The HCUP Cost-to-Charge Ratio (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 (CCR) for Emergency Department 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.
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. 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.
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 estimate costs using hospital-specific ratios, where provided, or by weighted average ratios for hospitals in peer groups defined by hospital characteristics and State.
There is one CCR File per data year for the NIS, KID, and NRD. Users can merge the data elements from the appropriate CCR File onto the corresponding NIS and KID, using the included HCUP hospital identification number (HOSP_NIS or HOSP_KID beginning with data year 2012 and HOSPID in prior years). For the NRD, the merge key is the NRD hospital identification number (HOSP_NRD) in all data years. The filenames for the CCR Files for the NIS, KID, and NRD are listed in the separate Appendix to the User Guide (in Excel format).
The following table provides links to the Summary Statistics for the CCR Files for the NIS, KID, and NRD starting in 2018.
In February 2026, the structure of the CCR Files for the SID was revised. Previously, there was one combined multi-state CCR File for the SID per data year (2001-2023) that included information for all States with available data. The previously combined multi-state CCR Files for the SID have been split into State-specific files. There is one CCR File per SID for each data year. The unit of observation within the CCR Files for the SID remains hospitals in the SID, identified by the HCUP hospital identification number (HOSPID). The availability of data elements within the CCR Files for the SID continues to depend on HCUP Partner permission for data release.
The CCR Files for the SID are in ASCII comma separated value (CSV) format (the files do not require a password). Any CCR File for the SID obtained starting in March 2026 will be State-specific and have the filename of CCR_SID_<YYYY>_<SS>, where <YYYY> is the data year and <SS> is the 2-character State abbreviation. The filenames for the combined multi-state CCR Files for the SID obtained prior to March 2026 are listed in the separate Appendix to the User Guide (in Excel format).
The following table provides links to the Summary Statistics for the previously combined multi-state CCR Files for the SID starting in 2018.
The HCUP CCR for Inpatient Files are available in ASCII comma-separated values (CSV) format. Any analyses using the NIS, KID, NRD, and SID require a statistical software package such as SAS, SPSS, or Stata.
User documentation for the HCUP CCR for Inpatient Files includes a user guide and a methodologies document.
The user guide contains:
The methodologies document contains:
User Documentation for CCR for Inpatient Files
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.
| Internet Citation: Cost-to-Charge Ratio for Inpatient Files. Healthcare Cost and Utilization Project (HCUP). March 2026. Agency for Healthcare Research and Quality, Rockville, MD. hcup-us.ahrq.gov/db/ccr/ip-ccr/ip-ccr.jsp. |
| Are you having problems viewing or printing pages on this website? |
| If you have comments, suggestions, and/or questions, please contact hcup@ahrq.gov. |
| If you are experiencing issues related to Section 508 accessibility of information on this website, please contact hcup@ahrq.gov. |
| Privacy Notice, Viewers & Players |
| Last modified 03/04/26 |
Email Updates