Z47.81 (Encounter for orthopedic aftercare following surgical amputation) was the least profitable primary diagnosis in home health through the first three quarters of 2018. The average reimbursement per episode was $3,031, while the average cost per episode was $2,907.
 
The data represent about 700,000 PPS episodes that ended between January 2018 and September 2018. The care was provided by more than 1,000 provider locations nationwide. 
 
ICD-10 codes and description
Average margin per standard episode
Average skilled nursing visits per episode
Average therapy visits per episode
Average costs per episode
Average reimbursement per episode
 
Z47.81 (Encounter for orthopedic aftercare following surgical amputation)
 
5.3%
11.3
7.1
$2,907
$3,031
 
E11.621 (Type 2 diabetes mellitus with foot ulcer)
 
5.4%
14.0
3.1
$2,564
$2,658
 
I87.2 (Venous insufficiency (chronic) (peripheral))
 
6.3%
13.7
3.5
$2,654
$2,816
 
I13.0 (Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease)
 
13.9%
9.0
7.2
$2,593
$2,895
 
J44.1 (Chronic obstructive pulmonary disease with (acute) exacerbation)
 
14.9%
8.6
7.5
$2,619
$2,957
 
J44.0 (Chronic obstructive pulmonary disease with acute lower respiratory infection)
 
15.8%
8.8
7.9
$2,628
$3,004
 
I69.354 (Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side)
 
15.8%
5.9
16.0
$3,701
$4,217
 
I69.351 (Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side)
 
16.3%
5.9
16.1
$3,704
$4,280
 
I48.0 (Paroxysmal atrial fibrillation)
 
16.9%
8.7
7.8
$2,572
$2,926
 
N39.0 (Urinary tract infection, site not specified)
 
16.9%
8.2
8.1
$2,646
$3,048
 
Source: Minneapolis-based ABILITY Network