| 36201 - Background diabetic retinopathy - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 19.69 | |
| 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 | ||
| DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 901,552 | ||||
| Total Hospitalizations with ICD 36201 - Background diabetic retinopathy | 8,110 | ||||
| DRG Share of Total Hospitalizations | 3.95 | ||||
| % of Total ICD 36201 - Background diabetic retinopathy in DRG | 3.83 | ||||
| Avg LOS at DRG | 6.79 | ||||
| Avg LOS with ICD 36201 - Background diabetic retinopathy | 7.19 | ||||
| Readmission Rate at DRG | 25.38 | ||||
| Readmission Rate with ICD 36201 - Background diabetic retinopathy | 30.92 | ||||
| Unplanned Readmission Rate at DRG | 17.1 | ||||
| Unplanned Readmission Rate with ICD 36201 - Background diabetic retinopathy | 21.93 | ||||
| Total Medicare payments at DRG | $11,142,976,193 | ||||
| Total Medicare payments with ICD 36201 - Background diabetic retinopathy | $103,445,840 | ||||
| Total Medicare payment per Day at DRG | $1,821 | ||||
| Total Medicare payment per Day with ICD 36201 - Background diabetic retinopathy | $1,775 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,360 | ||||
| Total Medicare payment per Hospitalization with ICD 36201 - Background diabetic retinopathy | $12,755 | ||||
| Total Medicare Charges at DRG | $48,288,426,708 | ||||
| Total Medicare Charges with ICD 36201 - Background diabetic retinopathy | $477,277,203 | ||||
| Avg Charges at DRG | $53,561 | ||||
| Avg Charges with ICD 36201 - Background diabetic retinopathy | $58,850 | ||||
| Mortality Rate at DRG | 15.16 | ||||
| Mortality Rate with ICD 36201 - Background diabetic retinopathy | 9.82 | ||||
| SNF Discharge Rate at DRG | 28.41 | ||||
| SNF Discharge Rate with ICD 36201 - Background diabetic retinopathy | 25.41 | ||||
| Home Discharge Rate at DRG | 23.21 | ||||
| Home Discharge Rate with ICD 36201 - Background diabetic retinopathy | 31.41 |
| DRG 638: DIABETES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 637: DIABETES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 108,430 | ||||
| Total Hospitalizations with ICD 36201 - Background diabetic retinopathy | 5,386 | ||||
| DRG Share of Total Hospitalizations | 0.47 | ||||
| % of Total ICD 36201 - Background diabetic retinopathy in DRG | 2.55 | ||||
| Avg LOS at DRG | 4.3 | ||||
| Avg LOS with ICD 36201 - Background diabetic retinopathy | 4.79 | ||||
| Readmission Rate at DRG | 23.84 | ||||
| Readmission Rate with ICD 36201 - Background diabetic retinopathy | 27.76 | ||||
| Unplanned Readmission Rate at DRG | 17.3 | ||||
| Unplanned Readmission Rate with ICD 36201 - Background diabetic retinopathy | 21.22 | ||||
| Total Medicare payments at DRG | $625,714,200 | ||||
| Total Medicare payments with ICD 36201 - Background diabetic retinopathy | $33,392,103 | ||||
| Total Medicare payment per Day at DRG | $1,343 | ||||
| Total Medicare payment per Day with ICD 36201 - Background diabetic retinopathy | $1,295 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,771 | ||||
| Total Medicare payment per Hospitalization with ICD 36201 - Background diabetic retinopathy | $6,200 | ||||
| Total Medicare Charges at DRG | $2,802,144,531 | ||||
| Total Medicare Charges with ICD 36201 - Background diabetic retinopathy | $158,487,069 | ||||
| Avg Charges at DRG | $25,843 | ||||
| Avg Charges with ICD 36201 - Background diabetic retinopathy | $29,426 | ||||
| Mortality Rate at DRG | 0.32 | ||||
| Mortality Rate with ICD 36201 - Background diabetic retinopathy | 0.28 | ||||
| SNF Discharge Rate at DRG | 15.22 | ||||
| SNF Discharge Rate with ICD 36201 - Background diabetic retinopathy | 13.41 | ||||
| Home Discharge Rate at DRG | 53.6 | ||||
| Home Discharge Rate with ICD 36201 - Background diabetic retinopathy | 56.11 |
| DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 252: OTHER VASCULAR PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 074: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 073: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 102,753 | ||||
| Total Hospitalizations with ICD 36201 - Background diabetic retinopathy | 3,245 | ||||
| DRG Share of Total Hospitalizations | 0.45 | ||||
