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 3, 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.
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.
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 0.2 percent of records in the HCUP-3 NIS had missing LOS. A hot-deck procedure was used 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 2.5 percent of records had missing total charges, with a majority of missing cases concentrated among three States (Kansas, California, and Washington). A hot-deck procedure was used to impute total charges for these cases, controlling for DRG, health maintenance organization (HMO) payer status (important for California and Washington), and 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 1994 Hospital Inpatient Stays
PCCHPR - Total % of total Mean total principal procedures discharges discharges Mean LOS charges
Total 34,622,215 100.00 5.55 10,275
No procedure 13,030,181 37.64 4.75 5,576
1 Incision and excision 72,134 0.21 11.71 35,163
of CNS
2 Insertion, replacement, 27,407 0.08 10.53 27,808
or removal of extracranial
ventricular shunt
3 Laminectomy, excision 365,275 1.06 4.05 11,862
intervertebral disc
4 Diagnostic spinal tap 278,752 0.81 6.59 10,729
5 Insertion of catheter or 49,981 0.14 6.52 10,284
spinal stimulator and
injection into spinal
canal
6 Decompression peripheral 6,520 0.02 2.83 7,768
nerve
7 Other diagnostic nervous 15,150 0.04 11.37 33,476
system procedures
8 Other non-OR or closed 12,287 0.04 7.06 9,723
therapeutic nervous
system procedures
9 Other OR therapeutic 59,904 0.17 8.79 27,760
nervous system procedures
10 Thyroidectomy, partial 48,600 0.14 2.43 7,769
or complete
11 Diagnostic endocrine 2,083 0.01 7.95 13,524
procedures
12 Other therapeutic 25,802 0.07 5.48 15,765
endocrine procedures
13 Corneal transplant 7,443 0.02 2.07 7,530
14 Glaucoma procedures 9,785 0.03 2.16 4,489
15 Lens and cataract 13,256 0.04 3.42 6,661
procedures
16 Repair of retinal tear, 18,563 0.05 1.86 6,726
detachment
17 Destruction of lesion 1,539 0.00 17.75 40,789
of retina and choroid
18 Diagnostic procedures 1,414 0.00 5.34 8,955
on eye
19 Other therapeutic 21,029 0.06 4.21 9,119
procedures on eyelids,
conjunctiva, cornea
20 Other intraocular 30,052 0.09 2.37 6,867
therapeutic procedures
21 Other extraocular 8,801 0.03 3.93 10,764
muscle and orbit
therapeutic procedures
22 Tympanoplasty 2,628 0.01 1.38 6,371
23 Myringotomy 6,389 0.02 4.34 9,228
24 Mastoidectomy 5,964 0.02 2.36 8,819
25 Diagnostic procedures 406 0.00 9.24 14,732
on ear
26 Other therapeutic ear 14,909 0.04 3.90 8,780
procedures
27 Control of epistaxis 18,049 0.05 4.60 7,418
28 Plastic procedures 14,837 0.04 2.24 6,858
on nose
29 Dental procedures 12,977 0.04 8.21 12,048
30 Tonsillectomy and/or 33,808 0.10 1.70 4,574
adenoidectomy
31 Diagnostic procedures 6,522 0.02 8.15 14,690
on nose, mouth and pharynx
32 Other non-OR therapeutic 14,345 0.04 4.66 9,699
procedures on nose,
mouth and pharynx
33 Other OR therapeutic 76,410 0.22 3.86 10,768
procedures on nose,
mouth and pharynx
34 Tracheostomy, temporary 57,479 0.17 43.13 144,582
and permanent
35 Tracheoscopy and 28,963 0.08 5.82 8,662
laryngoscopy with biopsy
36 Lobectomy or 59,225 0.17 10.36 29,189
