Accelerate Your Growth

Power your team with the highest quality, daily updated intelligence on hospitals, physicians, and other healthcare providers

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

  HCPCS Code Procedure Description Estimated Number of Procedures Estimated Total Payments

1.

36415

Routine venipuncture

120,204,036

$280,375,002

2.

G0463

Hospital outpatient clinic visit

101,639,339

$9,001,885,065

3.

85025

Complete blood count w/automated differential white blood cell count

89,622,719

$813,052,338

4.

80053

Comprehensive metabolic panel

75,445,330

$931,410,767

5.

97110

Therapeutic exercises

40,715,666

$1,725,196,538

6.

80048

Metabolic panel total calcium

36,113,604

$299,898,812

7.

85610

Prothrombin time

33,064,663

$285,178,320

8.

93005

Electrocardiogram tracing

31,857,593

$239,867,853

9.

99283

Emergency dept visit - moderate

30,952,053

$4,670,138,022

10.

99284

Emergency dept visit - severe

28,819,588

$8,617,148,495

11.

81001

Urinalysis auto w/scope

28,298,119

$117,658,513

12.

J2405

Ondansetron hydrochloride injection

28,051,382

$18,941,173

13.

84443

Assay thyroid stimulating hormone

27,519,427

$563,000,518

14.

80061

Lipid panel

27,227,527

$471,168,949

15.

99285

Emergency dept visit - low

24,293,567

$16,678,713,936

16.

A9270

Non-covered item or service

24,160,305

$306

17.

85027

Complete blood count automated

23,731,844

$132,472,946

18.

J3010

Fentanyl citrate injeciton

20,143,031

$7,764,019

19.

97140

Manual therapy 1+ regions

19,462,276

$530,834,711

20.

84484

Assay of troponin quantity

18,828,437

$132,751,067

21.

83036

Glycosylated hemoglobin test

18,142,507

$225,160,176

22.

J2250

Injection midazolam hydrochloride

17,060,527

$5,479,674

23.

87086

Urine culture/colony count

16,546,011

$140,032,050

24.

83735

Assay of magnesium

16,016,492

$86,663,717

25.

71020

Chest x-ray 2 views - frontal & lateral

15,603,634

$695,604,186

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

  HCPCS Code Procedure Description Estimated Number of Procedures Estimated Total Payments

1.

99285

Emergency dept visit - low

24,293,567

$16,678,713,936

2.

G0463

Hospital outpatient clinic visit

101,639,339

$9,001,885,065

3.

99284

Emergency dept visit - severe

28,819,588

$8,617,148,495

4.

99283

Emergency dept visit - moderate

30,952,053

$4,670,138,022

5.

C9600

Percutaneous transcatheter placement of drug eluting intracoronary stent(s) w/ coro­nary angioplasty

328,233

$2,894,807,615

6.

J1745

Infliximab injection

848,216

$2,489,224,380

7.

33249

Insertion or replacement of permanent im­plantable defibrillator system w/

transveinous lead

69,969

$1,974,096,680

8.

J9299

Injection, nivolumab

481,842

$1,948,876,753

9.

93306

Transthoracic echocardiogram with

doppler ultrasound

6,395,777

$1,734,840,831

10.

97110

Therapeutic exercises

40,715,666

$1,725,196,538

11.

47562

Laparoscopic cholecystectomy

544,826

$1,719,233,763

12.

66984

Cataract surgery w/ intraocular lens

1,082,672

$1,685,893,107

13.

78452

Heart muscle SPECT image

2,342,450

$1,652,136,922

14.

J9310

Rituximab injection

375,028

$1,649,126,677

15.

J2505

Injection, pegfilgrastim 6mg

537,934

$1,647,021,061

16.

33264

Removal & replacement of implantable de­fibrillator

52,550

$1,598,645,166

17.

74177

CT scan abdomen & pelvis w/contrast

5,776,605

$1,546,937,512

18.

93458

Left heart ventricular angiography

838,114

$1,461,372,373

19.

93656

Pulmonary vein isolation for atrial fibrillation

93,974

$1,441,029,104

20.

63685

Insert/redo spine nerve generator

42,257

$1,440,855,116

21.

77386

Intensity modulated radiation treatment de­livery, complex

3,067,493

$1,410,804,083

22.

J9355

Trastuzumab injection

474,785

$1,366,917,123

23.

96413

Chemotherapy IV infusion 1 hr

5,568,393

$1,308,810,838

24.

J9035

Bevacizumab injection

390,509

$1,277,073,121

25.

90670

Pneumococcal conjugate vaccine

10,446,540

$1,230,871,361

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.