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On January 1, the Centers for Medicaid and Medicare Services (CMS) released changes made to its list of inpatient-only procedures. Currently, there are approximately 1,700 surgical procedures on the list, with some being added and removed every year. One of the most notable—as well as controversial—adjustments this year is the removal of total knee arthroplasty, or knee replacements, from the inpatient-only list. The procedure can now be performed in an outpatient or inpatient setting.

A major implication of this change is that ambulatory surgery centers (ASCs) and other outpatient care centers can offer this procedure, potentially drawing patients and revenue away from more traditional hospital inpatient departments. One factor driving patients to ASCs for procedures, especially knee and hip replacements, is the cost difference. Hip replacements at an outpatient surgery center cost between $22–25,000. The same procedure at a hospital is around $40,000. Currently hip replacements are not covered by Medicare in an inpatient setting. The effects of a shift like this can’t be accurately predicted yet, as hospitals and health systems have acquired or partnered with ASCs and outpatient centers in anticipation of such events.

The following list features the top 25 all-payer and Medicare inpatient procedures by volume, with ICD-9 and ICD-10 codes. Injections, transfusions, and diagnostic tests dominated both lists, with “Insertion of Infusion Device into Superior Vena Cava” (ICD-10 code 02HV33Z) taking the number 2 spot on each. X-rays (fluoroscopy) were also prevalent in the all-payer and Medicare procedure lists.

Top 25 All-Payer Inpatient Procedures by ICD-10 Code

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ICD-10 CodeDescriptionNumber of ProceduresICD-9 CodeExplore These Claims
1.3E0234ZIntroduction of Serum, Toxoid and Vaccine into Muscle1,920,6799955Explore This Code
2.02HV33ZInsertion of Infusion Device into Superior Vena Cava1,657,2733893Explore This Code
3.10E0XZZDelivery of Products of Conception1,603,9657359Explore This Code
4.30233N1Transfusion of Nonautologous Red Blood Cells into Peripheral Vein1,561,0809904Explore This Code
5.3E0G76ZIntroduction of Nutritional Substance into Upper GI, Via Natural or Artificial Opening1,466,7319635Explore This Code
6.10D00Z1Extraction of Products of Conception, Low Cervical, Open Approach1,018,1250741Explore This Code
7.4A023N7Measurement of Cardiac Sampling and Pressure, Left Heart959,9653722Explore This Code
8.B2111ZZFluoroscopy of Multiple Coronary Arteries using Low Osmolar Contrast950,6388856Explore This Code
9.0BH17EZInsertion of Endotracheal Airway into Trachea, Via Natural or Artificial Opening910,4249604Explore This Code
10.5A1D60ZPerformance of Urinary Filtration, Multiple745,2713995Explore This Code
11.B2151ZZFluoroscopy of Left Heart using Low Osmolar Contrast634,3788853Explore This Code
12.10907ZCDrainage of Amniotic Fluid, Therapeutic from Products of Conception, Via Natural or Artificial Opening564,5137309Explore This Code
13.5A1945ZRespiratory Ventilation, 24-96 Consecutive Hours541,9629671Explore This Code
14.0DJ08ZZInspection of Upper Intestinal Tract, Via Natural or Artificial Opening Endoscopic495,0484513Explore This Code
15.5A1955ZRespiratory Ventilation, Greater than 96 Consecutive Hours479,9829672Explore This Code
16.0DB68ZXExcision of Stomach, Via Natural or Artificial Opening Endoscopic, Diagnostic462,1554516Explore This Code
17.5A09357Assistance with Respiratory Ventilation, Less than 24 Consecutive Hours, Continuous Positive Airway Pressure461,5679390Explore This Code
18.HZ2ZZZZDetoxification Services for Substance Abuse Treatment435,0239462Explore This Code
19.0SRC0J9Replacement of Right Knee Joint with Synthetic Substitute,Cemented, Open Approach419,5868154Explore This Code
20.0SRD0J9Replacement of Left Knee Joint with Synthetic Substitute, Cemented, Open Approach391,1658154Explore This Code
21.B548ZZAUltrasonography of Superior Vena Cava, Guidance351,4870028Explore This Code
22.0FT44ZZResection of Gallbladder, Percutaneous Endoscopic Approach336,1835123Explore This Code
23.5A1935ZRespiratory Ventilation, Less than 24 Consecutive Hours336,0059671Explore This Code
24.009U3ZXDrainage of Spinal Canal, Diagnostic318,7520331Explore This Code
25.027034ZDilation of Coronary Artery, One Artery with Drug-eluting Intralumi­nal Device, Percutaneous Approach298,1760066Explore This Code

Fig 1. Data from Definitive Healthcare based on 2016 Medicare SAF data (most recent available), released in fall 2017. Calendar year 2017 data will be released in fall 2018.

