*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| Z538 - Procedure and treatment not carried out for other reasons - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 13.68 | |
| 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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD Z538 - Procedure and treatment not carried out for other reasons | 1,131 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD Z538 - Procedure and treatment not carried out for other reasons in DRG | 3.95 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD Z538 - Procedure and treatment not carried out for other reasons | 8.29 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 28.22 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 18.74 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD Z538 - Procedure and treatment not carried out for other reasons | $14,578,387 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD Z538 - Procedure and treatment not carried out for other reasons | $1,555 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD Z538 - Procedure and treatment not carried out for other reasons | $12,890 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $89,598,796 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $79,221 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 14.85 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 24.4 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 19.72 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 310: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 292,335 | ||||
| Total Hospitalizations with ICD Z538 - Procedure and treatment not carried out for other reasons | 502 | ||||
| DRG Share of Total Hospitalizations | 0.89 | ||||
| % of Total ICD Z538 - Procedure and treatment not carried out for other reasons in DRG | 1.75 | ||||
| Avg LOS at DRG | 2.96 | ||||
| Avg LOS with ICD Z538 - Procedure and treatment not carried out for other reasons | 2.89 | ||||
| Readmission Rate at DRG | 19.18 | ||||
| Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 17.03 | ||||
| Unplanned Readmission Rate at DRG | 13.96 | ||||
| Unplanned Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 10.56 | ||||
| Total Medicare payments at DRG | $1,347,436,356 | ||||
| Total Medicare payments with ICD Z538 - Procedure and treatment not carried out for other reasons | $2,434,874 | ||||
| Total Medicare payment per Day at DRG | $1,557 | ||||
| Total Medicare payment per Day with ICD Z538 - Procedure and treatment not carried out for other reasons | $1,679 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,609 | ||||
| Total Medicare payment per Hospitalization with ICD Z538 - Procedure and treatment not carried out for other reasons | $4,850 | ||||
| Total Medicare Charges at DRG | $7,385,462,160 | ||||
| Total Medicare Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $16,827,808 | ||||
| Avg Charges at DRG | $25,264 | ||||
| Avg Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $33,522 | ||||
| Mortality Rate at DRG | 0.57 | ||||
| Mortality Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | NA | ||||
| SNF Discharge Rate at DRG | 11.55 | ||||
| SNF Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 7.17 | ||||
| Home Discharge Rate at DRG | 63.79 | ||||
| Home Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 73.31 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 307: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 300: PERIPHERAL VASCULAR DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 190,819 | ||||
| Total Hospitalizations with ICD Z538 - Procedure and treatment not carried out for other reasons | 398 | ||||
| DRG Share of Total Hospitalizations | 0.58 | ||||
| % of Total ICD Z538 - Procedure and treatment not carried out for other reasons in DRG | 1.39 | ||||
| Avg LOS at DRG | 5.63 | ||||
| Avg LOS with ICD Z538 - Procedure and treatment not carried out for other reasons | 6.42 | ||||
| Readmission Rate at DRG | 28.97 | ||||
| Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 26.65 | ||||
| Unplanned Readmission Rate at DRG | 22.07 | ||||
| Unplanned Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 22.46 | ||||
| Total Medicare payments at DRG | $2,165,853,817 | ||||
| Total Medicare payments with ICD Z538 - Procedure and treatment not carried out for other reasons | $4,711,303 | ||||
| Total Medicare payment per Day at DRG | $2,015 | ||||
| Total Medicare payment per Day with ICD Z538 - Procedure and treatment not carried out for other reasons | $1,845 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,350 | ||||
| Total Medicare payment per Hospitalization with ICD Z538 - Procedure and treatment not carried out for other reasons | $11,837 | ||||
| Total Medicare Charges at DRG | $10,686,431,125 | ||||
| Total Medicare Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $24,305,086 | ||||
| Avg Charges at DRG | $56,003 | ||||
| Avg Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $61,068 | ||||
| Mortality Rate at DRG | 5.35 | ||||
| Mortality Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 7.29 | ||||
| SNF Discharge Rate at DRG | 23.91 | ||||
| SNF Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 32.16 | ||||
| Home Discharge Rate at DRG | 39.51 | ||||
| Home Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 27.64 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 699: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 249,842 | ||||
| Total Hospitalizations with ICD Z538 - Procedure and treatment not carried out for other reasons | 273 | ||||
| DRG Share of Total Hospitalizations | 0.76 | ||||
| % of Total ICD Z538 - Procedure and treatment not carried out for other reasons in DRG | 0.95 | ||||
| Avg LOS at DRG | 6.05 | ||||
| Avg LOS with ICD Z538 - Procedure and treatment not carried out for other reasons | 7.57 | ||||
| Readmission Rate at DRG | 35.06 | ||||
| Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 38.66 | ||||
| Unplanned Readmission Rate at DRG | 11.16 | ||||
| Unplanned Readmission Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 14.95 | ||||
| Total Medicare payments at DRG | $2,933,944,169 | ||||
| Total Medicare payments with ICD Z538 - Procedure and treatment not carried out for other reasons | $3,619,488 | ||||
| Total Medicare payment per Day at DRG | $1,941 | ||||
| Total Medicare payment per Day with ICD Z538 - Procedure and treatment not carried out for other reasons | $1,751 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,743 | ||||
| Total Medicare payment per Hospitalization with ICD Z538 - Procedure and treatment not carried out for other reasons | $13,258 | ||||
| Total Medicare Charges at DRG | $15,164,864,310 | ||||
| Total Medicare Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $24,589,969 | ||||
| Avg Charges at DRG | $60,698 | ||||
| Avg Charges with ICD Z538 - Procedure and treatment not carried out for other reasons | $90,073 | ||||
| Mortality Rate at DRG | 15.95 | ||||
| Mortality Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 20.88 | ||||
| SNF Discharge Rate at DRG | 27.24 | ||||
| SNF Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 23.08 | ||||
| Home Discharge Rate at DRG | 12.21 | ||||
| Home Discharge Rate with ICD Z538 - Procedure and treatment not carried out for other reasons | 7.33 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MASSACHUSETTS GENERAL HOSPITAL | 55 FRUIT ST | BOSTON | MA | 02114 | 186 |
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 183 |
| CLEVELAND CLINIC | 9500 EUCLID AVE | CLEVELAND | OH | 44195 | 174 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. EDITH NEBUWA ANIEDOBE | 1500 FOREST GLEN RD | SILVER SPRING | MD | 20910 | 17 |
| Dr. ANANTHA K RAO | 6495 NEW HAMPSHIRE AVE | HYATTSVILLE | MD | 20783 | 11 |
| Dr. WILLIAM R JARNAGIN | 1275 YORK AVE | NEW YORK | NY | 10021 | 11 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. JAY GRAHAM | 622 W 168TH ST PH 14-C | NEW YORK | NY | 10032 | 18 |
| Dr. NAHEL ELIAS | 55 FRUIT ST | BOSTON | MA | 02114 | 17 |
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 17 |