*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M769 - Unspecified enthesopathy, lower limb, excluding foot - as a primary diagnosis code | M769 - Unspecified enthesopathy, lower limb, excluding foot - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 4.84 | |
| Readmission Rate (%) | 14.6 | |
| Unplanned Readmission Rate (%) | NA | |
| 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 558: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 39,224 |
| Total Hospitalizations with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 49 |
| DRG Share of Total Hospitalizations | 0.12 |
| % of Total ICD M769 - Unspecified enthesopathy, lower limb, excluding foot in DRG | 71.01 |
| Avg LOS at DRG | 4.42 |
| Avg LOS with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 3.49 |
| Readmission Rate at DRG | 18.22 |
| Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA |
| Unplanned Readmission Rate at DRG | 9.29 |
| Unplanned Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA |
| Total Medicare payments at DRG | $239,468,231 |
| Total Medicare payments with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $241,983 |
| Total Medicare payment per Day at DRG | $1,381 |
| Total Medicare payment per Day with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $1,415 |
| Total Medicare payment per Hospitalization at DRG | $6,105 |
| Total Medicare payment per Hospitalization with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $4,938 |
| Total Medicare Charges at DRG | $1,104,766,925 |
| Total Medicare Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $1,119,416 |
| Avg Charges at DRG | $28,166 |
| Avg Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $22,845 |
| Mortality Rate at DRG | 0.2 |
| Mortality Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA |
| SNF Discharge Rate at DRG | 32.92 |
| SNF Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 32.65 |
| Home Discharge Rate at DRG | 33.95 |
| Home Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 32.65 |
*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 558: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT 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 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,522,684 | ||||
| Total Hospitalizations with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 442 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD M769 - Unspecified enthesopathy, lower limb, excluding foot in DRG | 30.82 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 2.35 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 7.21 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $5,129,704 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $4,932 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $11,606 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $28,232,094 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $63,874 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 17.42 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 30.32 |
*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 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 474,314 | ||||
| Total Hospitalizations with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 20 | ||||
| DRG Share of Total Hospitalizations | 1.44 | ||||
| % of Total ICD M769 - Unspecified enthesopathy, lower limb, excluding foot in DRG | 1.39 | ||||
| Avg LOS at DRG | 3.53 | ||||
| Avg LOS with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 3.55 | ||||
| Readmission Rate at DRG | 18.03 | ||||
| Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Unplanned Readmission Rate at DRG | 12.55 | ||||
| Unplanned Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Total Medicare payments at DRG | $2,312,733,090 | ||||
| Total Medicare payments with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $100,594 | ||||
| Total Medicare payment per Day at DRG | $1,380 | ||||
| Total Medicare payment per Day with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $1,417 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,876 | ||||
| Total Medicare payment per Hospitalization with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $5,030 | ||||
| Total Medicare Charges at DRG | $11,559,952,314 | ||||
| Total Medicare Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $553,981 | ||||
| Avg Charges at DRG | $24,372 | ||||
| Avg Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $27,699 | ||||
| Mortality Rate at DRG | 0.22 | ||||
| Mortality Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| SNF Discharge Rate at DRG | 25.96 | ||||
| SNF Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Home Discharge Rate at DRG | 43.58 | ||||
| Home Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA |
*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 469: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 408,103 | ||||
| Total Hospitalizations with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 15 | ||||
| DRG Share of Total Hospitalizations | 1.24 | ||||
| % of Total ICD M769 - Unspecified enthesopathy, lower limb, excluding foot in DRG | 1.05 | ||||
| Avg LOS at DRG | 3.52 | ||||
| Avg LOS with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 3.6 | ||||
| Readmission Rate at DRG | 17.83 | ||||
| Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Unplanned Readmission Rate at DRG | 13.81 | ||||
| Unplanned Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Total Medicare payments at DRG | $2,416,862,532 | ||||
| Total Medicare payments with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $75,667 | ||||
| Total Medicare payment per Day at DRG | $1,682 | ||||
| Total Medicare payment per Day with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $1,401 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,922 | ||||
| Total Medicare payment per Hospitalization with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $5,044 | ||||
| Total Medicare Charges at DRG | $13,267,744,847 | ||||
| Total Medicare Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $380,601 | ||||
| Avg Charges at DRG | $32,511 | ||||
| Avg Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $25,373 | ||||
| Mortality Rate at DRG | 0.72 | ||||
| Mortality Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| SNF Discharge Rate at DRG | 14.1 | ||||
| SNF Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Home Discharge Rate at DRG | 62.97 | ||||
| Home Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 537: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 434,264 | ||||
| Total Hospitalizations with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 12 | ||||
| DRG Share of Total Hospitalizations | 1.32 | ||||
| % of Total ICD M769 - Unspecified enthesopathy, lower limb, excluding foot in DRG | 0.84 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | 5.08 | ||||
| Readmission Rate at DRG | 22.76 | ||||
| Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Unplanned Readmission Rate at DRG | 16.46 | ||||
| Unplanned Readmission Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Total Medicare payments at DRG | $2,472,138,198 | ||||
| Total Medicare payments with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $77,022 | ||||
| Total Medicare payment per Day at DRG | $1,444 | ||||
| Total Medicare payment per Day with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $1,263 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,693 | ||||
| Total Medicare payment per Hospitalization with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $6,419 | ||||
| Total Medicare Charges at DRG | $12,478,361,060 | ||||
| Total Medicare Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $508,400 | ||||
| Avg Charges at DRG | $28,735 | ||||
| Avg Charges with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | $42,367 | ||||
| Mortality Rate at DRG | 0.91 | ||||
| Mortality Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| SNF Discharge Rate at DRG | 22.02 | ||||
| SNF Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA | ||||
| Home Discharge Rate at DRG | 46.68 | ||||
| Home Discharge Rate with ICD M769 - Unspecified enthesopathy, lower limb, excluding foot | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ST. JOSEPH HOSPITAL | 2700 DOLBEER ST | EUREKA | CA | 95501 | 24 |
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 17 |
| BON SECOURS ST. MARY'S HOSPITAL | 5801 BREMO RD | RICHMOND | VA | 23226 | 14 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. WILLIIAM B. KILGORE | 2826 HARRIS ST | EUREKA | CA | 95503 | 23 |
| Dr. MARK DOUGLAS SUPROCK | 10030 GILEAD RD | HUNTERSVILLE | NC | 28078 | 14 |
| Dr. PETER BRODIE WOOD | 615 LILLY RD NE | OLYMPIA | WA | 98506 | 11 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. WILLIIAM B. KILGORE | 2826 HARRIS ST | EUREKA | CA | 95503 | 23 |
| Dr. MARK DOUGLAS SUPROCK | 10030 GILEAD RD | HUNTERSVILLE | NC | 28078 | 14 |
| Dr. PETER BRODIE WOOD | 615 LILLY RD NE | OLYMPIA | WA | 98506 | 11 |