Statistics From the HCUP-3 Nationwide Inpatient Sample for 1993: Principal Procedures

Overview

The Healthcare Cost and Utilization Project (HCUP-3) is a Federal-State-industry partnership to assemble health care data for use in health services research and health policy analysis. The information presented here is based on data from the HCUP-3 Nationwide Inpatient Sample (NIS) Release 2, which contains all discharge records from a 20-percent sample of U.S. community hospitals from 17 States. Unlike other commonly used databases, the HCUP-3 database includes all payers.

HCUP-3 Nationwide Inpatient Sample

The NIS sample of hospitals is a stratified probability sample of community hospitals, with sampling probabilities proportional to the number of U.S. community hospitals in each stratum. Strata were defined based on five characteristics: region (Northeast, South, Midwest, West); location (urban, rural); teaching status; ownership/control (government, non-Federal; private, not-for-profit; private, investor-owned) and bed size (small, medium, large, varying by location and teaching status). The frame is limited to community hospitals, as defined by the American Hospital Association Annual Survey of Hospitals, from States participating in HCUP-3.

Sampling weights were used to obtain national estimates for the measures presented here—discharges, average length of stay, and average total charges. Comparisons between the NIS and the National Hospital Discharge Survey demonstrated that the number of discharges and lengths of stay were essentially the same when considered on a national or regional basis. Comparisons between the NIS and the Medicare Provider Analysis and Review (MEDPAR) data for enrollees not covered by health maintenance organizations demonstrated that the number of discharges was essentially the same.

Definitions

PCCHPR: Clinical Classifications for Health Policy Research (CCHPR) was developed at AHCPR as a way to classify diagnoses and procedures into clinically meaningful categories for use in aggregate statistical reporting. Unlike DRGs (diagnosis-related groups) and severity-of-illness classifications, CCHPR classifies single diagnoses (DCCHPR) and single procedures (PCCHPR) into clinically similar groups without attempting to control for intensity of resource use. For this guide, the PCCHPR Version 2 was used to classify principal procedures into 231 procedure categories. All valid procedure codes are classified.

MEAN LOS: Mean length of stay (LOS) is calculated by dividing the sum of inpatient days by the number of patients within the CCHPR category. Inpatient days are calculated by subtracting day of admission from day of discharge, so persons entering and leaving a hospital on the same day have a length of stay of zero. Only 0.1 percent of records in the HCUP-3 NIS had missing LOS. We used a hot-deck procedure to impute LOS for these cases, controlling for diagnosis-related group (DRG) and hospital characteristics (geographic region, ownership, urban/rural location, size, and teaching status).

MEAN TOTAL CHARGE: Mean total charge is calculated by dividing the sum of patient charges by the number of patients within the CCHPR category. Total charges represent the dollar amount charged for the hospitalization rather than the amount paid or the actual costs to provide the care. Physician payments are not included. Although capitation and negotiated discounts have made total charges an imprecise measure of reimbursements, charges still represent one of the only ways to approximate costs of hospital care. Only 2.9 percent of records had missing total charges with a majority of missing cases concentrated among three States (Kansas, California, and Washington). We used a hot-deck procedure to impute total charges for these cases, controlling for DRG, HMO payer status (important for California and Washington), a hospital characteristics (geographic region, ownership, urban/rural location, size, and teaching status).

For information about the HCUP-3 databases, contact:
Healthcare Cost and Utilization Project (HCUP-3)
Phone: 866-290-HCUP (4287) toll-free
E-mail: hcup@ahrq.gov

Table of Contents
[Note: Subject areas correspond to chapters of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)]

PCCHPR categories Subject areas

1 - 9 1 Operations on the Nervous System 10 - 12 2 Operations on the Endocrine System 13 - 21 3 Operations on the Eye 22 - 26 4 Operations on the Ear 27 - 33 5 Operations on the Nose, Mouth, and Pharynx 34 - 42 6 Operations on the Respiratory System 43 - 63 7 Operations on the Cardiovascular System 64 - 67 8 Operations on the Hemic and Lymphatic System 68 - 99 9 Operations on the Digestive System 100 - 112 10 Operations on the Urinary System 113 - 118 11 Operations on the Male Genital Organs 119 - 121 12 Operations on the Female Genital Organs 123 - 132 122 13 Obstetrical Procedures 133 - 141 142 - 164 14 Operations on the Musculoskeletal System 165 - 175 15 Operations on the Integumentary System 176 - 231 16 Miscellaneous Diagnostic and Therapeutic Procedures

