| 4169 - Chronic pulmonary heart disease, unspecified - as a primary diagnosis code | 4169 - Chronic pulmonary heart disease, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 7.14 | |
| Readmission Rate (%) | 29.45 | |
| Unplanned Readmission Rate (%) | 16.48 | |
| 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 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 315: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 316: OTHER CIRCULATORY SYSTEM DIAGNOSES 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 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 102,753 | ||||
| Total Hospitalizations with ICD 4169 - Chronic pulmonary heart disease, unspecified | 404 | ||||
| DRG Share of Total Hospitalizations | 0.45 | ||||
| % of Total ICD 4169 - Chronic pulmonary heart disease, unspecified in DRG | 42.48 | ||||
| Avg LOS at DRG | 7.33 | ||||
| Avg LOS with ICD 4169 - Chronic pulmonary heart disease, unspecified | 6.38 | ||||
| Readmission Rate at DRG | 32.63 | ||||
| Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 29.38 | ||||
| Unplanned Readmission Rate at DRG | 22.44 | ||||
| Unplanned Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 20.22 | ||||
| Total Medicare payments at DRG | $1,376,213,228 | ||||
| Total Medicare payments with ICD 4169 - Chronic pulmonary heart disease, unspecified | $4,877,827 | ||||
| Total Medicare payment per Day at DRG | $1,828 | ||||
| Total Medicare payment per Day with ICD 4169 - Chronic pulmonary heart disease, unspecified | $1,893 | ||||
| Total Medicare payment per Hospitalization at DRG | $13,393 | ||||
| Total Medicare payment per Hospitalization with ICD 4169 - Chronic pulmonary heart disease, unspecified | $12,074 | ||||
| Total Medicare Charges at DRG | $5,899,767,418 | ||||
| Total Medicare Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $17,901,262 | ||||
| Avg Charges at DRG | $57,417 | ||||
| Avg Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $44,310 | ||||
| Mortality Rate at DRG | 5.59 | ||||
| Mortality Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 5.69 | ||||
| SNF Discharge Rate at DRG | 19.0 | ||||
| SNF Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 23.02 | ||||
| Home Discharge Rate at DRG | 40.54 | ||||
| Home Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 32.92 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| LONGMONT UNITED HOSPITAL | 1950 W MOUNTAIN VIEW AVE | LONGMONT | CO | 80501 | 15 |
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 274,950 | ||||
| Total Hospitalizations with ICD 4169 - Chronic pulmonary heart disease, unspecified | 6,529 | ||||
| DRG Share of Total Hospitalizations | 1.2 | ||||
| % of Total ICD 4169 - Chronic pulmonary heart disease, unspecified in DRG | 8.92 | ||||
| Avg LOS at DRG | 6.96 | ||||
| Avg LOS with ICD 4169 - Chronic pulmonary heart disease, unspecified | 7.54 | ||||
| Readmission Rate at DRG | 27.13 | ||||
| Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 30.03 | ||||
| Unplanned Readmission Rate at DRG | 20.24 | ||||
| Unplanned Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 21.46 | ||||
| Total Medicare payments at DRG | $2,790,739,849 | ||||
| Total Medicare payments with ICD 4169 - Chronic pulmonary heart disease, unspecified | $66,594,531 | ||||
| Total Medicare payment per Day at DRG | $1,457 | ||||
| Total Medicare payment per Day with ICD 4169 - Chronic pulmonary heart disease, unspecified | $1,353 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,150 | ||||
| Total Medicare payment per Hospitalization with ICD 4169 - Chronic pulmonary heart disease, unspecified | $10,200 | ||||
| Total Medicare Charges at DRG | $11,867,056,741 | ||||
| Total Medicare Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $317,668,177 | ||||
| Avg Charges at DRG | $43,161 | ||||
| Avg Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $48,655 | ||||
| Mortality Rate at DRG | 7.44 | ||||
| Mortality Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 6.42 | ||||
| SNF Discharge Rate at DRG | 20.22 | ||||
| SNF Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 22.74 | ||||
| Home Discharge Rate at DRG | 37.4 | ||||
| Home Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 31.25 |
| DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 192: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 901,552 | ||||
| Total Hospitalizations with ICD 4169 - Chronic pulmonary heart disease, unspecified | 3,419 | ||||
| DRG Share of Total Hospitalizations | 3.95 | ||||
| % of Total ICD 4169 - Chronic pulmonary heart disease, unspecified in DRG | 4.67 | ||||
| Avg LOS at DRG | 6.79 | ||||
| Avg LOS with ICD 4169 - Chronic pulmonary heart disease, unspecified | 7.72 | ||||
| Readmission Rate at DRG | 25.38 | ||||
| Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 29.3 | ||||
| Unplanned Readmission Rate at DRG | 17.1 | ||||
| Unplanned Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 19.34 | ||||
| Total Medicare payments at DRG | $11,142,976,193 | ||||
| Total Medicare payments with ICD 4169 - Chronic pulmonary heart disease, unspecified | $42,954,866 | ||||
| Total Medicare payment per Day at DRG | $1,821 | ||||
