Medicare Geographic Variation - by National, State & County

The Medicare Geographic Variation by National, State & County dataset provides information on the geographic differences in the use and quality of health care…

Part of the CMS Data Feeds Dataset › Medicare

Dataplex delivers this CMS feed as the analysis-ready table DWV.MEDICARE_GEOGRAPHIC_VARIATION__BY_NATIONAL_STATE__COUNTY on Snowflake and Databricks — four annual reporting periods (2021–2024) aligned to a single schema, refreshed automatically whenever CMS publishes a new file. Every row carries lineage back to the exact CMS source file that produced it.

Key facts

Snowflake	DWV.MEDICARE_GEOGRAPHIC_VARIATION__BY_NATIONAL_STATE__COUNTY
Databricks	cms_dwv.medicare_geographic_variation__by_national_state__county
Coverage	Jan 2021 – Dec 2024 (4 of 4 annual reporting periods)
Rows	151,256 (total across all reporting periods)
Cadence	Annual
Update pattern	Time-partitioned — each file adds one reporting year
CMS published	2026-05-15
Loaded	2026-05-15
Columns	267 data + 6 lineage
File versions	4
License	CMS public data — U.S. Government work
Platforms	Snowflake Marketplace · Databricks Delta Sharing

Included in the CMS Data Feeds Dataset — start a free trial on Snowflake Marketplace.

Current — CMS last published this feed on 2026-05-15. Coverage is complete through the 2024 reporting year. Next CMS release expected ~May 2027.

Time-partitioned feed — each file version covers one reporting year, so history is additive. Query the full table for all years; filter on YEAR for a single period. Do not filter to the latest file only — that would return just the 2024 reporting year.

Sample queries

Snowflake

-- Each file version covers one reporting period (2021, 2022, 2023, 2024) — history is additive
SELECT *
FROM DWV.MEDICARE_GEOGRAPHIC_VARIATION__BY_NATIONAL_STATE__COUNTY
LIMIT 100;

Databricks

About this feed

The Medicare Geographic Variation by National, State & County dataset provides information on the geographic differences in the use and quality of health care services for the Original Medicare population. This dataset contains demographic, spending, use, and quality indicators at the state level (including the District of Columbia, Puerto Rico, and the Virgin Islands) and the county level.

Spending is standardized to remove geographic differences in payment rates for individual services as a source of variation. In general, total standardized per capita costs are less than actual per capita costs because the extra payments Medicare made to hospitals were removed, such as payments for medical education (both direct and indirect) and payments to hospitals that serve a disproportionate share of low-income patients. Standardization does not adjust for differences in beneficiaries’ health status.

— Source: CMS feed metadata

Keywords: National, States & Territories, Counties, Medicare, Original Medicare, Health Care Use & Payments, Health Equity Theme: Medicare

Coverage timeline

2021 🟩 · 2022 🟩 · 2023 🟩 · 2024 🟩

4 of 4 annual reporting periods present — no gaps.

Release history

Reporting period	CMS published	Loaded	Latest file
2024-01-01 – 2024-12-31	2026-05-15	2026-05-15	✓
2023-01-01 – 2023-12-31	2025-04-24	2025-04-24
2022-01-01 – 2022-12-31	2024-05-16	2024-05-16
2021-01-01 – 2021-12-31	2023-03-06	2023-08-29

Data dictionary

📋 267 data columns + 6 lineage columns

Column-level definitions are maintained by CMS in the official Medicare Geographic Variation - by National, State & County data dictionary.

