Medicare Provider Utilization and Payment Data: Inpatient

The Inpatient Utilization and Payment Public Use File (Inpatient PUF) provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments. The PUF is organized by hospital and Medicare Severity Diagnosis Related Group (MS-DRG) and covers Fiscal Year (FY) 2011 through FY 2017.

Hospitals determine what they will charge for items and services provided to patients and these charges are the amount the hospital bills for an item or service. The Total Payment amount includes the MS-DRG amount, bill total per diem, beneficiary primary payer claim payment amount, beneficiary Part A coinsurance amount, beneficiary deductible amount, beneficiary blood deducible amount and DRG outlier amount.

Inpatient PUF users will be able to make comparisons between individual hospital-level charges and payments within local markets, and nationwide, for services that might be furnished in connection with a particular inpatient stay. Individual years of the Inpatient PUF can be found using the left menu.

Inquiries regarding this data can be sent to MedicareProviderData@cms.hhs.gov.

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Page Last Modified:
11/27/2019 05:28 PM