DRG 036                              **Sample Data Not Accurate For This DRG**
Orbital Procedures
MDC 2 - Diseases & Disorders of the Eye
All-Payer Summary Information for Short-Term, General, Nonfederal U.S. Hospitals*
Patient Distribution
Estimated Number of Patients with DRG 3,984
 
Age Number
of Cases		 Percent
of Total
0-17 Years 567 14.2
18-34 Years 1,005 25.2
35-49 Years 928 23.3
50-64 Years 710 17.8
65+ Years 343 19.4
 
Race/Ethnicity
White 3,233 56.1
Black 158 4.0
Asian 27 0.7
American Indian 0 0.0
Hispanic 21 0.5
Other 311 7.8
Unrecorded 1,234 31.0
 
Sex
Male 2,362 59.3
Female 1,622 40.7
 
Patient Destination
Total Discharged Alive 3,968 99.6
  Discharged to Home/Self Care 3,790 95.1
  Left against Medical Advice 1 0.0
  Transferred to Other Short-Term Hospital 9 0.2
  Discharged to SNF 28 0.7
  Discharged to ICF 22 0.6
  Dischrged to Other Facility 56 1.4
  Other 61 1.5
Total Expired 16 0.4
Average length of Stay 2.2 days
 
Patient Distribution by Payer
  Number
of Cases		 Percent
of Total
Medicare 803 20.2
Medicaid 269 6.8
Private Insurance 2,349 59.0
Self Pay 69 1.7
Workers' Compensation 58 1.4
Other 437 11.0
Charge Data per Discharge
Mean $ 12,715
Standard Deviation 11,994
25th Percentile 5938.0
50th Percentile 9165.0
75th Percentile 15487.0
Patient Distribution by Hospital Cohort
Region Number
of Cases		 Percent
of Total
Northeast 917 23.0
North Central 825 20.7
South 1,370 34.4
West 871 21.9
 
Bed Size
0-199 Beds 883 22.2
200-299 Beds 696 17.5
300-499 Beds 1,177 29.6
500+ Beds 1,228 30.8
 
Teaching Status
Teaching 1,671 42.0
Non-Teaching 2,313 58.1
Top Five Associated Principal Diagnoses and Procedures**
Code Title Occurence Percent
of Total
Diagnoses
470 DEVIATED NASAL SEPTUM 1,565 31.9
738.0 ACQ NOSE DEFORMITY 603 15.1
784.7 EPISTAXIS 678 10.7
478.1 NASAL & SINUS DIS NEC 199 5.0
802.0 NASAL BONE FX-CLOSED 198 5.0
Procedures
21.88 SEPTOPLASTY NEC 2,116 53.1
21.84 REVISION RHINOPLASTY 363 9.1
21.83 TOT NASAL RECONSTRUCTION 234 8.4
21.87 RHINOPLASTY NEC 279 7.0
21.86 LIMITED RHINOPLASTY 121 3.0
**Occurences are estimated.
Mortality and Complication Rate Trends
Mortality Rate (%)  
Average Annual Change (%)
1999 2000 2001  
5.53 5.57 4.7 -.414
 
 
Complication Rate (%)  
Average Annual Change (%)
1999 2000 2001  
.14 .4 .262
 
 
*Medicare and all-payer summary data will differ slightly because of variances in hospital inclusions by type. For more information, see "Description of the Database."

 

 

DRG 036
Orbital Procedures
MDC 2 - Diseases & Disorders of the Eye
Medicare Summary Information of All U.S. Acute Care Hospitals*
Descriptive Information
DRG Type Surgical
2001 HCFA Case Wright .9451
2001 PPS Inlier Payment Rate by hospital type  
  Typical Large Urban $ 3,826
  Typical Other $ 3,747
 
Total Number of Discharges 527
Percentage of Total Discharges fo All DRGs 0.00%
Percentage Rank 408
Discharge Rate per 100,000 U.S. Population .2
 
Average length of Stay (ALOS) 3
Percentage of Special Care Days 17.7%
Percentage of Outliers 1.7%
 
Average per Discharge**
  2000 ($) 2001 ($)
Charges 10,825 12,645
Costs 4,425 5,147
Reimbursement 3,908 4,292
**Totals may reflect rounding
 
Average Charges per Discharge**
  Charge per
Discharge ($)		 Percent
of Total
General Care Units 1,621 12.8
Special Care Units 645 5.1
Total Routine Care Services 2,266 17.9
 
