*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter - as a primary diagnosis code | M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.72 | |
| Readmission Rate (%) | 27.82 | |
| Unplanned Readmission Rate (%) | 10.75 | |
| 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 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 480: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | 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) | DRG 466: REVISION OF HIP OR KNEE REPLACEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 240,618 | ||||
| Total Hospitalizations with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 55 | ||||
| DRG Share of Total Hospitalizations | 0.73 | ||||
| % of Total ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter in DRG | 26.44 | ||||
| Avg LOS at DRG | 4.81 | ||||
| Avg LOS with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 4.8 | ||||
| Readmission Rate at DRG | 26.3 | ||||
| Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 26.0 | ||||
| Unplanned Readmission Rate at DRG | 7.83 | ||||
| Unplanned Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | ||||
| Total Medicare payments at DRG | $2,989,116,299 | ||||
| Total Medicare payments with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $692,357 | ||||
| Total Medicare payment per Day at DRG | $2,581 | ||||
| Total Medicare payment per Day with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $2,623 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,423 | ||||
| Total Medicare payment per Hospitalization with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $12,588 | ||||
| Total Medicare Charges at DRG | $15,603,027,471 | ||||
| Total Medicare Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $4,897,852 | ||||
| Avg Charges at DRG | $64,846 | ||||
| Avg Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $89,052 | ||||
| Mortality Rate at DRG | 0.4 | ||||
| Mortality Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 66.28 | ||||
| SNF Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 60.0 | ||||
| Home Discharge Rate at DRG | 3.84 | ||||
| Home Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 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 482: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|
| Total Hospitalizations at DRG | 72,876 | |
| Total Hospitalizations with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 15 | |
| DRG Share of Total Hospitalizations | 0.22 | |
| % of Total ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter in DRG | 7.21 | |
| Avg LOS at DRG | 3.74 | |
| Avg LOS with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 3.6 | |
| Readmission Rate at DRG | 24.38 | |
| Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| Unplanned Readmission Rate at DRG | 4.75 | |
| Unplanned Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| Total Medicare payments at DRG | $724,201,881 | |
| Total Medicare payments with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $161,223 | |
| Total Medicare payment per Day at DRG | $2,654 | |
| Total Medicare payment per Day with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $2,986 | |
| Total Medicare payment per Hospitalization at DRG | $9,937 | |
| Total Medicare payment per Hospitalization with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $10,748 | |
| Total Medicare Charges at DRG | $3,794,322,454 | |
| Total Medicare Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $892,804 | |
| Avg Charges at DRG | $52,065 | |
| Avg Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $59,520 | |
| Mortality Rate at DRG | 0.19 | |
| Mortality Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| SNF Discharge Rate at DRG | 53.08 | |
| SNF Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| Home Discharge Rate at DRG | 10.18 | |
| Home Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 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 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 480: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 466: REVISION OF HIP OR KNEE REPLACEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 240,618 | ||||
| Total Hospitalizations with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 167 | ||||
| DRG Share of Total Hospitalizations | 0.73 | ||||
| % of Total ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter in DRG | 27.02 | ||||
| Avg LOS at DRG | 4.81 | ||||
| Avg LOS with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 4.75 | ||||
| Readmission Rate at DRG | 26.3 | ||||
| Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 20.38 | ||||
| Unplanned Readmission Rate at DRG | 7.83 | ||||
| Unplanned Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 9.55 | ||||
| Total Medicare payments at DRG | $2,989,116,299 | ||||
| Total Medicare payments with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $2,104,442 | ||||
| Total Medicare payment per Day at DRG | $2,581 | ||||
| Total Medicare payment per Day with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $2,654 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,423 | ||||
| Total Medicare payment per Hospitalization with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $12,601 | ||||
| Total Medicare Charges at DRG | $15,603,027,471 | ||||
| Total Medicare Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $13,503,345 | ||||
| Avg Charges at DRG | $64,846 | ||||
| Avg Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $80,858 | ||||
| Mortality Rate at DRG | 0.4 | ||||
| Mortality Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 66.28 | ||||
| SNF Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 71.86 | ||||
| Home Discharge Rate at DRG | 3.84 | ||||
| Home Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 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 534: FRACTURES OF FEMUR WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 536: FRACTURES OF HIP AND PELVIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 493: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH COMPLICATION OR COMORBIDITY (CC) | DRG 482: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 8,839 | ||||
| Total Hospitalizations with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 24 | ||||
| DRG Share of Total Hospitalizations | 0.03 | ||||
| % of Total ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter in DRG | 3.88 | ||||
| Avg LOS at DRG | 3.71 | ||||
| Avg LOS with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 3.75 | ||||
| Readmission Rate at DRG | 18.48 | ||||
| Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | ||||
| Unplanned Readmission Rate at DRG | 8.23 | ||||
| Unplanned Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | ||||
| Total Medicare payments at DRG | $43,863,513 | ||||
| Total Medicare payments with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $100,051 | ||||
| Total Medicare payment per Day at DRG | $1,338 | ||||
| Total Medicare payment per Day with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $1,112 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,962 | ||||
| Total Medicare payment per Hospitalization with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $4,169 | ||||
| Total Medicare Charges at DRG | $205,178,916 | ||||
| Total Medicare Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $656,487 | ||||
| Avg Charges at DRG | $23,213 | ||||
| Avg Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $27,354 | ||||
| Mortality Rate at DRG | 1.07 | ||||
| Mortality Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 52.71 | ||||
| SNF Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 50.0 | ||||
| Home Discharge Rate at DRG | 6.7 | ||||
| Home Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 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 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 483: MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | |
|---|---|---|
| Total Hospitalizations at DRG | 55,395 | |
| Total Hospitalizations with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 11 | |
| DRG Share of Total Hospitalizations | 0.17 | |
| % of Total ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter in DRG | 1.78 | |
| Avg LOS at DRG | 2.48 | |
| Avg LOS with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | 3.27 | |
| Readmission Rate at DRG | 10.12 | |
| Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| Unplanned Readmission Rate at DRG | 3.88 | |
| Unplanned Readmission Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| Total Medicare payments at DRG | $919,481,919 | |
| Total Medicare payments with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $152,452 | |
| Total Medicare payment per Day at DRG | $6,689 | |
| Total Medicare payment per Day with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $4,235 | |
| Total Medicare payment per Hospitalization at DRG | $16,599 | |
| Total Medicare payment per Hospitalization with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $13,859 | |
| Total Medicare Charges at DRG | $4,627,801,183 | |
| Total Medicare Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $1,018,556 | |
| Avg Charges at DRG | $83,542 | |
| Avg Charges with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | $92,596 | |
| Mortality Rate at DRG | NA | |
| Mortality Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| SNF Discharge Rate at DRG | 18.76 | |
| SNF Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA | |
| Home Discharge Rate at DRG | 33.3 | |
| Home Discharge Rate with ICD M979XXA - Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter | NA |