Inpatient Definitions and Methodology

All information in this report is taken from the Medicare Provider Analysis and Review (MedPAR) file which is updated annually by CMS based on the federal fiscal year.  The file includes billing data for 100% of all Medicare fee-for-service claims for discharges during the twelve months ending September 30.  The report is based on the most recent period available and is consistent with CMS Data Release policies.

Statistics for Federal fiscal years 2003-2007 are summarized for the DRG selected. (MS-DRGs were introduced in FY2008 and do not correspond to DRGs.

• Number of Medicare Inpatients - total number of IPPS discharges for the DRG.
• Average Length of Stay - total patient days divided by the number of discharges.
• Average Charges - total gross charges divided by the number of discharges
• Average Reimbursed - Medicare Reimbursement is the amount paid to the hospital and/or patient by Medicare for the services reported on a bill. This amount does not include any capital pass-thru amount or organ acquisition amount. In addition, it excludes amounts paid by or on behalf of the patient (e.g. deductibles or coinsurance).  The average reported for a DRG is total Medicare reimbursement divided by the number of discharges. (Note that this is different than the "Average Payment" now reported for MS-DRGs.)
• Average Cost - Costs are calculated for each patient on the basis of ratios of costs to charges for routine services and ancillary areas. Click here for cost allocation methodology.  The average reported for a DRG is total allocated cost divided by the number of discharges.