Outpatient Spine Surgery in the Medicare Population: Trends in Hospital Outpatient and Ambulatory Surgical Center Utilization, 2010-2021

Document Type

Conference Proceeding

Publication Date


Publication Title

OREF Midwest Region Resident Research Symposium Program


Purpose: To demonstrate procedural trends in outpatient spine surgery within the Medicare population and to quantify changes in outpatient volume after removal of a procedure from the “inpatient-only” list. Significance: Recent emphasis has been placed on transitioning appropriately selected surgical procedures to hospital outpatient department (HOPD) and ambulatory surgical center (ASC) settings for improved efficiency. Methods: The Medicare Physician Supplier Procedure Summary public-use files from 2010-2021 were queried for spine procedures within Healthcare Common Procedure Coding System (HCPCS) ranges 22010-22899 and 62380-63103. Procedures were referenced to each year’s Medicare ASC Covered Procedures List. Annual totals and changes in volume were calculated. Results: A total of 12 procedure codes in the above range were included on the ASC list in 2010, which expanded to 58 in 2021. Within this timeframe, the compound annual growth rate (CAGR) of these procedures was 15.7% per year at ASCs and 9.9% per year for HOPDs. High growth of outpatient cervical surgery was observed after lifting inpatient-only restrictions; for HCPCS 22551 (anterior cervical discectomy and fusion, first interspace), growth of 383% and 303% was observed in HOPDs and ASCs, respectively. Conclusion: A transition of previously inpatient-only procedures has contributed to recent growth of outpatient spine surgery in the Medicare population.

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Orthopaedic Research and Education Foundation OREF Midwest Region Resident Research Symposium, May 15, 2023, Chicago, IL

Third place winner.