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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 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 |

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% |

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 |

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 | 1,192 | 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 |