*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing - as a primary diagnosis code | M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 9.63 | |
| Readmission Rate (%) | 29.17 | |
| Unplanned Readmission Rate (%) | 19.46 | |
| 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 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 188,863 | |
| Total Hospitalizations with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 302 | |
| DRG Share of Total Hospitalizations | 0.57 | |
| % of Total ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing in DRG | 76.65 | |
| Avg LOS at DRG | 11.75 | |
| Avg LOS with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 12.58 | |
| Readmission Rate at DRG | 12.14 | |
| Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 26.14 | |
| Unplanned Readmission Rate at DRG | 7.97 | |
| Unplanned Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 19.32 | |
| Total Medicare payments at DRG | $3,216,901,374 | |
| Total Medicare payments with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $5,807,472 | |
| Total Medicare payment per Day at DRG | $1,450 | |
| Total Medicare payment per Day with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $1,529 | |
| Total Medicare payment per Hospitalization at DRG | $17,033 | |
| Total Medicare payment per Hospitalization with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $19,230 | |
| Total Medicare Charges at DRG | $7,709,712,645 | |
| Total Medicare Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $16,628,273 | |
| Avg Charges at DRG | $40,822 | |
| Avg Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $55,061 | |
| Mortality Rate at DRG | 0.11 | |
| Mortality Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | |
| SNF Discharge Rate at DRG | 19.54 | |
| SNF Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 15.23 | |
| Home Discharge Rate at DRG | 19.47 | |
| Home Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 16.89 |
*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 949: AFTERCARE WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 188,863 | ||||
| Total Hospitalizations with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 369 | ||||
| DRG Share of Total Hospitalizations | 0.57 | ||||
| % of Total ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing in DRG | 18.25 | ||||
| Avg LOS at DRG | 11.75 | ||||
| Avg LOS with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 12.45 | ||||
| Readmission Rate at DRG | 12.14 | ||||
| Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 24.84 | ||||
| Unplanned Readmission Rate at DRG | 7.97 | ||||
| Unplanned Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 18.94 | ||||
| Total Medicare payments at DRG | $3,216,901,374 | ||||
| Total Medicare payments with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $7,112,756 | ||||
| Total Medicare payment per Day at DRG | $1,450 | ||||
| Total Medicare payment per Day with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $1,549 | ||||
| Total Medicare payment per Hospitalization at DRG | $17,033 | ||||
| Total Medicare payment per Hospitalization with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $19,276 | ||||
| Total Medicare Charges at DRG | $7,709,712,645 | ||||
| Total Medicare Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $19,515,476 | ||||
| Avg Charges at DRG | $40,822 | ||||
| Avg Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $52,887 | ||||
| Mortality Rate at DRG | 0.11 | ||||
| Mortality Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| SNF Discharge Rate at DRG | 19.54 | ||||
| SNF Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 15.18 | ||||
| Home Discharge Rate at DRG | 19.47 | ||||
| Home Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 17.62 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | DRG 052: SPINAL DISORDERS AND INJURIES WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 841: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH COMPLICATION OR COMORBIDITY (CC) | DRG 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 122,730 | ||||
| Total Hospitalizations with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 66 | ||||
| DRG Share of Total Hospitalizations | 0.37 | ||||
| % of Total ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing in DRG | 3.26 | ||||
| Avg LOS at DRG | 7.61 | ||||
| Avg LOS with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 11.55 | ||||
| Readmission Rate at DRG | 21.31 | ||||
| Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 34.55 | ||||
| Unplanned Readmission Rate at DRG | 14.13 | ||||
| Unplanned Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| Total Medicare payments at DRG | $1,397,885,220 | ||||
| Total Medicare payments with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $1,227,020 | ||||
| Total Medicare payment per Day at DRG | $1,497 | ||||
| Total Medicare payment per Day with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $1,610 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,390 | ||||
| Total Medicare payment per Hospitalization with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $18,591 | ||||