Operating Room 4,239 33.5
Anesthesiology 788 6.2
Laboratory 826 6.5
Radiology 314 2.5
Medical Supplies 1,579 12.5
Pharmacy 1,631 12.9
All Other Ancillary Services 1,001 7.9
Total Ancillary Services 10,379 82.1
 
Total All Services 12,645 100.0
**Totals may reflect rounding
Discharge Rates by Patient Age
Age Number
of Cases		 Per
100,000 U.S.
Population
0-64 Year 345 0.1
65-74 Years 224 1.1
75-84 Years 140 1.1
85+ 43 1.0
 
Patient Distribution
Age DRG
056 (%)		 All
DRGs (%)
0-64 Years 22.2 15.3
65-69 Years 20.9 13.7
70-74 Years 23.3 16.7
75-79 Years 15.0 18.7
80-84 Years 11.6 16.6
85+ Years 8.2 19.0
 
Proportion of Patients
Discharged Alive		 99.4 95.6
 
Patient Destination    
Discharged to Home 88.6 58.0
Left against Medical Advice 0.2 0.6
Transfered to Other
Short-Term Hospital		 1.1 3.3
Discharged to SNF 3.2 15.0
Discharged to ICF 0.8 3.0
Discharged to Other Facility 0.6 5.5
Other 4.9 10.1
Mortality and Complication Rate Trends
Mortality Rate (%)  
Average Annual Change (%)
1999 2000 2001
6.69 5.17 6.4 -.149
 
 
Complication Rate (%)  
Average Annual Change (%)
1999 2000 2001  
.79 .21 .58 -.105
 
 
*Medicare and all-payer summary data will differ slightly because of variances in hospital inclusions by type. For more information, see "Description of the Database."

 

 

DRG 036
Orbital Procedures
MDC 2 - Diseases & Disorders of the Eye
Medicare Information by Comparison Group
  DRG Occurrence Hospital Performance at Percentile Level
 
Hospital Comparison Group No. of Hosp. with Cases As a % of Group* Avg.No. per Hosp.** Average length of Stay (days) Special Care Unit Days (% Total Days) Outlier Cases (% Total Discharges)
       
        75th 50th 25th 75th 50th 25th 75th 50th 25th
All U.S. Hospitals 389 8.40 2.4 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
All U.S. Hospitals 0 to 99 Beds 36 1.56 1.5 3.00 1.00 1.00 10.00 0.00 0.00 0.00 0.00 0.00
All U.S. Hospitals 100 to 249 Beds 152 10.12 1.6 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
All U.S. Hospitals 250 to 399 Beds 86 16.35 1.2 5.00 2.00 1.00 12.50 0.00 0.00 0.00 0.00 0.00
All U.S. Hospitals 400 or More Beds 115 39.25 1.6 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Urban Hospitals 319 12.07 1.4 3.67 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Urban Hospitals 0 to 99 Beds 8 1.19 1.4 1.75 1.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Urban Hospitals 100 to 249 Beds 117 9.87 1.3 3.50 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Urban Hospitals 250 to 399 Beds 81 16.40 1.3 4.50 2.00 1.00 7.69 0.00 0.00 0.00 0.00 0.00
Urban Hospitals 400 or More Beds 113 38.83 1.6 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Rural Hospitals 70 3.52 1.2 4.00 2.50 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Rural Hospitals 0 to 99 Beds 28 1.71 1.3 3.50 1.00 1.00 27.21 0.00 0.00 0.00 0.00 0.00