Data columns

Column	Type
YEAR	NUMBER
BENE_GEO_LVL	TEXT
BENE_GEO_DESC	TEXT
BENE_GEO_CD	NUMBER
BENE_AGE_LVL	TEXT
BENES_TOTAL_CNT	NUMBER
BENES_WTH_PTAPTB_CNT	NUMBER
BENES_FFS_CNT	NUMBER
BENES_MA_CNT	NUMBER
MA_PRTCPTN_RATE	NUMBER
BENE_AVG_AGE	NUMBER
BENE_FEML_PCT	NUMBER
BENE_MALE_PCT	NUMBER
BENE_RACE_WHT_PCT	NUMBER
BENE_RACE_BLACK_PCT	NUMBER
BENE_RACE_HSPNC_PCT	NUMBER
BENE_RACE_OTHR_PCT	NUMBER
BENE_DUAL_PCT	NUMBER
BENE_AVG_RISK_SCRE	NUMBER
TOT_MDCR_PYMT_AMT	NUMBER
TOT_MDCR_STDZD_PYMT_AMT	NUMBER
TOT_MDCR_PYMT_PC	NUMBER
TOT_MDCR_STDZD_PYMT_PC	NUMBER
IP_MDCR_PYMT_AMT	NUMBER
IP_MDCR_PYMT_PCT	NUMBER
IP_MDCR_PYMT_PC	NUMBER
IP_MDCR_PYMT_PER_USER	NUMBER
IP_MDCR_STDZD_PYMT_AMT	NUMBER
IP_MDCR_STDZD_PYMT_PCT	NUMBER
IP_MDCR_STDZD_PYMT_PC	NUMBER
IP_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_IP_CVRD_STAY_CNT	NUMBER
BENES_IP_PCT	NUMBER
IP_CVRD_STAYS_PER_1000_BENES	NUMBER
IP_CVRD_DAYS_PER_1000_BENES	NUMBER
ACUTE_HOSP_READMSN_CNT	NUMBER
ACUTE_HOSP_READMSN_PCT	NUMBER
BENES_ER_VISITS_CNT	NUMBER
ER_VISITS_PER_1000_BENES	NUMBER
BENES_ER_VISITS_PCT	NUMBER
OP_MDCR_PYMT_AMT	NUMBER
OP_MDCR_PYMT_PCT	NUMBER
OP_MDCR_PYMT_PC	NUMBER
OP_MDCR_PYMT_PER_USER	NUMBER
OP_MDCR_STDZD_PYMT_AMT	NUMBER
OP_MDCR_STDZD_PYMT_PCT	NUMBER
OP_MDCR_STDZD_PYMT_PC	NUMBER
OP_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_OP_CNT	NUMBER
BENES_OP_PCT	NUMBER
OP_VISITS_PER_1000_BENES	NUMBER
ASC_MDCR_PYMT_AMT	NUMBER
ASC_MDCR_PYMT_PCT	NUMBER
ASC_MDCR_PYMT_PC	NUMBER
ASC_MDCR_PYMT_PER_USER	NUMBER
ASC_MDCR_STDZD_PYMT_AMT	NUMBER
ASC_MDCR_STDZD_PYMT_PCT	NUMBER
ASC_MDCR_STDZD_PYMT_PC	NUMBER
ASC_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_ASC_CNT	NUMBER
BENES_ASC_PCT	NUMBER
ASC_EVNTS_PER_1000_BENES	NUMBER
SNF_MDCR_PYMT_AMT	NUMBER
SNF_MDCR_PYMT_PCT	NUMBER
SNF_MDCR_PYMT_PC	NUMBER
SNF_MDCR_PYMT_PER_USER	NUMBER
SNF_MDCR_STDZD_PYMT_AMT	NUMBER
SNF_MDCR_STDZD_PYMT_PCT	NUMBER
SNF_MDCR_STDZD_PYMT_PC	NUMBER
SNF_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_SNF_CNT	NUMBER
BENES_SNF_PCT	NUMBER
SNF_CVRD_STAYS_PER_1000_BENES	NUMBER
SNF_CVRD_DAYS_PER_1000_BENES	NUMBER
IRF_MDCR_PYMT_AMT	NUMBER
IRF_MDCR_PYMT_PCT	NUMBER
IRF_MDCR_PYMT_PC	NUMBER
IRF_MDCR_PYMT_PER_USER	NUMBER
IRF_MDCR_STDZD_PYMT_AMT	NUMBER
IRF_MDCR_STDZD_PYMT_PCT	NUMBER
IRF_MDCR_STDZD_PYMT_PC	NUMBER
IRF_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_IRF_CNT	NUMBER
BENES_IRF_PCT	NUMBER
IRF_CVRD_STAYS_PER_1000_BENES	NUMBER
IRF_CVRD_DAYS_PER_1000_BENES	NUMBER
LTCH_MDCR_PYMT_AMT	NUMBER
LTCH_MDCR_PYMT_PCT	NUMBER
LTCH_MDCR_PYMT_PC	NUMBER
LTCH_MDCR_PYMT_PER_USER	NUMBER
LTCH_MDCR_STDZD_PYMT_AMT	NUMBER
LTCH_MDCR_STDZD_PYMT_PCT	NUMBER
LTCH_MDCR_STDZD_PYMT_PC	NUMBER
LTCH_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_LTCH_CNT	NUMBER
