| V4364 - Hip joint replacement - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 11.0 | |
| 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 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 946: REHABILITATION WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 939,378 | ||||
| Total Hospitalizations with ICD V4364 - Hip joint replacement | 59,047 | ||||
| DRG Share of Total Hospitalizations | 4.11 | ||||
| % of Total ICD V4364 - Hip joint replacement in DRG | 8.53 | ||||
| Avg LOS at DRG | 3.12 | ||||
| Avg LOS with ICD V4364 - Hip joint replacement | 3.02 | ||||
| Readmission Rate at DRG | 12.54 | ||||
| Readmission Rate with ICD V4364 - Hip joint replacement | 12.08 | ||||
| Unplanned Readmission Rate at DRG | 3.52 | ||||
| Unplanned Readmission Rate with ICD V4364 - Hip joint replacement | 3.48 | ||||
| Total Medicare payments at DRG | $11,301,359,598 | ||||
| Total Medicare payments with ICD V4364 - Hip joint replacement | $734,368,825 | ||||
| Total Medicare payment per Day at DRG | $3,853 | ||||
| Total Medicare payment per Day with ICD V4364 - Hip joint replacement | $4,124 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,031 | ||||
| Total Medicare payment per Hospitalization with ICD V4364 - Hip joint replacement | $12,437 | ||||
| Total Medicare Charges at DRG | $51,993,364,479 | ||||
| Total Medicare Charges with ICD V4364 - Hip joint replacement | $3,308,433,719 | ||||
| Avg Charges at DRG | $55,349 | ||||
| Avg Charges with ICD V4364 - Hip joint replacement | $56,031 | ||||
| Mortality Rate at DRG | 0.07 | ||||
| Mortality Rate with ICD V4364 - Hip joint replacement | 0.04 | ||||
| SNF Discharge Rate at DRG | 32.49 | ||||
| SNF Discharge Rate with ICD V4364 - Hip joint replacement | 31.8 | ||||
| Home Discharge Rate at DRG | 21.06 | ||||
| Home Discharge Rate with ICD V4364 - Hip joint replacement | 20.68 |
| DRG 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 35,958 | ||||
| Total Hospitalizations with ICD V4364 - Hip joint replacement | 15,554 | ||||
| DRG Share of Total Hospitalizations | 0.16 | ||||
| % of Total ICD V4364 - Hip joint replacement in DRG | 2.25 | ||||
| Avg LOS at DRG | 2.99 | ||||
| Avg LOS with ICD V4364 - Hip joint replacement | 3.05 | ||||
| Readmission Rate at DRG | 12.52 | ||||
| Readmission Rate with ICD V4364 - Hip joint replacement | 14.19 | ||||
| Unplanned Readmission Rate at DRG | 3.68 | ||||
| Unplanned Readmission Rate with ICD V4364 - Hip joint replacement | 4.27 | ||||
| Total Medicare payments at DRG | $583,650,288 | ||||
| Total Medicare payments with ICD V4364 - Hip joint replacement | $252,334,724 | ||||
| Total Medicare payment per Day at DRG | $5,437 | ||||
| Total Medicare payment per Day with ICD V4364 - Hip joint replacement | $5,314 | ||||
| Total Medicare payment per Hospitalization at DRG | $16,231 | ||||
| Total Medicare payment per Hospitalization with ICD V4364 - Hip joint replacement | $16,223 | ||||
| Total Medicare Charges at DRG | $2,634,206,014 | ||||
| Total Medicare Charges with ICD V4364 - Hip joint replacement | $999,027,325 | ||||
| Avg Charges at DRG | $73,258 | ||||
| Avg Charges with ICD V4364 - Hip joint replacement | $64,230 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD V4364 - Hip joint replacement | NA | ||||
| SNF Discharge Rate at DRG | 25.14 | ||||
| SNF Discharge Rate with ICD V4364 - Hip joint replacement | 26.53 | ||||
| Home Discharge Rate at DRG | 25.55 | ||||
| Home Discharge Rate with ICD V4364 - Hip joint replacement | 25.09 |
| DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 536: FRACTURES OF HIP AND PELVIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 285,340 | ||||
| Total Hospitalizations with ICD V4364 - Hip joint replacement | 9,033 | ||||
| DRG Share of Total Hospitalizations | 1.25 | ||||
| % of Total ICD V4364 - Hip joint replacement in DRG | 1.31 | ||||
| Avg LOS at DRG | 4.24 | ||||