Rural Hospitals 100 to 249 Beds 35 11.08 1.1 4.00 3.00 2.00 0.00 0.00 0.00 0.00 0.00 0.00
Rural Hospitals 250 to 399 Beds 5 15.63 1.6 6.00 4.00 4.00 25.00 0.00 0.00 0.00 0.00 0.00
Not-For-Profit 265 9.87 1.4 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Investor-Owned 59 8.48 1.2 6.00 3.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Government 62 5.54 1.5 2.67 1.47 1.00 0.00 0.00 0.00 0.00 0.00 0.00
System-Affiliated 215 11.29 1.3 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Freestanding 174 6.38 1.4 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Major Teaching 86 30.82 1.6 3.50 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Minor Teaching 118 14.84 1.4 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Non-Teaching 185 5.20 1.2 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
New England 21 12.35 1.7 4.00 2.25 1.50 0.00 0.00 0.00 0.00 0.00 0.00
Middle Atlantic 34 7.07 1.4 3.25 1.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
South Atlantic 68 9.76 1.2 4.75 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
East North Central 70 12.96 1.3 4.00 2.00 1.00 12.50 0.00 0.00 0.00 0.00 0.00
East South Central 45 10.82 1.6 4.00 2.00 1.00 14.29 0.00 0.00 0.00 0.00 0.00
West North Central 37 6.30 1.5 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
West South Central 42 6.40 1.3 3.50 2.00 1.00 33.33 0.00 0.00 0.00 0.00 0.00
Mountain 28 8.36 1.4 5.50 2.50 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Pacific 44 7.69 1.3 3.50 2.00 1.00 18.75 0.00 0.00 0.00 0.00 0.00
Profitability High 116 10.68 1.4 4.00 2.00 1.00 29.71 0.00 0.00 0.00 0.00 0.00
Profitability Moderate 201 9.25 1.4 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Profitability Low 57 5.25 1.3 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Medicare Admissions (%) High 25 2.25 1.2 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Medicare Admissions (%) Moderate 223 10.01 1.3 4.00 2.00 1.00 7.69 0.00 0.00 0.00 0.00 0.00
Medicare Admissions (%) Low 137 12.32 1.5 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Case Mix Complexity High 236 21.07 1.4 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Case Mix Complexity Moderate 139 6.22 1.2 3.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Case Mix Complexity Low 10 0.90 1.2 4.00 1.17 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Managed Care Penetration High 32 7.17 1.2 6.00 3.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Managed Care Penetration Moderate 209 11.12 1.4 4.00 3.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
Managed Care Penetration Low 148 6.42 1.4 4.00 2.00 1.00 0.00 0.00 0.00 0.00 0.00 0.00
 
