• Medicare IPPS claims data are for federal fiscal year ending 09/30/2019 (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.
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Key Attending Providers

  • Medicare IPPS claims data are for 4 quarters ending on 03/31/2020 (Quarterly Inpatient SAF). / Definitions
Name Cases Payment Cost CMI
Dr. Jignesh Desai M.D. 620 $9,197,884.00 $8,061,305.00 2.3097
Deep Ajmani MD 513 $4,613,960.00 $3,128,669.00 1.4851
Ardel C Cagata MD 436 $4,040,618.00 $2,888,804.00 1.4967
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 12/31/2018 / 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%  
IPPS Dashboard
Analyze the factors that define a hospital's payment under IPPS
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Trend Report

Inpatient Utilization Statistics FY 2019 FY 2018 FY 2017 FY 2016 FY 2015
Case Mix Index 1.9181 1.8668 1.8067 1.8388 1.8325
Medical MS-DRGs 67.29% 68.13% 67.52% 67.07% 68.30%
Surgical MS-DRGs 32.71% 31.87% 32.48% 32.91% 31.70%
Routine Discharges to home 9,955 10,040 10,262 9,967 10,537
Discharges to other acute care hospitals 84 41 55 58 57
Discharges to Skilled Nursing Facilities (SNF) 4,402 4,646 4,735 4,873 4,988
Deaths 526 561 597 592 615
Other Discharges 5,102 4,864 4,644 3,971 3,304
Total Discharges 20,069 20,152 20,293 19,461 19,501
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) 10,592 8,938 8,124 7,050 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 12/31/2018. / 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 1,547 5.8 $47,332 $11,155 $8,788 1.7286 84.1% 84.1%
293-292-291 Heart failure & shock 1,209 4.8 $33,843 $8,096 $6,429 1.2555 95.0% 81.9%
470-469 Major joint replacement or reattachment of lower extremity 952 2.1 $103,991 $14,136 $18,508 2.0806 7.7% 7.7%
195-194-193 Simple pneumonia & pleurisy 692 3.9 $29,270 $7,360 $5,180 1.1216 91.8% 57.4%
684-683-682 Renal failure 602 4.2 $28,320 $7,609 $5,492 1.1694 94.5% 43.5%
189 Pulmonary edema & respiratory failure 581 4.3 $33,409 $8,137 $6,084 1.2353 0.0% 0.0%
310-309-308 Cardiac arrhythmia & conduction disorders 465 3.3 $26,662 $5,866 $4,710 0.8650 73.8% 35.1%
066-065-064 Intracranial hemorrhage or cerebral infarction 457 3.8 $43,116 $8,102 $6,438 1.2761 79.2% 36.8%
379-378-377 G.I. hemorrhage 429 4.4 $35,264 $8,280 $7,131 1.2697 95.1% 37.1%
392-391 Esophagitis, gastroent & misc digest disorders 411 3.5 $23,388 $5,787 $4,406 0.8620 22.9% 22.9%
855-854-853 Infectious & parasitic diseases w O.R. procedure 351 10.7 $113,045 $28,103 $21,941 4.5692 100.0% 82.9%
247-246 Percutaneous cardiovascular proc w drug-eluting stent 342 3.8 $99,864 $15,866 $14,783 2.5017 36.5% 36.5%
179-178-177 Respiratory infections & inflammations 336 5.6 $39,883 $10,638 $7,516 1.7127 97.6% 78.9%
641-640 Misc disorders of nutrition,metabolism,fluids/electrolytes 314 3.3 $22,251 $6,278 $4,493 0.9962 55.7% 55.7%
690-689 Kidney & urinary tract infections 308 3.4 $22,981 $6,045 $4,238 0.9477 48.4% 48.4%
192-191-190 Chronic obstructive pulmonary disease 305 3.4 $23,666 $6,243 $4,328 0.9774 82.3% 35.1%
455-454-453 Combined anterior/posterior spinal fusion 263 4.6 $217,494 $46,070 $38,156 6.4658 79.1% 12.9%
254-253-252 Other vascular procedures 244 5.5 $86,324 $17,263 $17,293 2.8775 88.1% 56.6%
331-330-329 Major small & large bowel procedures 233 8.4 $81,796 $19,378 $16,816 3.0519 75.5% 29.6%
603-602 Cellulitis 229 3.2 $17,531 $6,379 $3,814 0.9831 22.7% 22.7%
All Other Base MS-DRGs 9,799 5.0 $64,392 $13,549 $12,152 2.1393
T O T A L S 20,069 4.7 $58,176 $12,304 $10,806 1.9181

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 12/31/2018. / Definitions
  Number Medicare Inpatients Average Length of Stay Average Charges Average Cost Medicare CMI CMI Adjusted Avg. Cost
Cardiology 2,823 4.1 $33,795 $6,037 1.1705 $5,157
Cardiovascular Surgery 1,004 5.6 $156,434 $27,672 4.2383 $6,529
Gynecology 81 3.5 $47,051 $8,714 1.3939 $6,252
Medicine 4,853 4.8 $36,371 $7,019 1.3818 $5,079
Neurology 1,264 3.8 $38,029 $6,117 1.2491 $4,897
Neurosurgery 244 5.0 $136,514 $25,724 3.5458 $7,255
Obstetrics 43 4.3 $22,690 $5,735 0.9380 $6,114
Oncology 323 5.7 $50,997 $9,510 1.7660 $5,385
Orthopedic Surgery 2,493 3.4 $112,806 $20,337 2.9275 $6,947
Orthopedics 428 4.0 $27,745 $5,107 1.0961 $4,659
Psychiatry 240 6.1 $20,753 $7,018 1.1163 $6,287
Pulmonology 2,424 4.4 $34,863 $6,351 1.3522 $4,697
Surgery 1,924 8.0 $84,871 $16,842 3.4027 $4,950
Surgery for Malignancy 120 4.8 $69,897 $12,568 2.2249 $5,649
Urology 1,361 4.1 $31,687 $6,138 1.2758 $4,811
Vascular Surgery 440 5.1 $87,351 $17,458 2.7066 $6,450
Burns 0 0.0 $0 $0 0.0000 $0
TOTAL 20,069 4.73 $58,176 $10,806 1.9181 $5,633