pneumonectomy
37 Diagnostic bronchoscopy 183,070 0.53 11.81 21,870
and biopsy of bronchus
38 Other diagnostic 13,988 0.04 11.51 34,067
procedures on lung
and bronchus
39 Incision of pleura, 165,329 0.48 9.22 15,449
thoracentesis, chest
drainage
40 Other diagnostic 19,759 0.06 9.58 19,471
procedures of respiratory
tract and mediastinum
41 Other non-OR therapeutic 12,876 0.04 8.62 16,067
procedures on respiratory
system
42 Other OR therapeutic 40,475 0.12 11.73 30,474
procedures on respiratory
system
43 Heart valve procedures 67,543 0.20 13.60 63,096
44 Coronary artery bypass 319,242 0.92 10.85 47,318
graft (CABG)
45 Percutaneous coronary 409,969 1.18 4.34 19,277
angioplasty (PTCA)
46 Coronary thrombolysis 1,194 0.00 4.77 14,712
47 Diagnostic cardiac 610,891 1.76 4.57 11,857
catheterization,
coronary arteriography
48 Insertion, revision, 190,410 0.55 6.68 25,712
replacement, removal
of cardiac pacemaker or
cardioverter/defibrillator
49 Other OR heart 67,848 0.20 8.02 37,995
procedures
50 Extracorporeal 1,244 0.00 18.61 112,197
circulation auxiliary to
open heart procedures
51 Endarterectomy, vessel 106,362 0.31 4.75 14,245
of head and neck
52 Aortic resection, 43,487 0.13 11.47 40,544
replacement or anastomosis
53 Varicose vein stripping, 6,842 0.02 2.64 6,216
lower limb
54 Other vascular 185,114 0.53 11.73 23,955
catheterization, not
heart
55 Peripheral vascular 104,157 0.30 10.62 27,299
bypass
56 Other vascular bypass 11,090 0.03 12.11 46,535
and shunt, not heart
57 Creation, revision and 72,332 0.21 9.40 21,389
removal of arteriovenous
fistula or vessel-to-
vessel cannula for
dialysis
58 Hemodialysis 127,503 0.37 6.31 11,564
59 Other OR procedures on 4,364 0.01 8.21 29,665
vessels of head and neck
60 Embolectomy and 20,810 0.06 9.48 24,184
endarterectomy of
lower limbs
61 Other OR procedures on 180,166 0.52 9.55 29,320
vessels other than head
and neck
62 Other diagnostic cardio- 41,322 0.12 6.40 14,715
vascular procedures
63 Other non-OR therapeutic 37,443 0.11 9.76 21,823
cardiovascular procedures
64 Bone marrow transplant 7,310 0.02 34.93 168,513
65 Bone marrow biopsy 69,381 0.20 10.68 20,128
66 Procedures on spleen 20,715 0.06 10.06 32,840
67 Other therapeutic 58,959 0.17 6.43 15,851
procedures, hemic and
lymphatic system
68 Injection or ligation 329 0.00 9.50 31,613
of esophageal varices
69 Esophageal dilatation 10,261 0.03 7.02 10,303
70 Upper gastrointestinal 621,369 1.79 6.77 10,985
endoscopy, biopsy
71 Gastrostomy, temporary 85,265 0.25 16.58 23,576
and permanent
72 Colostomy, temporary 13,300 0.04 14.91 33,048
and permanent
73 Ileostomy and other 5,761 0.02 17.88 38,425
enterostomy
74 Gastrectomy, partial 24,320 0.07 16.60 43,914
and total
75 Small bowel resection 44,153 0.13 16.24 42,138
76 Colonoscopy and biopsy 245,530 0.71 7.27 10,659
77 Proctoscopy and 16,564 0.05 6.92 10,667
anorectal biopsy
78 Colorectal resection 242,399 0.70 12.29 27,887
79 Local excision of 1,603 0.00 7.68 14,569
large intestine lesion
(not endoscopic)
80 Appendectomy 233,060 0.67 3.93 8,992
81 Hemorrhoid procedures 20,514 0.06 2.98 5,636
82 Endoscopic cannulation 39,465 0.11 7.35 13,191
of pancreas (ERCP)
83 Biopsy of liver 30,275 0.09 9.23 17,685