Statistics From the Nationwide Inpatient Sample for 1993 Hospital Inpatient Stays

PCCHPR— Total % of total Mean total Principal Procedure discharges discharges Mean LOS charges

Total 34,714,497 100.00 5.79 9,833

No procedure 12,821,858 36.94 4.81 5,249

1 Incision and excision 70,200 0.20 13.05 35,114 of CNS 2 Insertion, replacement, 28,142 0.08 12.14 28,255 or removal of extracranial ventricular shunt 3 Laminectomy, excision 357,019 1.03 4.61 11,476 intervertebral disc 4 Diagnostic spinal tap 296,012 0.85 6.59 9,565 5 Insertion of catheter or 50,620 0.15 6.68 9,519 spinal stimulator and injection into spinal canal 6 Decompression peripheral 6,428 0.02 2.72 6,526 nerve 7 Other diagnostic nervous 15,435 0.04 11.86 30,520 system procedures 8 Other non-OR or closed 13,116 0.04 7.28 9,352 therapeutic nervous system procedures 9 Other OR therapeutic 62,905 0.18 9.43 26,629 nervous system procedures 10 Thyroidectomy, partial 50,289 0.14 2.42 6,950 or complete 11 Diagnostic endocrine 2,123 0.01 7.98 13,427 procedures 12 Other therapeutic 25,847 0.07 5.96 15,161 endocrine procedures 13 Corneal transplant 7,869 0.02 2.08 6,897 14 Glaucoma procedures 10,356 0.03 2.41 4,432 15 Lens and cataract 14,658 0.04 3.57 6,115 procedures 16 Repair of retinal tear, 24,878 0.07 1.82 5,956 detachment 17 Destruction of lesion 1,774 0.01 14.65 27,604 of retina and choroid 18 Diagnostic procedures 1,357 0.00 7.53 12,144 on eye 19 Other therapeutic 21,420 0.06 4.29 8,206 procedures on eyelids, conjunctiva, cornea 20 Other intraocular 33,652 0.10 2.50 6,430 therapeutic procedures 21 Other extraocular 10,107 0.03 3.93 9,927 muscle and orbit therapeutic procedures 22 Tympanoplasty 3,372 0.01 1.29 5,592 23 Myringotomy 6,929 0.02 4.76 8,535 24 Mastoidectomy 6,675 0.02 2.95 8,406 25 Diagnostic procedures 526 0.00 11.47 19,138 on ear 26 Other therapeutic ear 16,040 0.05 3.92 8,076 procedures 27 Control of epistaxis 19,679 0.06 4.84 6,893 28 Plastic procedures 18,553 0.05 2.11 5,919 on nose 29 Dental procedures 14,177 0.04 10.97 12,010 30 Tonsillectomy and/or 49,801 0.14 1.56 3,794 adenoidectomy 31 Diagnostic procedures 7,742 0.02 7.97 13,743 on nose, mouth and pharynx 32 Other non-OR therapeutic 16,035 0.05 4.63 8,880 procedures on nose, mouth and pharynx 33 Other OR therapeutic 79,257 0.23 3.91 9,930 procedures on nose, mouth and pharynx 34 Tracheostomy, temporary 56,446 0.16 45.66 139,083 and permanent 35 Tracheoscopy and 31,509 0.09 5.22 8,150 laryngoscopy with biopsy 36 Lobectomy or 60,559 0.17 10.56 27,839 pneumonectomy 37 Diagnostic bronchoscopy 187,679 0.54 11.71 20,884 and biopsy of bronchus 38 Other diagnostic 14,567 0.04 11.65 31,738 procedures on lung and bronchus 39 Incision of pleura, 167,603 0.48 9.74 14,951 thoracentesis, chest drainage 40 Other diagnostic 20,725 0.06 9.91 18,568 procedures of respiratory tract and mediastinum 41 Other non-OR therapeutic 12,728 0.04 8.69 14,834 procedures on respiratory system 42 Other OR therapeutic 41,871 0.12 12.27 29,094 procedures on respiratory system 43 Heart valve procedures 69,946 0.20 