 20.39 | |
| Unplanned Readmission Rate (%) | 9.89 | |
| 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) | DRG 555: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 43,543 | ||||
| Total Hospitalizations with ICD M25561 - Pain in right knee | 1,534 | ||||
| DRG Share of Total Hospitalizations | 0.13 | ||||
| % of Total ICD M25561 - Pain in right knee in DRG | 79.28 | ||||
| Avg LOS at DRG | 4.54 | ||||
| Avg LOS with ICD M25561 - Pain in right knee | 4.07 | ||||
| Readmission Rate at DRG | 18.05 | ||||
| Readmission Rate with ICD M25561 - Pain in right knee | 17.97 | ||||
| Unplanned Readmission Rate at DRG | 10.73 | ||||
| Unplanned Readmission Rate with ICD M25561 - Pain in right knee | 9.81 | ||||
| Total Medicare payments at DRG | $293,427,765 | ||||
| Total Medicare payments with ICD M25561 - Pain in right knee | $9,663,242 | ||||
| Total Medicare payment per Day at DRG | $1,485 | ||||
| Total Medicare payment per Day with ICD M25561 - Pain in right knee | $1,547 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,739 | ||||
| Total Medicare payment per Hospitalization with ICD M25561 - Pain in right knee | $6,299 | ||||
| Total Medicare Charges at DRG | $1,161,067,318 | ||||
| Total Medicare Charges with ICD M25561 - Pain in right knee | $31,484,094 | ||||
| Avg Charges at DRG | $26,665 | ||||
| Avg Charges with ICD M25561 - Pain in right knee | $20,524 | ||||
| Mortality Rate at DRG | 0.19 | ||||
| Mortality Rate with ICD M25561 - Pain in right knee | NA | ||||
| SNF Discharge Rate at DRG | 27.91 | ||||
| SNF Discharge Rate with ICD M25561 - Pain in right knee | 33.83 | ||||
| Home Discharge Rate at DRG | 35.39 | ||||
| Home Discharge Rate with ICD M25561 - Pain in right knee | 29.14 |
*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) | |
|---|---|
| Total Hospitalizations at DRG | 8,316 |
| Total Hospitalizations with ICD M25561 - Pain in right knee | 13 |
| DRG Share of Total Hospitalizations | 0.03 |
| % of Total ICD M25561 - Pain in right knee in DRG | 0.67 |
| Avg LOS at DRG | 2.38 |
| Avg LOS with ICD M25561 - Pain in right knee | 2.08 |
| Readmission Rate at DRG | 9.79 |
| Readmission Rate with ICD M25561 - Pain in right knee | NA |
| Unplanned Readmission Rate at DRG | 3.56 |
| Unplanned Readmission Rate with ICD M25561 - Pain in right knee | NA |
| Total Medicare payments at DRG | $60,167,626 |
| Total Medicare payments with ICD M25561 - Pain in right knee | $86,662 |
| Total Medicare payment per Day at DRG | $3,044 |
| Total Medicare payment per Day with ICD M25561 - Pain in right knee | $3,210 |
| Total Medicare payment per Hospitalization at DRG | $7,235 |
| Total Medicare payment per Hospitalization with ICD M25561 - Pain in right knee | $6,666 |
| Total Medicare Charges at DRG | $348,193,427 |
| Total Medicare Charges with ICD M25561 - Pain in right knee | $449,902 |
| Avg Charges at DRG | $41,870 |
| Avg Charges with ICD M25561 - Pain in right knee | $34,608 |
| Mortality Rate at DRG | NA |
| Mortality Rate with ICD M25561 - Pain in right knee | NA |
| SNF Discharge Rate at DRG | 17.4 |
| SNF Discharge Rate with ICD M25561 - Pain in right knee | NA |
| Home Discharge Rate at DRG | 41.37 |
| Home Discharge Rate with ICD M25561 - Pain in right knee | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| STRAITH HOSPITAL FOR SPECIAL SURGERY | 23901 LAHSER RD | SOUTHFIELD | MI | 48033 | 12 |
| LONG ISLAND JEWISH MEDICAL CENTER | 270-05 76 AVE | NEW HYDE PARK | NY | 11040 | 11 |
| NORTH SHORE UNIVERSITY HOSPITAL | 300 COMMUNITY DRIVE | MANHASSET | NY | 11030 | 11 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. DAVID MARK GORDON | 28455 HAGGERTY RD | NOVI | MI | 48377 | 12 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. DAVID MARK GORDON | 28455 HAGGERTY RD | NOVI | MI | 48377 | 12 |