*(Number of hospitals with cases / number of hospitals in comparison group) x 100.
**Number of cases in comparison group / number of hospitals with cases.

 

 

DRG 036
Orbital Procedures
MDC 2 - Diseases & Disorders of the Eye
Medicare Information by Comparison Group
  Average per Discharge
 
Hospital Comparison Group Charge ($) Costs ($) Reimbursement ($)
 
  75th 50th 25th 75th 50th 25th 75th 50th 25th
All U.S. Hospitals 14,068 9,345 5,776 5,564 3,521 2,206 4,750 3,733 3,303
All U.S. Hospitals 0 to 99 Beds 9,042 7,023 4,830 4,272 2,899 1,673 3,796 3,351 2,970
All U.S. Hospitals 100 to 249 Beds 13,893 8,966 5,456 5,204 3,341 2,113 4,099 3,587 3,279
All U.S. Hospitals 250 to 399 Beds 17,295 11,178 7,179 7,234 4,678 2,513 4,923 3,807 3,323
All U.S. Hospitals 400 or More Beds 13,021 9,463 5,643 5,560 3,544 2,206 5,568 4,231 3,460
Urban Hospitals 14,984 9,492 5,918 5,708 3,486 2,135 4,923 3,899 3,348
Urban Hospitals 0 to 99 Beds 8,685 6,668 4,447 4,734 4,295 3,270 5,309 3,900 2,778
Urban Hospitals 100 to 249 Beds 14,068 9,181 5,713 5,023 3,220 2,049 4,250 3,735 3,317
Urban Hospitals 250 to 399 Beds 17,650 11,296 7,128 7,211 4,042 2,505 4,884 3,797 3,324
Urban Hospitals 400 or More Beds 13,021 9,498 5,669 5,560 3,655 2,206 5,568 4,331 3,492
Rural Hospitals 10,268 7,800 5,123 5,128 3,899 2,438 3,654 3,358 3,056
Rural Hospitals 0 to 99 Beds 9,079 7,023 5,124 4,153 2,899 2,004 3,611 3,351 2,995
Rural Hospitals 100 to 249 Beds 6,627 7,798 5,108 5,855 4,041 2,493 3,615 3,356 3,209
Rural Hospitals 250 to 399 Beds 12,609 10,268 9,934 6,375 6,144 5,580 4,969 4,047 0
Not-For-Profit 12,993 8,841 5,643 5,354 3,525 2,267 4,591 3,715 3,315
Investor-Owned 22,097 13,126 8,483 6,373 3,142 1,598 4,363 3,487 3,145
Government 11,987 8,159 5,313 5,710 3,943 2,491 5,627 4,121 3,347
System-Affiliated 16,219 10,087 6,565 5,618 3,270 2,049 4,664 3,735 3,292
Freestanding 12,639 8,162 5,007 5,470 3,956 2,251 4,875 3,724 3,310
Major Teaching 16,219 10,254 6,443 7,176 4,271 2,893 6,259 5,468 4,347
Minor Teaching 12,148 9,285 5,669 5,495 3,438 2,042 4,331 3,734 3,329
Non-Teaching 15,846 8,440 5,776 5,026 3,224 2,116 3,962 3,468 3,209
New England 9,980 9,208 5,551 5,236 4,295 3,059 5,265 4,151 3,782
Middle Atlantic 14,647 7,642 4,856 5,495 3,345 1,734 5,591 3,922 3,323
South Atlantic 15,711 10,267 5,455 5,815 3,811 2,119 4,162 3,446 3,162
East North Central 20,774 7,796 6,152 5,708 3,664 2,880 4,331 3,587 3,329
East South Central 12,943 8,431 5,715 5,580 3,142 2,165 3,727 3,366 3,167
West North Central 12,288 6,684 4,966 5,088 2,736 2,036 4,218 3,615 3,172
West South Central 19,650 9,933 7,020 6,510 3,161 1,849 4,420 3,873 3,315
Mountain 17,760 9,051 6,872 5,265 3,472 2,372 5,006 3,948 3,356
Pacific 25,935 10,852 8,371 5,169 4,159 2,480 6,301 4,780 3,953
Profitability High 16,666 10,262 7,255 5,572 3,576 1,953 4,143 3,499 3,234
Profitability Moderate 15,718 8,736 5,313 5,894 3,843 2,487 4,687 3,733 3,329
Profitability Low 12,362 9,284 5,673 5,088 3,303 2,110 5,456 4,231 3,556
Medicare Admissions (%) High 10,389 6,779 4,803 4,420 2,699 1,666 3,654 3,359 3,143
Medicare Admissions (%) Moderate 11,718 8,925 5,783 5,680 3,597 2,362 3,962 3,522 3,226
Medicare Admissions (%) Low 16,879 10,260 6,395 5,893 3,644 2,083 5,921 4,865 3,876
Case Mix Complexity High 13,966 10,201 6,739 6,426 4,040 2,478 5,035 3,939 3,357
Case Mix Complexity Moderate 13,243 7,798 5,256 4,725 3,151 1,925 4,029 3,488 3,209
Case Mix Complexity Low 10,104 6,004 4,803 3,597 2,349 1,554 5,591 3,333 2,983
Managed Care Penetration High 24,808 14,182 9,243 6,695 3,931 3,610 5,420 4,108 3,699
Managed Care Penetration Moderate 13,640 9,388 6,368 5,564 3,525 2,395 5,011 3,870 3,348
Managed Care Penetration Low 11,976 8,381 5,004 5,399 3,460 2,139 4,094 3,507 3,179
 

 

 

DRG 036
Orbital Procedures
MDC 2 - Diseases & Disorders of the Eye
Medicare Information by Comparison Group
  Average per Discharge
 