14.56 61,910 44 Coronary artery bypass 312,109 0.90 11.80 47,622 graft (CABG) 45 Percutaneous coronary 377,611 1.09 4.64 18,528 angioplasty (PTCA) 46 Coronary thrombolysis 1,298 0.00 5.71 15,861 47 Diagnostic cardiac 626,695 1.81 4.75 11,234 catheterization, coronary arteriography 48 Insertion, revision, 180,385 0.52 7.36 25,548 replacement, removal of cardiac pacemaker or cardioverter/defibrillator 49 Other OR heart 80,323 0.23 8.27 35,224 procedures 50 Extracorporeal 1,279 0.00 17.55 112,796 circulation auxiliary to open heart procedures 51 Endarterectomy, vessel 90,713 0.26 5.32 14,134 of head and neck 52 Aortic resection, 44,927 0.13 11.88 39,278 replacement or anastomosis 53 Varicose vein stripping, 8,060 0.02 2.50 6,008 lower limb 54 Other vascular 171,852 0.50 13.15 24,444 catheterization, not heart 55 Peripheral vascular 92,517 0.27 11.51 26,805 bypass 56 Other vascular bypass 10,147 0.03 13.03 48,051 and shunt, not heart 57 Creation, revision and 70,384 0.20 9.89 20,812 removal of arteriovenous fistula or vessel-to- vessel cannula for dialysis 58 Hemodialysis 115,129 0.33 6.56 11,121 59 Other OR procedures on 5,833 0.02 8.01 27,344 vessels of head and neck 60 Embolectomy and 20,702 0.06 10.29 23,393 endarterectomy of lower limbs 61 Other OR procedures on 170,958 0.49 9.80 27,421 vessels other than head and neck 62 Other diagnostic cardio- 45,301 0.13 6.81 14,061 vascular procedures 63 Other non-OR therapeutic 35,285 0.10 10.30 20,961 cardiovascular procedures 64 Bone marrow transplant 9,291 0.03 38.13 170,086 65 Bone marrow biopsy 72,676 0.21 11.35 19,490 66 Procedures on spleen 20,332 0.06 10.69 31,780 67 Other therapeutic 65,744 0.19 6.38 14,280 procedures, hemic and lymphatic system 68 Injection or ligation 1,328 0.00 8.01 18,305 of esophageal varices 69 Esophageal dilatation 10,919 0.03 6.81 9,434 70 Upper gastrointestinal 605,485 1.74 7.15 10,602 endoscopy, biopsy 71 Gastrostomy, temporary 77,186 0.22 17.85 22,849 and permanent 72 Colostomy, temporary 14,372 0.04 16.08 33,427 and permanent 73 Ileostomy and other 5,627 0.02 19.65 36,765 enterostomy 74 Gastrectomy, partial 24,954 0.07 17.74 42,644 and total 75 Small bowel resection 42,569 0.12 16.78 39,588 76 Colonoscopy and biopsy 248,744 0.72 7.66 10,176 77 Proctoscopy and 16,822 0.05 7.25 9,961 anorectal biopsy 78 Colorectal resection 238,660 0.69 12.77 26,909 79 Local excision of 1,815 0.01 8.19 15,308 large intestine lesion (not endoscopic) 80 Appendectomy 228,330 0.66 4.13 8,559 81 Hemorrhoid procedures 26,242 0.08 3.07 5,242 82 Endoscopic cannulation 40,020 0.12 7.81 12,776 of pancreas (ERCP) 83 Biopsy of liver 33,270 0.10 9.09 15,562 84 Cholecystectomy and 451,531 1.30 5.10 12,370 common duct exploration 85 Inguinal and femoral 78,955 0.23 4.64 9,777 hernia repair 86 Other hernia repair 90,135 0.26 5.19 10,839 87 Laparoscopy 28,669 0.08 3.92 9,894 88 Abdominal paracentesis 52,304 0.15 9.28 14,162 89 Exploratory laparotomy 33,469 0.10 9.60 24,512 90 Excision, lysis 65,739 0.19 10.23 20,043 peritoneal adhesions 91 Peritoneal dialysis 24,430 