| Dr. ADNAN M DAHDUL | 14 CHESTNUT PL | LUDLOW | MA | 01056 | 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 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | 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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,522,684 | ||||
| Total Hospitalizations with ICD M25561 - Pain in right knee | 6,633 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD M25561 - Pain in right knee in DRG | 7.83 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD M25561 - Pain in right knee | 2.61 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD M25561 - Pain in right knee | 8.68 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD M25561 - Pain in right knee | 2.85 | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD M25561 - Pain in right knee | $73,423,219 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD M25561 - Pain in right knee | $4,249 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD M25561 - Pain in right knee | $11,069 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD M25561 - Pain in right knee | $375,488,232 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD M25561 - Pain in right knee | $56,609 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD M25561 - Pain in right knee | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD M25561 - Pain in right knee | 23.28 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD M25561 - Pain in right knee | 36.2 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| 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) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 188,863 | ||||
| Total Hospitalizations with ICD M25561 - Pain in right knee | 1,911 | ||||
| DRG Share of Total Hospitalizations | 0.57 | ||||
| % of Total ICD M25561 - Pain in right knee in DRG | 2.25 | ||||
| Avg LOS at DRG | 11.75 | ||||
| Avg LOS with ICD M25561 - Pain in right knee | 12.31 | ||||
| Readmission Rate at DRG | 12.14 | ||||
| Readmission Rate with ICD M25561 - Pain in right knee | 10.21 | ||||
| Unplanned Readmission Rate at DRG | 7.97 | ||||
| Unplanned Readmission Rate with ICD M25561 - Pain in right knee | 6.77 | ||||
| Total Medicare payments at DRG | $3,216,901,374 | ||||
| Total Medicare payments with ICD M25561 - Pain in right knee | $32,813,683 | ||||
| Total Medicare payment per Day at DRG | $1,450 | ||||
| Total Medicare payment per Day with ICD M25561 - Pain in right knee | $1,395 | ||||
| Total Medicare payment per Hospitalization at DRG | $17,033 | ||||
| Total Medicare payment per Hospitalization with ICD M25561 - Pain in right knee | $17,171 | ||||
| Total Medicare Charges at DRG | $7,709,712,645 | ||||
| Total Medicare Charges with ICD M25561 - Pain in right knee | $80,989,699 | ||||
| Avg Charges at DRG | $40,822 | ||||
| Avg Charges with ICD M25561 - Pain in right knee | $42,381 | ||||
| Mortality Rate at DRG | 0.11 | ||||
| Mortality Rate with ICD M25561 - Pain in right knee | NA | ||||
| SNF Discharge Rate at DRG | 19.54 | ||||
| SNF Discharge Rate with ICD M25561 - Pain in right knee | 19.62 | ||||
| Home Discharge Rate at DRG | 19.47 | ||||
| Home Discharge Rate with ICD M25561 - Pain in right knee | 21.35 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | DRG 312: SYNCOPE AND COLLAPSE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 51,757 | ||||
| Total Hospitalizations with ICD M25561 - Pain in right knee | 1,277 | ||||
| DRG Share of Total Hospitalizations | 0.16 | ||||
| % of Total ICD M25561 - Pain in right knee in DRG | 1.51 | ||||
| Avg LOS at DRG | 4.41 | ||||
| Avg LOS with ICD M25561 - Pain in right knee | 6.52 | ||||
| Readmission Rate at DRG | 17.16 | ||||
