Medicare Utilization Measures (Hospital) (MS-DRG)

Averages

These measures describe the covered charges and total payment averages for medicare recipients. Volume is available in the value rows' denominator field. The measures are separated by individual MS-DRG numbers and they can all be grouped under measure group id 55 and 56.

• Average Covered Charges Measures

• Average Total Payments Measures

Medians

These measures describe the number of cases and median covered charges and reimbursements for a procedure. Volume is available in the value rows' denominator field. The measures are separated by individual MS-DRG numbers.

• Median Medicare Reimbursement (Hospital) (MS-DRG)

• Number of Cases (Hospital) (MS-DRG)

Queries

Acquiring data on CMS Average Covered Charges and Average Total Payments

select a.* from entity_values as a, measure_groups_measures as b
where a.measure_id = b.measure_id
and a.entity_id = ######
and b.measure_group_id in (55,56)

Acquiring data on CMS Number of Cases and Median Reimbursements

select a.* from entity_values as a, measure_groups_measures as b
where a.measure_id = b.measure_id
and a.entity_id = ######
and b.measure_group_id in (1, 2)