0.07 6.02 10,384 92 Other GI diagnostic 6,682 0.02 8.35 15,102 procedures 93 Other non-OR upper GI 81,548 0.23 6.63 11,892 therapeutic procedures 94 Other OR upper GI 76,642 0.22 12.43 29,890 therapeutic procedures 95 Other non-OR lower GI 52,439 0.15 7.18 10,288 therapeutic procedures 96 Other OR lower GI 116,060 0.33 9.20 18,424 therapeutic procedures 97 Other gastrointestinal 16,008 0.05 10.63 18,516 diagnostic procedures 98 Other non-OR gastro- 45,513 0.13 7.15 12,716 intestinal therapeutic procedures 99 Other OR gastro- 100,227 0.29 12.99 30,780 intestinal therapeutic procedures 100 Endoscopy and endoscopic 96,401 0.28 7.94 10,580 biopsy of the urinary tract 101 Transurethral excision, 109,953 0.32 4.01 7,762 drainage, or removal urinary obstruction 102 Ureteral catheterization 26,136 0.08 4.91 9,649 103 Nephrotomy and 22,235 0.06 9.28 18,849 nephrostomy 104 Nephrectomy, partial 37,727 0.11 9.43 21,648 or complete 105 Kidney transplant 11,894 0.03 15.25 70,193 106 Genitourinary 43,320 0.12 3.50 6,721 incontinence procedures 107 Extracorporeal 9,630 0.03 2.98 8,290 lithotripsy, urinary 108 Indwelling catheter 15,798 0.05 6.97 7,407 109 Procedures on the urethra 27,776 0.08 5.23 9,006 110 Other diagnostic 21,592 0.06 6.81 12,681 procedures of urinary tract 111 Other non-OR therapeutic 24,274 0.07 4.62 7,183 procedures of urinary tract 112 Other OR therapeutic 60,584 0.17 8.54 18,001 procedures of urinary tract 113 Transurethral 227,193 0.65 4.73 7,688 prostatectomy (TURP) 114 Open prostatectomy 75,918 0.22 6.72 14,839 115 Circumcision 1,062,451 3.06 2.47 1,518 116 Diagnostic procedures, 6,145 0.02 9.25 12,246 male genital 117 Other non-OR therapeutic 5,851 0.02 6.79 9,892 procedures, male genital 118 Other OR therapeutic 47,183 0.14 3.99 9,515 procedures, male genital 119 Oophorectomy, unilateral 72,547 0.21 4.37 9,330 and bilateral 120 Other operations on ovary 39,937 0.12 3.27 7,613 121 Ligation of fallopian 76,057 0.22 2.16 5,094 tubes 122 Removal ectopic pregnancy 30,173 0.09 2.77 7,022 123 Other operations on 17,150 0.05 2.93 7,288 fallopian tubes 124 Hysterectomy, abdominal 522,015 1.50 3.91 8,659 and vaginal 125 Other excision of 32,748 0.09 3.38 7,852 cervix and uterus 126 Abortion (termination 7,923 0.02 2.42 4,556 of pregnancy) 127 Dilatation and curettage 68,601 0.20 1.48 4,178 (D&C), aspiration after delivery or abortion 128 Diagnostic dilatation 21,488 0.06 3.58 7,070 and curettage (D&C) 129 Repair of cystocele and 47,757 0.14 3.17 6,159 rectocele, obliteration of vaginal vault 130 Other diagnostic 9,545 0.03 7.55 11,271 procedures, female organs 131 Other non-OR therapeutic 8,012 0.02 3.16 5,303 procedures, female organs 132 Other OR therapeutic 52,110 0.15 4.03 8,759 procedures, female organs 133 Episiotomy 796,607 2.29 1.95 3,119 134 Cesarean section 822,392 2.37 4.00 6,785 135 Forceps, vacuum, and 367,914 1.06 2.09 3,560 breech delivery 136 Artificial rupture of 84,769 0.24 1.74 2,887 membranes to assist delivery 137 Other procedures to 975,351 2.81 1.89 3,221 assist delivery 138 Diagnostic