BENES_LTCH_PCT	NUMBER
LTCH_CVRD_STAYS_PER_1000_BENES	NUMBER
LTCH_CVRD_DAYS_PER_1000_BENES	NUMBER
HH_MDCR_PYMT_AMT	NUMBER
HH_MDCR_PYMT_PCT	NUMBER
HH_MDCR_PYMT_PC	NUMBER
HH_MDCR_PYMT_PER_USER	NUMBER
HH_MDCR_STDZD_PYMT_AMT	NUMBER
HH_MDCR_STDZD_PYMT_PCT	NUMBER
HH_MDCR_STDZD_PYMT_PC	NUMBER
HH_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_HH_CNT	NUMBER
BENES_HH_PCT	NUMBER
HH_EPISODES_PER_1000_BENES	NUMBER
HH_VISITS_PER_1000_BENES	NUMBER
HOSPC_MDCR_PYMT_AMT	NUMBER
HOSPC_MDCR_PYMT_PCT	NUMBER
HOSPC_MDCR_PYMT_PC	NUMBER
HOSPC_MDCR_PYMT_PER_USER	NUMBER
HOSPC_MDCR_STDZD_PYMT_AMT	NUMBER
HOSPC_MDCR_STDZD_PYMT_PCT	NUMBER
HOSPC_MDCR_STDZD_PYMT_PC	NUMBER
HOSPC_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_HOSPC_CNT	NUMBER
BENES_HOSPC_PCT	NUMBER
HOSPC_CVRD_STAYS_PER_1000_BENES	NUMBER
HOSPC_CVRD_DAYS_PER_1000_BENES	NUMBER
EM_MDCR_PYMT_AMT	NUMBER
EM_MDCR_PYMT_PCT	NUMBER
EM_MDCR_PYMT_PC	NUMBER
EM_MDCR_PYMT_PER_USER	NUMBER
EM_MDCR_STDZD_PYMT_AMT	NUMBER
EM_MDCR_STDZD_PYMT_PCT	NUMBER
EM_MDCR_STDZD_PYMT_PC	NUMBER
EM_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_EM_CNT	NUMBER
BENES_EM_PCT	NUMBER
EM_EVNTS_PER_1000_BENES	NUMBER
PRCDRS_MDCR_PYMT_AMT	NUMBER
PRCDRS_MDCR_PYMT_PCT	NUMBER
PRCDRS_MDCR_PYMT_PC	NUMBER
PRCDRS_MDCR_PYMT_PER_USER	NUMBER
PRCDRS_MDCR_STDZD_PYMT_AMT	NUMBER
PRCDRS_MDCR_STDZD_PYMT_PCT	NUMBER
PRCDRS_MDCR_STDZD_PYMT_PC	NUMBER
PRCDRS_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_PRCDRS_CNT	NUMBER
BENES_PRCDRS_PCT	NUMBER
PRCDR_EVNTS_PER_1000_BENES	NUMBER
TESTS_MDCR_PYMT_AMT	NUMBER
TESTS_MDCR_PYMT_PCT	NUMBER
TESTS_MDCR_PYMT_PC	NUMBER
TESTS_MDCR_PYMT_PER_USER	NUMBER
TESTS_MDCR_STDZD_PYMT_AMT	NUMBER
TESTS_MDCR_STDZD_PYMT_PCT	NUMBER
TESTS_MDCR_STDZD_PYMT_PC	NUMBER
TESTS_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_TESTS_CNT	NUMBER
BENES_TESTS_PCT	NUMBER
TESTS_EVNTS_PER_1000_BENES	NUMBER
IMGNG_MDCR_PYMT_AMT	NUMBER
IMGNG_MDCR_PYMT_PCT	NUMBER
IMGNG_MDCR_PYMT_PC	NUMBER
IMGNG_MDCR_PYMT_PER_USER	NUMBER
IMGNG_MDCR_STDZD_PYMT_AMT	NUMBER
IMGNG_MDCR_STDZD_PYMT_PCT	NUMBER
IMGNG_MDCR_STDZD_PYMT_PC	NUMBER
IMGNG_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_IMGNG_CNT	NUMBER
BENES_IMGNG_PCT	NUMBER
IMGNG_EVNTS_PER_1000_BENES	NUMBER
DME_MDCR_PYMT_AMT	NUMBER
DME_MDCR_PYMT_PCT	NUMBER
DME_MDCR_PYMT_PC	NUMBER
DME_MDCR_PYMT_PER_USER	NUMBER
DME_MDCR_STDZD_PYMT_AMT	NUMBER
DME_MDCR_STDZD_PYMT_PCT	NUMBER
DME_MDCR_STDZD_PYMT_PC	NUMBER
DME_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_DME_CNT	NUMBER
BENES_DME_PCT	NUMBER
DME_EVNTS_PER_1000_BENES	NUMBER
OP_DLYS_MDCR_PYMT_AMT	NUMBER
OP_DLYS_MDCR_PYMT_PCT	NUMBER
OP_DLYS_MDCR_PYMT_PC	NUMBER
OP_DLYS_MDCR_PYMT_PER_USER	NUMBER
OP_DLYS_MDCR_STDZD_PYMT_AMT	NUMBER
