The following list highlights the top 20 surgical procedures performed at long term care (LTC) facilities in 2019, as classified by HCPCS/CPT code. LTC facilities — including skilled nursing facilities, home health agencies, and assisted living facilities — serve elderly patients by providing care in the absence of other reliable caretaker options.
The top three procedures performed are related to debridement— a surgical procedure used to remove damage or foreign objects from an area. The most common procedure is debridement of wounds down to and including the subcutaneous tissue "CPT code 11042". Procedures related to debridement make up over 70 percent of the procedures represented on this list and have an average charge per procedure of $318.
The most expensive procedure, EGD Biopsy Single/Multiple "CPT code 43239", has an average charge of $1,333 per procedure while the least expensive procedure, Routine Venipuncture "CPT code 3641", has an average charge of $18 per procedure.
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Rank | HCPCS/CPT Code | HCPCS Description | Number of Total Procedures | Total Charges | Avg Charge/Procedure | Explore These Claims |
1 | 11042 | Deb subq tissue 20 sq cm/< | 368,409 | $113,047,748 | $307 | Explore This Code |
2 | 11043 | Deb musc/fascia 20 sq cm/< | 244,315 | $135,648,784 | $555 | Explore This Code |
3 | 11721 | Debride nail 6 or more | 179,642 | $12,222,340 | $68 | Explore This Code |
4 | 17250 | Chem caut of granltj tissue | 139,181 | $33,240,170 | $239 | Explore This Code |
5 | 36415 | ROUTINE VENIPUNCTURE | 123,507 | $2,254,920 | $18 | Explore This Code |
6 | 11720 | Debride nail 1-5 | 71,689 | $3,202,007 | $45 | Explore This Code |
7 | 11046 | Deb musc/fascia add-on | 29,519 | $10,251,601 | $347 | Explore This Code |
8 | 11045 | Deb subq tissue add-on | 28,123 | $5,320,152 | $189 | Explore This Code |
9 | 11056 | Trim skin lesions 2 to 4 | 27,482 | $2,336,493 | $85 | Explore This Code |
10 | 11055 | Trim skin lesion | 23,119 | $1,580,177 | $68 | Explore This Code |
11 | 11719 | Trim nail(s) any number | 21,492 | $683,120 | $32 | Explore This Code |
12 | 69210 | REMOVE IMPACTED EAR WAX UNI | 18,248 | $1,262,445 | $69 | Explore This Code |
13 | 11044 | Deb bone 20 sq cm/< | 8,697 | $6,217,569 | $715 | Explore This Code |
14 | 20610 | Drain/inj joint/bursa w/o us | 5,699 | $1,227,070 | $215 | Explore This Code |
15 | 36416 | CAPILLARY BLOOD DRAW | 4,726 | $94,422 | $20 | Explore This Code |
16 | 11730 | Removal of nail plate | 4,222 | $670,251 | $159 | Explore This Code |
17 | 43239 | EGD BIOPSY SINGLE/MULTIPLE | 3,829 | $4,339,852 | $1,133 | Explore This Code |
18 | 10060 | Drainage of skin abscess | 3,497 | $1,110,566 | $318 | Explore This Code |
19 | 12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 3,299 | $1,360,002 | $412 | Explore This Code |
20 | 51798 | US URINE CAPACITY MEASURE | 3,174 | $169,342 | $53 | Explore This Code |
Fig 1 Data from Definitive Healthcare based on All-Payor Commercial Claims analytics from CY 2019.