*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| Z421 - Encounter for breast reconstruction following mastectomy - as a primary diagnosis code | Z421 - Encounter for breast reconstruction following mastectomy - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 3.23 | |
| Readmission Rate (%) | 8.75 | |
| Unplanned Readmission Rate (%) | 4.85 | |
| 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 585: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 584: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 581: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 583: MASTECTOMY FOR MALIGNANCY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 572: SKIN DEBRIDEMENT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 2,592 | ||||
| Total Hospitalizations with ICD Z421 - Encounter for breast reconstruction following mastectomy | 974 | ||||
| DRG Share of Total Hospitalizations | 0.01 | ||||
| % of Total ICD Z421 - Encounter for breast reconstruction following mastectomy in DRG | 50.91 | ||||
| Avg LOS at DRG | 2.5 | ||||
| Avg LOS with ICD Z421 - Encounter for breast reconstruction following mastectomy | 2.64 | ||||
| Readmission Rate at DRG | 7.13 | ||||
| Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 6.03 | ||||
| Unplanned Readmission Rate at DRG | 4.06 | ||||
| Unplanned Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 3.01 | ||||
| Total Medicare payments at DRG | $24,332,331 | ||||
| Total Medicare payments with ICD Z421 - Encounter for breast reconstruction following mastectomy | $9,910,840 | ||||
| Total Medicare payment per Day at DRG | $3,749 | ||||
| Total Medicare payment per Day with ICD Z421 - Encounter for breast reconstruction following mastectomy | $3,850 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,387 | ||||
| Total Medicare payment per Hospitalization with ICD Z421 - Encounter for breast reconstruction following mastectomy | $10,175 | ||||
| Total Medicare Charges at DRG | $156,786,499 | ||||
| Total Medicare Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $70,273,346 | ||||
| Avg Charges at DRG | $60,489 | ||||
| Avg Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $72,149 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| SNF Discharge Rate at DRG | 1.5 | ||||
| SNF Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Home Discharge Rate at DRG | 81.37 | ||||
| Home Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 84.09 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 580: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 571: SKIN DEBRIDEMENT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 582: MASTECTOMY FOR MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 578: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 577: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 32,775 | ||||
| Total Hospitalizations with ICD Z421 - Encounter for breast reconstruction following mastectomy | 68 | ||||
| DRG Share of Total Hospitalizations | 0.1 | ||||
| % of Total ICD Z421 - Encounter for breast reconstruction following mastectomy in DRG | 3.55 | ||||
| Avg LOS at DRG | 4.93 | ||||
| Avg LOS with ICD Z421 - Encounter for breast reconstruction following mastectomy | 4.32 | ||||
| Readmission Rate at DRG | 16.64 | ||||
| Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Unplanned Readmission Rate at DRG | 9.37 | ||||
| Unplanned Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Total Medicare payments at DRG | $321,966,863 | ||||
| Total Medicare payments with ICD Z421 - Encounter for breast reconstruction following mastectomy | $854,685 | ||||
| Total Medicare payment per Day at DRG | $1,993 | ||||
| Total Medicare payment per Day with ICD Z421 - Encounter for breast reconstruction following mastectomy | $2,907 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,824 | ||||
| Total Medicare payment per Hospitalization with ICD Z421 - Encounter for breast reconstruction following mastectomy | $12,569 | ||||
| Total Medicare Charges at DRG | $1,646,314,545 | ||||
| Total Medicare Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $7,645,549 | ||||
| Avg Charges at DRG | $50,231 | ||||
| Avg Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $112,435 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| SNF Discharge Rate at DRG | 17.01 | ||||
| SNF Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Home Discharge Rate at DRG | 43.69 | ||||
| Home Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 77.94 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 983: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 607: MINOR SKIN DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|
| Total Hospitalizations at DRG | 11,723 | ||