OP_DLYS_MDCR_STDZD_PYMT_PCT	NUMBER
OP_DLYS_MDCR_STDZD_PYMT_PC	NUMBER
OP_DLYS_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_OP_DLYS_CNT	NUMBER
BENES_OP_DLYS_PCT	NUMBER
OP_DLYS_VISITS_PER_1000_BENES	NUMBER
FQHC_RHC_MDCR_PYMT_AMT	NUMBER
FQHC_RHC_MDCR_PYMT_PCT	NUMBER
FQHC_RHC_MDCR_PYMT_PC	NUMBER
FQHC_RHC_MDCR_PYMT_PER_USER	NUMBER
FQHC_RHC_MDCR_STDZD_PYMT_AMT	NUMBER
FQHC_RHC_MDCR_STDZD_PYMT_PCT	NUMBER
FQHC_RHC_MDCR_STDZD_PYMT_PC	NUMBER
FQHC_RHC_MDCR_STDZD_PYMT_PU	NUMBER
BENES_FQHC_RHC_CNT	NUMBER
BENES_FQHC_RHC_PCT	NUMBER
FQHC_RHC_VISITS_PER_1000_BENES	NUMBER
AMBLNC_MDCR_PYMT_AMT	NUMBER
AMBLNC_MDCR_PYMT_PCT	NUMBER
AMBLNC_MDCR_PYMT_PC	NUMBER
AMBLNC_MDCR_PYMT_PER_USER	NUMBER
AMBLNC_MDCR_STDZD_PYMT_AMT	NUMBER
AMBLNC_MDCR_STDZD_PYMT_PCT	NUMBER
AMBLNC_MDCR_STDZD_PYMT_PC	NUMBER
AMBLNC_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_AMBLNC_CNT	NUMBER
BENES_AMBLNC_PCT	NUMBER
AMBLNC_EVNTS_PER_1000_BENES	NUMBER
TRTMNTS_MDCR_PYMT_AMT	NUMBER
TRTMNTS_MDCR_PYMT_PCT	NUMBER
TRTMNTS_MDCR_PYMT_PC	NUMBER
TRTMNTS_MDCR_PYMT_PER_USER	NUMBER
TRTMNTS_MDCR_STDZD_PYMT_AMT	NUMBER
TRTMNTS_MDCR_STDZD_PYMT_PCT	NUMBER
TRTMNTS_MDCR_STDZD_PYMT_PC	NUMBER
TRTMNTS_MDCR_STDZD_PYMT_PER_USER	NUMBER
BENES_TRTMNTS_CNT	NUMBER
BENES_TRTMNTS_PCT	NUMBER
TRTMNTS_EVNTS_PER_1000_BENES	NUMBER
PTB_OTHR_SRVCS_MDCR_PYMT_AMT	NUMBER
PTB_OTHR_SRVCS_MDCR_STDZD_PYMT	NUMBER
TOT_PBPMT_RDCTN_AMT	TEXT
TOT_PBPMT_RDCTN_PCC	TEXT
PQI03_DBTS_AGE_LT_65	TEXT
PQI03_DBTS_AGE_65_74	TEXT
PQI03_DBTS_AGE_GE_75	TEXT
PQI05_COPD_ASTHMA_AGE_40_64	TEXT
PQI05_COPD_ASTHMA_AGE_65_74	TEXT
PQI05_COPD_ASTHMA_AGE_GE_75	TEXT
PQI07_HYPRTNSN_AGE_LT_65	TEXT
PQI07_HYPRTNSN_AGE_65_74	TEXT
PQI07_HYPRTNSN_AGE_GE_75	TEXT
PQI08_CHF_AGE_LT_65	TEXT
PQI08_CHF_AGE_65_74	TEXT
PQI08_CHF_AGE_GE_75	TEXT
PQI11_BCTRL_PNA_AGE_LT_65	TEXT
PQI11_BCTRL_PNA_AGE_65_74	TEXT
PQI11_BCTRL_PNA_AGE_GE_75	TEXT
PQI12_UTI_AGE_LT_65	TEXT
PQI12_UTI_AGE_65_74	TEXT
PQI12_UTI_AGE_GE_75	TEXT
PQI15_ASTHMA_AGE_LT_40	TEXT
PQI16_LWRXTRMTY_AMPUTN_AGE_LT_65	TEXT
PQI16_LWRXTRMTY_AMPUTN_AGE_65_74	TEXT
PQI16_LWRXTRMTY_AMPUTN_AGE_GE_75	TEXT
BENES_EVER_MA_CNT	NUMBER
EVER_MA_PRTCPTN_RATE	NUMBER
TOT_MDCR_STDZD_RA_PYMT_AMT	NUMBER
TOT_MDCR_STDZD_RA_PYMT_PC	NUMBER
ASC_EVENTS_PER_1000_BENES	NUMBER
HH_CVRD_STAYS_PER_1000_BENES	NUMBER
PTB_DRUGS_MDCR_PYMT_AMT	NUMBER
PTB_DRUGS_MDCR_PYMT_PCT	NUMBER
PTB_DRUGS_MDCR_PYMT_PC	NUMBER
PTB_DRUGS_MDCR_PYMT_PU	NUMBER
PTB_DRUGS_MDCR_STDZD_PYMT_AMT	NUMBER
PTB_DRUGS_MDCR_STDZD_PYMT_PCT	NUMBER
PTB_DRUGS_MDCR_STDZD_PYMT_PC	NUMBER
PTB_DRUGS_MDCR_STDZD_PYMT_PU	NUMBER
BENES_PTB_DRUGS_CNT	NUMBER
BENES_PTB_DRUGS_PCT	NUMBER
PQI10_DHYDRTN_AGE_LT_65	TEXT
PQI10_DHYDRTN_AGE_65_74	TEXT
PQI10_DHYDRTN_AGE_GE_75	TEXT
BENES_OM_CNT	NUMBER

