• Medicare IPPS claims data are for federal fiscal year ending 09/30/2021 (Final rule MedPAR).
  • These reports are consistent with CMS cell size suppression policy.
  • The Case Mix Index (CMI) for LTAC hospitals reflects LTAC regulations.
Sample Hospital
Louisville, KY  11111
CMS Certification Number: 000000

Sample Report | Order Information

Provider Analysis
Attending physician utilization measures including cases, CMI, cost, payment, length of stay and more.
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Key Attending Providers

  • Medicare IPPS claims data are for 4 quarters ending on 09/30/2022 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Ardel C Cagata MD 255 $3,477,095.00 $3,520,838.00 1.9672
Deep Ajmani MD 219 $2,269,650.00 $2,003,476.00 1.5834
Paul Thompson DO 209 $2,612,420.00 $2,441,508.00 1.9321
Market Analysis
Build color coded maps based on more detailed Patient Origin data
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Patient Origin

  • Medicare Hospital Market Service Area file for calendar year ending 12/31/2021 / Definitions
ZIP Code of Residence Discharges Days of Care Charges Discharges Inc/(Dec) Market Share Market Share
5-years prior
40219 1,061 6,313 $72,116,409 0.3% 63.2% 56.4%
40216 1,049 6,657 $77,883,866 -7.1% 46.6% 36.8%
40229 1,017 6,156 $72,355,140 8.7% 58.5% 55.5%
40165 956 5,573 $64,708,652 -4.8% 57.6% 55.6%
40272 856 5,236 $62,980,072 1.1% 42.4% 35.0%
40291 773 4,383 $56,352,204 -3.0% 44.4% 39.8%
40214 771 4,565 $53,653,731 -2.4% 45.6% 37.2%
40241 665 3,461 $42,876,222 -6.6% 63.5% 55.0%
40211 613 4,122 $42,187,537 -2.9% 49.1% 39.2%
40218 607 3,514 $36,460,013 -12.4% 49.2% 43.8%
All other ZIP Codes 15,312 89,783 $1,114,511,436    
Total 23,680 139,763 $1,696,085,282 -5.3%  
IPPS Dashboard
Analyze the factors that define a hospital's payment under IPPS
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Trend Report

Inpatient Utilization Statistics FY 2021 FY 2020 FY 2019 FY 2018 FY 2017
Case Mix Index 2.1081 2.0413 1.9181 1.8668 1.8067
Medical MS-DRGs 70.64% 67.88% 67.29% 68.13% 67.52%
Surgical MS-DRGs 29.36% 32.12% 32.71% 31.87% 32.48%
Routine Discharges to home 6,208 8,097 9,955 10,040 10,262
Discharges to other acute care hospitals 77 88 84 41 55
Discharges to Skilled Nursing Facilities (SNF) 2,886 3,226 4,402 4,646 4,735
Deaths 732 599 526 561 597
Other Discharges 4,935 4,244 5,102 4,864 4,644
Total Discharges 14,838 16,254 20,069 20,152 20,293
Psychiatric Discharges (DPU, included in Total)
Rehabilitation Discharges (DPU, included in Total)
Medicare Advantage (HMO) Discharges (NOT included in Total) 11,067 10,620 10,592 8,938 N/A
MS-DRG Coding Indicators
Use coding indicators and comparative data to identify areas for improvement
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Statistics for the Top 20 Base MS-DRGs