| % of Total ICD 36201 - Background diabetic retinopathy in DRG | 1.53 | ||||
| Avg LOS at DRG | 7.33 | ||||
| Avg LOS with ICD 36201 - Background diabetic retinopathy | 6.79 | ||||
| Readmission Rate at DRG | 32.63 | ||||
| Readmission Rate with ICD 36201 - Background diabetic retinopathy | 33.18 | ||||
| Unplanned Readmission Rate at DRG | 22.44 | ||||
| Unplanned Readmission Rate with ICD 36201 - Background diabetic retinopathy | 23.98 | ||||
| Total Medicare payments at DRG | $1,376,213,228 | ||||
| Total Medicare payments with ICD 36201 - Background diabetic retinopathy | $42,491,748 | ||||
| Total Medicare payment per Day at DRG | $1,828 | ||||
| Total Medicare payment per Day with ICD 36201 - Background diabetic retinopathy | $1,927 | ||||
| Total Medicare payment per Hospitalization at DRG | $13,393 | ||||
| Total Medicare payment per Hospitalization with ICD 36201 - Background diabetic retinopathy | $13,095 | ||||
| Total Medicare Charges at DRG | $5,899,767,418 | ||||
| Total Medicare Charges with ICD 36201 - Background diabetic retinopathy | $177,588,903 | ||||
| Avg Charges at DRG | $57,417 | ||||
| Avg Charges with ICD 36201 - Background diabetic retinopathy | $54,727 | ||||
| Mortality Rate at DRG | 5.59 | ||||
| Mortality Rate with ICD 36201 - Background diabetic retinopathy | 2.62 | ||||
| SNF Discharge Rate at DRG | 19.0 | ||||
| SNF Discharge Rate with ICD 36201 - Background diabetic retinopathy | 17.9 | ||||
| Home Discharge Rate at DRG | 40.54 | ||||
| Home Discharge Rate with ICD 36201 - Background diabetic retinopathy | 49.89 |
| DRG 699: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 65,391 | ||||
| Total Hospitalizations with ICD 36201 - Background diabetic retinopathy | 2,500 | ||||
| DRG Share of Total Hospitalizations | 0.29 | ||||
| % of Total ICD 36201 - Background diabetic retinopathy in DRG | 1.18 | ||||
| Avg LOS at DRG | 4.44 | ||||
| Avg LOS with ICD 36201 - Background diabetic retinopathy | 4.53 | ||||
| Readmission Rate at DRG | 25.11 | ||||
| Readmission Rate with ICD 36201 - Background diabetic retinopathy | 28.56 | ||||
| Unplanned Readmission Rate at DRG | 17.33 | ||||
| Unplanned Readmission Rate with ICD 36201 - Background diabetic retinopathy | 19.51 | ||||
| Total Medicare payments at DRG | $440,473,524 | ||||
| Total Medicare payments with ICD 36201 - Background diabetic retinopathy | $18,185,178 | ||||
| Total Medicare payment per Day at DRG | $1,517 | ||||
| Total Medicare payment per Day with ICD 36201 - Background diabetic retinopathy | $1,606 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,736 | ||||
| Total Medicare payment per Hospitalization with ICD 36201 - Background diabetic retinopathy | $7,274 | ||||
| Total Medicare Charges at DRG | $2,010,786,421 | ||||
| Total Medicare Charges with ICD 36201 - Background diabetic retinopathy | $86,974,064 | ||||
| Avg Charges at DRG | $30,750 | ||||
| Avg Charges with ICD 36201 - Background diabetic retinopathy | $34,790 | ||||
| Mortality Rate at DRG | 0.36 | ||||
| Mortality Rate with ICD 36201 - Background diabetic retinopathy | NA | ||||
| SNF Discharge Rate at DRG | 19.61 | ||||
| SNF Discharge Rate with ICD 36201 - Background diabetic retinopathy | 10.72 | ||||
| Home Discharge Rate at DRG | 51.17 | ||||
| Home Discharge Rate with ICD 36201 - Background diabetic retinopathy | 66.52 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| UNIVERSITY OF MICHIGAN HEALTH SYSTEM | 1500 EAST MEDICAL CENTER DRIVE | ANN ARBOR | MI | 48109 | 994 |
| CLEVELAND CLINIC | 9500 EUCLID AVE | CLEVELAND | OH | 44195 | 835 |
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W 13 MILE RD | ROYAL OAK | MI | 48073 | 821 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. MILAP POKHAREL | 4511 N CAMPBELL AVE | TUCSON | AZ | 85718 | 132 |
| Dr. RADHA KRISHNA KROTHAPALLI | 4163 LOMAC ST | MONTGOMERY | AL | 36106 | 107 |
| Dr. LUIS GUTIERREZ-PERRY | 3406 BOB ROGERS DR. | EAGLE PASS | TX | 78852 | 90 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. SERGIO ZAMORA | 2450 EL INDIO HWY | EAGLE PASS | TX | 78852 | 457 |
| Dr. MILAP POKHAREL | 4511 N CAMPBELL AVE | TUCSON | AZ | 85718 | 207 |
| Dr. MANISH PANDYA | 812 W MAPLE ST | FARMINGTON | NM | 87401 | 157 |