84 Cholecystectomy and 447,538 1.29 4.91 12,964
common duct exploration
85 Inguinal and femoral 67,139 0.19 5.04 11,316
hernia repair
86 Other hernia repair 89,981 0.26 5.10 11,890
87 Laparoscopy 23,794 0.07 3.97 10,411
88 Abdominal paracentesis 53,932 0.16 8.97 14,774
89 Exploratory laparotomy 29,763 0.09 9.35 25,807
90 Excision, lysis 67,592 0.20 9.99 21,285
peritoneal adhesions
91 Peritoneal dialysis 21,560 0.06 6.66 11,332
92 Other GI diagnostic 8,504 0.02 7.48 16,731
procedures
93 Other non-OR upper GI 88,843 0.26 6.15 12,024
therapeutic procedures
94 Other OR upper GI 80,991 0.23 11.47 30,153
therapeutic procedures
95 Other non-OR lower GI 53,403 0.15 6.86 10,296
therapeutic procedures
96 Other OR lower GI 112,384 0.32 8.91 19,427
therapeutic procedures
97 Other gastrointestinal 14,635 0.04 10.23 18,757
diagnostic procedures
98 Other non-OR gastro- 46,356 0.13 6.82 13,069
intestinal therapeutic
procedures
99 Other OR gastro- 100,107 0.29 12.55 31,401
intestinal therapeutic
procedures
100 Endoscopy and endoscopic 80,756 0.23 7.70 11,182
biopsy of the urinary
tract
101 Transurethral excision, 100,765 0.29 3.84 8,050
drainage, or removal
urinary obstruction
102 Ureteral catheterization 29,709 0.09 4.80 10,378
103 Nephrotomy and 21,791 0.06 8.78 19,480
nephrostomy
104 Nephrectomy, partial 38,083 0.11 8.72 22,046
or complete
105 Kidney transplant 13,153 0.04 13.93 72,158
106 Genitourinary 43,654 0.13 3.20 7,084
incontinence procedures
107 Extracorporeal 6,417 0.02 3.39 10,025
lithotripsy, urinary
108 Indwelling catheter 13,981 0.04 6.96 8,026
109 Procedures on the urethra 25,511 0.07 5.25 9,858
110 Other diagnostic 21,882 0.06 6.93 14,176
procedures of urinary
tract
111 Other non-OR therapeutic 23,230 0.07 4.72 7,619
procedures of urinary
tract
112 Other OR therapeutic 55,727 0.16 8.10 18,810
procedures of urinary
tract
113 Transurethral 187,857 0.54 4.45 8,146
prostatectomy (TURP)
114 Open prostatectomy 69,366 0.20 5.87 14,525
115 Circumcision 1,041,441 3.01 2.29 1,600
116 Diagnostic procedures, 5,313 0.02 9.38 13,369
male genital
117 Other non-OR therapeutic 5,066 0.01 6.28 11,124
procedures, male
genital
118 Other OR therapeutic 38,833 0.11 3.88 9,945
procedures, male genital
119 Oophorectomy, 70,386 0.20 4.25 9,939
unilateral and bilateral
120 Other operations on ovary 37,986 0.11 3.14 8,036
121 Ligation of fallopian 72,123 0.21 2.02 5,313
tubes
122 Removal ectopic pregnancy 27,597 0.08 2.61 7,433
123 Other operations on 15,320 0.04 2.77 7,468
fallopian tubes
124 Hysterectomy, abdominal 510,348 1.47 3.66 8,994
and vaginal
125 Other excision of 35,618 0.10 3.22 8,157
cervix and uterus
126 Abortion (termination 7,294 0.02 2.31 4,847
of pregnancy)
127 Dilatation and curettage 57,322 0.17 1.56 4,575
(D&C), aspiration after
delivery or abortion
128 Diagnostic dilatation 17,820 0.05 4.19 7,694
and curettage (D&C)
129 Repair of cystocele and 47,869 0.14 2.92 6,403
rectocele, obliteration
of vaginal vault
130 Other diagnostic 9,195 0.03 7.58 11,398
procedures, female organs
131 Other non-OR therapeutic 7,738 0.02 3.08 5,846
procedures, female organs
132 Other OR therapeutic 50,398 0.15 3.85 9,270
procedures, female organs
133 Episiotomy 760,435 2.20 1.77 3,247
