Of all the ways the healthcare industry as a whole can lower costs and improve care, one of the most promising is the continued shift to outpatient services. Made possible by medical advances, regulatory changes, and better patient management, the growth of healthcare delivery in an outpatient setting, and even outside the hospital, has led to lower costs, better outcomes, and higher patient satisfaction in several clinical areas, including surgery. While most hospitals offer outpatient surgery, ambulatory surgery centers have been praised as a superior choice for certain procedures, both because of facility efficiencies and greater regulatory controls for reimbursements under the outpatient prospective payment system. However, as seen in the tables below, outpatient procedures at hospitals are still a healthcare staple.

Definitive Healthcare data shows that metabolic panels, emergency department visits, and urine analyses are the most common outpatient hospital procedures by volume. The routine nature of these procedures ensures their places at the top of this list. Injected cancer treatments also rank high on the list both by volume and by total payments, as well as other specialty drugs that treat rare inflammatory diseases such as rheumatoid arthritis. Various CT scans rank in several places on the list of top procedures by total payments. This is consistent with the prevalence of emergency department visits, which often revolve around recently sustained injuries involving the head and neck, as well as strokes.

Top 25 Hospital Outpatient Procedures by Volume

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HCPCS CodeProcedure DescriptionEstimated Number of ProceduresEstimated Total PaymentsExplore These Claims
1.36415Routine venipuncture120,204,036$280,375,002 Explore This Code
2.G0463Hospital outpatient clinic visit101,639,339$9,001,885,065 Explore This Code
3.85025Complete blood count w/automated differential white blood cell count89,622,719$813,052,338 Explore This Code
4.80053Comprehensive metabolic panel75,445,330$931,410,767 Explore This Code
5.97110Therapeutic exercises40,715,666$1,725,196,538 Explore This Code
6.80048Metabolic panel total calcium36,113,604$299,898,812 Explore This Code
7.85610Prothrombin time33,064,663$285,178,320 Explore This Code
8.93005Electrocardiogram tracing31,857,593$239,867,853 Explore This Code
9.99283Emergency dept visit - moderate30,952,053$4,670,138,022 Explore This Code
10.99284Emergency dept visit - severe28,819,588$8,617,148,495 Explore This Code
11.81001Urinalysis auto w/scope28,298,119$117,658,513 Explore This Code
12.J2405Ondansetron hydrochloride injection28,051,382$18,941,173 Explore This Code
13.84443Assay thyroid stimulating hormone27,519,427$563,000,518 Explore This Code
14.80061Lipid panel27,227,527$471,168,949 Explore This Code
15.99285Emergency dept visit - low24,293,567$16,678,713,936 Explore This Code
16.A9270Non-covered item or service24,160,305$306 Explore This Code
17.85027Complete blood count automated23,731,844$132,472,946 Explore This Code
18.J3010Fentanyl citrate injeciton20,143,031$7,764,019 Explore This Code
19.97140Manual therapy 1+ regions19,462,276$530,834,711 Explore This Code
20.84484Assay of troponin quantity18,828,437$132,751,067 Explore This Code
21.83036Glycosylated hemoglobin test18,142,507$225,160,176 Explore This Code
22.J2250Injection midazolam hydrochloride17,060,527$5,479,674 Explore This Code
23.87086Urine culture/colony count16,546,011$140,032,050 Explore This Code
24.83735Assay of magnesium16,016,492$86,663,717 Explore This Code
25.71020Chest x-ray 2 views - frontal & lateral15,603,634$695,604,186 Explore This Code

Fig 1. Data from Definitive Healthcare based on calendar year 2016 CMS data released in fall 2017. Calendar year 2017 CMS data release planned for fall 2018.

 

Top 25 Hospital Outpatient Procedures by Total Payments

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.

HCPCS CodeProcedure DescriptionEstimated Number of ProceduresEstimated Total PaymentsExplore These Claims
1.99285Emergency dept visit - low24,293,567$16,678,713,936Explore This Code
2.G0463Hospital outpatient clinic visit101,639,339$9,001,885,065Explore This Code
3.99284Emergency dept visit - severe28,819,588$8,617,148,495Explore This Code
4.99283Emergency dept visit - moderate30,952,053$4,670,138,022Explore This Code
5.C9600Percutaneous transcatheter placement of drug eluting intracoronary stent(s) w/ coro­nary angioplasty328,233$2,894,807,615Explore This Code
6.J1745Infliximab injection848,216$2,489,224,380Explore This Code
7.33249Insertion or replacement of permanent im­plantable defibrillator system w/transveinous lead69,969$1,974,096,680Explore This Code
8.J9299Injection, nivolumab481,842$1,948,876,753Explore This Code
9.93306Transthoracic echocardiogram with doppler ultrasound6,395,777$1,734,840,831Explore This Code
10.97110Therapeutic exercises40,715,666$1,725,196,538Explore This Code
11.47562Laparoscopic cholecystectomy544,826$1,719,233,763Explore This Code
12.66984Cataract surgery w/ intraocular lens1,082,672$1,685,893,107Explore This Code
13.78452Heart muscle SPECT image2,342,450$1,652,136,922Explore This Code
14.J9310Rituximab injection375,028$1,649,126,677Explore This Code
15.J2505Injection, pegfilgrastim 6mg537,934$1,647,021,061Explore This Code
16.33264Removal & replacement of implantable de­fibrillator52,550$1,598,645,166Explore This Code
17.74177CT scan abdomen & pelvis w/contrast5,776,605$1,546,937,512Explore This Code
18.93458Left heart ventricular angiography838,114$1,461,372,373Explore This Code
19.93656Pulmonary vein isolation for atrial fibrillation93,974$1,441,029,104Explore This Code
20.63685Insert/redo spine nerve generator42,257$1,440,855,116Explore This Code
21.77386Intensity modulated radiation treatment de­livery, complex3,067,493$1,410,804,083Explore This Code
22.J9355Trastuzumab injection474,785$1,366,917,123Explore This Code
23.96413Chemotherapy IV infusion 1 hr5,568,393$1,308,810,838Explore This Code
24.J9035Bevacizumab injection390,509$1,277,073,121Explore This Code
25.90670Pneumococcal conjugate vaccine10,446,540$1,230,871,361Explore This Code

Fig 2. Data from Definitive Healthcare based on calendar year 2016 CMS data released in fall 2017. Calendar year 2017 CMS data release planned for fall 2018.