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Cost-to-Charge Ratio Files

The HCUP Cost-to-Charge Ratio Files are hospital-level files designed to supplement the data elements in the SID, NIS, KID, and NRD. 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 SID, NIS, KID, and NRD contain data on total charges for each hospital discharge in the databases. This charge information represents the amount that hospitals billed for services, but does not reflect how much hospital services actually cost or the specific amounts that hospitals received in payment. In some cases, users may be interested in seeing how hospital charges translate into actual costs.

The HCUP Cost-to-Charge Ratio Files enable this conversion. 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 on the appropriate file to 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). Using the merged data elements from the cost-to-charge ratio files and the total charges reported in the SID, NIS, KID, and NRD, users may convert the hospital total charge data to cost estimates by simply multiplying total charges with the appropriate cost-to-charge ratio.

HCUP Cost-to-Charge Ratio 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 Cost-to-Charge Ratio 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 variables allow researchers to obtain costs by hospital where provided or by weighted average for hospitals in peer groups defined by hospital characteristics and state.
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The HCUP Cost-to-Charge Ratio Files are available for the HCUP inpatient databases beginning with 2001 data. Files for linkage to the following years and types of data are currently available:
  • CCR for Central Distributor SID: 2001 to 2017
  • CCR for NIS: 2001 to 2017
  • CCR for KID: 2003, 2006, 2009, 2012, 2016
  • CCR for NRD: 2010 to 2017
The 2010 CCR-NIS and CCR-SID were revised in August 2013.

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Two versions of the 2010 CCR files were released. The version 2 files (August 2013) are the most recent. An earlier version was released in August 2012.

Cost estimates using earlier versions may differ somewhat from estimates generated with the new CCRs. The initial version contained usable accounting reports for about 61% of HCUP hospitals. The revised 2010 CCR files contain usable 2010 accounting reports for 89% of HCUP hospitals. For hospitals with no usable report in each version, the CCR was imputed from a weighted average for a peer group within the state (GAPICC). For hospitals that were missing accounting reports in the initial files, the APICC was calculated from the updated reports. In addition, several HCUP states had a particularly high proportion of hospitals with missing reports in the initial version, which results in a smaller number of hospitals used for imputation. GAPICC was recalculated using the updated weighted average for a peer group within the state. Additional information is provided in the CCR User Guides for the 2010 NIS and SID.
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The HCUP Cost-to-Charge Ratio Files are available in ASCII 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 Cost-to-Charge Ratio Files contain:
  • A more detailed description
  • Instructions for linking the files to the NIS, KID, NRD, or SID
  • State participation
  • A description of internal validation methods
  • Descriptions of key variables.
Downloading Information

Web Browser Download: Your browser may support loading the User Guides from this Web page. To download the User Guides from this Web page, click on the following links with the right mouse button and select "Save Link As" (Firefox) or "Save Target As" (Internet Explorer). After saving a file, find it by using Windows® Explorer (Windows® 98/95/NT) or File Manager (Windows® 3.x), and then open the file by double-clicking on it.

CCR User Guide for Central Distributor SID CCR User Guide for NIS CCR User Guide for KID
CCR User Guide for NRD
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HCUP Cost-to-Charge Ratio Files are provided as separate files available from the HCUP Central Distributor. These files are free of charge.

The CCR files are automatically included with orders for the NIS, KID, and NRD databases. The CCR files for the SID must be requested separately when ordering the accompanying SID. Contact the HCUP Central Distributor to obtain your own copy of these files.
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Internet Citation: Cost-to-Charge Ratio Files. Healthcare Cost and Utilization Project (HCUP). May 2020. Agency for Healthcare Research and Quality, Rockville, MD.
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Last modified 5/26/20