Top 25 Medicare Inpatient Procedures by ICD-10 Code

Definitive's Healthcare Insights are developed with data from the Definitive Healthcare platform. Want even more insights? Start a Free Trial now and get access to the highest quality data and intelligence on hospitals, physicians, and other healthcare providers.

ICD-10 CodeDescriptionNumber of ProceduresICD-9 CodeExplore These Claims
1.30233N1Transfusion of Nonautologous Red Blood Cells into Peripheral Vein641,0119904Explore This Code
2.02HV33ZInsertion of Infusion Device into Superior Vena Cava620,9573893Explore This Code
3.5A1D60ZPerformance of Urinary Filtration, Multiple385,1613995Explore This Code
4.B2111ZZFluoroscopy of Multiple Coronary Arteries using Low Osmolar Contrast357,0218856Explore This Code
5.4A023N7Measurement of Cardiac Sampling and Pressure, Left Heart343,0443722Explore This Code
6.0BH17EZInsertion of Endotracheal Airway into Trachea, Via Natural or Artificial Opening313,9469604Explore This Code
7.B2151ZZFluoroscopy of Left Heart using Low Osmolar Contrast221,1748853Explore This Code
8.0DJ08ZZInspection of Upper Intestinal Tract, Via Natural or Artificial Opening Endoscopic196,4934513Explore This Code
9.5A09357Assistance with Respiratory Ventilation, Less than 24 Consecutive Hours, Continuous Positive Airway Pressure190,3779390Explore This Code
10.5A1945ZRespiratory Ventilation, 24-96 Consecutive Hours190,1989671Explore This Code
11.0DB68ZXExcision of Stomach, Via Natural or Artificial Opening Endoscopic, Diagnostic177,1214516Explore This Code
12.5A1955ZRespiratory Ventilation, Greater than 96 Consecutive Hours171,1799672Explore This Code
13.0SRC0J9Replacement of Right Knee Joint with Synthetic Substitute, Cement­ed, Open Approach170,3768154Explore This Code
14.0SRD0J9Replacement of Left Knee Joint with Synthetic Substitute, Cement­ed, Open Approach158,6008154Explore This Code
15.B548ZZAUltrasonography of Superior Vena Cava156,1700028Explore This Code
16.5A1D00ZPerformance of Urinary Filtration, Single148,6073995Explore This Code
17.0DJD8ZZInspection of Lower Intestinal Tract, Via Natural or Artificial Opening Endoscopic122,4984523Explore This Code
18.5A1935ZRespiratory Ventilation, Less than 24 Consecutive Hours116,5129671Explore This Code
19.027034ZDilation of Coronary Artery, One Artery with Drug-eluting Intraluminal Device107,6710066Explore This Code
20.5A1221ZPerformance of Cardiac Output, Continuous104,1583961Explore This Code
21.3E0234ZIntroduction of Serum, Toxoid and Vaccine into Muscle99,4619955Explore This Code
22.05HM33ZInsertion of Infusion Device into Right Internal Jugular Vein92,4943893Explore This Code
23.5A2204ZRestoration of Cardiac Rhythm, Single90,4589962Explore This Code
24.5A09457Assistance with Respiratory Ventilation, 24-96 Consecutive Hours, Continuous Positive Airway Pressure79,9949390Explore This Code
25.0DH63UZInsertion of Feeding Device into Stomach, Percutaneous Approach79,0224311Explore This Code

Fig 2. Data from Definitive Healthcare based on 2016 Medicare SAF data (most recent available), released in fall 2017. Calendar year 2017 data will be released in fall 2018.