• Medicare IPPS claims data are for federal fiscal year ending 09/30/2020 (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

Sample Report | Order Information

Provider Analysis
Attending physician utilization measures including cases, CMI, cost, payment, length of stay and more.
More Information | Sample Report

Key Attending Providers

  • Medicare IPPS claims data are for 4 quarters ending on 03/31/2021 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Dr. Jignesh Desai M.D. 507 $9,505,986.00 $8,806,701.00 2.5115
Deep Ajmani MD 283 $3,088,001.00 $2,147,227.00 1.6986
Ardel C Cagata MD 275 $2,819,038.00 $2,019,855.00 1.5809
Market Analysis
Build color coded maps based on more detailed Patient Origin data
More Information | Sample Report

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
More Information | Sample Report

Trend Report

Inpatient Utilization Statistics FY 2020 FY 2019 FY 2018 FY 2017 FY 2016
Case Mix Index 2.0413 1.9181 1.8668 1.8067 1.8388
Medical MS-DRGs 67.88% 67.29% 68.13% 67.52% 67.07%
Surgical MS-DRGs 32.12% 32.71% 31.87% 32.48% 32.91%
Routine Discharges to home 8,097 9,955 10,040 10,262 9,967
Discharges to other acute care hospitals 88 84 41 55 58
Discharges to Skilled Nursing Facilities (SNF) 3,226 4,402 4,646 4,735 4,873
Deaths 599 526 561 597 592
Other Discharges 4,244 5,102 4,864 4,644 3,971
Total Discharges 16,254 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) 10,620 10,592 8,938 8,124 N/A
MS-DRG Coding Indicators
Use coding indicators and comparative data to identify areas for improvement
More Information | Sample Report

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 1,572 5.7 $48,650 $11,383 $9,288 1.7521 86.2% 86.2%
293-292-291 Heart failure & shock 1,007 4.7 $35,805 $8,074 $7,172 1.2666 97.5% 83.4%
684-683-682 Renal failure 431 4.3 $30,386 $7,293 $6,278 1.1390 94.0% 44.5%
195-194-193 Simple pneumonia & pleurisy 414 3.9 $31,509 $7,340 $5,865 1.1496 91.1% 62.8%
066-065-064 Intracranial hemorrhage or cerebral infarction 396 3.5 $42,311 $7,988 $6,482 1.3113 81.8% 40.2%
189 Pulmonary edema & respiratory failure 380 4.2 $34,151 $7,797 $6,436 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 346 3.9 $34,424 $8,157 $7,222 1.2878 97.1% 39.6%
179-178-177 Respiratory infections & inflammations 343 6.0 $44,011 $11,644 $8,715 1.7675 98.3% 81.9%
855-854-853 Infectious & parasitic diseases w O.R. procedure 321 10.5 $112,930 $30,013 $23,115 4.5661 99.7% 81.9%
470-469 Major joint replacement or reattachment of lower extremity 316 2.9 $113,305 $14,146 $21,615 2.1723 17.4% 17.4%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 297 3.7 $104,750 $15,905 $16,151 2.4601 37.4% 37.4%
392-391 Esophagitis, gastroent & misc digest disorders 278 3.4 $24,815 $5,547 $4,852 0.8824 25.5% 25.5%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 249 3.4 $26,233 $6,142 $5,373 1.0359 61.0% 61.0%
455-454-453 Combined anterior/posterior spinal fusion 246 4.8 $262,695 $47,376 $49,306 6.4747 82.9% 17.5%
484-483 Major joint & limb reattachment proc of upper extremity 245 1.4 $124,362 $17,473 $23,429 2.3921 100.0% 0.0%
254-253-252 Other vascular procedures 232 5.5 $83,138 $18,849 $17,566 2.9319 92.2% 57.3%
192-191-190 Chronic obstructive pulmonary disease 195 3.6 $28,039 $6,293 $5,353 0.9920 92.3% 45.1%
282-281-280 Acute myocardial infarction, discharged alive 186 4.2 $47,970 $8,612 $7,989 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 8,247 5.0 $68,922 $14,568 $13,853 2.3004
T O T A L S 16,254 4.8 $62,996 $13,137 $12,348 2.0413

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
More Information | Sample Report

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 2,258 4.2 $35,927 $6,808 1.2075 $5,638
Cardiovascular Surgery 939 5.5 $164,388 $30,936 4.4073 $7,019
Gynecology 62 3.3 $55,884 $10,551 1.4306 $7,375
Medicine 4,255 4.8 $39,423 $7,830 1.4681 $5,333
Neurology 1,016 3.7 $38,744 $6,504 1.3113 $4,960
Neurosurgery 235 5.5 $136,685 $27,553 3.7373 $7,372
Obstetrics 54 3.3 $17,927 $4,728 0.8779 $5,386
Oncology 355 5.4 $51,538 $10,343 1.8815 $5,497
Orthopedic Surgery 1,708 3.9 $129,455 $24,904 3.2853 $7,581
Orthopedics 302 3.9 $28,933 $5,696 1.1324 $5,030
Psychiatry 218 5.6 $20,989 $7,347 1.1673 $6,294
Pulmonology 1,794 4.7 $39,674 $7,604 1.4828 $5,128
Surgery 1,526 7.9 $92,739 $19,197 3.5861 $5,353
Surgery for Malignancy 116 4.7 $76,499 $14,623 2.2799 $6,414
Urology 997 4.3 $33,903 $7,006 1.3199 $5,308
Vascular Surgery 415 4.5 $87,452 $18,662 2.6800 $6,963
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 16,254 4.82 $62,996 $12,348 2.0413 $6,049