OBJECTIVES:  To estimate the differences in the cost of care to the hospital, length of stay, and mortality rates for Medicare patients with congestive heart failure having an inpatient admission for one of the following three reasons: cardiac, pulmonary or vascular. METHODS:  This study was a retrospective observational analysis, conducted using the 2013 HCUP NIS database. Inpatient admissions (n=230,868) were included in this analysis if Medicare was the primary payer and if the patient had a ICD-9 diagnosis code of congestive heart failure. Hospitalizations meeting the inclusion criteria were categorized and subsequently analyzed by the congestive heart failure patient’s primary diagnosis or reason for admission as follows: cardiac (n=185,619), pulmonary (n=40,844), and vascular (n=4,365). RESULTS:  There were significant differences across the three groups (cardiac, pulmonary, vascular) with inpatient vascular admissions having the highest rate of diagnoses on record. Patients with vascular admissions were more likely to be male, African American, and coming from teaching hospitals located in urban areas. Vascular inpatient admissions had significantly higher total costs (mean of $25,927, SD $27,499) than cardiac (mean of $14,674, SD $20,581) and pulmonary (mean of $9,837, SD $20,980). Length of stay was significantly longer as well: vascular group (mean of 7.74 days, SD 8.84) compared to either cardiac (mean of 5.53 days, SD 5.33) or pulmonary (mean of 5.11 days, SD 4.33). Mortality rates were higher for vascular 5.18% versus 3.58% for cardiac and 2.44% for pulmonary. CONCLUSIONS:  Whether a congestive heart failure patient is admitted to the hospital for cardiac, pulmonary, or vascular reasons can significantly impact the burden of illness to the hospital for their inpatient stay.