*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M5386 - Other specified dorsopathies, lumbar region - as a primary diagnosis code | M5386 - Other specified dorsopathies, lumbar region - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 4.29 | |
| Readmission Rate (%) | 14.57 | |
| Unplanned Readmission Rate (%) | 10.62 | |
| 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 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 519: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|
| Total Hospitalizations at DRG | 30,062 | |||
| Total Hospitalizations with ICD M5386 - Other specified dorsopathies, lumbar region | 33 | |||
| DRG Share of Total Hospitalizations | 0.09 | |||
| % of Total ICD M5386 - Other specified dorsopathies, lumbar region in DRG | 28.95 | |||
| Avg LOS at DRG | 2.14 | |||
| Avg LOS with ICD M5386 - Other specified dorsopathies, lumbar region | 1.06 | |||
| Readmission Rate at DRG | 11.6 | |||
| Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | |||
| Unplanned Readmission Rate at DRG | 3.9 | |||
| Unplanned Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | |||
| Total Medicare payments at DRG | $199,571,619 | |||
| Total Medicare payments with ICD M5386 - Other specified dorsopathies, lumbar region | $231,586 | |||
| Total Medicare payment per Day at DRG | $3,102 | |||
| Total Medicare payment per Day with ICD M5386 - Other specified dorsopathies, lumbar region | $6,617 | |||
| Total Medicare payment per Hospitalization at DRG | $6,639 | |||
| Total Medicare payment per Hospitalization with ICD M5386 - Other specified dorsopathies, lumbar region | $7,018 | |||
| Total Medicare Charges at DRG | $1,429,977,155 | |||
| Total Medicare Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $1,253,011 | |||
| Avg Charges at DRG | $47,568 | |||
| Avg Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $37,970 | |||
| Mortality Rate at DRG | NA | |||
| Mortality Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | |||
| SNF Discharge Rate at DRG | 8.82 | |||
| SNF Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | |||
| Home Discharge Rate at DRG | 68.77 | |||
| Home Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | 87.88 |
*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 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION 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 455: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITHOUT COMPLICATION OR COMORBIDITY (CC)/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 M5386 - Other specified dorsopathies, lumbar region | 454 | ||||
| DRG Share of Total Hospitalizations | 0.66 | ||||
| % of Total ICD M5386 - Other specified dorsopathies, lumbar region in DRG | 32.27 | ||||
| Avg LOS at DRG | 3.28 | ||||
| Avg LOS with ICD M5386 - Other specified dorsopathies, lumbar region | 3.08 | ||||
| Readmission Rate at DRG | 16.7 | ||||
| Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | 12.9 | ||||
| Unplanned Readmission Rate at DRG | 4.47 | ||||
| Unplanned Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | 3.62 | ||||
| Total Medicare payments at DRG | $5,278,830,730 | ||||
| Total Medicare payments with ICD M5386 - Other specified dorsopathies, lumbar region | $11,616,092 | ||||
| Total Medicare payment per Day at DRG | $7,462 | ||||
| Total Medicare payment per Day with ICD M5386 - Other specified dorsopathies, lumbar region | $8,315 | ||||
| Total Medicare payment per Hospitalization at DRG | $24,512 | ||||
| Total Medicare payment per Hospitalization with ICD M5386 - Other specified dorsopathies, lumbar region | $25,586 | ||||
| Total Medicare Charges at DRG | $25,567,888,167 | ||||
| Total Medicare Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $51,839,685 | ||||
| Avg Charges at DRG | $118,724 | ||||
| Avg Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $114,184 | ||||
| Mortality Rate at DRG | 0.03 | ||||
| Mortality Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| SNF Discharge Rate at DRG | 15.71 | ||||
| SNF Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | 11.23 | ||||
| Home Discharge Rate at DRG | 51.89 | ||||
| Home Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | 59.47 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 454: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 459: SPINAL FUSION EXCEPT CERVICAL WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 518: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR DISC DEVICE OR NEUROSTIMULATOR | DRG 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 30,121 | ||||