| Total Hospitalizations with ICD Z421 - Encounter for breast reconstruction following mastectomy | 17 | ||
| DRG Share of Total Hospitalizations | 0.04 | ||
| % of Total ICD Z421 - Encounter for breast reconstruction following mastectomy in DRG | 0.89 | ||
| Avg LOS at DRG | 3.14 | ||
| Avg LOS with ICD Z421 - Encounter for breast reconstruction following mastectomy | 2.0 | ||
| Readmission Rate at DRG | 12.89 | ||
| Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| Unplanned Readmission Rate at DRG | 7.1 | ||
| Unplanned Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| Total Medicare payments at DRG | $122,697,695 | ||
| Total Medicare payments with ICD Z421 - Encounter for breast reconstruction following mastectomy | $156,782 | ||
| Total Medicare payment per Day at DRG | $3,328 | ||
| Total Medicare payment per Day with ICD Z421 - Encounter for breast reconstruction following mastectomy | $4,611 | ||
| Total Medicare payment per Hospitalization at DRG | $10,466 | ||
| Total Medicare payment per Hospitalization with ICD Z421 - Encounter for breast reconstruction following mastectomy | $9,222 | ||
| Total Medicare Charges at DRG | $633,485,759 | ||
| Total Medicare Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $741,933 | ||
| Avg Charges at DRG | $54,038 | ||
| Avg Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $43,643 | ||
| Mortality Rate at DRG | 0.25 | ||
| Mortality Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| SNF Discharge Rate at DRG | 9.06 | ||
| SNF Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| Home Discharge Rate at DRG | 70.16 | ||
| Home Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 82.35 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| THE JOHNS HOPKINS HOSPITAL | 600 N WOLFE ST | BALTIMORE | MD | 21287 | 34 |
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 34 |
| MOFFITT CANCER CENTER | 12902 MAGNOLIA DR | TAMPA | FL | 33612 | 33 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SUHAIL K KANCHWALA | 3400 SPRUCE ST | PHILADELPHIA | PA | 19104 | 18 |
| Dr. BERNARD W CHANG | 227 SAINT PAUL PL | BALTIMORE | MD | 21202 | 14 |
| Dr. JUSTIN M SACKS | 600 N WOLFE ST | BALTIMORE | MD | 21287 | 14 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SUHAIL K KANCHWALA | 3400 SPRUCE ST | PHILADELPHIA | PA | 19104 | 18 |
| Dr. BERNARD W CHANG | 227 SAINT PAUL PL | BALTIMORE | MD | 21202 | 15 |
| Dr. JUSTIN M SACKS | 600 N WOLFE ST | BALTIMORE | MD | 21287 | 15 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 585: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 584: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 581: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 583: MASTECTOMY FOR MALIGNANCY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 572: SKIN DEBRIDEMENT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 2,592 | ||||
| Total Hospitalizations with ICD Z421 - Encounter for breast reconstruction following mastectomy | 986 | ||||
| DRG Share of Total Hospitalizations | 0.01 | ||||
| % of Total ICD Z421 - Encounter for breast reconstruction following mastectomy in DRG | 48.29 | ||||
| Avg LOS at DRG | 2.5 | ||||
| Avg LOS with ICD Z421 - Encounter for breast reconstruction following mastectomy | 2.63 | ||||
| Readmission Rate at DRG | 7.13 | ||||
| Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 6.16 | ||||
| Unplanned Readmission Rate at DRG | 4.06 | ||||
| Unplanned Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 3.08 | ||||
| Total Medicare payments at DRG | $24,332,331 | ||||
| Total Medicare payments with ICD Z421 - Encounter for breast reconstruction following mastectomy | $10,032,367 | ||||
| Total Medicare payment per Day at DRG | $3,749 | ||||
| Total Medicare payment per Day with ICD Z421 - Encounter for breast reconstruction following mastectomy | $3,862 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,387 | ||||
| Total Medicare payment per Hospitalization with ICD Z421 - Encounter for breast reconstruction following mastectomy | $10,175 | ||||
| Total Medicare Charges at DRG | $156,786,499 | ||||
| Total Medicare Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $70,998,775 | ||||
| Avg Charges at DRG | $60,489 | ||||
| Avg Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $72,007 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| SNF Discharge Rate at DRG | 1.5 | ||||
| SNF Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Home Discharge Rate at DRG | 81.37 | ||||
| Home Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 84.18 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 580: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 582: MASTECTOMY FOR MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 571: SKIN DEBRIDEMENT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 578: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 577: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 32,775 | ||||
