CMS Data Browser
🛡️ Public data only — no PHI permitted on this instance.
About this page
Inventory of CMS public datasets available to the platform: dataset name, update frequency, last refresh, record count, primary use case, and ingestion status across PFS, OPPS, MS-DRG, HCRIS, and quality-measure feeds.
Source: data_public/cms_data_browser.py; CMS.gov public-data APIs.
CMS Public Data Browser
Curated catalog of 20 CMS public datasets used in diligence · API connections · sample records · quality measures — 1,705 corpus deals
Datasets
20
Active
20
Total Records
54M
Last Full Refresh
2025-03-15
API Connections
8
HCRIS Provider Types
8
Quality Measures
10
Corpus Deals
1,705
Dataset Catalog
| Dataset | Category | Update Freq | Last Refresh | Records | Primary Use | Status |
|---|---|---|---|---|---|---|
| Medicare Physician Fee Schedule (PFS) | Fee Schedule | annual (Nov/Dec release) | 2024-12-15 | 8,850 | Professional rate benchmarking, RVU analysis, practice valuation | CURRENT |
| OPPS / APC Rates | Fee Schedule | annual (Nov/Dec release) | 2024-12-15 | 1,180 | HOPD / ASC site-of-service analysis, HOPPS repricing | CURRENT |
| MS-DRG / IPPS Rates | Fee Schedule | annual (Aug FY release) | 2024-10-01 | 748 | Inpatient rate benchmarking, DRG shift analysis, 3M coding audit | CURRENT |
| HCRIS Cost Reports - Hospitals | Cost Reports | continuous (quarterly refresh) | 2024-12-31 | 28,500 | Hospital operating performance, benchmarking | CURRENT |
| HCRIS Cost Reports - SNF | Cost Reports | continuous (quarterly refresh) | 2024-12-31 | 65,000 | SNF diligence, payer mix analysis | CURRENT |
| HCRIS Cost Reports - Home Health | Cost Reports | continuous (quarterly refresh) | 2024-12-31 | 48,000 | Home health diligence, PDGM compliance | CURRENT |
| Medicare Advantage Plan Enrollment (PPQs) | MA Data | monthly | 2025-02-15 | 185,000 | MA market share, SNP penetration, competitive benchmarking | CURRENT |
| MA Star Ratings | Quality | annual (October release) | 2024-10-15 | 625 | MA Star bonus payment analysis, benchmark | CURRENT |
| Provider Enrollment / PECOS | Provider Data | continuous | 2025-02-28 | 2,850,000 | Due diligence, credentialing, provider verification | CURRENT |
| Open Payments / Sunshine Act | Transparency | annual (June release) | 2024-06-30 | 12,500,000 | Conflict-of-interest screening, DOJ FCA diligence | CURRENT |
| Medicare Utilization - Physician | Utilization | annual (July release) | 2024-07-15 | 1,850,000 | Provider productivity, billing pattern analysis | CURRENT |
| Medicare Utilization - Hospital Inpatient | Utilization | annual (July release) | 2024-07-15 | 425,000 | Hospital volume benchmarking, DRG mix | CURRENT |
| Hospital Compare | Quality | quarterly | 2024-12-15 | 128,500 | Quality benchmarking, VBP analysis | CURRENT |
| Nursing Home Care Compare | Quality | quarterly | 2024-12-15 | 185,000 | SNF quality, diligence | CURRENT |
| Home Health Compare | Quality | quarterly | 2024-12-15 | 125,000 | Home health diligence, HHVBP | CURRENT |
