• Medicare IPPS claims data are for federal fiscal year ending 09/30/2017 (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 03/31/2018 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Deep Ajmani MD 832 $7,721,900.00 $6,122,829.00 1.5449
Joshua N Quaye MD 630 $6,666,041.00 $5,642,933.00 1.6175
Julius B Larosa M.D. 587 $5,152,318.00 $4,418,914.00 1.4632
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Patient Origin

  • Medicare Hospital Market Service Area file for calendar year ending 12/31/2017 / Definitions
ZIP Code of Residence Discharges Days of Care Charges Discharges Inc/(Dec) Market Share
40219 1,201 6,191 60,383,772 -3.4% 57.5%
40229 1,120 5,813 59,032,329 9.1% 55.7%
40216 1,053 5,638 53,309,409 0.5% 35.1%
40165 1,009 5,245 52,710,781 -3.3% 52.6%
40214 1,004 5,211 52,816,173 18.0% 41.6%
40272 968 5,006 52,773,725 13.7% 37.1%
40211 814 4,770 43,655,784 21.7% 43.9%
40291 795 3,642 38,114,105 11.7% 39.0%
40241 768 3,109 36,350,953 1.3% 54.4%
40218 735 3,928 37,593,793 9.7% 44.4%
All other ZIP Codes 19,267 97,413 1,099,094,003    
Total 28,734 145,966 1,585,834,827 7.5%  
Analyze the factors that define a hospital's payment under IPPS
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Trend Report

Inpatient Utilization Statistics FY 2017 FY 2016 FY 2015 FY 2014 FY 2013
Case Mix Index 1.8067 1.8388 1.8325 1.8405 1.7994
Medical MS-DRGs 67.52% 67.07% 68.30% 67.59% 66.13%
Surgical MS-DRGs 32.48% 32.91% 31.70% 32.41% 33.87%
Routine Discharges to home 10,262 9,967 10,537 9,415 9,014
Discharges to other acute care hospitals 55 58 57 76 95
Discharges to Skilled Nursing Facilities (SNF) 4,735 4,873 4,988 4,332 4,645
Deaths 597 592 615 495 589
Other Discharges 4,644 3,971 3,304 3,191 4,009
Total Discharges 20,293 19,461 19,501 17,509 18,352
Psychiatric Discharges (DPU, included in Total) 0 0 0 0 50
Rehabilitation Discharges (DPU, included in Total) 0 0 0 0 0
Medicare Advantage (HMO) Discharges (NOT included in Total) 8,124 7,050 6,813 5,815 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 12/31/2016. / 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
293-292-291 Heart failure & shock 1,143 5.0 $34,252 $8,319 $7,501 1.2804 90.1% 67.5%
192-191-190 Chronic obstructive pulmonary disease 1,128 4.5 $32,179 $7,205 $6,947 1.0686 91.9% 72.3%
470-469 Major joint replacement or reattachment of lower extremity 1,019 2.4 $92,048 $13,829 $18,255 2.1259 4.8% 4.8%
872-871 Septicemia or severe sepsis w/o MV 96+ hours 897 6.0 $46,397 $10,508 $9,688 1.6073 78.5% 78.5%
684-683-682 Renal failure 600 4.7 $29,628 $7,320 $6,501 1.1058 89.2% 37.8%
690-689 Kidney & urinary tract infections 548 3.6 $22,344 $5,926 $4,752 0.9040 44.0% 44.0%
310-309-308 Cardiac arrhythmia & conduction disorders 525 3.8 $27,533 $5,832 $5,677 0.8659 75.2% 33.3%
379-378-377 G.I. hemorrhage 473 4.3 $34,688 $7,879 $7,629 1.1639 89.9% 26.8%
392-391 Esophagitis, gastroent & misc digest disorders 461 3.7 $23,763 $5,550 $4,932 0.8254 18.7% 18.7%
066-065-064 Intracranial hemorrhage or cerebral infarction 434 4.0 $40,463 $7,780 $6,898 1.2079 79.0% 32.0%
195-194-193 Simple pneumonia & pleurisy 408 4.0 $28,344 $6,915 $5,885 1.0480 77.9% 35.3%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 355 4.0 $26,229 $5,669 $5,689 0.9289 49.6% 49.6%
460-459 Spinal fusion except cervical 339 3.8 $139,079 $28,315 $26,960 4.2163 8.8% 8.8%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 317 3.8 $93,800 $15,018 $15,207 2.4933 32.8% 32.8%
179-178-177 Respiratory infections & inflammations 293 5.3 $36,877 $10,287 $7,985 1.6441 90.8% 65.5%
189 Pulmonary edema & respiratory failure 293 5.2 $41,256 $8,341 $8,787 1.2135 0.0% 0.0%
603-602 Cellulitis 273 3.8 $19,225 $6,520 $4,621 0.9654 19.8% 19.8%
331-330-329 Major small & large bowel procedures 261 9.7 $80,719 $18,877 $18,061 2.9980 73.9% 28.4%
254-253-252 Other vascular procedures 232 5.9 $78,134 $16,411 $17,133 2.9160 87.5% 56.9%
390-389-388 G.I. obstruction 207 4.2 $21,417 $5,826 $4,768 0.8589 69.1% 11.6%
All Other Base MS-DRGs 10,087 5.4 $61,789 $13,546 $12,739 2.1417
T O T A L S 20,293 4.9 $53,864 $11,557 $11,078 1.8067

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 12/31/2016. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,862 4.3 $33,693 $6,829 1.1300 $6,043
Cardiovascular Surgery 909 5.8 $130,809 $24,819 3.9202 $6,331
Gynecology 92 3.7 $43,709 $8,838 1.3177 $6,707
Medicine 4,495 4.8 $33,752 $7,215 1.2101 $5,962
Neurology 1,287 3.8 $36,248 $6,476 1.1425 $5,668
Neurosurgery 266 5.8 $121,847 $25,023 3.4858 $7,178
Obstetrics 48 3.8 $16,321 $4,477 0.8163 $5,484
Oncology 331 5.1 $44,243 $8,946 1.6861 $5,306
Orthopedic Surgery 2,572 3.5 $99,918 $19,913 2.8125 $7,080
Orthopedics 390 4.0 $26,595 $5,522 1.0217 $5,405
Psychiatry 280 5.3 $19,010 $6,137 0.9764 $6,285
Pulmonology 2,637 4.8 $36,243 $7,701 1.2948 $5,947
Surgery 2,021 8.7 $85,012 $18,389 3.3577 $5,477
Surgery for Malignancy 166 5.2 $76,007 $15,178 2.0672 $7,342
Urology 1,589 4.4 $30,458 $6,600 1.1837 $5,576
Vascular Surgery 347 5.7 $76,097 $16,456 2.8210 $5,833
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 20,293 4.92 $53,864 $11,078 1.8067 $6,131