*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder - as a primary diagnosis code | M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.17 | |
| Readmission Rate (%) | 21.11 | |
| Unplanned Readmission Rate (%) | 7.39 | |
| 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 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 551: MEDICAL BACK PROBLEMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|
| Total Hospitalizations at DRG | 195,476 | ||
| Total Hospitalizations with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 105 | ||
| DRG Share of Total Hospitalizations | 0.59 | ||
| % of Total ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder in DRG | 56.15 | ||
| Avg LOS at DRG | 4.48 | ||
| Avg LOS with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 4.52 | ||
| Readmission Rate at DRG | 20.57 | ||
| Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 18.0 | ||
| Unplanned Readmission Rate at DRG | 9.88 | ||
| Unplanned Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | NA | ||
| Total Medicare payments at DRG | $1,320,662,237 | ||
| Total Medicare payments with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $720,234 | ||
| Total Medicare payment per Day at DRG | $1,508 | ||
| Total Medicare payment per Day with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $1,516 | ||
| Total Medicare payment per Hospitalization at DRG | $6,756 | ||
| Total Medicare payment per Hospitalization with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $6,859 | ||
| Total Medicare Charges at DRG | $6,024,639,461 | ||
| Total Medicare Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $2,914,091 | ||
| Avg Charges at DRG | $30,820 | ||
| Avg Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $27,753 | ||
| Mortality Rate at DRG | 0.24 | ||
| Mortality Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | NA | ||
| SNF Discharge Rate at DRG | 33.36 | ||
| SNF Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 22.86 | ||
| Home Discharge Rate at DRG | 30.98 | ||
| Home Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 44.76 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 885: PSYCHOSES | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 895: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | DRG 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY 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 | 1,100,860 | ||||
| Total Hospitalizations with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 2,262 | ||||
| DRG Share of Total Hospitalizations | 3.35 | ||||
| % of Total ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder in DRG | 14.2 | ||||
| Avg LOS at DRG | 11.86 | ||||
| Avg LOS with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 10.98 | ||||
| Readmission Rate at DRG | 27.58 | ||||
| Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 25.66 | ||||
| Unplanned Readmission Rate at DRG | 13.34 | ||||
| Unplanned Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 9.77 | ||||
| Total Medicare payments at DRG | $9,312,828,663 | ||||
| Total Medicare payments with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $16,989,823 | ||||
| Total Medicare payment per Day at DRG | $713 | ||||
| Total Medicare payment per Day with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $684 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,460 | ||||
| Total Medicare payment per Hospitalization with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $7,511 | ||||
| Total Medicare Charges at DRG | $32,341,464,302 | ||||
| Total Medicare Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $49,560,937 | ||||
| Avg Charges at DRG | $29,378 | ||||
| Avg Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $21,910 | ||||
| Mortality Rate at DRG | 0.04 | ||||
| Mortality Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | NA | ||||
| SNF Discharge Rate at DRG | 5.83 | ||||
| SNF Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 2.03 | ||||
| Home Discharge Rate at DRG | 79.47 | ||||
| Home Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 87.53 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 195,476 | ||||
| Total Hospitalizations with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 388 | ||||
| DRG Share of Total Hospitalizations | 0.59 | ||||
| % of Total ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder in DRG | 2.44 | ||||
| Avg LOS at DRG | 4.48 | ||||
| Avg LOS with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 4.55 | ||||
| Readmission Rate at DRG | 20.57 | ||||
| Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 19.41 | ||||
| Unplanned Readmission Rate at DRG | 9.88 | ||||
| Unplanned Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 8.09 | ||||
| Total Medicare payments at DRG | $1,320,662,237 | ||||
| Total Medicare payments with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $2,608,593 | ||||
| Total Medicare payment per Day at DRG | $1,508 | ||||
