*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| Z87311 - Personal history of (healed) other pathological fracture - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 13.28 | |
| 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 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD Z87311 - Personal history of (healed) other pathological fracture | 514 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD Z87311 - Personal history of (healed) other pathological fracture in DRG | 4.66 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD Z87311 - Personal history of (healed) other pathological fracture | 5.46 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 17.42 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 12.65 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD Z87311 - Personal history of (healed) other pathological fracture | $5,904,187 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD Z87311 - Personal history of (healed) other pathological fracture | $2,106 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD Z87311 - Personal history of (healed) other pathological fracture | $11,487 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $26,778,549 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $52,098 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 13.81 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 30.16 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 21.79 |
*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 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 240,618 | ||||
| Total Hospitalizations with ICD Z87311 - Personal history of (healed) other pathological fracture | 228 | ||||
| DRG Share of Total Hospitalizations | 0.73 | ||||
| % of Total ICD Z87311 - Personal history of (healed) other pathological fracture in DRG | 2.07 | ||||
| Avg LOS at DRG | 4.81 | ||||
| Avg LOS with ICD Z87311 - Personal history of (healed) other pathological fracture | 4.61 | ||||
| Readmission Rate at DRG | 26.3 | ||||
| Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 24.66 | ||||
| Unplanned Readmission Rate at DRG | 7.83 | ||||
| Unplanned Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 8.07 | ||||
| Total Medicare payments at DRG | $2,989,116,299 | ||||
| Total Medicare payments with ICD Z87311 - Personal history of (healed) other pathological fracture | $2,919,436 | ||||
| Total Medicare payment per Day at DRG | $2,581 | ||||
| Total Medicare payment per Day with ICD Z87311 - Personal history of (healed) other pathological fracture | $2,775 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,423 | ||||
| Total Medicare payment per Hospitalization with ICD Z87311 - Personal history of (healed) other pathological fracture | $12,805 | ||||
| Total Medicare Charges at DRG | $15,603,027,471 | ||||
| Total Medicare Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $13,945,568 | ||||
| Avg Charges at DRG | $64,846 | ||||
| Avg Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $61,165 | ||||
| Mortality Rate at DRG | 0.4 | ||||
| Mortality Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | NA | ||||
| SNF Discharge Rate at DRG | 66.28 | ||||
| SNF Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 59.21 | ||||
| Home Discharge Rate at DRG | 3.84 | ||||
| Home Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 4.82 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD Z87311 - Personal history of (healed) other pathological fracture | 190 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD Z87311 - Personal history of (healed) other pathological fracture in DRG | 1.72 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD Z87311 - Personal history of (healed) other pathological fracture | 5.32 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 24.58 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 18.44 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD Z87311 - Personal history of (healed) other pathological fracture | $1,773,984 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD Z87311 - Personal history of (healed) other pathological fracture | $1,756 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD Z87311 - Personal history of (healed) other pathological fracture | $9,337 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $7,543,834 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $39,704 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | NA | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 30.0 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 25.79 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 359,935 | ||||
| Total Hospitalizations with ICD Z87311 - Personal history of (healed) other pathological fracture | 137 | ||||
| DRG Share of Total Hospitalizations | 1.1 | ||||
| % of Total ICD Z87311 - Personal history of (healed) other pathological fracture in DRG | 1.24 | ||||
| Avg LOS at DRG | 12.3 | ||||
| Avg LOS with ICD Z87311 - Personal history of (healed) other pathological fracture | 10.55 | ||||
| Readmission Rate at DRG | 16.01 | ||||
| Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 18.11 | ||||
| Unplanned Readmission Rate at DRG | 9.86 | ||||
| Unplanned Readmission Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 8.66 | ||||
| Total Medicare payments at DRG | $5,883,826,653 | ||||
| Total Medicare payments with ICD Z87311 - Personal history of (healed) other pathological fracture | $2,100,597 | ||||
| Total Medicare payment per Day at DRG | $1,329 | ||||
| Total Medicare payment per Day with ICD Z87311 - Personal history of (healed) other pathological fracture | $1,454 | ||||
| Total Medicare payment per Hospitalization at DRG | $16,347 | ||||
| Total Medicare payment per Hospitalization with ICD Z87311 - Personal history of (healed) other pathological fracture | $15,333 | ||||
| Total Medicare Charges at DRG | $15,374,824,749 | ||||
| Total Medicare Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $5,669,163 | ||||
| Avg Charges at DRG | $42,716 | ||||
| Avg Charges with ICD Z87311 - Personal history of (healed) other pathological fracture | $41,381 | ||||
| Mortality Rate at DRG | 0.3 | ||||
| Mortality Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | NA | ||||
| SNF Discharge Rate at DRG | 27.95 | ||||
| SNF Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 33.58 | ||||
| Home Discharge Rate at DRG | 26.85 | ||||
| Home Discharge Rate with ICD Z87311 - Personal history of (healed) other pathological fracture | 19.71 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| SHARP GROSSMONT HOSPITAL | 5555 GROSSMONT CENTER DR | LA MESA | CA | 91942 | 79 |
| MEMORIAL SLOAN KETTERING CANCER CENTER | 1275 YORK AVE | NEW YORK | NY | 10065 | 74 |
| ST. FRANCIS HOSPITAL ROSLYN | 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 65 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. JOHN A. KLINE | 150 MUNDY ST | WILKES BARRE | PA | 18702 | 19 |
| Dr. LUCIAN P. BEDNARZ | 5 MORGAN HWY | SCRANTON | PA | 18508 | 17 |
| Dr. MICHAEL W HENNIGAN | 1847 FLORIDA AVE | PANAMA CITY | FL | 32405 | 17 |