  • Costs calculated per hospital's cost report for the period ending 12/31/2021. / Definitions
Base MS-DRG Base MS-DRG Description IPPS Cases ALOS Average Charges Average Payment Average Cost Case Mix Index CC/MCC Rate MCC Rate
872-871 Septicemia or severe sepsis w/o MV 96+ hours 1,566 5.9 $53,262 $12,283 $11,162 1.7368 84.5% 84.5%
293-292-291 Heart failure & shock 846 5.0 $38,239 $8,363 $8,592 1.2867 97.9% 89.0%
179-178-177 Respiratory infections & inflammations 791 5.7 $46,169 $13,451 $10,073 1.7897 98.6% 92.0%
684-683-682 Renal failure 383 4.7 $33,767 $7,585 $7,720 1.1736 96.1% 51.7%
310-309-308 Cardiac arrhythmia & conduction disorders 351 3.5 $27,798 $5,343 $5,895 0.8594 72.4% 36.2%
066-065-064 Intracranial hemorrhage or cerebral infarction 342 3.7 $44,464 $8,247 $7,789 1.3220 83.9% 39.5%
379-378-377 G.I. hemorrhage 337 4.3 $38,421 $8,872 $8,945 1.3458 97.6% 44.8%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 294 3.9 $111,762 $16,729 $18,393 2.5183 46.6% 46.6%
855-854-853 Infectious & parasitic diseases w O.R. procedure 284 10.8 $115,190 $27,934 $25,600 4.3203 99.6% 78.2%
195-194-193 Simple pneumonia & pleurisy 270 4.1 $35,059 $7,390 $7,008 1.1670 94.4% 70.4%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 247 3.6 $29,097 $6,498 $6,584 1.0740 67.6% 67.6%
189 Pulmonary edema & respiratory failure 238 4.5 $38,243 $7,937 $8,170 1.2248 0.0% 0.0%
392-391 Esophagitis, gastroent & misc digest disorders 229 3.5 $26,905 $5,975 $5,882 0.8965 27.5% 27.5%
690-689 Kidney & urinary tract infections 192 3.7 $26,498 $6,108 $5,770 0.9667 54.7% 54.7%
254-253-252 Other vascular procedures 192 4.8 $88,197 $19,371 $20,084 2.9037 90.1% 50.0%
287-286 Circulatory disorders except AMI, w card cath 187 5.1 $65,915 $11,098 $11,623 1.6963 51.3% 51.3%
455-454-453 Combined anterior/posterior spinal fusion 169 5.3 $308,474 $50,337 $60,515 6.5930 84.6% 22.5%
700-699-698 Other kidney & urinary tract diagnoses 162 5.2 $38,531 $9,350 $8,877 1.4559 100.0% 74.1%
482-481-480 Hip & femur procedures except major joint 159 6.0 $76,141 $15,942 $16,852 2.4154 90.6% 39.0%
192-191-190 Chronic obstructive pulmonary disease 152 3.2 $27,751 $6,365 $5,757 1.0084 96.7% 54.6%
All Other Base MS-DRGs 7,447 5.5 $81,983 $16,638 $17,844 2.4717
T O T A L S 14,838 5.3 $68,755 $14,264 $14,702 2.1081

Search for Individual MS-DRGs

  • Enter MS-DRG desired and statistics will appear in a new window.
  • (Only MS-DRGs representing more than 10 patients are reported.)
  • Click here for MS-DRG Definitions (PDF or Excel). / Definitions

Search for Prior DRGs and Statistics (FY 2003-2007)

  • Enter DRG desired and statistics will appear in a new window.
  • (Only DRGs representing more than 10 patients are reported.)
  • Please note that Prior DRGs numbers do not correspond to MS-DRGs.
  • Also please note that "Average Reimbursement" for DRGs is different than "Average Payment" now reported for MS-DRGs.
  • Click here for DRG Definitions (PDF or Excel). / Definitions
Clinical Cost Analyzer
Explore online costs by MS-DRG, medical service, routine service, or department
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Statistics by Medical Service

  • Costs calculated per hospital's cost report for the period ending 12/31/2021. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,003 4.4 $40,001 $8,358 1.2304 $6,793
Cardiovascular Surgery 938 5.3 $181,597 $36,601 4.5803 $7,991
Gynecology 41 4.0 $50,135 $10,537 1.4584 $7,225
Medicine 4,090 5.2 $47,333 $10,278 1.5765 $6,519
Neurology 889 4.0 $41,849 $8,021 1.3412 $5,980
Neurosurgery 231 5.5 $151,453 $33,088 4.0922 $8,086
Obstetrics 35 3.3 $21,686 $5,621 0.8873 $6,335
Oncology 368 5.5 $69,334 $14,570 2.2841 $6,379
Orthopedic Surgery 1,058 5.2 $145,126 $29,757 3.5836 $8,304
Orthopedics 296 4.4 $33,707 $7,319 1.2083 $6,058
Psychiatry 194 6.6 $23,947 $9,795 1.1659 $8,401
Pulmonology 1,859 5.4 $48,240 $10,276 1.6800 $6,117
Surgery 1,397 8.3 $98,667 $22,535 3.5151 $6,411
Surgery for Malignancy 112 4.1 $70,656 $14,811 2.1904 $6,762
Urology 949 4.9 $37,544 $8,589 1.3745 $6,249
Vascular Surgery 378 4.2 $96,268 $22,048 2.7598 $7,989
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 14,838 5.31 $68,755 $14,702 2.1081 $6,974