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High Volume Medicare DRGs
[Staff Writers]
The ten highest volume Medicare DRGs represent about 30% of total Medicare patients. Each of these higher volume DRGs represent from about 2% to 6% of total Medicare volume.
***
| DRG | DRG Description | % Total | Rel Wt | |
| 1 | 127 | Heart Failure & Shock | 5.99 | 1.0234 |
| 2 | 089 | Simple Pneumonia & Pleurisy Age>17 w/CC1 | 3.85 | 1.1447 |
| 3 | 014 | Specific Cerebrovascular Disorders except TIA | 3.18 | 1.2056 |
| 4 | 430 | Psychoses | 3.18 | 0.9153 |
| 5 | 088 | Chronic Obstructive Pulmonary Disease | 3.11 | 1.0067 |
| 6 | 209 | Major Joint & Limb Reattachment Procedures, Lower Extremity | 2.78 | 2.3491 |
| 7 | 140 | Angina Pectoris | 2.33 | 0.6241 |
| 8 | 182 | Esophagitis, Gastroent & Misc Digest Disorders Age>17 w/CC1 | 2.09 | 0.7617 |
| 9 | 174 | G.I. Hemorrhage w/CC1 | 2.07 | 0.9657 |
| 10 | 296 | Nutritional & Misc Metabolic Disorders Age>17w/CC1 | 1.93 | 0.9313 |
Source: Health Care Financing Administration [CMS] 2005
Conclusion
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DRGs
The top three DRG’s likely don’t surprise anyone very much. Outside of acute traumatic injury, we are likely to pass from this life the result of some form of circulatory failure. But, what is interesting is number six in this list, as this might dramatically alter number 1 and 4.
It seems that as much time and effort which has been placed in cardiovascular medicine, that perhaps the next frontier is orthopedics. Indeed, the success that has been accomplished in reducing cardiovascular morbidity is pushing out people’s active lives in ways that perhaps our joints have not been accustomed.
I will be eager to see DRG 2006 move up in rankings. Wouldn’t that be nice?
Tom
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