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Cost-to-Charge Ratios for Emergency Department Files


Cost-to-Charge Ratios for Emergency Department Files

The HCUP Cost-to-Charge Ratios for Emergency Department Files (CCR for ED Files) are hospital-level files designed to supplement the data elements in the State Emergency Department Databases (SEDD) and Nationwide Emergency Department Sample (NEDS), beginning with data year 2012. HCUP Cost-to-Charge Ratios for Inpatient Files are also available. The CCR Files are part of a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality. HCUP databases, tools, and software inform decision making at the national, State, and community levels.


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Overview of the CCR for ED Files

The HCUP Emergency Department databases contain data on total charges for each hospital emergency department (ED) visit in the databases. The charge information for ED visits represents the amount that hospitals billed for services, but does not reflect how much hospital services cost or the specific amounts that hospitals received in payment. For some analyses, users may be interested in estimating how hospital charges translate into actual costs.

The HCUP CCR for ED Files enable this conversion. Each file contains hospital-specific cost-to-charge ratios based on all-payer ED costs for nearly every hospital in the corresponding SEDD and NEDS. Cost information was obtained from the hospital accounting reports collected by the Centers for Medicare & Medicaid Services. Some imputations for missing values were necessary.

Users can merge the data elements on the appropriate file to the corresponding SEDD or NEDS by the HCUP hospital identification number (HOSPID for the SEDD and HOSP_NEDS for the NEDS). Using the merged data elements from the cost-to-charge ratio files and the total charges reported in the SEDD or NEDS, users may convert the hospital total charge data to cost estimates by simply multiplying the HCUP total charges element (TOTCHG) by the appropriate cost-to-charge ratio.

HCUP CCR for ED Files are designed to be used exclusively with the HCUP SEDD or NEDS. The CCR Files are unique by year and database.


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Description of the CCR for ED Files

The HCUP CCR for ED Files are used to estimate the cost of resource use for ED visits based on the reported total charge and the cost-to-charge ratios provided in the supplemental files. Costs reflect the actual expenses incurred in the production of hospital services, such as wages, supplies, and utility costs; charges represent the amount a hospital billed for the case. Hospital charges reflect the amount the hospital billed for the entire ED visit and do not include professional (physician) fees.

The CCR for ED Files allow researchers to obtain costs using hospital-specific ratios, where provided, or by weighted average ratios for hospitals in peer groups defined by hospital characteristics and State.


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File Information

Data Year SAS File Name Observations Data Elements Data Type Summary Statistics Password
2021 edcc2021CD.csv 2152 8 SEDD X N/A
2021 cc2021NEDS.csv 993 4 NEDS X N/A
2020 edcc2020CD.csv 2201 8 SEDD X N/A
2020 cc2020NEDS.csv 995 4 NEDS X N/A
2019 edcc2019NEDS.csv 989 4 NEDS X N/A
2019 edcc2019CD.csv 2185 8 SEDD X N/A
2018 edcc2018NEDS.csv 990 4 NEDS X N/A
2018 edcc2018CD_v2 2191 8 SEDD X N/A
2018 edcc2018CD.csv 1718 8 SEDD X N/A
2017 edcc2017NEDS.csv 984 4 NEDS N/A N/A
2017 edcc2017CD_v2.csv 1458 8 SEDD N/A N/A
2016 edcc2016NEDS.csv 953 4 NEDS N/A N/A
2016 edcc2016CD.csv 1442 8 SEDD N/A N/A
2015 edcc2015NEDS.csv 953 4 NEDS N/A N/A
2015 edcc2015CD.csv 1441 8 SEDD N/A N/A
2014 edcc2014NEDS.csv 945 4 NEDS N/A N/A
2014 edcc2014CD.csv 1387 8 SEDD N/A N/A
2013 edcc2013NEDS.csv 947 4 NEDS N/A N/A
2013 edcc2013CD.csv 1394 8 SEDD N/A N/A
2012 edcc2012NEDS.csv 950 4 NEDS N/A N/A
2012 edcc2012CD.csv 1331 8 SEDD N/A N/A

Revision History

The 2017-2018 CCR-SEDD were revised in October 2021.


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Hardware and Software Requirements

The HCUP CCR for ED Files are available in comma-separated values (CSV) format. The SEDD and NEDS files require a statistical software package such as SAS, SPSS, or Stata to use for analytic purposes.


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User Documentation

User documentation for the HCUP CCR for ED Files includes a user guide and a methodologies document.

The user guide contains:

  • A more detailed description of the files' purpose, usage, and format
  • Instructions for linking the files to the SEDD or NEDS
  • Descriptions of key data elements
  • A summary of State participation

The methodologies document contains:

  • An overview of the CCR method
  • A detailed description of the development process for the CCR files
  • A summary of the CCR imputation model
  • Guidance for using the CCRs with HCUP databases

User Documentation for CCR for ED Files


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How Can Users Obtain the HCUP CCR for ED Files?

The CCR-NEDS Files are provided as separate files available with the HCUP Central Distributor NEDS. These files are free of charge.

The CCR Files for the SEDD must be requested separately when ordering the accompanying SEDD.


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Internet Citation: Cost-to-Charge Ratios for Emergency Department Files. Healthcare Cost and Utilization Project (HCUP). March 2024. Agency for Healthcare Research and Quality, Rockville, MD.
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Last modified 03/21/24