*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M4800 - Spinal stenosis, site unspecified - as a primary diagnosis code | M4800 - Spinal stenosis, site unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.46 | |
| Readmission Rate (%) | 21.37 | |
| Unplanned Readmission Rate (%) | 10.42 | |
| 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 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 551: MEDICAL BACK PROBLEMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 195,476 | ||||
| Total Hospitalizations with ICD M4800 - Spinal stenosis, site unspecified | 856 | ||||
| DRG Share of Total Hospitalizations | 0.59 | ||||
| % of Total ICD M4800 - Spinal stenosis, site unspecified in DRG | 68.43 | ||||
| Avg LOS at DRG | 4.48 | ||||
| Avg LOS with ICD M4800 - Spinal stenosis, site unspecified | 5.21 | ||||
| Readmission Rate at DRG | 20.57 | ||||
| Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 20.78 | ||||
| Unplanned Readmission Rate at DRG | 9.88 | ||||
| Unplanned Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 10.83 | ||||
| Total Medicare payments at DRG | $1,320,662,237 | ||||
| Total Medicare payments with ICD M4800 - Spinal stenosis, site unspecified | $6,716,531 | ||||
| Total Medicare payment per Day at DRG | $1,508 | ||||
| Total Medicare payment per Day with ICD M4800 - Spinal stenosis, site unspecified | $1,507 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,756 | ||||
| Total Medicare payment per Hospitalization with ICD M4800 - Spinal stenosis, site unspecified | $7,846 | ||||
| Total Medicare Charges at DRG | $6,024,639,461 | ||||
| Total Medicare Charges with ICD M4800 - Spinal stenosis, site unspecified | $24,722,279 | ||||
| Avg Charges at DRG | $30,820 | ||||
| Avg Charges with ICD M4800 - Spinal stenosis, site unspecified | $28,881 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD M4800 - Spinal stenosis, site unspecified | NA | ||||
| SNF Discharge Rate at DRG | 33.36 | ||||
| SNF Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 30.96 | ||||
| Home Discharge Rate at DRG | 30.98 | ||||
| Home Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 27.57 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 459: SPINAL FUSION EXCEPT CERVICAL WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 16,812 |
| Total Hospitalizations with ICD M4800 - Spinal stenosis, site unspecified | 13 |
| DRG Share of Total Hospitalizations | 0.05 |
| % of Total ICD M4800 - Spinal stenosis, site unspecified in DRG | 1.04 |
| Avg LOS at DRG | 7.66 |
| Avg LOS with ICD M4800 - Spinal stenosis, site unspecified | 4.62 |
| Readmission Rate at DRG | 36.82 |
| Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | NA |
| Unplanned Readmission Rate at DRG | 8.15 |
| Unplanned Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | NA |
| Total Medicare payments at DRG | $685,730,928 |
| Total Medicare payments with ICD M4800 - Spinal stenosis, site unspecified | $508,043 |
| Total Medicare payment per Day at DRG | $5,325 |
| Total Medicare payment per Day with ICD M4800 - Spinal stenosis, site unspecified | $8,467 |
| Total Medicare payment per Hospitalization at DRG | $40,788 |
| Total Medicare payment per Hospitalization with ICD M4800 - Spinal stenosis, site unspecified | $39,080 |
| Total Medicare Charges at DRG | $3,152,175,405 |
| Total Medicare Charges with ICD M4800 - Spinal stenosis, site unspecified | $1,823,942 |
| Avg Charges at DRG | $187,496 |
| Avg Charges with ICD M4800 - Spinal stenosis, site unspecified | $140,303 |
| Mortality Rate at DRG | 2.12 |
| Mortality Rate with ICD M4800 - Spinal stenosis, site unspecified | NA |
| SNF Discharge Rate at DRG | 31.97 |
| SNF Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | NA |
| Home Discharge Rate at DRG | 20.62 |
| Home Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ENCOMPASS HEALTH REHABILITATION HOSPITAL OF TOMS RIVER | 14 HOSPITAL DR | TOMS RIVER | NJ | 08755 | 19 |
*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 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD M4800 - Spinal stenosis, site unspecified | 10,617 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD M4800 - Spinal stenosis, site unspecified in DRG | 5.39 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD M4800 - Spinal stenosis, site unspecified | 6.2 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 23.42 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 16.77 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD M4800 - Spinal stenosis, site unspecified | $124,201,523 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD M4800 - Spinal stenosis, site unspecified | $1,887 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD M4800 - Spinal stenosis, site unspecified | $11,698 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD M4800 - Spinal stenosis, site unspecified | $596,764,522 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD M4800 - Spinal stenosis, site unspecified | $56,208 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD M4800 - Spinal stenosis, site unspecified | 9.29 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 33.81 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 21.63 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 522,791 | ||||
| Total Hospitalizations with ICD M4800 - Spinal stenosis, site unspecified | 3,659 | ||||
| DRG Share of Total Hospitalizations | 1.59 | ||||
| % of Total ICD M4800 - Spinal stenosis, site unspecified in DRG | 1.86 | ||||
| Avg LOS at DRG | 3.14 | ||||
| Avg LOS with ICD M4800 - Spinal stenosis, site unspecified | 3.34 | ||||
| Readmission Rate at DRG | 17.1 | ||||
| Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 17.66 | ||||
| Unplanned Readmission Rate at DRG | 12.62 | ||||
| Unplanned Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 13.49 | ||||
| Total Medicare payments at DRG | $2,290,151,156 | ||||
| Total Medicare payments with ICD M4800 - Spinal stenosis, site unspecified | $16,334,142 | ||||
| Total Medicare payment per Day at DRG | $1,394 | ||||
| Total Medicare payment per Day with ICD M4800 - Spinal stenosis, site unspecified | $1,336 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,381 | ||||
| Total Medicare payment per Hospitalization with ICD M4800 - Spinal stenosis, site unspecified | $4,464 | ||||
| Total Medicare Charges at DRG | $13,619,287,561 | ||||
| Total Medicare Charges with ICD M4800 - Spinal stenosis, site unspecified | $102,498,271 | ||||
| Avg Charges at DRG | $26,051 | ||||
| Avg Charges with ICD M4800 - Spinal stenosis, site unspecified | $28,013 | ||||
| Mortality Rate at DRG | 0.18 | ||||
| Mortality Rate with ICD M4800 - Spinal stenosis, site unspecified | NA | ||||
| SNF Discharge Rate at DRG | 8.57 | ||||
| SNF Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 14.59 | ||||
| Home Discharge Rate at DRG | 72.49 | ||||
| Home Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 61.63 |
*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 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 408,103 | ||||
| Total Hospitalizations with ICD M4800 - Spinal stenosis, site unspecified | 2,872 | ||||
| DRG Share of Total Hospitalizations | 1.24 | ||||
| % of Total ICD M4800 - Spinal stenosis, site unspecified in DRG | 1.46 | ||||
| Avg LOS at DRG | 3.52 | ||||
| Avg LOS with ICD M4800 - Spinal stenosis, site unspecified | 3.64 | ||||
| Readmission Rate at DRG | 17.83 | ||||
| Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 16.03 | ||||
| Unplanned Readmission Rate at DRG | 13.81 | ||||
| Unplanned Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 12.5 | ||||
| Total Medicare payments at DRG | $2,416,862,532 | ||||
| Total Medicare payments with ICD M4800 - Spinal stenosis, site unspecified | $17,331,254 | ||||
| Total Medicare payment per Day at DRG | $1,682 | ||||
| Total Medicare payment per Day with ICD M4800 - Spinal stenosis, site unspecified | $1,660 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,922 | ||||
| Total Medicare payment per Hospitalization with ICD M4800 - Spinal stenosis, site unspecified | $6,035 | ||||
| Total Medicare Charges at DRG | $13,267,744,847 | ||||
| Total Medicare Charges with ICD M4800 - Spinal stenosis, site unspecified | $96,398,312 | ||||
| Avg Charges at DRG | $32,511 | ||||
| Avg Charges with ICD M4800 - Spinal stenosis, site unspecified | $33,565 | ||||
| Mortality Rate at DRG | 0.72 | ||||
| Mortality Rate with ICD M4800 - Spinal stenosis, site unspecified | 0.59 | ||||
| SNF Discharge Rate at DRG | 14.1 | ||||
| SNF Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 18.84 | ||||
| Home Discharge Rate at DRG | 62.97 | ||||
| Home Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 54.53 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 443,386 | ||||
| Total Hospitalizations with ICD M4800 - Spinal stenosis, site unspecified | 2,727 | ||||
| DRG Share of Total Hospitalizations | 1.35 | ||||
| % of Total ICD M4800 - Spinal stenosis, site unspecified in DRG | 1.38 | ||||
| Avg LOS at DRG | 5.27 | ||||
| Avg LOS with ICD M4800 - Spinal stenosis, site unspecified | 5.53 | ||||
| Readmission Rate at DRG | 21.6 | ||||
| Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 21.04 | ||||
| Unplanned Readmission Rate at DRG | 15.91 | ||||
| Unplanned Readmission Rate with ICD M4800 - Spinal stenosis, site unspecified | 15.32 | ||||
| Total Medicare payments at DRG | $3,812,834,208 | ||||
| Total Medicare payments with ICD M4800 - Spinal stenosis, site unspecified | $23,878,200 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD M4800 - Spinal stenosis, site unspecified | $1,582 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
| Total Medicare payment per Hospitalization with ICD M4800 - Spinal stenosis, site unspecified | $8,756 | ||||
| Total Medicare Charges at DRG | $18,110,468,211 | ||||
| Total Medicare Charges with ICD M4800 - Spinal stenosis, site unspecified | $115,666,407 | ||||
| Avg Charges at DRG | $40,846 | ||||
| Avg Charges with ICD M4800 - Spinal stenosis, site unspecified | $42,415 | ||||
| Mortality Rate at DRG | 3.59 | ||||
| Mortality Rate with ICD M4800 - Spinal stenosis, site unspecified | 3.96 | ||||
| SNF Discharge Rate at DRG | 22.57 | ||||
| SNF Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 31.06 | ||||
| Home Discharge Rate at DRG | 40.95 | ||||
| Home Discharge Rate with ICD M4800 - Spinal stenosis, site unspecified | 29.7 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MORRISTOWN MEDICAL CENTER | 100 MADISON AVE | MORRISTOWN | NJ | 07960 | 1,034 |
| ST. FRANCIS HOSPITAL ROSLYN | 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 947 |
| VALLEY HOSPITAL | 223 N VAN DIEN AVE | RIDGEWOOD | NJ | 07450 | 868 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ROBERT GOLDMAN | 160 HANOVER AVENUE | MORRISTOWN | NJ | 07962 | 82 |
| Dr. RICHARD DAVID HEEKIN | 2 SHIRCLIFF WAY | JACKSONVILLE | FL | 32204 | 81 |
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 80 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RUBEN DE LOS SANTOS | 1955 EAST MAIN ST | EAGLE PASS | TX | 78852 | 676 |
| Dr. MUHAMMAD MAHMOOD ALAM | 1019 E WATER ST | ELMIRA | NY | 14901 | 95 |
| Dr. PADMASHREE S. ADUSUMILLI | 14 HOSPITAL DR | TOMS RIVER | NJ | 08755 | 92 |