| Avg LOS with ICD V4364 - Hip joint replacement | 4.22 | ||||
| Readmission Rate at DRG | 16.32 | ||||
| Readmission Rate with ICD V4364 - Hip joint replacement | 16.83 | ||||
| Unplanned Readmission Rate at DRG | 10.58 | ||||
| Unplanned Readmission Rate with ICD V4364 - Hip joint replacement | 11.26 | ||||
| Total Medicare payments at DRG | $1,475,002,556 | ||||
| Total Medicare payments with ICD V4364 - Hip joint replacement | $45,850,227 | ||||
| Total Medicare payment per Day at DRG | $1,218 | ||||
| Total Medicare payment per Day with ICD V4364 - Hip joint replacement | $1,201 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,169 | ||||
| Total Medicare payment per Hospitalization with ICD V4364 - Hip joint replacement | $5,076 | ||||
| Total Medicare Charges at DRG | $6,348,002,652 | ||||
| Total Medicare Charges with ICD V4364 - Hip joint replacement | $205,735,987 | ||||
| Avg Charges at DRG | $22,247 | ||||
| Avg Charges with ICD V4364 - Hip joint replacement | $22,776 | ||||
| Mortality Rate at DRG | 0.12 | ||||
| Mortality Rate with ICD V4364 - Hip joint replacement | NA | ||||
| SNF Discharge Rate at DRG | 15.9 | ||||
| SNF Discharge Rate with ICD V4364 - Hip joint replacement | 21.2 | ||||
| Home Discharge Rate at DRG | 54.0 | ||||
| Home Discharge Rate with ICD V4364 - Hip joint replacement | 46.3 |
| DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 812: RED BLOOD CELL DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 285,530 | ||||
| Total Hospitalizations with ICD V4364 - Hip joint replacement | 7,924 | ||||
| DRG Share of Total Hospitalizations | 1.25 | ||||
| % of Total ICD V4364 - Hip joint replacement in DRG | 1.15 | ||||
| Avg LOS at DRG | 4.72 | ||||
| Avg LOS with ICD V4364 - Hip joint replacement | 4.69 | ||||
| Readmission Rate at DRG | 18.55 | ||||
| Readmission Rate with ICD V4364 - Hip joint replacement | 17.8 | ||||
| Unplanned Readmission Rate at DRG | 12.87 | ||||
| Unplanned Readmission Rate with ICD V4364 - Hip joint replacement | 12.63 | ||||
| Total Medicare payments at DRG | $1,922,582,097 | ||||
| Total Medicare payments with ICD V4364 - Hip joint replacement | $52,896,535 | ||||
| Total Medicare payment per Day at DRG | $1,427 | ||||
| Total Medicare payment per Day with ICD V4364 - Hip joint replacement | $1,422 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,733 | ||||
| Total Medicare payment per Hospitalization with ICD V4364 - Hip joint replacement | $6,675 | ||||
| Total Medicare Charges at DRG | $8,696,353,387 | ||||
| Total Medicare Charges with ICD V4364 - Hip joint replacement | $242,208,800 | ||||
| Avg Charges at DRG | $30,457 | ||||
| Avg Charges with ICD V4364 - Hip joint replacement | $30,566 | ||||
| Mortality Rate at DRG | 2.4 | ||||
| Mortality Rate with ICD V4364 - Hip joint replacement | 2.27 | ||||
| SNF Discharge Rate at DRG | 23.54 | ||||
| SNF Discharge Rate with ICD V4364 - Hip joint replacement | 27.52 | ||||
| Home Discharge Rate at DRG | 44.6 | ||||
| Home Discharge Rate with ICD V4364 - Hip joint replacement | 39.18 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| HOSPITAL FOR SPECIAL SURGERY | 535 E 70TH ST | NEW YORK | NY | 10021 | 2,218 |
| CHRISTIANA CARE WILMINGTON HOSPITAL | 501 W 14TH ST | WILMINGTON | DE | 19801 | 2,112 |
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W 13 MILE RD | ROYAL OAK | MI | 48073 | 2,096 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. THOMAS KELLY TKACH | 1110 N LEE AVE | OKLAHOMA CITY | OK | 73103 | 245 |
| Dr. JOHN TERRY DEARBORN | 2000 MOWRY AVE | FREMONT | CA | 94538 | 212 |
| Dr. ANDREW GLEN YUN | 13160 MINDANAO WAY | MARINA DEL REY | CA | 90292 | 207 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. ROBERT DAVID HOLLAND | HELEN HAYES HOSPITAL | WEST HAVERSTRAW | NY | 10993 | 427 |
| Dr. ALEXANDER DEJESUS | 6400 EDGELAKE DR | SARASOTA | FL | 34240 | 394 |
| Dr. THOMAS KELLY TKACH | 1110 N LEE AVE | OKLAHOMA CITY | OK | 73103 | 247 |