| Readmission Rate with ICD M25561 - Pain in right knee | 14.09 | ||||
| Unplanned Readmission Rate at DRG | 9.0 | ||||
| Unplanned Readmission Rate with ICD M25561 - Pain in right knee | 8.39 | ||||
| Total Medicare payments at DRG | $332,400,259 | ||||
| Total Medicare payments with ICD M25561 - Pain in right knee | $12,186,947 | ||||
| Total Medicare payment per Day at DRG | $1,455 | ||||
| Total Medicare payment per Day with ICD M25561 - Pain in right knee | $1,464 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,422 | ||||
| Total Medicare payment per Hospitalization with ICD M25561 - Pain in right knee | $9,543 | ||||
| Total Medicare Charges at DRG | $1,234,809,519 | ||||
| Total Medicare Charges with ICD M25561 - Pain in right knee | $32,170,250 | ||||
| Avg Charges at DRG | $23,858 | ||||
| Avg Charges with ICD M25561 - Pain in right knee | $25,192 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD M25561 - Pain in right knee | NA | ||||
| SNF Discharge Rate at DRG | 25.37 | ||||
| SNF Discharge Rate with ICD M25561 - Pain in right knee | 26.31 | ||||
| Home Discharge Rate at DRG | 42.31 | ||||
| Home Discharge Rate with ICD M25561 - Pain in right knee | 29.76 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 561: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 949: AFTERCARE WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 95,335 | ||||
| Total Hospitalizations with ICD M25561 - Pain in right knee | 1,006 | ||||
| DRG Share of Total Hospitalizations | 0.29 | ||||
| % of Total ICD M25561 - Pain in right knee in DRG | 1.19 | ||||
| Avg LOS at DRG | 10.22 | ||||
| Avg LOS with ICD M25561 - Pain in right knee | 10.71 | ||||
| Readmission Rate at DRG | 9.28 | ||||
| Readmission Rate with ICD M25561 - Pain in right knee | 7.65 | ||||
| Unplanned Readmission Rate at DRG | 5.52 | ||||
| Unplanned Readmission Rate with ICD M25561 - Pain in right knee | 4.93 | ||||
| Total Medicare payments at DRG | $1,423,955,801 | ||||
| Total Medicare payments with ICD M25561 - Pain in right knee | $15,382,157 | ||||
| Total Medicare payment per Day at DRG | $1,462 | ||||
| Total Medicare payment per Day with ICD M25561 - Pain in right knee | $1,428 | ||||
| Total Medicare payment per Hospitalization at DRG | $14,936 | ||||
| Total Medicare payment per Hospitalization with ICD M25561 - Pain in right knee | $15,290 | ||||
| Total Medicare Charges at DRG | $2,977,958,847 | ||||
| Total Medicare Charges with ICD M25561 - Pain in right knee | $32,654,736 | ||||
| Avg Charges at DRG | $31,237 | ||||
| Avg Charges with ICD M25561 - Pain in right knee | $32,460 | ||||
| Mortality Rate at DRG | 0.08 | ||||
| Mortality Rate with ICD M25561 - Pain in right knee | NA | ||||
| SNF Discharge Rate at DRG | 15.14 | ||||
| SNF Discharge Rate with ICD M25561 - Pain in right knee | 13.62 | ||||
| Home Discharge Rate at DRG | 25.42 | ||||
| Home Discharge Rate with ICD M25561 - Pain in right knee | 30.62 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| QUAIL CREEK SURGICAL HOSPITAL | 6819 PLUM CREEK DR | AMARILLO | TX | 79124 | 360 |
| ENCOMPASS HEALTH REHABILITATION HOSPITAL OF TOMS RIVER | 14 HOSPITAL DR | TOMS RIVER | NJ | 08755 | 285 |
| KESSLER INSTITUTE FOR REHABILITATION | 1199 PLEASANT VALLEY WAY | WEST ORANGE | NJ | 07052 | 262 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RONALD THANE MORGAN | 1600 S COULTER ST | AMARILLO | TX | 79106 | 158 |
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 140 |
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 131 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RONALD THANE MORGAN | 1600 S COULTER ST | AMARILLO | TX | 79106 | 158 |
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 145 |
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 139 |