| 514 - Pulmonary congestion and hypostasis - as a primary diagnosis code | 514 - Pulmonary congestion and hypostasis - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 8.02 | |
| Readmission Rate (%) | 30.24 | |
| Unplanned Readmission Rate (%) | 22.23 | |
| 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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 274,950 | ||||
| Total Hospitalizations with ICD 514 - Pulmonary congestion and hypostasis | 5,392 | ||||
| DRG Share of Total Hospitalizations | 1.2 | ||||
| % of Total ICD 514 - Pulmonary congestion and hypostasis in DRG | 91.64 | ||||
| Avg LOS at DRG | 6.96 | ||||
| Avg LOS with ICD 514 - Pulmonary congestion and hypostasis | 3.36 | ||||
| Readmission Rate at DRG | 27.13 | ||||
| Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 27.81 | ||||
| Unplanned Readmission Rate at DRG | 20.24 | ||||
| Unplanned Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 22.16 | ||||
| Total Medicare payments at DRG | $2,790,739,849 | ||||
| Total Medicare payments with ICD 514 - Pulmonary congestion and hypostasis | $41,352,030 | ||||
| Total Medicare payment per Day at DRG | $1,457 | ||||
| Total Medicare payment per Day with ICD 514 - Pulmonary congestion and hypostasis | $2,280 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,150 | ||||
| Total Medicare payment per Hospitalization with ICD 514 - Pulmonary congestion and hypostasis | $7,669 | ||||
| Total Medicare Charges at DRG | $11,867,056,741 | ||||
| Total Medicare Charges with ICD 514 - Pulmonary congestion and hypostasis | $136,770,192 | ||||
| Avg Charges at DRG | $43,161 | ||||
| Avg Charges with ICD 514 - Pulmonary congestion and hypostasis | $25,365 | ||||
| Mortality Rate at DRG | 7.44 | ||||
| Mortality Rate with ICD 514 - Pulmonary congestion and hypostasis | 2.02 | ||||
| SNF Discharge Rate at DRG | 20.22 | ||||
| SNF Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 12.54 | ||||
| Home Discharge Rate at DRG | 37.4 | ||||
| Home Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 61.02 |
| DRG 982: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|
| Total Hospitalizations at DRG | 31,742 |
| Total Hospitalizations with ICD 514 - Pulmonary congestion and hypostasis | 16 |
| DRG Share of Total Hospitalizations | 0.14 |
| % of Total ICD 514 - Pulmonary congestion and hypostasis in DRG | 0.27 |
| Avg LOS at DRG | 7.58 |
| Avg LOS with ICD 514 - Pulmonary congestion and hypostasis | 5.69 |
| Readmission Rate at DRG | 25.44 |
| Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | NA |
| Unplanned Readmission Rate at DRG | 14.47 |
| Unplanned Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | NA |
| Total Medicare payments at DRG | $583,003,764 |
| Total Medicare payments with ICD 514 - Pulmonary congestion and hypostasis | $274,575 |
| Total Medicare payment per Day at DRG | $2,422 |
| Total Medicare payment per Day with ICD 514 - Pulmonary congestion and hypostasis | $3,017 |
| Total Medicare payment per Hospitalization at DRG | $18,367 |
| Total Medicare payment per Hospitalization with ICD 514 - Pulmonary congestion and hypostasis | $17,161 |
| Total Medicare Charges at DRG | $2,600,081,468 |
| Total Medicare Charges with ICD 514 - Pulmonary congestion and hypostasis | $1,365,492 |
| Avg Charges at DRG | $81,913 |
| Avg Charges with ICD 514 - Pulmonary congestion and hypostasis | $85,343 |
| Mortality Rate at DRG | 0.96 |
| Mortality Rate with ICD 514 - Pulmonary congestion and hypostasis | NA |
| SNF Discharge Rate at DRG | 25.55 |
| SNF Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | NA |
| Home Discharge Rate at DRG | 40.29 |
| Home Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| METHODIST UNIVERSITY HOSPITAL | 1265 UNION AVE | MEMPHIS | TN | 38104 | 86 |
| CONWAY REGIONAL MEDICAL CENTER | 2302 COLLEGE AVE | CONWAY | AR | 72034 | 35 |
| NOVANT HEALTH FORSYTH MEDICAL CENTER | 3333 SILAS CREEK PKWY | WINSTON SALEM | NC | 27103 | 31 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. GOPAL GOLLAPUPI KRISHNA | 917 BLANCO CIRCLE | SALINAS | CA | 93901 | 13 |
| Dr. JAMES R. DILLEY | 730 HIGHLAND OAKS DR | WINSTON-SALEM | NC | 27103 | 13 |
