Medicare Inpatient Data

Data dictionary fields for Medicare inpatient data in Payerset.

For Medicare inpatient rate calculations, see Medicare Inpatient Methodology.

Inpatient Data

Field Name	Friendly Name	Description / Sample Value
NPI	Provider NPI	Unique 10-digit National Provider Identifier. e.g. 1043270564 or No NPI Found
carrier_number	CCN	CMS Certification Number (6-digit provider identifier). e.g. 110107
Rndrng_Prvdr_Org_Name	Provider Organization Name	Name of the rendering provider's organization. e.g. Atrium Health Navicent
Rndrng_Prvdr_City	Provider City	City where the provider is located. e.g. Macon
Rndrng_Prvdr_St	Provider Street Address	Street address of the provider. e.g. 777 Hemlock Street
Rndrng_Prvdr_State_FIPS	State FIPS Code	U.S. Census state FIPS code. e.g. 13
Rndrng_Prvdr_Zip5	Provider ZIP Code	5-digit postal ZIP code. e.g. 31201
Rndrng_Prvdr_State_Abrvtn	State Abbreviation	USPS two-letter state abbreviation. e.g. GA
CBSA	CBSA Code	Core-Based Statistical Area code for geographic wage adjustment. e.g. 12060
drg_code	DRG Code	Medicare Severity Diagnosis-Related Group code. e.g. 470
operating_base_drg_payment	Operating Base DRG Payment	Wage-adjusted base payment × DRG weight, before adjustments. e.g. 15234.56
operating_dsh_factor	Operating DSH Factor	Disproportionate Share Hospital adjustment factor. e.g. 0.0298
operating_dsh_amount	Operating DSH Amount	Dollar amount of DSH add-on. e.g. 453.99
operating_ime_factor	Operating IME Factor	Indirect Medical Education adjustment factor. e.g. 0.0655
operating_ime_amount	Operating IME Amount	Dollar amount of IME add-on. e.g. 997.86
vbp_factor	VBP Adjustment Factor	Hospital Value-Based Purchasing adjustment (typically 0.98–1.02). e.g. 0.99879
hrrp_factor	HRRP Adjustment Factor	Hospital Readmissions Reduction Program adjustment (min 0.97). e.g. 0.9975
fee_schedule_dollar_amount	Operating Fee Schedule Amount	Total operating IPPS payment. e.g. 18250.75
capital_base_payment	Capital Base Payment	Federal capital rate × DRG weight × GAF × COLA. e.g. 1245.67
capital_dsh_factor	Capital DSH Factor	Capital Disproportionate Share adjustment factor. e.g. 0.05731
capital_dsh_amount	Capital DSH Amount	Dollar amount of capital DSH. e.g. 71.39
capital_ime_factor	Capital IME Factor	Capital Indirect Medical Education factor. e.g. 0.05496
capital_ime_amount	Capital IME Amount	Dollar amount of capital IME. e.g. 68.46
capital_fee_schedule_amount	Capital Fee Schedule Amount	Total capital IPPS payment. e.g. 1385.52
total_reimbursement_amount	Total Reimbursement Amount	Combined operating + capital payment. e.g. 19636.27
Total_Discharges	Total Discharges	Total number of discharges reported. e.g. 250 (may be null)
Avg_Submitted_Covered_Charges	Avg Covered Charges	Average submitted covered charges per discharge. e.g. 32500.50
Avg_Total_Payment_Amount	Avg Total Payment	Average total payment amount per discharge. e.g. 19500.75
Avg_Medicare_Payment_Amount	Avg Medicare Payment	Average amount paid by Medicare per discharge. e.g. 18000.25
Avg_Medicare_Payment_Percent	Medicare Payment %	Ratio of avg Medicare payment to operating fee schedule. e.g. 0.99
latitude	Latitude	Geographic latitude of the provider location. e.g. 32.8095
longitude	Geographic longitude	Geographic longitude of the provider location. e.g. -83.6168