Inpatient utilization · Reference

Per-CCN per-MS-DRG inpatient utilization, free + open. The dataset Definitive sells as Hospital Performance.

The CMS Medicare Inpatient Hospitals by Provider and Service file is annual. Check the loaded snapshot shown by the endpoint rather than inferring freshness from the publisher cadence. Supported responses identify available source and methodology fields; not every field has a complete 14-element provenance tuple.

Try the API → Outpatient sister dataset → Data catalog →

1. What this dataset is

Per-CCN per-MS-DRG Medicare inpatient discharge + payment + length-of-stay aggregates.

CMS publishes the “Medicare Inpatient Hospitals by Provider and Service” file annually each mid-June. One row per (CCN, MS-DRG code, data year). Each row carries the count of Medicare fee-for-service discharges, the average covered/total/Medicare payment amounts, and the average length of stay. Coverage extends back to data year 2018 in the current schema (legacy 2013-2017 schema is different and not ingested in Phase 2).

Fonteum publishes this public-use CMS dataset with Dataset JSON-LD and the source, observation, methodology, and license fields available for the endpoint. Optional provenance fields can be null.

2. What this dataset is NOT

No PHI. No claims. No patient records.

CMS pre-aggregates this file to facility-level rows before public release. The dataset contains:

NO patient identifiers — no names, no addresses, no dates of birth.
NO claim-level rows — only annual rollups per (CCN, MS-DRG).
NO discharge dates — just the data year.
NO cells with discharge counts under 11 — CMS pre-suppresses these per its privacy policy. Our schema preserves the suppression by allowing NULL in the count fields.

We additionally drop the provider-name and provider-address columns CMS ships with the file: those facts already live in the CMS Provider of Services (POS) file (canonical name + address per CCN), and dual-storage would create drift. Joins back to POS happen at query time via the federated identity bridge.

3. Refresh schedule

Configured probe schedule: 06:00 UTC daily. Loaded freshness is reported separately.

The configured Inngest cron schedule is 0 6 * * *. A configured probe does not prove a current load or a successful run. Check the endpoint's dated loaded snapshot; a full ingest is intended only when CMS publishes a new annual data year.

4. How it joins to other sources

CCN is the bridge to POS, Care Compare, ownership chains.

Every utilization row carries a CMS Certification Number (CCN). The federated identity layer (/identity) joins the CMS Provider of Services (POS) file (canonical facility name + address + type), Care Compare quality ratings, NH ownership chains, and now utilization in a single query.

Format guard: every CCN is validated against the ^[A-Z0-9]{6}$ pattern at ingest time. Rows failing the check are dropped before they reach inpatient_utilization_summary.

5. The API

`GET /api/v1/utilization/inpatient/[ccn]`

Returns the top-10 MS-DRGs by discharge count for the given CCN. Source-level provenance metadata appears where the endpoint supplies it; fields can be null and do not establish an individual-fact signature.

{
  "data": {
    "ccn": "010001",
    "data_year": 2022,
    "top_ms_drgs": [
      {
        "ms_drg_code": "470",
        "ms_drg_description": "MAJOR JOINT REPLACEMENT OR REATTACHMENT...",
        "total_discharges": 342,
        "avg_covered_charges": 65000,
        "avg_total_payments": 13800,
        "avg_medicare_payments": 12100,
        "avg_length_of_stay": 2.5,
        "data_year": 2022
      }
    ],
    "provenance": {
      "_source": "CMS Medicare Inpatient Hospitals by Provider and Service",
      "_dataset_id": "cms-inpatient-utilization",
      "_snapshot": "2022-12-31",
      "_methodology": "v2026.05.0",
      "_license": "US-Government-Works",
      "_coverage_period_start": "2018-01-01",
      "_coverage_period_end": "ongoing"
    }
  },
  "meta": { "request_id": "req_...", "api_version": "v1", "...": "..." }
}

6. License + redistribution

US-Government-Works. Anyone can redistribute.

CMS publishes this file as a federal-government work, public domain in the U.S. under 17 U.S.C. §105 and the Open Government Data Act. The SPDX identifier US-Government-Works is what Fonteum surfaces in the provenance contract’s _license field for every row derived from this dataset.

7. How to cite

APA-ish, with the upstream CMS source named.

Fonteum. (2026). CMS Medicare Inpatient
Hospitals by Provider and Service [data set]. https://fonteum.com/docs/utilization-inpatient.
Retrieved [date]. Original source: Centers for Medicare & Medicaid
Services. License: US-Government-Works.

Detailed researcher citation guidance lives at /cite; the researcher-api docs describe the citation TOS for the free tier.

8. Verify the snapshot

SHA-256 attestation + S3 cache mirror.

For a snapshot that has an attestation and retained source bytes, the /verify surface exposes the recorded digest. Coverage and source-byte retention are not universal.