Top 10 Outpatient Procedures

Overview Given the ongoing transition away from inpatient care, outpatient treatment has become an important component of hospital operations. New medical technologies, as well as incentives to reign in overall spending, have pushed hospitals to offer more services on an outpatient basis. The following tables identify the top 10 outpatient hospital procedures by ICD 9 code by volume and total payments in 2015.

In terms of total volume, diagnostic procedures are the most common, comprising six of the top 10. Routine venipuncture, or blood draws, was ranked number one with nearly 120 million procedures performed in 2015. Other tests included blood cell counts, metabolic panels, and electrocardiogram tracing. Clinic and emergency visits were also very common, reflecting two core operations of most hospitals.

Unlike the procedures with the most volume, those with the highest payments tend to be direct care rather than diagnostic tests. Most of the procedures make the top 10 list due to a combination of significant volume and above-average payments. ED visits are more expensive than clinic visits given the greater resource use associated with triage, regardless of the actual severity of each case, though higher-acuity visits are reimbursed more. A few procedures, such as catheter placement of intracoronary drug and insertion or replacement of defibrillator with leads, have comparatively low volume but exceptionally high costs. Another example is Infliximab injection, an immunosuppressant used to treat a variety of conditions, which is delivered through infusion.

Nearly all the top 10 procedures displayed volume or payment growth since 2014. While a single year of changes isn’t enough to draw solid conclusions, the increase in volume for the most common procedures is consistent with the growing focus on outpatient care overall. For the procedures with the most payments, greater demand in recent years can explain some of the increase in average per claim payments, such as for emergency and clinic visits.

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ICD 9 Code   Description Total Proc, 2015 Total Proc, 2014 Net Growth/ Decline Growth/ Decline %
36415 Routine venipuncture 119,742,874 121,416,156 -1,673,282 -1.4%
G0463 Hospital clinic visit 99,433,734 95,549,107 3,884,627 4.1%
85025 Complete blood count with differential white blood cell 85,814,312 82,909,991 2,904,321 3.5%
80053 Comprehensive metabolic panel 71,797,346 68,785,102 3,012,244 4.4%
97110 Therapeutic exercises 37,722,819 35,843,502 1,879,317 5.2%
80048 Metabolic panel total calcium 35,086,568 34,836,534 250,034 0.7%
85610 Prothrombin time test 34,280,073 35,532,496 -1,252,423 -3.5%
99283 Emergency dept visit, moderate severity 31,434,887 31,351,121 83,766 0.3%
93005 EKG tracing 30,644,409 29,601,993 1,042,416 3.5%
99284 Emergency dept visit, high severity 28,148,154 26,900,648 -1,673,282 4.6%