*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| Z952 - Presence of prosthetic heart valve - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 16.06 | |
| 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 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD Z952 - Presence of prosthetic heart valve | 44,758 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD Z952 - Presence of prosthetic heart valve in DRG | 7.54 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD Z952 - Presence of prosthetic heart valve | 5.29 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 29.1 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 22.2 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD Z952 - Presence of prosthetic heart valve | $420,354,315 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD Z952 - Presence of prosthetic heart valve | $1,774 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD Z952 - Presence of prosthetic heart valve | $9,392 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD Z952 - Presence of prosthetic heart valve | $1,865,838,897 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD Z952 - Presence of prosthetic heart valve | $41,687 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD Z952 - Presence of prosthetic heart valve | 3.95 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 19.14 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 37.73 |
*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 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 292,335 | ||||
| Total Hospitalizations with ICD Z952 - Presence of prosthetic heart valve | 9,568 | ||||
| DRG Share of Total Hospitalizations | 0.89 | ||||
| % of Total ICD Z952 - Presence of prosthetic heart valve in DRG | 1.61 | ||||
| Avg LOS at DRG | 2.96 | ||||
| Avg LOS with ICD Z952 - Presence of prosthetic heart valve | 2.99 | ||||
| Readmission Rate at DRG | 19.18 | ||||
| Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 21.12 | ||||
| Unplanned Readmission Rate at DRG | 13.96 | ||||
| Unplanned Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 15.47 | ||||
| Total Medicare payments at DRG | $1,347,436,356 | ||||
| Total Medicare payments with ICD Z952 - Presence of prosthetic heart valve | $45,106,455 | ||||
| Total Medicare payment per Day at DRG | $1,557 | ||||
| Total Medicare payment per Day with ICD Z952 - Presence of prosthetic heart valve | $1,578 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,609 | ||||
| Total Medicare payment per Hospitalization with ICD Z952 - Presence of prosthetic heart valve | $4,714 | ||||
| Total Medicare Charges at DRG | $7,385,462,160 | ||||
| Total Medicare Charges with ICD Z952 - Presence of prosthetic heart valve | $239,132,582 | ||||
| Avg Charges at DRG | $25,264 | ||||
| Avg Charges with ICD Z952 - Presence of prosthetic heart valve | $24,993 | ||||
| Mortality Rate at DRG | 0.57 | ||||
| Mortality Rate with ICD Z952 - Presence of prosthetic heart valve | 0.64 | ||||
| SNF Discharge Rate at DRG | 11.55 | ||||
| SNF Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 9.47 | ||||
| Home Discharge Rate at DRG | 63.79 | ||||
| Home Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 65.4 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 949: AFTERCARE WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 434,264 | ||||
| Total Hospitalizations with ICD Z952 - Presence of prosthetic heart valve | 8,301 | ||||
| DRG Share of Total Hospitalizations | 1.32 | ||||
| % of Total ICD Z952 - Presence of prosthetic heart valve in DRG | 1.4 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD Z952 - Presence of prosthetic heart valve | 3.93 | ||||
| Readmission Rate at DRG | 22.76 | ||||
| Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 24.34 | ||||
| Unplanned Readmission Rate at DRG | 16.46 | ||||
| Unplanned Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 17.86 | ||||
| Total Medicare payments at DRG | $2,472,138,198 | ||||
| Total Medicare payments with ICD Z952 - Presence of prosthetic heart valve | $47,952,162 | ||||
| Total Medicare payment per Day at DRG | $1,444 | ||||
| Total Medicare payment per Day with ICD Z952 - Presence of prosthetic heart valve | $1,470 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,693 | ||||
| Total Medicare payment per Hospitalization with ICD Z952 - Presence of prosthetic heart valve | $5,777 | ||||
| Total Medicare Charges at DRG | $12,478,361,060 | ||||
| Total Medicare Charges with ICD Z952 - Presence of prosthetic heart valve | $235,600,666 | ||||
| Avg Charges at DRG | $28,735 | ||||
| Avg Charges with ICD Z952 - Presence of prosthetic heart valve | $28,382 | ||||
| Mortality Rate at DRG | 0.91 | ||||
| Mortality Rate with ICD Z952 - Presence of prosthetic heart valve | 0.99 | ||||
| SNF Discharge Rate at DRG | 22.02 | ||||
| SNF Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 21.79 | ||||
| Home Discharge Rate at DRG | 46.68 | ||||
| Home Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 44.61 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS | DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 352,097 | ||||
| Total Hospitalizations with ICD Z952 - Presence of prosthetic heart valve | 6,812 | ||||
| DRG Share of Total Hospitalizations | 1.07 | ||||
| % of Total ICD Z952 - Presence of prosthetic heart valve in DRG | 1.15 | ||||
| Avg LOS at DRG | 3.96 | ||||
| Avg LOS with ICD Z952 - Presence of prosthetic heart valve | 4.04 | ||||
| Readmission Rate at DRG | 35.38 | ||||
| Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 34.22 | ||||
| Unplanned Readmission Rate at DRG | 7.63 | ||||
| Unplanned Readmission Rate with ICD Z952 - Presence of prosthetic heart valve | 8.21 | ||||
| Total Medicare payments at DRG | $2,360,891,966 | ||||
| Total Medicare payments with ICD Z952 - Presence of prosthetic heart valve | $46,628,462 | ||||
| Total Medicare payment per Day at DRG | $1,693 | ||||
| Total Medicare payment per Day with ICD Z952 - Presence of prosthetic heart valve | $1,693 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,705 | ||||
| Total Medicare payment per Hospitalization with ICD Z952 - Presence of prosthetic heart valve | $6,845 | ||||
| Total Medicare Charges at DRG | $13,014,640,264 | ||||
| Total Medicare Charges with ICD Z952 - Presence of prosthetic heart valve | $255,656,633 | ||||
| Avg Charges at DRG | $36,963 | ||||
| Avg Charges with ICD Z952 - Presence of prosthetic heart valve | $37,530 | ||||
| Mortality Rate at DRG | 1.54 | ||||
| Mortality Rate with ICD Z952 - Presence of prosthetic heart valve | 2.29 | ||||
| SNF Discharge Rate at DRG | 24.0 | ||||
| SNF Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 22.4 | ||||
| Home Discharge Rate at DRG | 26.62 | ||||
| Home Discharge Rate with ICD Z952 - Presence of prosthetic heart valve | 28.32 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| CHRISTIANA CARE WILMINGTON HOSPITAL | 501 W 14TH ST | WILMINGTON | DE | 19801 | 1,772 |
| MORRISTOWN MEDICAL CENTER | 100 MADISON AVE | MORRISTOWN | NJ | 07960 | 1,686 |
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 1,587 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. LIZETTE ALVAREZ | 10010 KENNERLY RD | SAINT LOUIS | MO | 63128 | 82 |
| Dr. THEODORE L SCHREIBER | 8545 COMMON ROAD | WARREN | MI | 48093 | 75 |
| Dr. SOFIYA PRILIK | 400 E 34TH ST | NEW YORK | NY | 10016 | 63 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 260 |
| Dr. SHERRI A TUPPER | 311 SERVICE RD | E SANDWICH | MA | 02537 | 156 |
| Dr. PADMAJA KONDAMURI | 8840 CALUMET AVE | MUNSTER | IN | 46321 | 148 |