• Medicare IPPS claims data are for federal fiscal year ending 09/30/2018 (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

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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 06/30/2019 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Dr. Jignesh Desai M.D. 717 $10,108,290.00 $9,007,059.00 2.1768
Deep Ajmani MD 657 $6,556,078.00 $4,916,952.00 1.6284
Joshua N Quaye MD 551 $4,853,467.00 $3,934,806.00 1.4100
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Patient Origin
  • Medicare Hospital Market Service Area file for calendar year ending 12/31/2018 / Definitions
ZIP Code of Residence Discharges Days of Care Charges Discharges Inc/(Dec) Market Share
40219 1,180 6,025 67,136,206 -1.7% 55.9%
40229 1,135 5,801 64,277,524 1.3% 58.6%
40216 1,081 5,908 64,343,643 2.7% 36.8%
40165 1,061 5,621 62,138,680 5.2% 53.7%
40214 1,002 5,275 56,344,997 -0.2% 41.4%
40272 920 4,750 52,945,055 -5.0% 36.1%
40291 834 4,028 49,494,312 4.9% 41.4%
40211 790 4,482 44,641,135 -2.9% 45.6%
40241 750 3,003 39,277,465 -2.3% 57.8%
40218 748 3,761 37,918,263 1.8% 48.2%
All other ZIP Codes 19,670 97,940 1,234,242,363    
Total 29,171 146,594 1,772,759,643 1.5%  
Analyze the factors that define a hospital's payment under IPPS
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Trend Report
Inpatient Utilization Statistics FY 2018 FY 2017 FY 2016 FY 2015 FY 2014
Case Mix Index 1.8668 1.8067 1.8388 1.8325 1.8405
Medical MS-DRGs 68.13% 67.52% 67.07% 68.30% 67.59%
Surgical MS-DRGs 31.87% 32.48% 32.91% 31.70% 32.41%
Routine Discharges to home 10,040 10,262 9,967 10,537 9,415
Discharges to other acute care hospitals 41 55 58 57 76
Discharges to Skilled Nursing Facilities (SNF) 4,646 4,735 4,873 4,988 4,332
Deaths 561 597 592 615 495
Other Discharges 4,864 4,644 3,971 3,304 3,191
Total Discharges 20,152 20,293 19,461 19,501 17,509
Psychiatric Discharges (DPU, included in Total) 0 0 0 0 0
Rehabilitation Discharges (DPU, included in Total) 0 0 0 0 0
Medicare Advantage (HMO) Discharges (NOT included in Total) 8,938 8,124 7,050 6,813 N/A
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Statistics for the Top 20 Base MS-DRGs
  • Costs calculated per hospital's cost report for the period ending 12/31/2018. / 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 1,192 5.6 $47,561 $10,813 $8,772 1.7000 84.0% 84.0%
293-292-291 Heart failure & shock 1,186 4.6 $33,701 $8,361 $6,425 1.3296 92.8% 75.6%
470-469 Major joint replacement or reattachment of lower extremity 1,018 2.3 $99,141 $14,212 $17,828 2.1445 7.9% 7.9%
195-194-193 Simple pneumonia & pleurisy 693 3.8 $30,668 $7,114 $5,529 1.1173 87.4% 48.2%
684-683-682 Renal failure 639 4.3 $29,703 $7,193 $5,800 1.1243 92.3% 39.3%
189 Pulmonary edema & respiratory failure 504 4.7 $38,506 $7,730 $7,055 1.2198 0.0% 0.0%
690-689 Kidney & urinary tract infections 489 3.6 $24,981 $5,911 $4,683 0.9152 42.3% 42.3%
310-309-308 Cardiac arrhythmia & conduction disorders 471 3.3 $26,277 $5,593 $4,750 0.8646 75.8% 34.4%
192-191-190 Chronic obstructive pulmonary disease 461 3.9 $29,128 $6,310 $5,440 1.0081 85.9% 49.9%
066-065-064 Intracranial hemorrhage or cerebral infarction 454 3.7 $41,931 $7,839 $6,386 1.2524 80.6% 37.4%
392-391 Esophagitis, gastroent & misc digest disorders 430 3.5 $24,269 $5,579 $4,556 0.8545 20.0% 20.0%
379-378-377 G.I. hemorrhage 411 3.9 $33,677 $7,453 $6,733 1.1698 93.4% 29.7%
179-178-177 Respiratory infections & inflammations 376 4.9 $38,728 $9,671 $7,167 1.6376 92.6% 66.5%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 361 3.3 $23,429 $5,546 $4,523 0.9788 54.6% 54.6%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 309 3.8 $101,809 $15,188 $15,058 2.5267 37.5% 37.5%
855-854-853 Infectious & parasitic diseases w O.R. procedure 282 12.1 $122,292 $29,310 $23,488 4.7853 99.6% 87.6%
331-330-329 Major small & large bowel procedures 249 8.8 $76,794 $18,960 $16,093 3.0100 77.9% 29.3%
484-483 Major joint & limb reattachment proc of upper extremity 227 1.6 $108,001 $17,307 $19,420 2.4264 100.0% 0.0%
455-454-453 Combined anterior/posterior spinal fusion 227 5.0 $223,756 $44,776 $39,387 6.3667 65.6% 11.0%
603-602 Cellulitis 212 3.7 $20,581 $6,405 $4,443 0.9797 21.7% 21.7%
All Other Base MS-DRGs 9,961 5.2 $61,945 $13,027 $11,745 2.1019
T O T A L S 20,152 4.7 $56,736 $11,745 $10,564 1.8668

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 12/31/2018. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,825 4.0 $34,616 $6,196 1.1862 $5,223
Cardiovascular Surgery 912 5.6 $149,665 $26,232 4.2397 $6,187
Gynecology 64 3.3 $47,656 $8,643 1.2998 $6,649
Medicine 4,596 4.6 $35,317 $6,818 1.3059 $5,221
Neurology 1,308 3.7 $36,750 $6,049 1.2065 $5,014
Neurosurgery 234 5.4 $123,220 $23,699 3.6477 $6,497
Obstetrics 40 3.5 $17,007 $4,236 0.8615 $4,917
Oncology 329 6.0 $52,681 $9,752 1.7391 $5,608
Orthopedic Surgery 2,518 3.5 $110,268 $19,969 2.9025 $6,880
Orthopedics 401 3.5 $25,150 $4,608 1.0381 $4,439
Psychiatry 285 6.1 $19,925 $6,794 1.0961 $6,198
Pulmonology 2,561 4.4 $36,068 $6,609 1.3010 $5,080
Surgery 2,009 8.5 $85,869 $16,990 3.3570 $5,061
Surgery for Malignancy 149 5.3 $75,187 $13,974 2.0740 $6,738
Urology 1,569 4.2 $31,454 $6,143 1.1928 $5,150
Vascular Surgery 350 5.8 $85,254 $16,732 2.8064 $5,962
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 20,152 4.74 $56,736 $10,564 1.8668 $5,659