| V4365 - Knee joint replacement - as a primary or secondary diagnosis code | ||
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | ||
| Readmission Rate (%) | ||
| Unplanned Readmission Rate (%) | 9.75 | |
| 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 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) | DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 939,378 | ||||
| Total Hospitalizations with ICD V4365 - Knee joint replacement | 104,193 | ||||
| DRG Share of Total Hospitalizations | 4.11 | ||||
| % of Total ICD V4365 - Knee joint replacement in DRG | 10.91 | ||||
| Avg LOS at DRG | 3.12 | ||||
| Avg LOS with ICD V4365 - Knee joint replacement | 2.98 | ||||
| Readmission Rate at DRG | 12.54 | ||||
| Readmission Rate with ICD V4365 - Knee joint replacement | 11.35 | ||||
| Unplanned Readmission Rate at DRG | 3.52 | ||||
| Unplanned Readmission Rate with ICD V4365 - Knee joint replacement | 3.13 | ||||
| Total Medicare payments at DRG | $11,301,359,598 | ||||
| Total Medicare payments with ICD V4365 - Knee joint replacement | $1,269,070,796 | ||||
| Total Medicare payment per Day at DRG | $3,853 | ||||
| Total Medicare payment per Day with ICD V4365 - Knee joint replacement | $4,086 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,031 | ||||
| Total Medicare payment per Hospitalization with ICD V4365 - Knee joint replacement | $12,180 | ||||
| Total Medicare Charges at DRG | $51,993,364,479 | ||||
| Total Medicare Charges with ICD V4365 - Knee joint replacement | $5,638,705,875 | ||||
| Avg Charges at DRG | $55,349 | ||||
| Avg Charges with ICD V4365 - Knee joint replacement | $54,118 | ||||
| Mortality Rate at DRG | 0.07 | ||||
| Mortality Rate with ICD V4365 - Knee joint replacement | 0.03 | ||||
| SNF Discharge Rate at DRG | 32.49 | ||||
| SNF Discharge Rate with ICD V4365 - Knee joint replacement | 30.5 | ||||
| Home Discharge Rate at DRG | 21.06 | ||||
| Home Discharge Rate with ICD V4365 - Knee joint replacement | 22.21 |
| DRG 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 35,958 | ||||
| Total Hospitalizations with ICD V4365 - Knee joint replacement | 16,680 | ||||
| DRG Share of Total Hospitalizations | 0.16 | ||||
| % of Total ICD V4365 - Knee joint replacement in DRG | 1.75 | ||||
| Avg LOS at DRG | 2.99 | ||||
| Avg LOS with ICD V4365 - Knee joint replacement | 2.92 | ||||
| Readmission Rate at DRG | 12.52 | ||||
| Readmission Rate with ICD V4365 - Knee joint replacement | 11.21 | ||||
| Unplanned Readmission Rate at DRG | 3.68 | ||||
| Unplanned Readmission Rate with ICD V4365 - Knee joint replacement | 3.23 | ||||
| Total Medicare payments at DRG | $583,650,288 | ||||
| Total Medicare payments with ICD V4365 - Knee joint replacement | $271,192,902 | ||||
| Total Medicare payment per Day at DRG | $5,437 | ||||
| Total Medicare payment per Day with ICD V4365 - Knee joint replacement | $5,567 | ||||
| Total Medicare payment per Hospitalization at DRG | $16,231 | ||||
| Total Medicare payment per Hospitalization with ICD V4365 - Knee joint replacement | $16,259 | ||||
| Total Medicare Charges at DRG | $2,634,206,014 | ||||
| Total Medicare Charges with ICD V4365 - Knee joint replacement | $1,337,226,627 | ||||
| Avg Charges at DRG | $73,258 | ||||
| Avg Charges with ICD V4365 - Knee joint replacement | $80,169 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD V4365 - Knee joint replacement | NA | ||||
| SNF Discharge Rate at DRG | 25.14 | ||||
| SNF Discharge Rate with ICD V4365 - Knee joint replacement | 24.12 | ||||
| Home Discharge Rate at DRG | 25.55 | ||||
| Home Discharge Rate with ICD V4365 - Knee joint replacement | 25.53 |
| DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 368,382 | ||||
| Total Hospitalizations with ICD V4365 - Knee joint replacement | 13,744 | ||||
| DRG Share of Total Hospitalizations | 1.61 | ||||
| % of Total ICD V4365 - Knee joint replacement in DRG | 1.44 | ||||
| Avg LOS at DRG | 3.76 | ||||
