*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M4180 - Other forms of scoliosis, site unspecified - as a primary diagnosis code | M4180 - Other forms of scoliosis, site unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.66 | |
| Readmission Rate (%) | 23.24 | |
| Unplanned Readmission Rate (%) | 7.72 | |
| 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 457: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 454: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 458: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 456: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 13,267 | ||||
| Total Hospitalizations with ICD M4180 - Other forms of scoliosis, site unspecified | 80 | ||||
| DRG Share of Total Hospitalizations | 0.04 | ||||
| % of Total ICD M4180 - Other forms of scoliosis, site unspecified in DRG | 28.57 | ||||
| Avg LOS at DRG | 6.15 | ||||
| Avg LOS with ICD M4180 - Other forms of scoliosis, site unspecified | 5.13 | ||||
| Readmission Rate at DRG | 37.98 | ||||
| Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 43.04 | ||||
| Unplanned Readmission Rate at DRG | 7.67 | ||||
| Unplanned Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| Total Medicare payments at DRG | $663,107,672 | ||||
| Total Medicare payments with ICD M4180 - Other forms of scoliosis, site unspecified | $4,098,345 | ||||
| Total Medicare payment per Day at DRG | $8,133 | ||||
| Total Medicare payment per Day with ICD M4180 - Other forms of scoliosis, site unspecified | $9,996 | ||||
| Total Medicare payment per Hospitalization at DRG | $49,982 | ||||
| Total Medicare payment per Hospitalization with ICD M4180 - Other forms of scoliosis, site unspecified | $51,229 | ||||
| Total Medicare Charges at DRG | $2,896,079,147 | ||||
| Total Medicare Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $17,561,871 | ||||
| Avg Charges at DRG | $218,292 | ||||
| Avg Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $219,523 | ||||
| Mortality Rate at DRG | 0.1 | ||||
| Mortality Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| SNF Discharge Rate at DRG | 28.37 | ||||
| SNF Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 30.0 | ||||
| Home Discharge Rate at DRG | 23.93 | ||||
| Home Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 23.75 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 455: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 30,430 |
| Total Hospitalizations with ICD M4180 - Other forms of scoliosis, site unspecified | 20 |
| DRG Share of Total Hospitalizations | 0.09 |
| % of Total ICD M4180 - Other forms of scoliosis, site unspecified in DRG | 7.14 |
| Avg LOS at DRG | 2.96 |
| Avg LOS with ICD M4180 - Other forms of scoliosis, site unspecified | 4.8 |
| Readmission Rate at DRG | 12.68 |
| Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA |
| Unplanned Readmission Rate at DRG | 3.54 |
| Unplanned Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA |
| Total Medicare payments at DRG | $1,036,333,247 |
| Total Medicare payments with ICD M4180 - Other forms of scoliosis, site unspecified | $937,201 |
| Total Medicare payment per Day at DRG | $11,506 |
| Total Medicare payment per Day with ICD M4180 - Other forms of scoliosis, site unspecified | $9,763 |
| Total Medicare payment per Hospitalization at DRG | $34,056 |
| Total Medicare payment per Hospitalization with ICD M4180 - Other forms of scoliosis, site unspecified | $46,860 |
| Total Medicare Charges at DRG | $4,847,184,577 |
| Total Medicare Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $5,805,874 |
| Avg Charges at DRG | $159,290 |
| Avg Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $290,294 |
| Mortality Rate at DRG | NA |
| Mortality Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA |
| SNF Discharge Rate at DRG | 11.74 |
| SNF Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA |
| Home Discharge Rate at DRG | 59.56 |
| Home Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| UCSF MEDICAL CENTER | 505 PARNASSUS AVE | SAN FRANCISCO | CA | 94143 | 27 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 454: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 455: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 215,355 | ||||
| Total Hospitalizations with ICD M4180 - Other forms of scoliosis, site unspecified | 1,044 | ||||
| DRG Share of Total Hospitalizations | 0.66 | ||||
| % of Total ICD M4180 - Other forms of scoliosis, site unspecified in DRG | 19.09 | ||||
| Avg LOS at DRG | 3.28 | ||||
| Avg LOS with ICD M4180 - Other forms of scoliosis, site unspecified | 3.66 | ||||
| Readmission Rate at DRG | 16.7 | ||||
| Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 21.26 | ||||
| Unplanned Readmission Rate at DRG | 4.47 | ||||
| Unplanned Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 5.92 | ||||
| Total Medicare payments at DRG | $5,278,830,730 | ||||
| Total Medicare payments with ICD M4180 - Other forms of scoliosis, site unspecified | $27,648,654 | ||||
| Total Medicare payment per Day at DRG | $7,462 | ||||
| Total Medicare payment per Day with ICD M4180 - Other forms of scoliosis, site unspecified | $7,244 | ||||
| Total Medicare payment per Hospitalization at DRG | $24,512 | ||||
| Total Medicare payment per Hospitalization with ICD M4180 - Other forms of scoliosis, site unspecified | $26,483 | ||||
| Total Medicare Charges at DRG | $25,567,888,167 | ||||
| Total Medicare Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $146,843,851 | ||||
| Avg Charges at DRG | $118,724 | ||||
| Avg Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $140,655 | ||||