Hospital Comparison Group Laboratory ($) Radiology ($) Medical Supplies ($) Pharmacy ($)
  75th 50th 25th 75th 50th 25th 75th 50th 25th 75th 50th 25th
All U.S. Hospitals 973 412 153 188 48 0 1,841 678 389 1,786 1,037 550
All U.S. Hospitals 0 to 99 Beds 604 312 184 147 74 0 1,579 893 234 1,532 885 618
All U.S. Hospitals 100 to 249 Beds 990 323 156 179 28 0 2,050 343 421 1,023 1,133 590
All U.S. Hospitals 250 to 399 Beds 1,286 563 215 383 76 0 2,031 2,105 452 1,034 1,408 737
All U.S. Hospitals 400 or More Beds 753 281 102 186 0 0 1,735 744 317 1,454 829 438
Urban Hospitals 986 416 123 188 37 0 1,985 991 389 1,877 1,049 541
Urban Hospitals 0 to 99 Beds 814 350 42 656 44 0 2,040 1,391 684 1,380 348 58
Urban Hospitals 100 to 249 Beds 988 474 234 169 0 0 2,081 899 436 2,066 1,198 570
Urban Hospitals 250 to 399 Beds 1,234 536 215 434 70 0 2,031 1,114 452 1,978 1,382 737
Urban Hospitals 400 or More Beds 749 281 104 123 34 0 1,735 744 325 1,454 829 438
Rural Hospitals 926 413 202 223 84 0 1,557 921 381 1,555 971 680
Rural Hospitals 0 to 99 Beds 591 234 200 147 74 0 1,267 825 314 1,532 899 730
Rural Hospitals 100 to 249 Beds 1,070 418 456 435 92 0 1,598 1,170 406 1,793 1,048 649
Rural Hospitals 250 to 399 Beds 1,286 234 845 1,089 345 98 1,557 999 925 1,710 1,516 1,351
Not-For-Profit 881 395 153 185 34 0 1,599 823 361 1,656 961 506
Investor-Owned 1,876 922 289 345 121 0 2,845 1,731 823 3,558 1,768 1,049
Government 697 379 90 142 0 0 1,658 1,045 428 1,623 828 533
System-Affiliated 1,015 445 193 240 0 0 1,841 969 428 1,992 1,147 579
Freestanding 878 368 102 164 72 0 1,881 1,018 341 1,656 934 478
Major Teaching 937 268 91 181 45 0 1,846 720 275 1,642 843 317
Minor Teaching 766 392 171 172 0 0 1,647 968 481 1,544 964 562
Non-Teaching 1,223 445 185 211 70 0 2,041 1,035 403 2,190 1,170 659
New England 656 416 167 79 0 0 719 416 266 746 343 159
Middle Atlantic 645 188 33 149 0 0 991 474 220 1,055 831 182
South Atlantic 1,077 491 123 343 84 0 2,557 1,131 606 2,235 994 488
East North Central 988 423 344 787 34 0 1,521 798 353 1,731 977 570
East South Central 1,070 393 193 150 48 0 2,543 1,376 625 1,786 1,122 790
West North Central 652 334 454 124 0 0 1,517 741 258 1,433 894 576
West South Central 1,052 450 112 345 51 0 2,131 1,004 479 2,092 1,447 647
Mountain 977 433 189 156 79 0 1,936 1,370 382 1,990 1,163 849
Pacific 1,224 525 132 240 100 0 2,554 1,295 828 3,334 1,372 723
Profitability High 1,330 676 264 291 99 0 2,535 1,174 554 2,242 1,232 694
Profitability Moderate 854 389 121 177 37 0 1,567 824 356 1,728 978 489
Profitability Low 693 312 115 124 0 0 2,101 1,010 455 1,664 952 570
Medicare Admissions (%) High 986 333 89 192 70 0 1,567 832 452 1,350 924 570
Medicare Admissions (%) Moderate 960 410 183 218 57 0 1,833 991 418 1,910 1,147 643
Medicare Admissions (%) Low 980 460 234 177 0 0 1,777 990 348 1,625 933 441
Case Mix Complexity High 1,072 435 172 229 48 0 2,234 1,039 446 2,024 1,138 591
Case Mix Complexity Moderate 869 777 138 155 64 0 1,555 882 363 1,555 903 492
Case Mix Complexity Low 978 224 90 419 0 0 1,567 989 307 1,421 865 675
Managed Care Penetration High 1,963 567 347 509 220 32 2,493 1,323 477 3,777 1,606 759
Managed Care Penetration Moderate 887 393 158 169 0 0 2,049 121 403 1,715 1,011 562
Managed Care Penetration Low 923 393 117 164 35 0 1,589 849 365 1,776 1,002 539
 

 

 

DRG 036
Orbital Procedures
MDC 3 - Diseases & Disorders of the Ear, Nose, Mouth & Throat
State-Level Medicare Information
  Average per Discharge
   
  Average length of Stay (days) Charges ($) Costs ($) Reimbursement ($)
State
  75th 50th 25th 75th 50th 25th 75th 50th 25th 75th 50th 25th
Alabama 3.67 2.00 1.00 11,943 8,412 2,970 3,567 2,123 1,684 3,789 3,257 2,059
Arizona 4.00 1.00 1.00 15,554 8,949 2,171 7,760 2,888 1,707 5,568 5,031 3,098
Arkansas 4.50 1.50 1.00 14,532 8,472 5,007 6,510 3,555 1,804 4,158 3,726 3,179
California 4.00 2.00 1.00 26,808 14,822 9,443 6,080 4,164 4,102 6,929 4,944 4,069
Colorado 5.00 3.00 1.00 18,028 11,243 7,179