*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M797 - Fibromyalgia - as a primary diagnosis code | M797 - Fibromyalgia - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 4.94 | |
| Readmission Rate (%) | 20.53 | |
| Unplanned Readmission Rate (%) | 13.1 | |
| 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 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 555: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 43,543 | |
| Total Hospitalizations with ICD M797 - Fibromyalgia | 700 | |
| DRG Share of Total Hospitalizations | 0.13 | |
| % of Total ICD M797 - Fibromyalgia in DRG | 83.93 | |
| Avg LOS at DRG | 4.54 | |
| Avg LOS with ICD M797 - Fibromyalgia | 3.58 | |
| Readmission Rate at DRG | 18.05 | |
| Readmission Rate with ICD M797 - Fibromyalgia | 16.09 | |
| Unplanned Readmission Rate at DRG | 10.73 | |
| Unplanned Readmission Rate with ICD M797 - Fibromyalgia | 11.73 | |
| Total Medicare payments at DRG | $293,427,765 | |
| Total Medicare payments with ICD M797 - Fibromyalgia | $3,692,989 | |
| Total Medicare payment per Day at DRG | $1,485 | |
| Total Medicare payment per Day with ICD M797 - Fibromyalgia | $1,474 | |
| Total Medicare payment per Hospitalization at DRG | $6,739 | |
| Total Medicare payment per Hospitalization with ICD M797 - Fibromyalgia | $5,276 | |
| Total Medicare Charges at DRG | $1,161,067,318 | |
| Total Medicare Charges with ICD M797 - Fibromyalgia | $22,033,967 | |
| Avg Charges at DRG | $26,665 | |
| Avg Charges with ICD M797 - Fibromyalgia | $31,477 | |
| Mortality Rate at DRG | 0.19 | |
| Mortality Rate with ICD M797 - Fibromyalgia | NA | |
| SNF Discharge Rate at DRG | 27.91 | |
| SNF Discharge Rate with ICD M797 - Fibromyalgia | 13.71 | |
| Home Discharge Rate at DRG | 35.39 | |
| Home Discharge Rate with ICD M797 - Fibromyalgia | 61.43 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 15 |
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 11 |
| NEW YORK-PRESBYTERIAN BROOKLYN METHODIST HOSPITAL | 506 6TH ST | BROOKLYN | NY | 11215 | 11 |
*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 885: PSYCHOSES | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH 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) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,522,684 | ||||
| Total Hospitalizations with ICD M797 - Fibromyalgia | 37,707 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD M797 - Fibromyalgia in DRG | 6.22 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD M797 - Fibromyalgia | 2.56 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD M797 - Fibromyalgia | 9.16 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD M797 - Fibromyalgia | 3.55 | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD M797 - Fibromyalgia | $427,788,619 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD M797 - Fibromyalgia | $4,440 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD M797 - Fibromyalgia | $11,345 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD M797 - Fibromyalgia | $2,250,508,595 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD M797 - Fibromyalgia | $59,684 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD M797 - Fibromyalgia | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD M797 - Fibromyalgia | 25.08 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD M797 - Fibromyalgia | 28.98 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS 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 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 539,642 | ||||
| Total Hospitalizations with ICD M797 - Fibromyalgia | 10,921 | ||||
| DRG Share of Total Hospitalizations | 1.64 | ||||
| % of Total ICD M797 - Fibromyalgia in DRG | 1.8 | ||||
| Avg LOS at DRG | 6.42 | ||||
| Avg LOS with ICD M797 - Fibromyalgia | 5.4 | ||||
| Readmission Rate at DRG | 26.55 | ||||
| Readmission Rate with ICD M797 - Fibromyalgia | 26.43 | ||||
| Unplanned Readmission Rate at DRG | 20.01 | ||||
| Unplanned Readmission Rate with ICD M797 - Fibromyalgia | 20.67 | ||||
| Total Medicare payments at DRG | $5,267,842,463 | ||||
| Total Medicare payments with ICD M797 - Fibromyalgia | $93,528,350 | ||||
| Total Medicare payment per Day at DRG | $1,520 | ||||
| Total Medicare payment per Day with ICD M797 - Fibromyalgia | $1,587 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,762 | ||||
| Total Medicare payment per Hospitalization with ICD M797 - Fibromyalgia | $8,564 | ||||