| Avg LOS with ICD V4365 - Knee joint replacement | 3.63 | ||||
| Readmission Rate at DRG | 18.51 | ||||
| Readmission Rate with ICD V4365 - Knee joint replacement | 18.01 | ||||
| Unplanned Readmission Rate at DRG | 12.91 | ||||
| Unplanned Readmission Rate with ICD V4365 - Knee joint replacement | 12.57 | ||||
| Total Medicare payments at DRG | $1,761,365,865 | ||||
| Total Medicare payments with ICD V4365 - Knee joint replacement | $63,727,416 | ||||
| Total Medicare payment per Day at DRG | $1,270 | ||||
| Total Medicare payment per Day with ICD V4365 - Knee joint replacement | $1,278 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,781 | ||||
| Total Medicare payment per Hospitalization with ICD V4365 - Knee joint replacement | $4,637 | ||||
| Total Medicare Charges at DRG | $7,996,276,956 | ||||
| Total Medicare Charges with ICD V4365 - Knee joint replacement | $295,877,644 | ||||
| Avg Charges at DRG | $21,706 | ||||
| Avg Charges with ICD V4365 - Knee joint replacement | $21,528 | ||||
| Mortality Rate at DRG | 0.32 | ||||
| Mortality Rate with ICD V4365 - Knee joint replacement | 0.19 | ||||
| SNF Discharge Rate at DRG | 27.88 | ||||
| SNF Discharge Rate with ICD V4365 - Knee joint replacement | 30.31 | ||||
| Home Discharge Rate at DRG | 42.37 | ||||
| Home Discharge Rate with ICD V4365 - Knee joint replacement | 40.49 |
| 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 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 885: PSYCHOSES | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 285,530 | ||||
| Total Hospitalizations with ICD V4365 - Knee joint replacement | 11,103 | ||||
| DRG Share of Total Hospitalizations | 1.25 | ||||
| % of Total ICD V4365 - Knee joint replacement in DRG | 1.16 | ||||
| Avg LOS at DRG | 4.72 | ||||
| Avg LOS with ICD V4365 - Knee joint replacement | 4.56 | ||||
| Readmission Rate at DRG | 18.55 | ||||
| Readmission Rate with ICD V4365 - Knee joint replacement | 17.28 | ||||
| Unplanned Readmission Rate at DRG | 12.87 | ||||
| Unplanned Readmission Rate with ICD V4365 - Knee joint replacement | 11.49 | ||||
| Total Medicare payments at DRG | $1,922,582,097 | ||||
| Total Medicare payments with ICD V4365 - Knee joint replacement | $72,329,386 | ||||
| Total Medicare payment per Day at DRG | $1,427 | ||||
| Total Medicare payment per Day with ICD V4365 - Knee joint replacement | $1,428 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,733 | ||||
| Total Medicare payment per Hospitalization with ICD V4365 - Knee joint replacement | $6,514 | ||||
| Total Medicare Charges at DRG | $8,696,353,387 | ||||
| Total Medicare Charges with ICD V4365 - Knee joint replacement | $325,444,559 | ||||
| Avg Charges at DRG | $30,457 | ||||
| Avg Charges with ICD V4365 - Knee joint replacement | $29,311 | ||||
| Mortality Rate at DRG | 2.4 | ||||
| Mortality Rate with ICD V4365 - Knee joint replacement | 1.39 | ||||
| SNF Discharge Rate at DRG | 23.54 | ||||
| SNF Discharge Rate with ICD V4365 - Knee joint replacement | 23.51 | ||||
| Home Discharge Rate at DRG | 44.6 | ||||
| Home Discharge Rate with ICD V4365 - Knee joint replacement | 46.2 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| CHRISTIANA CARE WILMINGTON HOSPITAL | 501 W 14TH ST | WILMINGTON | DE | 19801 | 3,270 |
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W 13 MILE RD | ROYAL OAK | MI | 48073 | 2,730 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 2,492 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. YU JEN LAI | 200 BELLE TERRE RD | PORT JEFFERSON | NY | 11777 | 365 |
| Dr. THOMAS KELLY TKACH | 1110 N LEE AVE | OKLAHOMA CITY | OK | 73103 | 348 |
| Dr. JOHN TERRY DEARBORN | 2000 MOWRY AVE | FREMONT | CA | 94538 | 278 |
| 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 | 754 |
| Dr. ELLEN S GITLER | 785 MAMARONECK AVE | WHITE PLAINS | NY | 10605 | 559 |
| Dr. MARIA D BRIONES | 785 MAMARONECK AVE | WHITE PLAINS | NY | 10605 | 443 |