134 Cesarean section 809,530 2.34 3.78 7,158
135 Forceps, vacuum, and 372,715 1.08 1.91 3,748
breech delivery
136 Artificial rupture of 72,646 0.21 1.60 3,073
membranes to assist
delivery
137 Other procedures to 1,048,869 3.03 1.75 3,398
assist delivery
138 Diagnostic amniocentesis 9,403 0.03 4.93 6,761
139 Fetal monitoring 94,862 0.27 2.18 3,380
140 Repair of current 513,104 1.48 1.71 3,129
obstetric laceration
141 Other therapeutic 9,939 0.03 1.99 3,818
obstetrical procedures
142 Partial excision bone 42,240 0.12 5.71 13,975
143 Bunionectomy or repair 7,106 0.02 2.21 6,302
of toe deformities
144 Treatment, facial 30,762 0.09 4.26 14,329
fracture or dislocation
145 Treatment, fracture or 61,228 0.18 3.49 9,373
dislocation of radius
and ulna
146 Treatment, fracture or 271,910 0.79 8.65 17,227
dislocation of hip
and femur
147 Treatment, fracture or 191,461 0.55 4.72 11,237
dislocation of lower
extremity (other than
hip or femur)
148 Other fracture and 85,331 0.25 4.53 12,194
dislocation procedure
149 Arthroscopy 6,889 0.02 3.37 9,591
150 Division of joint 6,098 0.02 2.99 8,611
capsule, ligament or
cartilage
151 Excision of semilunar 12,207 0.04 2.41 9,064
cartilage of knee
152 Arthroplasty knee 295,052 0.85 5.69 19,353
153 Hip replacement, total 277,023 0.80 7.83 22,122
and partial
154 Arthroplasty other than 68,768 0.20 2.41 8,657
hip or knee
155 Arthrocentesis 28,816 0.08 7.43 9,625
156 Injections and 4,762 0.01 8.02 10,574
aspirations of muscles,
tendons, bursa, joints
and soft tissue
157 Amputation of lower 105,183 0.30 14.28 24,178
extremity
158 Spinal fusion 56,399 0.16 7.16 25,895
159 Other diagnostic 23,362 0.07 11.54 20,335
procedures on
musculoskeletal system
160 Other therapeutic 116,281 0.34 3.65 9,320
procedures on
muscles and tendons
161 Other OR therapeutic 41,442 0.12 4.92 13,538
procedures on bone
162 Other OR therapeutic 64,111 0.19 5.91 13,736
procedures on joints
163 Other non-OR therapeutic 8,871 0.03 8.91 9,782
procedures on
musculoskeletal system
164 Other OR therapeutic 37,820 0.11 4.70 13,704
procedures on
musculoskeletal system
165 Breast biopsy and other 5,645 0.02 7.77 12,226
diagnostic procedures
on breast
166 Lumpectomy, 33,343 0.10 2.94 7,220
quadrantectomy of breast
167 Mastectomy 108,204 0.31 3.07 8,070
168 Incision and drainage, 67,918 0.20 7.06 10,220
skin and subcutaneous
tissue
169 Debridement of wound, 220,744 0.64 12.68 22,003
infection or burn
170 Excision of skin lesion 29,966 0.09 8.24 12,978
171 Suture of skin and 69,887 0.20 4.27 7,474
subcutaneous tissue
172 Skin graft 36,281 0.10 13.76 30,727
173 Other diagnostic 13,875 0.04 10.00 15,240
procedures on
skin and subcutaneous
tissue
174 Other non-OR therapeutic 130,346 0.38 11.36 20,332
procedures on skin and
breast
175 Other OR therapeutic 57,359 0.17 2.96 10,176
procedures on skin and
breast
176 Other organ 6,231 0.02 32.42 191,697
transplantation
177 Computerized axial 350,617 1.01 6.77 9,516
tomography (CT) scan head
178 CT scan chest 29,948 0.09 7.58 10,875
179 CT scan abdomen 98,266 0.28 6.01 9,242
180 Other CT scan 24,426 0.07 6.59 8,715
181 Myelogram 16,653 0.05 4.52 7,220
182 Mammography 1,819 0.01 8.53 7,694
183 Routine chest X-ray 10,514 0.03 5.99 6,641
