• Medicare IPPS claims data are for federal fiscal year ending 09/30/2020 (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 06/30/2020 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Dr. Jignesh Desai M.D. 572 $8,482,558.00 $7,478,763.00 2.3106
Deep Ajmani MD 447 $3,976,451.00 $2,743,868.00 1.4957
Ardel C Cagata MD 382 $3,511,405.00 $2,456,515.00 1.4667
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 12/31/2019 / Definitions
ZIP Code of Residence Discharges Days of Care Charges Discharges Inc/(Dec) Market Share Market Share
5-years prior
40216 1,231 6,624 67,193,675 13.9% 43.7% 31.5%
40219 1,218 6,038 64,298,632 3.2% 61.4% 54.2%
40165 1,197 5,976 67,134,264 12.8% 59.2% 54.0%
40229 1,136 5,621 59,625,434 0.1% 61.8% 56.3%
40272 984 5,188 57,992,639 7.0% 42.9% 31.8%
40214 933 4,949 52,729,400 -6.9% 44.5% 35.9%
40291 850 3,591 45,140,518 1.9% 44.2% 33.5%
40241 788 3,334 46,241,358 5.1% 58.6% 50.7%
40218 777 3,764 36,225,425 3.9% 49.7% 43.7%
40211 727 4,067 38,230,687 -8.0% 49.4% 40.6%
All other ZIP Codes 19,464 105,447 1,186,299,109    
Total 29,305 154,599 1,721,111,141 0.5%  
IPPS Dashboard
Analyze the factors that define a hospital's payment under IPPS
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Trend Report

Inpatient Utilization Statistics FY 2020 FY 2019 FY 2018 FY 2017 FY 2016
Case Mix Index 2.0403 1.9181 1.8668 1.8067 1.8388
Medical MS-DRGs 67.89% 67.29% 68.13% 67.52% 67.07%
Surgical MS-DRGs 32.11% 32.71% 31.87% 32.48% 32.91%
Routine Discharges to home 8,098 9,955 10,040 10,262 9,967
Discharges to other acute care hospitals 86 84 41 55 58
Discharges to Skilled Nursing Facilities (SNF) 3,238 4,402 4,646 4,735 4,873
Deaths 594 526 561 597 592
Other Discharges 4,161 5,102 4,864 4,644 3,971
Total Discharges 16,177 20,069 20,152 20,293 19,461
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) 10,703 10,592 8,938 8,124 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 12/31/2019. / 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 1,562 5.7 $48,625 $11,372 $9,285 1.7535 86.4% 86.4%
293-292-291 Heart failure & shock 1,002 4.7 $35,828 $8,071 $7,176 1.2662 97.5% 83.3%
684-683-682 Renal failure 426 4.3 $30,465 $7,294 $6,284 1.1377 93.9% 44.4%
195-194-193 Simple pneumonia & pleurisy 413 3.9 $31,501 $7,346 $5,865 1.1491 91.0% 62.7%
066-065-064 Intracranial hemorrhage or cerebral infarction 397 3.5 $42,388 $7,990 $6,493 1.3128 81.9% 40.3%
189 Pulmonary edema & respiratory failure 381 4.2 $34,117 $7,798 $6,430 1.2157 0.0% 0.0%
310-309-308 Cardiac arrhythmia & conduction disorders 377 3.4 $27,154 $5,714 $5,090 0.8702 75.3% 37.7%
379-378-377 G.I. hemorrhage 343 4.0 $34,439 $8,171 $7,227 1.2881 97.1% 39.7%
179-178-177 Respiratory infections & inflammations 338 6.0 $44,196 $11,604 $8,754 1.7657 98.2% 81.7%
855-854-853 Infectious & parasitic diseases w O.R. procedure 319 10.5 $111,495 $29,874 $22,755 4.5720 99.7% 82.1%
470-469 Major joint replacement or reattachment of lower extremity 316 2.9 $113,305 $14,125 $21,615 2.1723 17.4% 17.4%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 296 3.7 $104,799 $15,937 $16,155 2.4653 37.8% 37.8%
392-391 Esophagitis, gastroent & misc digest disorders 277 3.4 $24,893 $5,528 $4,859 0.8829 25.6% 25.6%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 249 3.4 $26,233 $6,158 $5,375 1.0359 61.0% 61.0%
484-483 Major joint & limb reattachment proc of upper extremity 244 1.4 $124,717 $17,479 $23,496 2.3921 100.0% 0.0%
455-454-453 Combined anterior/posterior spinal fusion 244 4.8 $260,676 $47,190 $48,914 6.4641 82.8% 17.2%
254-253-252 Other vascular procedures 228 5.5 $83,411 $18,822 $17,635 2.9316 92.1% 57.5%
192-191-190 Chronic obstructive pulmonary disease 194 3.6 $28,118 $6,308 $5,367 0.9913 92.3% 44.8%
282-281-280 Acute myocardial infarction, discharged alive 186 4.2 $47,970 $8,623 $7,990 1.3234 87.1% 58.1%
690-689 Kidney & urinary tract infections 176 3.4 $25,657 $5,960 $4,978 0.9454 47.2% 47.2%
All Other Base MS-DRGs 8,209 5.0 $68,881 $14,544 $13,846 2.2996
T O T A L S 16,177 4.8 $62,920 $13,113 $12,331 2.0403

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 12/31/2019. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,250 4.2 $35,960 $6,813 1.2074 $5,643
Cardiovascular Surgery 936 5.5 $164,419 $30,946 4.4089 $7,019
Gynecology 61 3.3 $56,712 $10,696 1.4432 $7,411
Medicine 4,237 4.8 $39,347 $7,816 1.4675 $5,326
Neurology 1,012 3.7 $38,841 $6,521 1.3119 $4,970
Neurosurgery 233 5.5 $136,814 $27,595 3.7461 $7,366
Obstetrics 54 3.3 $17,927 $4,728 0.8779 $5,386
Oncology 351 5.4 $51,486 $10,334 1.8746 $5,513
Orthopedic Surgery 1,702 3.9 $129,150 $24,847 3.2810 $7,573
Orthopedics 301 3.9 $28,914 $5,693 1.1333 $5,023
Psychiatry 215 5.6 $21,060 $7,381 1.1651 $6,335
Pulmonology 1,785 4.7 $39,471 $7,563 1.4793 $5,113
Surgery 1,517 7.8 $92,434 $19,119 3.5877 $5,329
Surgery for Malignancy 116 4.7 $76,499 $14,623 2.2799 $6,414
Urology 993 4.3 $33,937 $7,011 1.3200 $5,312
Vascular Surgery 410 4.5 $87,708 $18,727 2.6748 $7,001
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 16,177 4.81 $62,920 $12,331 2.0403 $6,044