| Hospice Care Compare | Quality | quarterly | 2024-12-15 | 45,000 | Hospice diligence, survey trends | CURRENT |
| CMS Chronic Conditions | Population Health | annual (December release) | 2024-12-15 | 35,500,000 | MA plan design, chronic disease management | CURRENT |
| Part D Drug Spending Dashboard | Drug Data | annual (September release) | 2024-09-30 | 485,000 | Drug pricing, IRA negotiation analysis | CURRENT |
| DAC (Data-at-a-Click) | Custom Analytics | quarterly | 2024-12-15 | 1,250 | Ad-hoc analytical queries | CURRENT |
| Innovation Center Model Data | VBC / Alternative Payment | model-specific | varies | 2,850 | VBC diligence, CMMI outcomes analysis | CURRENT |
Medicare PFS — Fee Schedule Sample (2025)
| CPT/HCPCS | Descriptor | Work RVU | Total RVU | Facility Rate | Non-Facility Rate | Year |
|---|---|---|---|---|---|---|
| 99213 | Office Visit, Established, Level 3 | 0.97 | 2.28 | $72.53 | $105.10 | 2025 |
| 99214 | Office Visit, Established, Level 4 | 1.50 | 3.33 | $107.83 | $149.81 | 2025 |
| 99215 | Office Visit, Established, Level 5 | 2.11 | 4.42 | $151.95 | $210.44 | 2025 |
| 90837 | Psychotherapy, 60 min | 2.00 | 4.05 | $138.89 | $161.19 | 2025 |
| 45378 | Diagnostic Colonoscopy | 3.36 | 10.20 | $352.98 | $0.00 | 2025 |
| 45385 | Colonoscopy w/ Biopsy | 4.21 | 12.81 | $443.21 | $0.00 | 2025 |
| 93458 | Cardiac Cath, Left Heart | 7.56 | 18.50 | $611.50 | $0.00 | 2025 |
| 66984 | Cataract Surgery w/ IOL | 7.35 | 20.45 | $678.95 | $0.00 | 2025 |
| 17311 | Mohs Surgery, First Stage | 7.45 | 14.25 | $485.68 | $0.00 | 2025 |
| 27447 | Total Knee Replacement | 20.25 | 36.85 | $1,252.45 | $0.00 | 2025 |
| 43239 | EGD w/ Biopsy | 2.64 | 6.85 | $236.15 | $0.00 | 2025 |
| 97140 | Manual Therapy (PT) | 0.43 | 1.25 | $43.18 | $0.00 | 2025 |
MS-DRG / IPPS Base Rate Sample (FY2025)
| MS-DRG | Description | Weight | Geo LOS | Arith LOS | Base Payment ($) | FY |
|---|---|---|---|---|---|---|
| 470 | Major Hip and Knee Joint Replacement (No MCC) | 1.8539 | 2.5 | 2.9 | $11,650 | 2025 |
| 469 | Major Hip and Knee Joint Replacement w/ MCC | 3.2415 | 5.3 | 6.8 | $20,485 | 2025 |
| 247 | Percutaneous Cardiovascular Procedure | 2.1254 | 2.1 | 2.6 | $13,425 | 2025 |
| 872 | Septicemia / Severe Sepsis | 1.3428 | 4.9 | 6.2 | $8,485 | 2025 |
| 392 | Esophagitis / Gastro | 0.7518 | 2.5 | 3.1 | $4,752 | 2025 |
| 291 | Heart Failure w/ MCC | 1.3425 | 4.5 | 5.6 | $8,485 | 2025 |
| 003 | ECMO or Trach with MV 96+ hrs | 19.8542 | 28.5 | 35.2 | $125,485 | 2025 |
| 765 | Cesarean Section w/ CC | 1.1254 | 3.2 | 3.8 | $7,112 | 2025 |
| 775 | Vaginal Delivery w/o CC | 0.5218 | 2.1 | 2.4 | $3,296 | 2025 |
| 885 | Psychoses | 1.0825 | 6.8 | 8.2 | $6,842 | 2025 |
HCRIS Cost Reports — Provider Type Aggregates
| Provider Type | Reports | Filing Year | Median Occupancy | Median Margin | Median CMI |
|---|---|---|---|---|---|
| Acute Care Hospital | 5,250 | 2023 | 65.2% | 2.85% | 1.65 |
