*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M25562 - Pain in left knee - as a primary diagnosis code | M25562 - Pain in left knee - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.97 | |
| Readmission Rate (%) | 20.29 | |
| Unplanned Readmission Rate (%) | 10.05 | |
| 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 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT 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 | 43,543 | ||||
| Total Hospitalizations with ICD M25562 - Pain in left knee | 1,469 | ||||
| DRG Share of Total Hospitalizations | 0.13 | ||||
| % of Total ICD M25562 - Pain in left knee in DRG | 80.05 | ||||
| Avg LOS at DRG | 4.54 | ||||
| Avg LOS with ICD M25562 - Pain in left knee | 4.07 | ||||
| Readmission Rate at DRG | 18.05 | ||||
| Readmission Rate with ICD M25562 - Pain in left knee | 18.47 | ||||
| Unplanned Readmission Rate at DRG | 10.73 | ||||
| Unplanned Readmission Rate with ICD M25562 - Pain in left knee | 9.88 | ||||
| Total Medicare payments at DRG | $293,427,765 | ||||
| Total Medicare payments with ICD M25562 - Pain in left knee | $8,984,364 | ||||
| Total Medicare payment per Day at DRG | $1,485 | ||||
| Total Medicare payment per Day with ICD M25562 - Pain in left knee | $1,501 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,739 | ||||
| Total Medicare payment per Hospitalization with ICD M25562 - Pain in left knee | $6,116 | ||||
| Total Medicare Charges at DRG | $1,161,067,318 | ||||
| Total Medicare Charges with ICD M25562 - Pain in left knee | $31,131,955 | ||||
| Avg Charges at DRG | $26,665 | ||||
| Avg Charges with ICD M25562 - Pain in left knee | $21,193 | ||||
| Mortality Rate at DRG | 0.19 | ||||
| Mortality Rate with ICD M25562 - Pain in left knee | NA | ||||
| SNF Discharge Rate at DRG | 27.91 | ||||
| SNF Discharge Rate with ICD M25562 - Pain in left knee | 33.9 | ||||
| Home Discharge Rate at DRG | 35.39 | ||||
| Home Discharge Rate with ICD M25562 - Pain in left knee | 27.16 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|
| Total Hospitalizations at DRG | 63,482 |
| Total Hospitalizations with ICD M25562 - Pain in left knee | 13 |
| DRG Share of Total Hospitalizations | 0.19 |
| % of Total ICD M25562 - Pain in left knee in DRG | 0.71 |
| Avg LOS at DRG | 4.05 |
| Avg LOS with ICD M25562 - Pain in left knee | 2.62 |
| Readmission Rate at DRG | 19.14 |
| Readmission Rate with ICD M25562 - Pain in left knee | NA |
| Unplanned Readmission Rate at DRG | 7.13 |
| Unplanned Readmission Rate with ICD M25562 - Pain in left knee | NA |
| Total Medicare payments at DRG | $1,360,037,568 |
| Total Medicare payments with ICD M25562 - Pain in left knee | $284,237 |
| Total Medicare payment per Day at DRG | $5,286 |
| Total Medicare payment per Day with ICD M25562 - Pain in left knee | $8,360 |
| Total Medicare payment per Hospitalization at DRG | $21,424 |
| Total Medicare payment per Hospitalization with ICD M25562 - Pain in left knee | $21,864 |
| Total Medicare Charges at DRG | $6,614,169,258 |
| Total Medicare Charges with ICD M25562 - Pain in left knee | $1,239,685 |
| Avg Charges at DRG | $104,190 |
| Avg Charges with ICD M25562 - Pain in left knee | $95,360 |
| Mortality Rate at DRG | 0.11 |
| Mortality Rate with ICD M25562 - Pain in left knee | NA |
| SNF Discharge Rate at DRG | 37.05 |
| SNF Discharge Rate with ICD M25562 - Pain in left knee | NA |
| Home Discharge Rate at DRG | 18.63 |
| Home Discharge Rate with ICD M25562 - Pain in left knee | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| HEALTHSOUTH REHABILITATION HOSPITAL OF TEXARKANA | 515 W 12TH ST | TEXARKANA | TX | 75501 | 13 |