amniocentesis 10,872 0.03 5.38 6,503 139 Fetal monitoring 106,739 0.31 2.19 3,040 140 Repair of current 488,334 1.41 1.82 2,970 obstetric laceration 141 Other therapeutic 11,044 0.03 1.95 3,433 obstetrical procedures 142 Partial excision bone 45,860 0.13 6.15 13,915 143 Bunionectomy or repair 9,369 0.03 2.19 5,675 of toe deformities 144 Treatment, facial 33,098 0.10 4.53 13,158 fracture or dislocation 145 Treatment, fracture or 60,660 0.17 3.47 8,384 dislocation of radius and ulna 146 Treatment, fracture or 266,214 0.77 9.55 16,873 dislocation of hip and femur 147 Treatment, fracture or 189,006 0.54 5.02 10,790 dislocation of lower extremity (other than hip or femur) 148 Other fracture and 86,450 0.25 4.70 10,911 dislocation procedure 149 Arthroscopy 9,152 0.03 3.67 9,495 150 Division of joint capsule, 6,921 0.02 2.84 7,199 ligament or cartilage 151 Excision of semilunar 14,800 0.04 2.59 8,705 cartilage of knee 152 Arthroplasty knee 282,177 0.81 6.29 18,384 153 Hip replacement, total 263,070 0.76 8.94 21,968 and partial 154 Arthroplasty other than 72,028 0.21 2.67 8,083 hip or knee 155 Arthrocentesis 27,902 0.08 7.91 9,430 156 Injections and 4,802 0.01 7.64 8,919 aspirations of muscles, tendons, bursa, joints and soft tissue 157 Amputation of lower 99,537 0.29 15.67 24,282 extremity 158 Spinal fusion 61,407 0.18 7.73 24,024 159 Other diagnostic 26,241 0.08 11.35 19,372 procedures on musculoskeletal system 160 Other therapeutic 120,768 0.35 3.70 8,654 procedures on muscles and tendons 161 Other OR therapeutic 45,230 0.13 5.20 12,928 procedures on bone 162 Other OR therapeutic 66,678 0.19 5.94 12,551 procedures on joints 163 Other non-OR therapeutic 9,160 0.03 9.81 9,974 procedures on musculoskeletal system 164 Other OR therapeutic 40,772 0.12 4.73 13,076 procedures on musculoskeletal system 165 Breast biopsy and other 6,424 0.02 7.48 11,482 diagnostic procedures on breast 166 Lumpectomy, 37,219 0.11 3.01 7,040 quadrantectomy of breast 167 Mastectomy 117,475 0.34 3.46 7,836 168 Incision and drainage, 62,553 0.18 7.34 9,681 skin and subcutaneous tissue 169 Debridement of wound, 214,275 0.62 13.58 21,080 infection or burn 170 Excision of skin lesion 33,263 0.10 7.79 12,120 171 Suture of skin and 69,953 0.20 4.36 6,725 subcutaneous tissue 172 Skin graft 35,876 0.10 13.89 28,860 173 Other diagnostic 14,959 0.04 11.21 15,788 procedures on skin and subcutaneous tissue 174 Other non-OR therapeutic 119,093 0.34 11.79 18,841 procedures on skin and breast 175 Other OR therapeutic 62,286 0.18 2.92 8,859 procedures on skin and breast 176 Other organ 5,096 0.01 39.09 193,721 transplantation 177 Computerized axial 373,186 1.08 7.27 9,326 tomography (CT) scan head 178 CT scan chest 32,036 0.09 8.21 10,759 179 CT scan abdomen 99,248 0.29 6.54 9,095 180 Other CT scan 27,052 0.08 6.86 7,814 181 Myelogram 26,452 0.08 4.05 5,755 182 Mammography 2,009 0.01 8.96 7,937 183 Routine chest X-ray 11,914 0.03 5.73 5,839 184 Intraoperative 767 0.00 9.24 15,672 cholangiogram 185 Upper gastrointestinal 31,982 0.09 7.03 8,114 X-ray 186 Lower