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Sample Hospital Louisville, KY 11111 CMS Certification Number: 000000 |
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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 |

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% |

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 |

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

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 |