• Medicare IPPS claims data are for federal fiscal year ending 09/30/2021 (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 12/31/2021 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Dr. Jignesh Desai M.D. 322 $5,490,106.00 $5,831,075.00 2.4773
Ardel C Cagata MD 247 $3,012,087.00 $2,768,559.00 1.8442
Dr. Hasan Aladili M.D. 233 $2,689,019.00 $2,315,421.00 1.7543
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 12/31/2020 / Definitions
ZIP Code of Residence Discharges Days of Care Charges Discharges Inc/(Dec) Market Share Market Share
5-years prior
40216 1,129 6,551 $68,820,257 -8.3% 46.4% 33.5%
40219 1,058 5,442 $60,533,659 -13.1% 61.0% 55.9%
40165 1,004 4,770 $58,795,518 -16.1% 59.6% 54.0%
40229 936 4,763 $56,833,136 -17.6% 58.4% 55.2%
40272 847 4,335 $53,628,180 -13.9% 40.7% 34.4%
40291 797 3,653 $47,303,845 -6.2% 43.8% 37.3%
40214 790 4,392 $49,131,548 -15.3% 43.5% 37.3%
40241 712 3,480 $43,068,033 -9.6% 60.8% 53.7%
40218 693 3,428 $37,765,386 -10.8% 52.1% 44.8%
40211 631 3,866 $36,023,980 -13.2% 48.1% 39.6%
All other ZIP Codes 16,412 87,581 $1,113,428,518    
Total 25,009 132,261 $1,625,332,060 -14.7%  
IPPS Dashboard
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 2.1076 2.0413 1.9181 1.8668 1.8067
Medical MS-DRGs 70.68% 67.88% 67.29% 68.13% 67.52%
Surgical MS-DRGs 29.32% 32.12% 32.71% 31.87% 32.48%
Routine Discharges to home 6,166 8,097 9,955 10,040 10,262
Discharges to other acute care hospitals 75 88 84 41 55
Discharges to Skilled Nursing Facilities (SNF) 2,873 3,226 4,402 4,646 4,735
Deaths 728 599 526 561 597
Other Discharges 4,925 4,244 5,102 4,864 4,644
Total Discharges 14,767 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) 11,185 10,620 10,592 8,938 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 12/31/2020. / 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 1,557 5.9 $53,290 $12,270 $11,041 1.7366 84.5% 84.5%
293-292-291 Heart failure & shock 846 5.0 $38,239 $8,347 $8,461 1.2867 97.9% 89.0%
179-178-177 Respiratory infections & inflammations 786 5.7 $46,172 $13,390 $9,943 1.7894 98.6% 92.0%
684-683-682 Renal failure 381 4.7 $33,702 $7,594 $7,598 1.1720 96.1% 51.4%
310-309-308 Cardiac arrhythmia & conduction disorders 351 3.5 $27,798 $5,343 $5,802 0.8594 72.4% 36.2%
066-065-064 Intracranial hemorrhage or cerebral infarction 342 3.7 $44,464 $8,223 $7,677 1.3220 83.9% 39.5%
379-378-377 G.I. hemorrhage 336 4.3 $38,415 $8,852 $8,869 1.3444 97.6% 44.6%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 293 3.9 $111,800 $16,736 $18,414 2.5201 46.8% 46.8%
855-854-853 Infectious & parasitic diseases w O.R. procedure 280 10.8 $115,542 $27,851 $25,430 4.3113 99.6% 77.9%
195-194-193 Simple pneumonia & pleurisy 270 4.1 $35,059 $7,374 $6,923 1.1670 94.4% 70.4%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 246 3.6 $29,046 $6,490 $6,477 1.0734 67.5% 67.5%
189 Pulmonary edema & respiratory failure 238 4.5 $38,087 $7,903 $8,023 1.2248 0.0% 0.0%
392-391 Esophagitis, gastroent & misc digest disorders 229 3.5 $26,886 $5,962 $5,792 0.8944 27.1% 27.1%
690-689 Kidney & urinary tract infections 191 3.7 $26,550 $6,140 $5,683 0.9660 54.5% 54.5%
254-253-252 Other vascular procedures 189 4.8 $85,903 $19,025 $19,479 2.8970 89.9% 49.2%
287-286 Circulatory disorders except AMI, w card cath 187 5.1 $65,915 $11,098 $11,537 1.6963 51.3% 51.3%
455-454-453 Combined anterior/posterior spinal fusion 169 5.3 $308,474 $50,337 $59,288 6.5930 84.6% 22.5%
700-699-698 Other kidney & urinary tract diagnoses 160 5.2 $38,326 $9,330 $8,733 1.4541 100.0% 73.8%
482-481-480 Hip & femur procedures except major joint 159 6.0 $76,141 $15,942 $16,702 2.4154 90.6% 39.0%
192-191-190 Chronic obstructive pulmonary disease 152 3.2 $27,758 $6,344 $5,677 1.0084 96.7% 54.6%
All Other Base MS-DRGs 7,405 5.5 $81,991 $16,623 $17,646 2.4737
T O T A L S 14,767 5.3 $68,710 $14,235 $14,522 2.1076

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 12/31/2020. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,003 4.4 $40,008 $8,249 1.2313 $6,700
Cardiovascular Surgery 937 5.3 $181,687 $36,406 4.5831 $7,944
Gynecology 41 4.0 $50,135 $10,430 1.4584 $7,152
Medicine 4,067 5.2 $47,356 $10,167 1.5760 $6,451
Neurology 889 4.0 $41,880 $7,909 1.3422 $5,893
Neurosurgery 231 5.5 $151,453 $32,977 4.0922 $8,058
Obstetrics 34 3.4 $22,026 $5,585 0.8945 $6,243
Oncology 363 5.4 $69,272 $14,528 2.2913 $6,340
Orthopedic Surgery 1,054 5.2 $145,234 $29,263 3.5807 $8,172
Orthopedics 295 4.5 $33,858 $7,260 1.2111 $5,995
Psychiatry 193 6.6 $23,952 $9,546 1.1655 $8,190
Pulmonology 1,852 5.4 $48,218 $10,138 1.6797 $6,036
Surgery 1,391 8.3 $98,554 $22,209 3.5141 $6,320
Surgery for Malignancy 109 4.1 $70,666 $14,721 2.1832 $6,743
Urology 943 4.8 $37,510 $8,479 1.3727 $6,177
Vascular Surgery 365 4.1 $94,094 $21,419 2.7528 $7,781
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 14,767 5.30 $68,710 $14,522 2.1076 $6,890