Lineage columns (present on every feed table)

Column	Type	Description
ROW_ID	TEXT	Unique row ID for this table (PK)
FILE_ID	TEXT	Source file — joins to FEEDS_FILES.ID (FK)
FILE_FEED_ID	TEXT	Parent feed — joins to FEEDS.ID (FK)
FILE_NAME	TEXT	Source file name as published by CMS
ROWNUM	NUMBER	Row number within the source file
CREATED_AT	TIMESTAMP_NTZ	Timestamp when the record was loaded

Row-level lineage

Every row in this table traces to the exact CMS source file that produced it. The FILE_ID column joins to the FEEDS_FILES catalog table, and FILE_FEED_ID joins to the FEEDS master table:

Trace any row back to its source file and reporting period:

SELECT d.YEAR, d.BENE_GEO_LVL, d.BENE_GEO_DESC,
       ff.TEMPORAL_START, ff.TEMPORAL_END, ff.CMS_FEED_MODIFIED
FROM DWV.MEDICARE_GEOGRAPHIC_VARIATION__BY_NATIONAL_STATE__COUNTY d
JOIN DWV.FEEDS_FILES ff ON d.FILE_ID = ff.ID;

Source & provenance

Published by the Centers for Medicare & Medicaid Services (bureau 009:38).

• Official CMS documentation

• Original%20medicare%20geographic%20variation%20public%20use%20file%20methods%20paper

Frequently asked questions

How often is Medicare Geographic Variation - by National, State & County updated?

Annually. CMS last published this feed on 2026-05-15, and Dataplex loaded it to the warehouse the same day. New releases are added automatically when CMS publishes them.

What years does Medicare Geographic Variation - by National, State & County cover?

2021 through 2024 — four annual reporting periods with no gaps. Each reporting year arrives as its own file version, and all years remain queryable side by side.

How many records are in Medicare Geographic Variation - by National, State & County?

151,256 rows across all four reporting periods. Because this feed is time-partitioned, the full table total is the meaningful count — no deduplication needed.

How do I get Medicare Geographic Variation - by National, State & County data?

It's included in the CMS Data Feeds Dataset on the Snowflake Marketplace (free trial available) and via Databricks Delta Sharing. Once mounted, query DWV.MEDICARE_GEOGRAPHIC_VARIATION__BY_NATIONAL_STATE__COUNTY directly — no pipeline setup required.

Related feeds

Multiple Chronic ConditionsSpecific Chronic ConditionsMedicare Inpatient Hospitals - by Geography and ServiceMedicare Durable Medical Equipment, Devices & Supplies - by Geography and ServiceMedicare Physician & Other Practitioners - by Geography and Service

Get this feed

1. Start a free trial on Snowflake Marketplace or purchase via Databricks

2. Mount the share — the database and DWV schema appear in your account immediately

3. Run the sample query above — no ETL, no pipeline maintenance

Questions about this feed? Contact us at [e-mail].

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