• Medicare IPPS claims data are for federal fiscal year ending 09/30/2019 (Proposed 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 12/31/2019 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Dr. Jignesh Desai M.D. 696 $10,121,913.00 $8,814,585.00 2.2669
Deep Ajmani MD 559 $5,093,862.00 $3,514,299.00 1.4974
Ardel C Cagata MD 460 $4,401,279.00 $3,051,106.00 1.5412
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 12/31/2018 / 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%  
IPPS Dashboard
Analyze the factors that define a hospital's payment under IPPS
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Trend Report
Inpatient Utilization Statistics FY 2019 FY 2018 FY 2017 FY 2016 FY 2015
Case Mix Index 1.9182 1.8668 1.8067 1.8388 1.8325
Medical MS-DRGs 67.30% 68.13% 67.52% 67.07% 68.30%
Surgical MS-DRGs 32.70% 31.87% 32.48% 32.91% 31.70%
Routine Discharges to home 9,897 10,040 10,262 9,967 10,537
Discharges to other acute care hospitals 82 41 55 58 57
Discharges to Skilled Nursing Facilities (SNF) 4,433 4,646 4,735 4,873 4,988
Deaths 531 561 597 592 615
Other Discharges 5,063 4,864 4,644 3,971 3,304
Total Discharges 20,006 20,152 20,293 19,461 19,501
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) 10,755 8,938 8,124 7,050 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 12/31/2018. / 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 1,546 5.8 $47,336 $11,118 $8,787 1.7291 84.2% 84.2%
293-292-291 Heart failure & shock 1,205 4.8 $33,837 $8,062 $6,430 1.2555 94.9% 81.9%
470-469 Major joint replacement or reattachment of lower extremity 951 2.1 $104,010 $14,098 $18,512 2.0807 7.7% 7.7%
195-194-193 Simple pneumonia & pleurisy 691 3.9 $29,244 $7,363 $5,181 1.1219 91.8% 57.5%
684-683-682 Renal failure 601 4.2 $28,254 $7,567 $5,476 1.1688 94.5% 43.4%
189 Pulmonary edema & respiratory failure 578 4.3 $33,402 $8,148 $6,080 1.2353 0.0% 0.0%
310-309-308 Cardiac arrhythmia & conduction disorders 466 3.4 $26,863 $5,877 $4,754 0.8667 73.8% 35.4%
066-065-064 Intracranial hemorrhage or cerebral infarction 458 3.8 $43,147 $8,075 $6,449 1.2774 79.3% 36.9%
379-378-377 G.I. hemorrhage 427 4.4 $35,347 $8,263 $7,148 1.2700 95.3% 37.0%
392-391 Esophagitis, gastroent & misc digest disorders 411 3.5 $23,388 $5,787 $4,406 0.8620 22.9% 22.9%
855-854-853 Infectious & parasitic diseases w O.R. procedure 348 10.7 $113,149 $27,900 $21,952 4.5650 100.0% 82.8%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 342 3.8 $99,891 $15,852 $14,790 2.4983 36.3% 36.3%
179-178-177 Respiratory infections & inflammations 334 5.6 $39,999 $10,660 $7,543 1.7119 97.6% 78.7%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 311 3.3 $22,212 $6,283 $4,488 0.9957 55.6% 55.6%
690-689 Kidney & urinary tract infections 307 3.4 $23,019 $6,005 $4,242 0.9482 48.5% 48.5%
192-191-190 Chronic obstructive pulmonary disease 305 3.4 $23,666 $6,233 $4,328 0.9774 82.3% 35.1%
455-454-453 Combined anterior/posterior spinal fusion 262 4.6 $217,312 $45,953 $38,134 6.4714 79.4% 13.0%
254-253-252 Other vascular procedures 240 5.5 $86,348 $17,345 $17,300 2.8860 88.7% 57.1%
331-330-329 Major small & large bowel procedures 233 8.4 $81,767 $19,373 $16,822 3.0519 75.5% 29.6%
603-602 Cellulitis 227 3.2 $17,574 $6,366 $3,820 0.9817 22.5% 22.5%
All Other Base MS-DRGs 9,763 5.0 $64,405 $13,529 $12,154 2.1405
T O T A L S 20,006 4.7 $58,179 $12,278 $10,806 1.9182

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 12/31/2018. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,818 4.1 $33,808 $6,043 1.1708 $5,161
Cardiovascular Surgery 1,003 5.6 $156,352 $27,662 4.2362 $6,530
Gynecology 81 3.5 $47,051 $8,715 1.3939 $6,252
Medicine 4,834 4.8 $36,415 $7,026 1.3819 $5,084
Neurology 1,263 3.8 $38,064 $6,120 1.2495 $4,898
Neurosurgery 244 5.0 $136,554 $25,731 3.5458 $7,257
Obstetrics 43 4.3 $22,690 $5,735 0.9380 $6,114
Oncology 321 5.7 $51,152 $9,540 1.7676 $5,397
Orthopedic Surgery 2,489 3.4 $112,773 $20,335 2.9268 $6,948
Orthopedics 425 3.9 $27,717 $5,101 1.0977 $4,647
Psychiatry 239 6.2 $20,785 $7,038 1.1176 $6,298
Pulmonology 2,417 4.4 $34,872 $6,354 1.3520 $4,700
Surgery 1,918 8.0 $84,883 $16,845 3.4015 $4,952
Surgery for Malignancy 119 4.7 $69,758 $12,538 2.2265 $5,631
Urology 1,359 4.1 $31,675 $6,134 1.2759 $4,808
Vascular Surgery 429 5.1 $86,804 $17,337 2.7191 $6,376
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 20,006 4.73 $58,179 $10,806 1.9182 $5,633