| Total Hospitalizations with ICD M5386 - Other specified dorsopathies, lumbar region | 62 | ||||
| DRG Share of Total Hospitalizations | 0.09 | ||||
| % of Total ICD M5386 - Other specified dorsopathies, lumbar region in DRG | 4.41 | ||||
| Avg LOS at DRG | 4.83 | ||||
| Avg LOS with ICD M5386 - Other specified dorsopathies, lumbar region | 4.1 | ||||
| Readmission Rate at DRG | 25.27 | ||||
| Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| Unplanned Readmission Rate at DRG | 5.39 | ||||
| Unplanned Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| Total Medicare payments at DRG | $1,452,399,208 | ||||
| Total Medicare payments with ICD M5386 - Other specified dorsopathies, lumbar region | $2,603,300 | ||||
| Total Medicare payment per Day at DRG | $9,984 | ||||
| Total Medicare payment per Day with ICD M5386 - Other specified dorsopathies, lumbar region | $10,249 | ||||
| Total Medicare payment per Hospitalization at DRG | $48,219 | ||||
| Total Medicare payment per Hospitalization with ICD M5386 - Other specified dorsopathies, lumbar region | $41,989 | ||||
| Total Medicare Charges at DRG | $6,527,772,651 | ||||
| Total Medicare Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $10,817,057 | ||||
| Avg Charges at DRG | $216,718 | ||||
| Avg Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $174,469 | ||||
| Mortality Rate at DRG | 0.06 | ||||
| Mortality Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| SNF Discharge Rate at DRG | 21.6 | ||||
| SNF Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| Home Discharge Rate at DRG | 38.16 | ||||
| Home Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | 48.39 |
*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 551: MEDICAL BACK PROBLEMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | 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) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 188,863 | ||||
| Total Hospitalizations with ICD M5386 - Other specified dorsopathies, lumbar region | 18 | ||||
| DRG Share of Total Hospitalizations | 0.57 | ||||
| % of Total ICD M5386 - Other specified dorsopathies, lumbar region in DRG | 1.28 | ||||
| Avg LOS at DRG | 11.75 | ||||
| Avg LOS with ICD M5386 - Other specified dorsopathies, lumbar region | 12.56 | ||||
| Readmission Rate at DRG | 12.14 | ||||
| Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| Unplanned Readmission Rate at DRG | 7.97 | ||||
| Unplanned Readmission Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| Total Medicare payments at DRG | $3,216,901,374 | ||||
| Total Medicare payments with ICD M5386 - Other specified dorsopathies, lumbar region | $345,534 | ||||
| Total Medicare payment per Day at DRG | $1,450 | ||||
| Total Medicare payment per Day with ICD M5386 - Other specified dorsopathies, lumbar region | $1,529 | ||||
| Total Medicare payment per Hospitalization at DRG | $17,033 | ||||
| Total Medicare payment per Hospitalization with ICD M5386 - Other specified dorsopathies, lumbar region | $19,196 | ||||
| Total Medicare Charges at DRG | $7,709,712,645 | ||||
| Total Medicare Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $521,649 | ||||
| Avg Charges at DRG | $40,822 | ||||
| Avg Charges with ICD M5386 - Other specified dorsopathies, lumbar region | $28,981 | ||||
| Mortality Rate at DRG | 0.11 | ||||
| Mortality Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| SNF Discharge Rate at DRG | 19.54 | ||||
| SNF Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA | ||||
| Home Discharge Rate at DRG | 19.47 | ||||
| Home Discharge Rate with ICD M5386 - Other specified dorsopathies, lumbar region | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| OKLAHOMA SPINE HOSPITAL | 14101 PARKWAY COMMONS DR | OKLAHOMA CITY | OK | 73134 | 40 |
| MARIN GENERAL HOSPITAL | 250 BON AIR RD | GREENBRAE | CA | 94904 | 31 |
| HOAG ORTHOPEDIC INSTITUTE | 16250 SAND CANYON AVENUE | IRVINE | CA | 92618 | 25 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ROBERT H. BYERS | 2 BON AIR RD | LARKSPUR | CA | 94939 | 16 |
| Dr. MICHAEL PAUL WEINSTEIN | 360 SAN MIGUEL DR | NEWPORT BEACH | CA | 92660 | 14 |
| Dr. BRIAN SU | 2 BON AIR RD | LARKSPUR | CA | 94939 | 13 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ROBERT H. BYERS | 2 BON AIR RD | LARKSPUR | CA | 94939 | 15 |
| Dr. BRIAN SU | 2 BON AIR RD | LARKSPUR | CA | 94939 | 14 |
| Dr. MICHAEL PAUL WEINSTEIN | 360 SAN MIGUEL DR | NEWPORT BEACH | CA | 92660 | 14 |