| Total Hospitalizations with ICD Z421 - Encounter for breast reconstruction following mastectomy | 73 | ||||
| DRG Share of Total Hospitalizations | 0.1 | ||||
| % of Total ICD Z421 - Encounter for breast reconstruction following mastectomy in DRG | 3.57 | ||||
| Avg LOS at DRG | 4.93 | ||||
| Avg LOS with ICD Z421 - Encounter for breast reconstruction following mastectomy | 4.18 | ||||
| Readmission Rate at DRG | 16.64 | ||||
| Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Unplanned Readmission Rate at DRG | 9.37 | ||||
| Unplanned Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Total Medicare payments at DRG | $321,966,863 | ||||
| Total Medicare payments with ICD Z421 - Encounter for breast reconstruction following mastectomy | $929,817 | ||||
| Total Medicare payment per Day at DRG | $1,993 | ||||
| Total Medicare payment per Day with ICD Z421 - Encounter for breast reconstruction following mastectomy | $3,049 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,824 | ||||
| Total Medicare payment per Hospitalization with ICD Z421 - Encounter for breast reconstruction following mastectomy | $12,737 | ||||
| Total Medicare Charges at DRG | $1,646,314,545 | ||||
| Total Medicare Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $8,309,381 | ||||
| Avg Charges at DRG | $50,231 | ||||
| Avg Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $113,827 | ||||
| Mortality Rate at DRG | 0.09 | ||||
| Mortality Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| SNF Discharge Rate at DRG | 17.01 | ||||
| SNF Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||||
| Home Discharge Rate at DRG | 43.69 | ||||
| Home Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 76.71 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 983: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 607: MINOR SKIN DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|
| Total Hospitalizations at DRG | 11,723 | ||
| Total Hospitalizations with ICD Z421 - Encounter for breast reconstruction following mastectomy | 19 | ||
| DRG Share of Total Hospitalizations | 0.04 | ||
| % of Total ICD Z421 - Encounter for breast reconstruction following mastectomy in DRG | 0.93 | ||
| Avg LOS at DRG | 3.14 | ||
| Avg LOS with ICD Z421 - Encounter for breast reconstruction following mastectomy | 1.89 | ||
| Readmission Rate at DRG | 12.89 | ||
| Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| Unplanned Readmission Rate at DRG | 7.1 | ||
| Unplanned Readmission Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| Total Medicare payments at DRG | $122,697,695 | ||
| Total Medicare payments with ICD Z421 - Encounter for breast reconstruction following mastectomy | $185,326 | ||
| Total Medicare payment per Day at DRG | $3,328 | ||
| Total Medicare payment per Day with ICD Z421 - Encounter for breast reconstruction following mastectomy | $5,148 | ||
| Total Medicare payment per Hospitalization at DRG | $10,466 | ||
| Total Medicare payment per Hospitalization with ICD Z421 - Encounter for breast reconstruction following mastectomy | $9,754 | ||
| Total Medicare Charges at DRG | $633,485,759 | ||
| Total Medicare Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $825,678 | ||
| Avg Charges at DRG | $54,038 | ||
| Avg Charges with ICD Z421 - Encounter for breast reconstruction following mastectomy | $43,457 | ||
| Mortality Rate at DRG | 0.25 | ||
| Mortality Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| SNF Discharge Rate at DRG | 9.06 | ||
| SNF Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | NA | ||
| Home Discharge Rate at DRG | 70.16 | ||
| Home Discharge Rate with ICD Z421 - Encounter for breast reconstruction following mastectomy | 84.21 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | 1515 HOLCOMBE BLVD | HOUSTON | TX | 77030 | 35 |
| THE JOHNS HOPKINS HOSPITAL | 600 N WOLFE ST | BALTIMORE | MD | 21287 | 34 |
| MOFFITT CANCER CENTER | 12902 MAGNOLIA DR | TAMPA | FL | 33612 | 34 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SUHAIL K KANCHWALA | 3400 SPRUCE ST | PHILADELPHIA | PA | 19104 | 18 |
| Dr. BERNARD W CHANG | 227 SAINT PAUL PL | BALTIMORE | MD | 21202 | 15 |
| Dr. GORDON K. LEE | 770 WELCH RD | PALO ALTO | CA | 94304 | 14 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SUHAIL K KANCHWALA | 3400 SPRUCE ST | PHILADELPHIA | PA | 19104 | 18 |
| Dr. BERNARD W CHANG | 227 SAINT PAUL PL | BALTIMORE | MD | 21202 | 16 |
| Dr. JUSTIN M SACKS | 600 N WOLFE ST | BALTIMORE | MD | 21287 | 15 |