Cost-to-Charge Ratio for Inpatient Files

The HCUP Cost-to-Charge Ratio for Inpatient Files (CCR for Inpatient Files) are hospital-level files designed to supplement the data elements in the SID, NIS, KID, and NRD. HCUP Cost-to-Charge Ratio for Emergency Department Files (CCR for ED 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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The HCUP Inpatient databases - the SID, NIS, KID, and NRD - contain data on total charges for each hospital discharge in the databases. Charges represents the amount that hospitals billed for services; this differs from costs, or the actual expenses incurred in the production of hospital services, such as wages, supplies, and utility. HCUP total charges exclude professional (physician) fees.

The HCUP CCR for Inpatient Files provide users with ratios that will allow the conversion of the HCUP charges into cost estimates. Each file contains hospital-specific cost-to-charge ratios based on all-payer inpatient cost for nearly every hospital in the corresponding SID, NIS, KID, and NRD. Cost information was obtained from the hospital accounting reports collected by the Centers for Medicare & Medicaid Services (CMS). Some imputations for missing values were necessary.

Users can merge the data elements from the appropriate CCR File onto the corresponding NIS, KID, NRD, or SID by the HCUP hospital identification number (HOSPID, and beginning with the 2012 databases, HOSP_NIS, HOSP_KID, or HOSP_NRD). The cost of inpatient care for a discharge can be estimated by multiplying the HCUP total charges data element (TOTCHG) by the appropriate cost-to-charge ratio.

HCUP CCR for Inpatient Files are designed to be used exclusively with the HCUP NIS, KID, NRD, or SID. The CCR files are unique by year and database.
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The HCUP CCR for Inpatient Files are used to estimate the cost of resource use for inpatient hospital stays and its variation across hospitals and conditions based on the reported total charge and the cost 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.

The CCR for Inpatient 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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Data Year SAS File Name Observations Data Elements Data Type Summary Statistics Password
2018 cc2018CDSID_v2.csv 2690 8 CD-SID X N/A
2018 cc2018NIS.csv 4550 4 NIS X N/A
2018 cc2018NRD.csv 2430 4 NRD X N/A
2017 cc2017CD_v2.csv 2318 8 CD-SID N/A N/A
2017 cc2017NIS.csv 4584 4 NIS N/A N/A
2017 cc2017NRD.csv 2454 4 NRD N/A N/A
2016 cc2016CD.csv 2297 8 CD-SID N/A N/A
2016 cc2016kid.csv 4200 4 KID N/A N/A
2016 cc2016NIS.csv 4575 4 NIS N/A N/A
2016 cc2016NRD.csv 2355 4 NRD N/A N/A
2015 cc2015CD.csv 2178 8 CD-SID N/A N/A
2015 cc2015NIS.csv 4573 4 NIS N/A N/A
2015 cc2015NRD.csv 2367 4 NRD N/A N/A
2014 cc2014CD.csv 2078 8 CD-SID N/A N/A
2014 cc2014NIS.csv 4411 4 NIS N/A N/A
2014 cc2014NRD.csv 2048 4 NRD N/A N/A
2013 cc2013CD.csv 1876 8 CD-SID N/A N/A
2013 cc2013NIS.csv 4363 4 NIS N/A N/A
2013 cc2013NRD.csv 2006 4 NRD N/A N/A
2012 cc2012CD.csv 2313 8 CD-SID N/A N/A
2012 cc2012kid.csv 4179 4 KID N/A N/A
2012 cc2012nis.csv 4378 4 NIS N/A N/A
2012 cc2012NRD.csv 1715 4 NRD N/A N/A
2011 cc2011CD.csv 2412 8 CD-SID N/A N/A
2011 cc2011NIS.csv 1008 7 NIS N/A N/A
2011 cc2011NRD.csv 1804 4 NRD N/A N/A
2010 cc2010CD.csv 2519 8 CD-SID N/A N/A
2010 cc2010NIS.csv 1010 7 NIS N/A N/A
2010 cc2010NRD.csv 1009 4 NRD N/A N/A
2009 cc2009CD.csv 2402 8 CD-SID N/A N/A
2009 cc2009KID.csv 3956 7 KID N/A N/A
2009 cc2009NIS.csv 1013 7 NIS N/A N/A
2008 cc2008CD.csv 2367 7 CD-SID N/A N/A
2008 cc2008NIS.csv 1017 6 NIS N/A N/A
2007 cc2007CD.csv 2305 7 CD-SID N/A N/A
2007 cc2007NIS.csv 1044 6 NIS N/A N/A
2006 cc2006CD.csv 2313 7 CD-SID N/A N/A
2006 cc2006KID.csv 3739 6 KID N/A N/A
2006 cc2006NIS.csv 1045 6 NIS N/A N/A
2005 cc2005CD.csv 1691 7 CD-SID N/A N/A
2005 cc2005NIS.csv 942 6 NIS N/A N/A
2004 cc2004CD.csv 1613 7 CD-SID N/A N/A
2004 cc2004NIS.csv 908 8 NIS N/A N/A
2003 cc2003CD.csv 1626 7 CD-SID N/A N/A
2003 cc2003KID.csv 2965 6 KID N/A N/A
2003 cc2003NIS.csv 855 6 NIS N/A N/A
2002 cc2002CD.csv 1602 7 CD-SID N/A N/A
2002 cc2002NIS.csv 855 6 NIS N/A N/A
2001 cc2001CD.csv 1578 7 CD-SID N/A N/A
2001 cc2001NIS.csv 851 6 NIS N/A N/A
Revision History

The 2018 CCR-SID was revised in December 2020
The 2010 CCR-NIS and CCR-SID were revised in August 2013.
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The HCUP CCR for Inpatient Files are available in ASCII comma-separated values (CSV) format. The NIS, KID, NRD, and SID files require a statistical software package such as SAS, SPSS, or Stata to use for analytic purposes.
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The User Guides for the HCUP CCR for Inpatient Files contain:
  • A more detailed description of the file's purpose, usage, and format
  • Instructions for linking the files to the NIS, KID, NRD, or SID
  • A summary of State participation
  • A description of internal validation methods
  • Descriptions of key data elements
User Guides for CCR for Inpatient Files
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HCUP CCR for Inpatient Files are provided as separate files available with the HCUP Central Distributor SID, NIS, KID, and NRD. These supplemental files are available free of charge from the HCUP Central Distributor.

The CCR for Inpatient Files are provided as complimentary files that are automatically included with download orders for the NIS, KID, and NRD databases. The CCR files for the SID can be added to an order for the accompanying SID - they are not automatically included with the order.
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Internet Citation: Cost-to-Charge Ratio for Inpatient Files. Healthcare Cost and Utilization Project (HCUP). April 2021. Agency for Healthcare Research and Quality, Rockville, MD.
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Last modified 4/8/21