| Mortality Rate at DRG | 0.03 | ||||
| Mortality Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| SNF Discharge Rate at DRG | 15.71 | ||||
| SNF Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 23.75 | ||||
| Home Discharge Rate at DRG | 51.89 | ||||
| Home Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 40.33 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 457: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 459: SPINAL FUSION EXCEPT CERVICAL WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 453: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD M4180 - Other forms of scoliosis, site unspecified | 188 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD M4180 - Other forms of scoliosis, site unspecified in DRG | 3.44 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD M4180 - Other forms of scoliosis, site unspecified | 6.89 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 24.39 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 15.85 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD M4180 - Other forms of scoliosis, site unspecified | $2,208,241 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD M4180 - Other forms of scoliosis, site unspecified | $1,704 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD M4180 - Other forms of scoliosis, site unspecified | $11,746 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $10,931,294 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $58,145 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 10.11 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 20.74 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 27.66 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 519: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 458: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 456: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 43,598 | ||||
| Total Hospitalizations with ICD M4180 - Other forms of scoliosis, site unspecified | 75 | ||||
| DRG Share of Total Hospitalizations | 0.13 | ||||
| % of Total ICD M4180 - Other forms of scoliosis, site unspecified in DRG | 1.37 | ||||
| Avg LOS at DRG | 2.56 | ||||
| Avg LOS with ICD M4180 - Other forms of scoliosis, site unspecified | 2.87 | ||||
| Readmission Rate at DRG | 13.58 | ||||
| Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 5.0 | ||||
| Unplanned Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| Total Medicare payments at DRG | $405,277,239 | ||||
| Total Medicare payments with ICD M4180 - Other forms of scoliosis, site unspecified | $680,175 | ||||
| Total Medicare payment per Day at DRG | $3,633 | ||||
| Total Medicare payment per Day with ICD M4180 - Other forms of scoliosis, site unspecified | $3,164 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,296 | ||||
| Total Medicare payment per Hospitalization with ICD M4180 - Other forms of scoliosis, site unspecified | $9,069 | ||||
| Total Medicare Charges at DRG | $2,108,105,162 | ||||
| Total Medicare Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $4,108,847 | ||||
| Avg Charges at DRG | $48,353 | ||||
| Avg Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $54,785 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| SNF Discharge Rate at DRG | 16.27 | ||||
| SNF Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 20.0 | ||||
| Home Discharge Rate at DRG | 57.43 | ||||
| Home Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 60.0 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | DRG 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD M4180 - Other forms of scoliosis, site unspecified | 64 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD M4180 - Other forms of scoliosis, site unspecified in DRG | 1.17 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD M4180 - Other forms of scoliosis, site unspecified | 5.06 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 25.42 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 18.64 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD M4180 - Other forms of scoliosis, site unspecified | $612,126 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD M4180 - Other forms of scoliosis, site unspecified | $1,889 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD M4180 - Other forms of scoliosis, site unspecified | $9,564 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $2,609,020 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD M4180 - Other forms of scoliosis, site unspecified | $40,766 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD M4180 - Other forms of scoliosis, site unspecified | NA | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 32.81 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD M4180 - Other forms of scoliosis, site unspecified | 18.75 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| SENTARA OBICI HOSPITAL | 2800 GODWIN BLVD | SUFFOLK | VA | 23434 | 81 |
| UCSF MEDICAL CENTER | 505 PARNASSUS AVE | SAN FRANCISCO | CA | 94143 | 67 |
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 62 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. BRYAN ALAN FOX | 100 WIMBLEDON SQ | CHESAPEAKE | VA | 23320 | 80 |
| Dr. THOMAS R HIGHLAND | 1 S KEENE ST | COLUMBIA | MO | 65201 | 18 |
| Dr. JEFFREY E DECKEY | 280 S MAIN ST | ORANGE | CA | 92868 | 18 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. BRYAN ALAN FOX | 100 WIMBLEDON SQ | CHESAPEAKE | VA | 23320 | 80 |
| Dr. THOMAS R HIGHLAND | 1 S KEENE ST | COLUMBIA | MO | 65201 | 20 |
| Dr. JEFFREY E DECKEY | 280 S MAIN ST | ORANGE | CA | 92868 | 18 |