| Dr. JOHN CAMERON PITTARD | 255 WARLEY ST | FLORENCE | SC | 29501 | 12 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. JOHN CAMERON PITTARD | 255 WARLEY ST | FLORENCE | SC | 29501 | 16 |
| Dr. DOUGLAS A STAHURA | 755 MEDICAL PARK DR | AIKEN | SC | 29801 | 12 |
| Dr. RAYMOND RICHARD CARRILLO | 917 BLANCO CIRCLE | SALINAS | CA | 93901 | 11 |
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | 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 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 274,950 | ||||
| Total Hospitalizations with ICD 514 - Pulmonary congestion and hypostasis | 8,443 | ||||
| DRG Share of Total Hospitalizations | 1.2 | ||||
| % of Total ICD 514 - Pulmonary congestion and hypostasis in DRG | 9.77 | ||||
| Avg LOS at DRG | 6.96 | ||||
| Avg LOS with ICD 514 - Pulmonary congestion and hypostasis | 4.47 | ||||
| Readmission Rate at DRG | 27.13 | ||||
| Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 27.72 | ||||
| Unplanned Readmission Rate at DRG | 20.24 | ||||
| Unplanned Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 21.68 | ||||
| Total Medicare payments at DRG | $2,790,739,849 | ||||
| Total Medicare payments with ICD 514 - Pulmonary congestion and hypostasis | $71,589,803 | ||||
| Total Medicare payment per Day at DRG | $1,457 | ||||
| Total Medicare payment per Day with ICD 514 - Pulmonary congestion and hypostasis | $1,899 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,150 | ||||
| Total Medicare payment per Hospitalization with ICD 514 - Pulmonary congestion and hypostasis | $8,479 | ||||
| Total Medicare Charges at DRG | $11,867,056,741 | ||||
| Total Medicare Charges with ICD 514 - Pulmonary congestion and hypostasis | $271,694,914 | ||||
| Avg Charges at DRG | $43,161 | ||||
| Avg Charges with ICD 514 - Pulmonary congestion and hypostasis | $32,180 | ||||
| Mortality Rate at DRG | 7.44 | ||||
| Mortality Rate with ICD 514 - Pulmonary congestion and hypostasis | 3.86 | ||||
| SNF Discharge Rate at DRG | 20.22 | ||||
| SNF Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 15.3 | ||||
| Home Discharge Rate at DRG | 37.4 | ||||
| Home Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 53.17 |
| DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 602,372 | ||||
| Total Hospitalizations with ICD 514 - Pulmonary congestion and hypostasis | 2,762 | ||||
| DRG Share of Total Hospitalizations | 2.64 | ||||
| % of Total ICD 514 - Pulmonary congestion and hypostasis in DRG | 3.2 | ||||
| Avg LOS at DRG | 13.11 | ||||
| Avg LOS with ICD 514 - Pulmonary congestion and hypostasis | 12.85 | ||||
| Readmission Rate at DRG | 15.99 | ||||
| Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 21.32 | ||||
| Unplanned Readmission Rate at DRG | 12.22 | ||||
| Unplanned Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 18.03 | ||||
| Total Medicare payments at DRG | $11,047,686,856 | ||||
| Total Medicare payments with ICD 514 - Pulmonary congestion and hypostasis | $51,707,473 | ||||
| Total Medicare payment per Day at DRG | $1,399 | ||||
| Total Medicare payment per Day with ICD 514 - Pulmonary congestion and hypostasis | $1,457 | ||||
| Total Medicare payment per Hospitalization at DRG | $18,340 | ||||
| Total Medicare payment per Hospitalization with ICD 514 - Pulmonary congestion and hypostasis | $18,721 | ||||
| Total Medicare Charges at DRG | $25,171,736,043 | ||||
| Total Medicare Charges with ICD 514 - Pulmonary congestion and hypostasis | $112,182,909 | ||||
| Avg Charges at DRG | $41,788 | ||||
| Avg Charges with ICD 514 - Pulmonary congestion and hypostasis | $40,617 | ||||
| Mortality Rate at DRG | 0.21 | ||||
| Mortality Rate with ICD 514 - Pulmonary congestion and hypostasis | NA | ||||
| SNF Discharge Rate at DRG | 17.37 | ||||
| SNF Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 20.24 | ||||
| Home Discharge Rate at DRG | 21.02 | ||||
| Home Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 15.75 |
| DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 311,763 | ||||
| Total Hospitalizations with ICD 514 - Pulmonary congestion and hypostasis | 1,129 | ||||
| DRG Share of Total Hospitalizations | 1.36 | ||||