| Total Medicare payment per Day with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $1,477 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,756 | ||||
| Total Medicare payment per Hospitalization with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $6,723 | ||||
| Total Medicare Charges at DRG | $6,024,639,461 | ||||
| Total Medicare Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $11,889,627 | ||||
| Avg Charges at DRG | $30,820 | ||||
| Avg Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $30,643 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | NA | ||||
| SNF Discharge Rate at DRG | 33.36 | ||||
| SNF Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 23.71 | ||||
| Home Discharge Rate at DRG | 30.98 | ||||
| Home Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 42.27 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 474,314 | ||||
| Total Hospitalizations with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 233 | ||||
| DRG Share of Total Hospitalizations | 1.44 | ||||
| % of Total ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder in DRG | 1.46 | ||||
| Avg LOS at DRG | 3.53 | ||||
| Avg LOS with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 4.13 | ||||
| Readmission Rate at DRG | 18.03 | ||||
| Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 15.98 | ||||
| Unplanned Readmission Rate at DRG | 12.55 | ||||
| Unplanned Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 7.31 | ||||
| Total Medicare payments at DRG | $2,312,733,090 | ||||
| Total Medicare payments with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $1,129,706 | ||||
| Total Medicare payment per Day at DRG | $1,380 | ||||
| Total Medicare payment per Day with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $1,174 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,876 | ||||
| Total Medicare payment per Hospitalization with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $4,849 | ||||
| Total Medicare Charges at DRG | $11,559,952,314 | ||||
| Total Medicare Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $6,476,410 | ||||
| Avg Charges at DRG | $24,372 | ||||
| Avg Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $27,796 | ||||
| Mortality Rate at DRG | 0.22 | ||||
| Mortality Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | NA | ||||
| SNF Discharge Rate at DRG | 25.96 | ||||
| SNF Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 24.89 | ||||
| Home Discharge Rate at DRG | 43.58 | ||||
| Home Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 45.06 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH 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) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 364,421 | ||||
| Total Hospitalizations with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 174 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder in DRG | 1.09 | ||||
| Avg LOS at DRG | 3.97 | ||||
| Avg LOS with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 4.38 | ||||
| Readmission Rate at DRG | 16.14 | ||||
| Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 15.06 | ||||
| Unplanned Readmission Rate at DRG | 10.98 | ||||
| Unplanned Readmission Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 9.64 | ||||
| Total Medicare payments at DRG | $1,924,528,848 | ||||
| Total Medicare payments with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $949,096 | ||||
| Total Medicare payment per Day at DRG | $1,332 | ||||
| Total Medicare payment per Day with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $1,246 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,281 | ||||
| Total Medicare payment per Hospitalization with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $5,455 | ||||
| Total Medicare Charges at DRG | $8,912,106,420 | ||||
| Total Medicare Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $4,125,953 | ||||
| Avg Charges at DRG | $24,456 | ||||
| Avg Charges with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | $23,712 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | NA | ||||
| SNF Discharge Rate at DRG | 15.72 | ||||
| SNF Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 10.92 | ||||
| Home Discharge Rate at DRG | 53.33 | ||||
| Home Discharge Rate with ICD M519 - Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder | 63.79 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| TURNING POINT HOSPITAL | 3015 VETERANS PKWY S | MOULTRIE | GA | 31788 | 274 |
| WINDMOOR HEALTHCARE OF CLEARWATER | 11300 US 19 N | CLEARWATER | FL | 33764 | 232 |
| BUCHANAN GENERAL HOSPITAL | 1535 SLATE CREEK RD | GRUNDY | VA | 24614 | 207 |
| 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 | 203 |
| Dr. FRANCIS KEVIN BUTLER | 2753 STATE ROAD 580 | CLEARWATER | FL | 33761 | 144 |
| Dr. DAVID MARK GORDON | 28455 HAGGERTY RD | NOVI | MI | 48377 | 54 |
| 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 | 258 |
| Dr. JASHUBHAI G PATEL | 1520 SLATE CREEK RD | GRUNDY | VA | 24614 | 171 |
| Dr. FRANCIS KEVIN BUTLER | 2753 STATE ROAD 580 | CLEARWATER | FL | 33761 | 166 |