| Total Medicare Charges at DRG | $25,503,568,329 | ||||
| Total Medicare Charges with ICD M797 - Fibromyalgia | $443,701,997 | ||||
| Avg Charges at DRG | $47,260 | ||||
| Avg Charges with ICD M797 - Fibromyalgia | $40,628 | ||||
| Mortality Rate at DRG | 5.62 | ||||
| Mortality Rate with ICD M797 - Fibromyalgia | 2.17 | ||||
| SNF Discharge Rate at DRG | 19.26 | ||||
| SNF Discharge Rate with ICD M797 - Fibromyalgia | 16.43 | ||||
| Home Discharge Rate at DRG | 39.65 | ||||
| Home Discharge Rate with ICD M797 - Fibromyalgia | 47.18 |
*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 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 364,421 | ||||
| Total Hospitalizations with ICD M797 - Fibromyalgia | 8,869 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD M797 - Fibromyalgia in DRG | 1.46 | ||||
| Avg LOS at DRG | 3.97 | ||||
| Avg LOS with ICD M797 - Fibromyalgia | 3.9 | ||||
| Readmission Rate at DRG | 16.14 | ||||
| Readmission Rate with ICD M797 - Fibromyalgia | 17.8 | ||||
| Unplanned Readmission Rate at DRG | 10.98 | ||||
| Unplanned Readmission Rate with ICD M797 - Fibromyalgia | 12.93 | ||||
| Total Medicare payments at DRG | $1,924,528,848 | ||||
| Total Medicare payments with ICD M797 - Fibromyalgia | $44,144,763 | ||||
| Total Medicare payment per Day at DRG | $1,332 | ||||
| Total Medicare payment per Day with ICD M797 - Fibromyalgia | $1,275 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,281 | ||||
| Total Medicare payment per Hospitalization with ICD M797 - Fibromyalgia | $4,977 | ||||
| Total Medicare Charges at DRG | $8,912,106,420 | ||||
| Total Medicare Charges with ICD M797 - Fibromyalgia | $218,305,907 | ||||
| Avg Charges at DRG | $24,456 | ||||
| Avg Charges with ICD M797 - Fibromyalgia | $24,614 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD M797 - Fibromyalgia | NA | ||||
| SNF Discharge Rate at DRG | 15.72 | ||||
| SNF Discharge Rate with ICD M797 - Fibromyalgia | 11.43 | ||||
| Home Discharge Rate at DRG | 53.33 | ||||
| Home Discharge Rate with ICD M797 - Fibromyalgia | 57.26 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 483: MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 917: POISONING AND TOXIC EFFECTS OF DRUGS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 185,287 | ||||
| Total Hospitalizations with ICD M797 - Fibromyalgia | 6,386 | ||||
| DRG Share of Total Hospitalizations | 0.56 | ||||
| % of Total ICD M797 - Fibromyalgia in DRG | 1.05 | ||||
| Avg LOS at DRG | 1.88 | ||||
| Avg LOS with ICD M797 - Fibromyalgia | 2.01 | ||||
| Readmission Rate at DRG | 5.88 | ||||
| Readmission Rate with ICD M797 - Fibromyalgia | 6.68 | ||||
| Unplanned Readmission Rate at DRG | 2.95 | ||||
| Unplanned Readmission Rate with ICD M797 - Fibromyalgia | 3.49 | ||||
| Total Medicare payments at DRG | $2,646,620,753 | ||||
| Total Medicare payments with ICD M797 - Fibromyalgia | $90,230,214 | ||||
| Total Medicare payment per Day at DRG | $7,610 | ||||
| Total Medicare payment per Day with ICD M797 - Fibromyalgia | $7,015 | ||||
| Total Medicare payment per Hospitalization at DRG | $14,284 | ||||
| Total Medicare payment per Hospitalization with ICD M797 - Fibromyalgia | $14,129 | ||||
| Total Medicare Charges at DRG | $13,348,793,527 | ||||
| Total Medicare Charges with ICD M797 - Fibromyalgia | $453,608,370 | ||||
| Avg Charges at DRG | $72,044 | ||||
| Avg Charges with ICD M797 - Fibromyalgia | $71,032 | ||||
| Mortality Rate at DRG | 0.07 | ||||
| Mortality Rate with ICD M797 - Fibromyalgia | NA | ||||
| SNF Discharge Rate at DRG | 12.21 | ||||
| SNF Discharge Rate with ICD M797 - Fibromyalgia | 15.24 | ||||
| Home Discharge Rate at DRG | 64.69 | ||||
| Home Discharge Rate with ICD M797 - Fibromyalgia | 60.1 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MISSION HOSPITAL | 509 BILTMORE AVE | ASHEVILLE | NC | 28801 | 2,130 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 1,871 |
| VIDANT MEDICAL CENTER | 2100 STANTONSBURG RD | GREENVILLE | NC | 27834 | 1,813 |
| 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 | 222 |
| Dr. JOHN R DICKERSON | 3223 N WEBB RD | WICHITA | KS | 67226 | 95 |
| Dr. WOJCIECH POLUHA | 107 LINCOLN ST | WORCESTER | MA | 01605 | 82 |
| 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 | 308 |
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 217 |
| Dr. HEMANT KUMAR SINHA | 35772 US HIGHWAY 231 | ASHVILLE | AL | 35953 | 165 |