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
Send Questions & Comments to: hcup@ahrq.gov
Return to
Statistics and Research Notes Based on HCUP Data
Return to HCUP
AHRQ Home Page