| Total Medicare Charges at DRG | $4,175,290,309 | ||||
| Total Medicare Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $2,971,777 | ||||
| Avg Charges at DRG | $34,020 | ||||
| Avg Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $45,027 | ||||
| Mortality Rate at DRG | 0.28 | ||||
| Mortality Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| SNF Discharge Rate at DRG | 21.64 | ||||
| SNF Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 21.21 | ||||
| Home Discharge Rate at DRG | 28.06 | ||||
| Home Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 16.67 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 840: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 947: SIGNS AND SYMPTOMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 847: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 29,081 | ||||
| Total Hospitalizations with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 37 | ||||
| DRG Share of Total Hospitalizations | 0.09 | ||||
| % of Total ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing in DRG | 1.83 | ||||
| Avg LOS at DRG | 9.8 | ||||
| Avg LOS with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 10.0 | ||||
| Readmission Rate at DRG | 37.3 | ||||
| Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 41.94 | ||||
| Unplanned Readmission Rate at DRG | 22.57 | ||||
| Unplanned Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 35.48 | ||||
| Total Medicare payments at DRG | $683,745,757 | ||||
| Total Medicare payments with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $759,388 | ||||
| Total Medicare payment per Day at DRG | $2,399 | ||||
| Total Medicare payment per Day with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $2,052 | ||||
| Total Medicare payment per Hospitalization at DRG | $23,512 | ||||
| Total Medicare payment per Hospitalization with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $20,524 | ||||
| Total Medicare Charges at DRG | $3,049,100,784 | ||||
| Total Medicare Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $3,136,770 | ||||
| Avg Charges at DRG | $104,849 | ||||
| Avg Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $84,778 | ||||
| Mortality Rate at DRG | 13.07 | ||||
| Mortality Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| SNF Discharge Rate at DRG | 16.93 | ||||
| SNF Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| Home Discharge Rate at DRG | 29.4 | ||||
| Home Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 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 181: RESPIRATORY NEOPLASMS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 180: RESPIRATORY NEOPLASMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 37,484 | ||||
| Total Hospitalizations with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 24 | ||||
| DRG Share of Total Hospitalizations | 0.11 | ||||
| % of Total ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing in DRG | 1.19 | ||||
| Avg LOS at DRG | 4.49 | ||||
| Avg LOS with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | 5.5 | ||||
| Readmission Rate at DRG | 27.89 | ||||
| Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| Unplanned Readmission Rate at DRG | 21.07 | ||||
| Unplanned Readmission Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| Total Medicare payments at DRG | $287,773,529 | ||||
| Total Medicare payments with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $223,695 | ||||
| Total Medicare payment per Day at DRG | $1,709 | ||||
| Total Medicare payment per Day with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $1,695 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,677 | ||||
| Total Medicare payment per Hospitalization with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $9,321 | ||||
| Total Medicare Charges at DRG | $1,483,578,942 | ||||
| Total Medicare Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $920,503 | ||||
| Avg Charges at DRG | $39,579 | ||||
| Avg Charges with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | $38,354 | ||||
| Mortality Rate at DRG | 4.3 | ||||
| Mortality Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| SNF Discharge Rate at DRG | 10.7 | ||||
| SNF Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA | ||||
| Home Discharge Rate at DRG | 44.82 | ||||
| Home Discharge Rate with ICD M8458XD - Pathological fracture in neoplastic disease, other specified site, subsequent encounter for fracture with routine healing | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 28 |
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W 13 MILE RD | ROYAL OAK | MI | 48073 | 22 |
| MEMORIAL SLOAN KETTERING CANCER CENTER | 1275 YORK AVE | NEW YORK | NY | 10065 | 16 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. TERRENCE MACARTHUR PUGH | 1100 BLYTHE BLVD | CHARLOTTE | NC | 28203 | 11 |
| No | ICD Diagnosis Code | Description |
|---|---|---|
| 1 | Z981 | Arthrodesis status |
| 2 | C7951 | Secondary malignant neoplasm of bone |
| 3 | D649 | Anemia, unspecified |
| 4 | K5900 | Constipation, unspecified |
| 5 | K219 | Gastro-esophageal reflux disease without esophagitis |
| 6 | I10 | Essential (primary) hypertension |