184 Intraoperative 612 0.00 8.56 14,947
cholangiogram
185 Upper gastrointestinal 25,082 0.07 6.73 8,591
X-ray
186 Lower gastrointestinal 7,970 0.02 5.62 7,136
X-ray
187 Intravenous pyelogram 42,402 0.12 3.31 4,594
188 Cerebral arteriogram 32,142 0.09 6.05 12,203
189 Contrast aortogram 14,437 0.04 4.81 10,989
190 Contrast arteriogram 15,249 0.04 5.50 11,045
of femoral and lower
extremity arteries
191 Arterio- or venogram 35,325 0.10 6.12 10,520
(not heart and head)
192 Diagnostic ultrasound 35,013 0.10 6.89 10,710
of head and neck
193 Diagnostic ultrasound 273,702 0.79 6.01 10,014
of heart (echocardiogram)
194 Diagnostic ultrasound 21,953 0.06 4.86 6,185
of gastrointestinal tract
195 Diagnostic ultrasound 40,456 0.12 6.45 9,070
of urinary tract
196 Diagnostic ultrasound 78,069 0.23 5.29 8,066
of abdomen or
retroperitoneum
197 Other diagnostic 91,420 0.26 5.63 7,747
ultrasound
198 Magnetic resonance 90,436 0.26 7.24 10,467
imaging
199 Electroencephalogram 40,745 0.12 8.13 10,524
(EEG)
200 Nonoperative urinary 733 0.00 4.86 6,433
system measurements
201 Cardiac stress tests 89,386 0.26 3.16 6,121
202 Electrocardiogram 46,029 0.13 5.48 7,395
203 Electrographic cardiac 118,375 0.34 3.94 5,964
monitoring
204 Swan-Ganz 22,920 0.07 9.53 26,244
catheterization for
monitoring
205 Arterial blood gases 94,814 0.27 6.15 9,148
206 Microscopic examination 12,783 0.04 4.95 4,233
(bacterial smear,
culture, toxicology)
207 Radioisotope bone scan 26,228 0.08 8.12 9,930
208 Radioisotope pulmonary 42,543 0.12 6.19 10,118
scan
209 Radioisotope scan and 43,332 0.13 6.05 9,211
function studies
210 Other radioisotope scan 5,097 0.01 8.24 11,233
211 Therapeutic radiology 74,619 0.22 7.89 11,919
212 Diagnostic physical 7,965 0.02 13.85 15,447
therapy
213 Physical therapy 141,853 0.41 13.57 14,195
exercises, manipulation,
and other procedures
214 Traction, splints, and 45,851 0.13 7.17 8,821
other wound care
215 Other physical therapy 47,319 0.14 15.20 14,102
and rehabilitation
216 Respiratory intubation 435,961 1.26 11.97 31,841
and mechanical
ventilation
217 Other respiratory 208,884 0.60 4.98 7,337
therapy
218 Psychological and 142,397 0.41 15.79 13,989
psychiatric evaluation
and therapy
219 Alcohol and drug 435,777 1.26 7.26 5,148
rehabilitation/
detoxification
220 Ophthalmologic and 4,817 0.01 5.34 6,771
otologic diagnosis and
treatment
221 Nasogastric tube 40,780 0.12 5.14 7,332
222 Blood transfusion 178,854 0.52 6.93 11,175
223 Enteral and parenteral 44,039 0.13 13.33 19,369
nutrition
224 Cancer chemotherapy 334,507 0.97 4.23 10,412
225 Conversion of cardiac 72,478 0.21 4.71 8,822
rhythm
226 Other diagnostic 54,097 0.16 6.52 10,336
radiology and related
techniques
227 Other diagnostic 61,460 0.18 7.27 11,534
procedures (interview,
evaluation, consultation)
228 Prophylactic 267,498 0.77 2.27 1,523
vaccinations and
inoculations
229 Nonoperative removal 5,370 0.02 3.38 6,554
of foreign body
230 Extracorporeal shock wave 54 0.00 4.75 13,553
lithotripsy, other than
urinary
231 Other therapeutic 430,856 1.24 6.29 9,287
procedures
Invalid procedure 2,552 0.01 4.72 6,496
Current as of November 1998
AHCPR Publication No.
97-0057
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