gastrointestinal 10,533 0.03 5.38 6,699 X-ray 187 Intravenous pyelogram 49,910 0.14 3.55 4,497 188 Cerebral arteriogram 35,219 0.10 6.04 11,439 189 Contrast aortogram 15,123 0.04 5.28 10,929 190 Contrast arteriogram of 15,082 0.04 5.28 10,433 femoral and lower extremity arteries 191 Arterio- or venogram 39,941 0.12 6.34 9,914 (not heart and head) 192 Diagnostic ultrasound 38,914 0.11 7.29 10,633 of head and neck 193 Diagnostic ultrasound 285,582 0.82 7.85 9,852 of heart (echocardiogram) 194 Diagnostic ultrasound 27,660 0.08 4.83 5,991 of gastrointestinal tract 195 Diagnostic ultrasound of 43,867 0.13 6.45 8,368 urinary tract 196 Diagnostic ultrasound 82,905 0.24 5.55 7,816 of abdomen or retroperitoneum 197 Other diagnostic 98,446 0.28 5.69 7,168 ultrasound 198 Magnetic resonance 92,611 0.27 7.67 10,309 imaging 199 Electroencephalogram 46,769 0.13 9.33 10,413 (EEG) 200 Nonoperative urinary 1,206 0.00 2.47 3,109 system measurements 201 Cardiac stress tests 90,407 0.26 3.42 5,843 202 Electrocardiogram 29,243 0.08 5.25 6,169 203 Electrographic cardiac 144,051 0.42 4.14 6,041 monitoring 204 Swan-Ganz 25,398 0.07 10.06 25,288 catheterization for monitoring 205 Arterial blood gases 126,544 0.36 6.18 8,854 206 Microscopic examination 14,327 0.04 5.74 4,422 (bacterial smear, culture, toxicology) 207 Radioisotope bone scan 29,590 0.09 8.87 9,671 208 Radioisotope pulmonary 47,472 0.14 6.66 9,704 scan 209 Radioisotope scan and 51,387 0.15 6.61 9,163 function studies 210 Other radioisotope scan 6,072 0.02 8.35 11,287 211 Therapeutic radiology 78,511 0.23 8.78 12,382 212 Diagnostic physical 8,383 0.02 11.98 12,392 therapy 213 Physical therapy 130,196 0.38 13.48 12,854 exercises, manipulation, and other procedures 214 Traction, splints, and 51,345 0.15 7.22 8,367 other wound care 215 Other physical therapy 51,966 0.15 15.23 12,904 and rehabilitation 216 Respiratory intubation 424,006 1.22 12.38 30,431 and mechanical ventilation 217 Other respiratory 248,794 0.72 5.00 6,603 therapy 218 Psychological and 138,398 0.40 17.53 14,193 psychiatric evaluation and therapy 219 Alcohol and drug 402,394 1.16 7.85 5,017 rehabilitation/ detoxification 220 Ophthalmologic and 4,856 0.01 5.94 6,718 otologic diagnosis and treatment 221 Nasogastric tube 43,607 0.13 5.63 7,245 222 Blood transfusion 163,509 0.47 7.19 10,990 223 Enteral and parenteral 41,384 0.12 14.31 18,624 nutrition 224 Cancer chemotherapy 409,631 1.18 4.14 9,486 225 Conversion of cardiac 71,080 0.20 5.08 8,674 rhythm 226 Other diagnostic 65,425 0.19 6.47 9,023 radiology and related techniques 227 Other diagnostic 68,322 0.20 7.31 10,763 procedures (interview, evaluation, consultation) 228 Prophylactic 135,742 0.39 2.57 1,596 vaccinations and inoculations 229 Nonoperative removal 5,691 0.02 3.63 6,207 of foreign body 230 Extracorporeal shock wave 71 0.00 3.55 7,522 lithotripsy, other than urinary 231 Other therapeutic 492,531 1.42 6.42 8,917 procedures

Invalid procedure 9,095 0.03 10.46 15,248

Current as of November 1998

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