| % of Total ICD 514 - Pulmonary congestion and hypostasis in DRG | 1.31 | ||||
| Avg LOS at DRG | 4.34 | ||||
| Avg LOS with ICD 514 - Pulmonary congestion and hypostasis | 5.58 | ||||
| Readmission Rate at DRG | 23.41 | ||||
| Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 27.39 | ||||
| Unplanned Readmission Rate at DRG | 16.67 | ||||
| Unplanned Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 20.31 | ||||
| Total Medicare payments at DRG | $1,867,955,174 | ||||
| Total Medicare payments with ICD 514 - Pulmonary congestion and hypostasis | $7,327,880 | ||||
| Total Medicare payment per Day at DRG | $1,382 | ||||
| Total Medicare payment per Day with ICD 514 - Pulmonary congestion and hypostasis | $1,164 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,992 | ||||
| Total Medicare payment per Hospitalization with ICD 514 - Pulmonary congestion and hypostasis | $6,491 | ||||
| Total Medicare Charges at DRG | $8,358,483,119 | ||||
| Total Medicare Charges with ICD 514 - Pulmonary congestion and hypostasis | $41,071,185 | ||||
| Avg Charges at DRG | $26,810 | ||||
| Avg Charges with ICD 514 - Pulmonary congestion and hypostasis | $36,378 | ||||
| Mortality Rate at DRG | 1.37 | ||||
| Mortality Rate with ICD 514 - Pulmonary congestion and hypostasis | 2.75 | ||||
| SNF Discharge Rate at DRG | 23.3 | ||||
| SNF Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 18.87 | ||||
| Home Discharge Rate at DRG | 45.55 | ||||
| Home Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 43.4 |
| 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) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 261,933 | ||||
| Total Hospitalizations with ICD 514 - Pulmonary congestion and hypostasis | 917 | ||||
| DRG Share of Total Hospitalizations | 1.15 | ||||
| % of Total ICD 514 - Pulmonary congestion and hypostasis in DRG | 1.06 | ||||
| Avg LOS at DRG | 4.1 | ||||
| Avg LOS with ICD 514 - Pulmonary congestion and hypostasis | 4.37 | ||||
| Readmission Rate at DRG | 23.4 | ||||
| Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 23.22 | ||||
| Unplanned Readmission Rate at DRG | 18.25 | ||||
| Unplanned Readmission Rate with ICD 514 - Pulmonary congestion and hypostasis | 17.78 | ||||
| Total Medicare payments at DRG | $1,493,154,986 | ||||
| Total Medicare payments with ICD 514 - Pulmonary congestion and hypostasis | $5,432,960 | ||||
| Total Medicare payment per Day at DRG | $1,391 | ||||
| Total Medicare payment per Day with ICD 514 - Pulmonary congestion and hypostasis | $1,355 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,701 | ||||
| Total Medicare payment per Hospitalization with ICD 514 - Pulmonary congestion and hypostasis | $5,925 | ||||
| Total Medicare Charges at DRG | $6,844,391,093 | ||||
| Total Medicare Charges with ICD 514 - Pulmonary congestion and hypostasis | $24,983,279 | ||||
| Avg Charges at DRG | $26,130 | ||||
| Avg Charges with ICD 514 - Pulmonary congestion and hypostasis | $27,245 | ||||
| Mortality Rate at DRG | 0.36 | ||||
| Mortality Rate with ICD 514 - Pulmonary congestion and hypostasis | NA | ||||
| SNF Discharge Rate at DRG | 12.08 | ||||
| SNF Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 12.76 | ||||
| Home Discharge Rate at DRG | 59.35 | ||||
| Home Discharge Rate with ICD 514 - Pulmonary congestion and hypostasis | 55.07 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| BARNES JEWISH HOSPITAL | 1 BARNES-JEWISH HOSPITAL PLZ | SAINT LOUIS | MO | 63110 | 548 |
| VILLA MARIA NURSING CENTER | 1050 NE 125TH ST | NORTH MIAMI | FL | 33161 | 476 |
| CHARLESTON AREA MEDICAL CENTER | 501 MORRIS ST | CHARLESTON | WV | 25301 | 405 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. PIERRE R TIBI | 811 AINSWORTH DR | PRESCOTT | AZ | 86301 | 45 |
| Dr. VENUGOPAL GOVINDAPPA | 255 WARLEY ST | FLORENCE | SC | 29501 | 38 |
| Dr. PATRICK MCCARTHY | 680 N LAKE SHORE DR | CHICAGO | IL | 60611 | 28 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. MIRIAM A FELIZ | 6447 MIAMI LAKES DR E APT 104 | HIALEAH | FL | 33014 | 399 |
| Dr. DAVID MARK GORDON | 28455 HAGGERTY RD | NOVI | MI | 48377 | 225 |
| Dr. MARK EDWIN MCKENZIE | 2010 GOLDRING AVE | LAS VEGAS | NV | 89106 | 69 |