| Critical Access Hospital (CAH) | 1,350 | 2023 | 48.5% | 1.20% | 1.15 |
| Specialty Hospital | 385 | 2023 | 58.5% | 5.20% | 1.45 |
| Long-Term Acute Care (LTACH) | 325 | 2023 | 72.5% | 3.85% | 1.85 |
| Inpatient Rehab Facility (IRF) | 1,250 | 2023 | 68.5% | 6.45% | 1.55 |
| Skilled Nursing Facility (SNF) | 14,850 | 2023 | 78.5% | 0.85% | 1.08 |
| Home Health Agency (HHA) | 11,250 | 2023 | 0.0% | 14.50% | 1.12 |
| Hospice | 4,850 | 2023 | 0.0% | 12.85% | 0.00 |
API Connection Status
| Source | Endpoint | Version | Auth | Rate Limit | Cache TTL (hr) | Last Pull |
|---|---|---|---|---|---|---|
| CMS Data.CMS.gov | https://data.cms.gov/provider-data/api/1/ | v1 | NO | 100 req/min | 24 | 2025-03-15 03:00 UTC |
| CMS QPP API | https://qpp.cms.gov/api/auth/v1/ | v1 | YES | 50 req/min | 24 | 2025-03-14 03:00 UTC |
| HRSA Data Warehouse | https://data.hrsa.gov/api/odata/ | odata v4 | NO | 100 req/min | 72 | 2025-03-10 03:00 UTC |
| NPPES NPI Registry | https://npiregistry.cms.hhs.gov/api/ | v2.1 | NO | 200 req/min | 168 | 2025-03-12 03:00 UTC |
| FDA Open Data | https://api.fda.gov/ | v1 | NO | 240 req/min | 24 | 2025-03-15 03:00 UTC |
| Socrata (multiple CMS) | https://data.cms.gov/resource/ | v2.1 | NO | 1000 req/hr (app token) | 24 | 2025-03-15 03:00 UTC |
| data.healthcare.gov | https://www.healthcare.gov/api/ | v1 | NO | 100 req/min | 72 | 2025-03-10 03:00 UTC |
| CMS Innovation Center | https://innovation.cms.gov/api/ | v1 | NO | 50 req/min | 168 | 2025-03-08 03:00 UTC |
Quality Measure National Medians
| Measure | Program | Type | Reporting Year | National Median | Measure Steward |
|---|---|---|---|---|---|
| Hospital 30-day Readmission | HRRP | outcome | 2024 | 14.8% | CMS / Yale-CORE |
| SNF 30-day Readmission (SNFRM) | SNF VBP | outcome | 2024 | 19.5% | CMS |
| HCAHPS Overall Rating 9-10 | Hospital Compare | experience | 2024 | 73.0% | CMS / AHRQ |
| CG-CAHPS Overall Provider Rating | Merit-Based Incentive (MIPS) | experience | 2024 | 4.32 | CMS |
| HEDIS Diabetes HbA1c Control (<8) | MA Stars | process | 2024 | 72.0% | NCQA |
| HEDIS Breast Cancer Screening | MA Stars | process | 2024 | 74.5% | NCQA |
| MA Medication Adherence - Diabetes | MA Stars | pharmacy | 2024 | 82.0% | PQA |
| Hospital-Acquired Conditions (HAC) Reduction | HAC Program | safety | 2024 | 100.0% | CMS |
| PSI-90 Composite | Hospital Compare | safety | 2024 | 100.0% | AHRQ |
| Home Health Improvement in Ambulation | HHVBP | outcome | 2024 | 68.5% | CMS |
CMS Data Browser: 20 public datasets active — 54M+ records aggregate.
PFS, OPPS, and MS-DRG rate data refreshed annually in Nov/Dec (calendar year) or Aug (fiscal year) cycles.
HCRIS cost reports refreshed quarterly — median hospital operating margin 2.85% on 5,250 annual filings.
Public API endpoints are rate-limited; Socrata auth token recommended for sustained pulls.
Quality measure data links to /health-equity and /ma-contracts for MA Stars context, and /clinical-outcomes for provider-level benchmarking.