Surgical Discharges

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Atlas Data – Hospital Discharges and Post-Acute Care – Selected Surgical Discharge Rates

Most patients defer to their physicians when it comes to deciding what care they receive. When it comes to elective surgery, physician opinion can vary widely as to when the treatment is necessary, and which patients are appropriate. Consequently, the frequency of discretionary surgery, such as knee or hip replacement or back surgery, also varies remarkably from one region to another.

Surgical Discharges 2015 – by HRR

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Surgical Discharges 2015 – by HSA

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Surgical Discharges 2015 – by State


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Surgical Discharges 2015 – by County


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Denominator Definition
100% of Medicare enrollees age 65-99 with full Part A entitlement and no HMO enrollment during the measurement period. Age, gender, race, and eligibility are determined using the Denominator file.

Numerator Definition
All Surgical Discharges
Number of discharges for surgical procedures: DRGs classified as “surgical” according to Medicare DRG definitions (CMS-DRG & MS-DRG).

Hospitalization for Hip Fracture
Number of discharges with ICD-9-CM primary diagnosis codes 820-820.99.

Inpatient Abdominal Aortic Aneurysm Repair
Number of discharges with ICD-9-CM procedure codes 38.44, 39.25, 39.71, 39.78 and diagnosis codes 441.3-441.9.

Inpatient Aortic/Mitral Valve Replacement
Number of discharges with ICD-9-CM procedure codes 35.05, 35.06, 35.09, 35.2-35.24.

Inpatient Back Surgery
Number of discharges with ICD-9-CM procedure codes 03.0, 03.02, 03.09, 03.6, 80.50-80.54, 80.59, 81.00-81.09, 81.31-81.39, 81.61-81.64, 84.60-84.69: excluding diagnosis codes 140-239.9, 324.1, 630-676, 720.0-720.9, 730-730.99, 733.1, 733.10, 733.13, 733.8, 733.81-733.82, 733.95, 805-806.9, 839-839.59, E800-E849.9: also excluding surgical codes 03.2-03.29.

Also discharges with ICD-9-CM procedure codes 03.93, 03.94, 78.50, 78.59, 78.60, 78.69, 78.90, 78.99, 84.51, 84.52, 84.58, 84.59, 84.80-84.85, 86.94-86.96: with above exclusions and only with diagnosis codes 353.9, 355.0, 355.9, 721.0-721.4, 721.42, 721.7-721.9, 721.90, 721.91, 722.0, 722.10, 722.11, 722.2, 722.4, 722.5, 722.51, 722.52, 722.6, 722.70-722.73, 722.80, 722.81, 722.83, 722.90-722.93, 723.0, 723.1, 723.8, 724.00-724.03, 724.09, 724.2-724.6, 724.70, 724.71, 724.79, 724.8, 724.9, 737.0, 737.1, 737.10, 737.19, 737.20, 737.3, 737.30, 737.32, 737.34, 737.39, 737.43, 737.8, 737.9, 738.4, 756.11, 756.12, 846.0, 846.1-846.3, 846.8, 846.9, 847.0, 847.2, 847.9.

Inpatient Carotid Endarterectomy
Number of discharges with ICD-9-CM procedure code 38.12.

Inpatient Cholecystectomy
Number of discharges with ICD-9-CM procedure codes 51.21-51.24.

Inpatient Coronary Angiography
Number of discharges with ICD-9-CM procedure codes 37.22, 37.23; 88.55-88.57.

Inpatient Coronary Artery Bypass Grafting (CABG)
Number of discharges with ICD-9-CM procedure codes 36.10-36.19.

Inpatient Hip Replacement
Number of discharges with ICD-9-CM procedure code 81.51. Excludes diagnosis codes 820-821.39, 996.4x.

Inpatient Knee Replacement
Number of discharges with ICD-9-CM procedure code 81.54.

Inpatient Lower Extremity Revascularization
Number of discharges with ICD-9-CM procedure code 39.29. Excludes diagnosis code 444.21 and patients with ESRD status = true in Denominator file.

Inpatient Mastectomy for Cancer
Number of discharges with ICD-9-CM procedure codes 85.41, 85.43, 85.45, 85.47 and diagnosis codes 174-174.9. Excludes diagnosis code 233.0

Inpatient Percutaneous Coronary Interventions (PCI)
Number of discharges with ICD-9-CM procedure codes 00.66, 36.06, 36.07, 36.09.

Inpatient Radical Prostatectomy
Number of discharges with ICD-9-CM procedure code 60.5x.

Inpatient Resection for Colon Cancer
Number of discharges with ICD-9-CM procedure codes 17.31-17.39, 45.7-45.79, 45.8 and diagnosis codes 153-153.9, 209.10-209.16.

Inpatient TURP for BPH
Number of discharges with ICD-9-CM procedure codes 60.2, 60.21, 60.29 and diagnosis slots 1-5 = 600-601.4, 601.8, 601.9, 602-602.1, 788.2-788.29, 788.4x.

Leg Amputations
Number of discharges with ICD-9-CM procedure codes 84.15-84.17.

Adjustments
Rates are adjusted for age, sex and race using the indirect method, using the U.S. Medicare population as the standard.