| Total Medicare payment per Day with ICD 4169 - Chronic pulmonary heart disease, unspecified | $1,628 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,360 | ||||
| Total Medicare payment per Hospitalization with ICD 4169 - Chronic pulmonary heart disease, unspecified | $12,564 | ||||
| Total Medicare Charges at DRG | $48,288,426,708 | ||||
| Total Medicare Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $210,557,618 | ||||
| Avg Charges at DRG | $53,561 | ||||
| Avg Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $61,585 | ||||
| Mortality Rate at DRG | 15.16 | ||||
| Mortality Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 15.65 | ||||
| SNF Discharge Rate at DRG | 28.41 | ||||
| SNF Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 28.4 | ||||
| Home Discharge Rate at DRG | 23.21 | ||||
| Home Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 19.98 |
| DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 602,372 | ||||
| Total Hospitalizations with ICD 4169 - Chronic pulmonary heart disease, unspecified | 1,214 | ||||
| DRG Share of Total Hospitalizations | 2.64 | ||||
| % of Total ICD 4169 - Chronic pulmonary heart disease, unspecified in DRG | 1.66 | ||||
| Avg LOS at DRG | 13.11 | ||||
| Avg LOS with ICD 4169 - Chronic pulmonary heart disease, unspecified | 12.88 | ||||
| Readmission Rate at DRG | 15.99 | ||||
| Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 27.26 | ||||
| Unplanned Readmission Rate at DRG | 12.22 | ||||
| Unplanned Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 22.74 | ||||
| Total Medicare payments at DRG | $11,047,686,856 | ||||
| Total Medicare payments with ICD 4169 - Chronic pulmonary heart disease, unspecified | $22,308,768 | ||||
| Total Medicare payment per Day at DRG | $1,399 | ||||
| Total Medicare payment per Day with ICD 4169 - Chronic pulmonary heart disease, unspecified | $1,427 | ||||
| Total Medicare payment per Hospitalization at DRG | $18,340 | ||||
| Total Medicare payment per Hospitalization with ICD 4169 - Chronic pulmonary heart disease, unspecified | $18,376 | ||||
| Total Medicare Charges at DRG | $25,171,736,043 | ||||
| Total Medicare Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $53,030,289 | ||||
| Avg Charges at DRG | $41,788 | ||||
| Avg Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $43,682 | ||||
| Mortality Rate at DRG | 0.21 | ||||
| Mortality Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 17.37 | ||||
| SNF Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 13.51 | ||||
| Home Discharge Rate at DRG | 21.02 | ||||
| Home Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 16.23 |
| DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 285,340 | ||||
| Total Hospitalizations with ICD 4169 - Chronic pulmonary heart disease, unspecified | 973 | ||||
| DRG Share of Total Hospitalizations | 1.25 | ||||
| % of Total ICD 4169 - Chronic pulmonary heart disease, unspecified in DRG | 1.33 | ||||
| Avg LOS at DRG | 4.24 | ||||
| Avg LOS with ICD 4169 - Chronic pulmonary heart disease, unspecified | 5.51 | ||||
| Readmission Rate at DRG | 16.32 | ||||
| Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 25.5 | ||||
| Unplanned Readmission Rate at DRG | 10.58 | ||||
| Unplanned Readmission Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 19.23 | ||||
| Total Medicare payments at DRG | $1,475,002,556 | ||||
| Total Medicare payments with ICD 4169 - Chronic pulmonary heart disease, unspecified | $5,282,333 | ||||
| Total Medicare payment per Day at DRG | $1,218 | ||||
| Total Medicare payment per Day with ICD 4169 - Chronic pulmonary heart disease, unspecified | $985 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,169 | ||||
| Total Medicare payment per Hospitalization with ICD 4169 - Chronic pulmonary heart disease, unspecified | $5,429 | ||||
| Total Medicare Charges at DRG | $6,348,002,652 | ||||
| Total Medicare Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $29,995,362 | ||||
| Avg Charges at DRG | $22,247 | ||||
| Avg Charges with ICD 4169 - Chronic pulmonary heart disease, unspecified | $30,828 | ||||
| Mortality Rate at DRG | 0.12 | ||||
| Mortality Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 15.9 | ||||
| SNF Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 22.92 | ||||
| Home Discharge Rate at DRG | 54.0 | ||||
| Home Discharge Rate with ICD 4169 - Chronic pulmonary heart disease, unspecified | 38.54 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| MISSION HOSPITAL | 509 BILTMORE AVE | ASHEVILLE | NC | 28801 | 377 |
| BEAUMONT HOSPITAL TROY | 44201 DEQUINDRE RD | TROY | MI | 48085 | 330 |
| ADVENTHEALTH SEBRING | 4200 SUN N LAKE BLVD | SEBRING | FL | 33872 | 315 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. DEEPAK T PATEL | 1739 US HIGHWAY 27 S | SEBRING | FL | 33870 | 77 |
| Dr. MOHAMED S ALI | 4818 W PROFESSIONAL DR | BAY CITY | MI | 48706 | 57 |
| Dr. VAN S BREEDING | 226 MEDICAL PLAZA LANE | WHITESBURG | KY | 41858 | 43 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. DEEPAK T PATEL | 1739 US HIGHWAY 27 S | SEBRING | FL | 33870 | 213 |
| Dr. VAN S BREEDING | 226 MEDICAL PLAZA LANE | WHITESBURG | KY | 41858 | 144 |
| Dr. MANISH SHROFF | 1501 W 11TH PL | BIG SPRING | TX | 79720 | 139 |