| FAIRLAWN REHABILITATION HOSPITAL | 189 MAY ST | WORCESTER | MA | 01602 | 12 |
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 11 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. NATHAN J WRIGHT | 2014 GALLERIA OAKS DR | TEXARKANA | TX | 75503 | 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 M25562 - Pain in left knee | 6,092 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD M25562 - Pain in left knee in DRG | 7.82 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD M25562 - Pain in left knee | 2.6 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD M25562 - Pain in left knee | 8.78 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD M25562 - Pain in left knee | 3.12 | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD M25562 - Pain in left knee | $67,219,827 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD M25562 - Pain in left knee | $4,242 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD M25562 - Pain in left knee | $11,034 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD M25562 - Pain in left knee | $345,687,976 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD M25562 - Pain in left knee | $56,745 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD M25562 - Pain in left knee | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD M25562 - Pain in left knee | 22.62 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD M25562 - Pain in left knee | 35.72 |
*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 M25562 - Pain in left knee | 1,727 | ||||
| DRG Share of Total Hospitalizations | 0.57 | ||||
| % of Total ICD M25562 - Pain in left knee in DRG | 2.22 | ||||
| Avg LOS at DRG | 11.75 | ||||
| Avg LOS with ICD M25562 - Pain in left knee | 12.4 | ||||
| Readmission Rate at DRG | 12.14 | ||||
| Readmission Rate with ICD M25562 - Pain in left knee | 9.69 | ||||
| Unplanned Readmission Rate at DRG | 7.97 | ||||
| Unplanned Readmission Rate with ICD M25562 - Pain in left knee | 6.54 | ||||
| Total Medicare payments at DRG | $3,216,901,374 | ||||
| Total Medicare payments with ICD M25562 - Pain in left knee | $29,831,881 | ||||
| Total Medicare payment per Day at DRG | $1,450 | ||||
| Total Medicare payment per Day with ICD M25562 - Pain in left knee | $1,393 | ||||
| Total Medicare payment per Hospitalization at DRG | $17,033 | ||||
| Total Medicare payment per Hospitalization with ICD M25562 - Pain in left knee | $17,274 | ||||
| Total Medicare Charges at DRG | $7,709,712,645 | ||||
| Total Medicare Charges with ICD M25562 - Pain in left knee | $72,676,103 | ||||
| Avg Charges at DRG | $40,822 | ||||
| Avg Charges with ICD M25562 - Pain in left knee | $42,082 | ||||
| Mortality Rate at DRG | 0.11 | ||||
| Mortality Rate with ICD M25562 - Pain in left knee | NA | ||||
| SNF Discharge Rate at DRG | 19.54 | ||||
| SNF Discharge Rate with ICD M25562 - Pain in left knee | 18.3 | ||||
| Home Discharge Rate at DRG | 19.47 | ||||
| Home Discharge Rate with ICD M25562 - Pain in left knee | 20.96 |
*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 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 312: SYNCOPE AND COLLAPSE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 51,757 | ||||
| Total Hospitalizations with ICD M25562 - Pain in left knee | 1,150 | ||||
| DRG Share of Total Hospitalizations | 0.16 | ||||
| % of Total ICD M25562 - Pain in left knee in DRG | 1.48 | ||||
| Avg LOS at DRG | 4.41 | ||||
| Avg LOS with ICD M25562 - Pain in left knee | 6.64 | ||||
