Top 25 surgical procedures at ambulatory surgery centers

Ambulatory surgery centers (ASCs) continue to be the focus of healthcare industry leaders seeking to reduce overall care costs. The expansion of care delivery outside of the traditional hospital setting correlates with falling costs, improved outcomes, and increased rates of patient satisfaction. Because of their limited offerings and outpatient focus, ASCs can offer diagnostic and outpatient procedures at lower rates than hospitals and other inpatient centers — often with shorter wait times for patients.

What are the most common surgical procedures?

According to Definitive Healthcare's ClaimsMx data, the most common surgical procedures at ASCs are largely diagnostic and focused on the gastrointestinal (GI) system. Colonoscopies and esophagogastroduodenoscopies appeared four times on our list, with a combined total of 5.7  million procedures. Cataract surgery and other related eye surgeries also made several appearances on the list, including claiming the top spot, with more than 3.5 million total claims across three types of procedures. 

In addition to cataract and GI-related procedures, epidural injections are the next most performed procedures. Rounding out the list are minimally invasive orthopedic surgeries.

The trends among the top surgical procedures reinforce the role of specialty surgery centers in healthcare delivery, which is to offer affordable and effective care that does not require overnight observation or other hospitalization.

25 most common surgical procedures at ambulatory surgery centers

Rank	CPT/HCPCS	Description	# of Procedures	Average Charges/Procedure
1.	66984	Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration of phacoemulsification); without endoscopic cyclophotocoagulation	2,824,839	$4,017
2.	43239	Esophagogastroduodenoscopy, flexible, transoral; biopsy; single or multiple	1,837,837	$2,471
3.	45380	Colonoscopy, flexible; with biopsy, single or multiple	1,656,648	$2,692
4.	45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	1,332,655	$2,534
5.	45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	940,054	$2,562
6.	64483	Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral; single level	730,034	$2,636
7.	20610	Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance	484,564	$551
8.	64493	Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level	471,173	$2,668
9.	66821	Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., YAG laser) (1 or more stages)	463,716	$1,157
10.	67028	Intravitreal injection of a pharmacologic agent (separate procedure)	402,223	$576
11.	62323	Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (i.e., fluoroscopy or CT)	399,329	$2,288
12.	64494	Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral, second level	338,860	$2,012
13.	36415	Collection of venous blood by venipuncture	326,899	$14
14.	64636	Destruction by neurolytic agent, paravertebral facet joint nerve(s) with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint	280,022	$2,598
15.	64635	Destruction by neurolytic agent, paravertebral facet joint nerve(s) with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint	274,572	$3,826
16.	64484	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level	241,981	$1,997
17.	64415	Injection(s), anesthetic agent(s) and/or steroid; brachial plexus	233,890	$1,807
18.	66982	Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation	224,566	$4,088
19.	62321	Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (i.e., fluoroscopy or CT)	213,539	$2,363
20.	29881	Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed	209,926	$7,613
21.	64721	Neuroplasty and/or transposition; median nerve at carpal tunnel	203,314	$4,669
22.	29826	Arthroscopy shoulder, surgical decompression of subacromial space with partial acromioplasty, with procedure	180,255	$7,456
23.	64490	Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level	178,646	$2,721
24.	26055	Tendon sheath incision (e.g., for trigger finger)	169,771	$4,325
25.	29827	Arthroscopy, shoulder, surgical; with rotator cuff repair	165,556	$11,014

Fig 1. Data from Definitive Healthcare’s ClaimsMx product for January – November 2021. Commercial claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data is accurate as of January 4, 2022.

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