| Readmission Rate at DRG | 17.16 | ||||
| Readmission Rate with ICD M25562 - Pain in left knee | 14.26 | ||||
| Unplanned Readmission Rate at DRG | 9.0 | ||||
| Unplanned Readmission Rate with ICD M25562 - Pain in left knee | 8.43 | ||||
| Total Medicare payments at DRG | $332,400,259 | ||||
| Total Medicare payments with ICD M25562 - Pain in left knee | $11,146,750 | ||||
| Total Medicare payment per Day at DRG | $1,455 | ||||
| Total Medicare payment per Day with ICD M25562 - Pain in left knee | $1,459 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,422 | ||||
| Total Medicare payment per Hospitalization with ICD M25562 - Pain in left knee | $9,693 | ||||
| Total Medicare Charges at DRG | $1,234,809,519 | ||||
| Total Medicare Charges with ICD M25562 - Pain in left knee | $27,953,145 | ||||
| Avg Charges at DRG | $23,858 | ||||
| Avg Charges with ICD M25562 - Pain in left knee | $24,307 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD M25562 - Pain in left knee | NA | ||||
| SNF Discharge Rate at DRG | 25.37 | ||||
| SNF Discharge Rate with ICD M25562 - Pain in left knee | 26.0 | ||||
| Home Discharge Rate at DRG | 42.31 | ||||
| Home Discharge Rate with ICD M25562 - Pain in left knee | 31.22 |
*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 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 603: CELLULITIS 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 M25562 - Pain in left knee | 937 | ||||
| DRG Share of Total Hospitalizations | 0.29 | ||||
| % of Total ICD M25562 - Pain in left knee in DRG | 1.2 | ||||
| Avg LOS at DRG | 10.22 | ||||
| Avg LOS with ICD M25562 - Pain in left knee | 10.66 | ||||
| Readmission Rate at DRG | 9.28 | ||||
| Readmission Rate with ICD M25562 - Pain in left knee | 6.57 | ||||
| Unplanned Readmission Rate at DRG | 5.52 | ||||
| Unplanned Readmission Rate with ICD M25562 - Pain in left knee | 3.56 | ||||
| Total Medicare payments at DRG | $1,423,955,801 | ||||
| Total Medicare payments with ICD M25562 - Pain in left knee | $14,353,206 | ||||
| Total Medicare payment per Day at DRG | $1,462 | ||||
| Total Medicare payment per Day with ICD M25562 - Pain in left knee | $1,437 | ||||
| Total Medicare payment per Hospitalization at DRG | $14,936 | ||||
| Total Medicare payment per Hospitalization with ICD M25562 - Pain in left knee | $15,318 | ||||
| Total Medicare Charges at DRG | $2,977,958,847 | ||||
| Total Medicare Charges with ICD M25562 - Pain in left knee | $29,949,771 | ||||
| Avg Charges at DRG | $31,237 | ||||
| Avg Charges with ICD M25562 - Pain in left knee | $31,963 | ||||
| Mortality Rate at DRG | 0.08 | ||||
| Mortality Rate with ICD M25562 - Pain in left knee | NA | ||||
| SNF Discharge Rate at DRG | 15.14 | ||||
| SNF Discharge Rate with ICD M25562 - Pain in left knee | 13.77 | ||||
| Home Discharge Rate at DRG | 25.42 | ||||
| Home Discharge Rate with ICD M25562 - Pain in left knee | 31.06 |
| 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 | 335 |
| ENCOMPASS HEALTH REHABILITATION HOSPITAL OF TOMS RIVER | 14 HOSPITAL DR | TOMS RIVER | NJ | 08755 | 257 |
| KESSLER INSTITUTE FOR REHABILITATION | 1199 PLEASANT VALLEY WAY | WEST ORANGE | NJ | 07052 | 221 |
| 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 | 147 |
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 142 |
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 137 |
| 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 | 147 |
| Dr. RONALD THANE MORGAN | 1600 S COULTER ST | AMARILLO | TX | 79106 | 147 |
| Dr. DAVID ELMORE TUEL | 880 MEMORIAL DR | OAKLAND | MD | 21550 | 141 |