Nebraska Outpatient Surgical Procedures

annual report 2011

© January 2015

Nebraska Outpatient Surgical Proceduresannual report 2011

aa/ada/eoe

Nebraska Department of Health & Human Services Division of Public Health Joseph M. Acierno, M.D., J.D. Acting Chief Executive OfficerChief Medical Officer, Director

Jenifer Roberts-Johnson, J.D. Deputy Director, Public Health

Ming Qu, MEd., PhD Administrator, Epidemiology and Informatics Unit

Office of Health Statistics Michelle Hood Administrator

Janis Singleton Administrative Assistant

Heather Tewes, M.S. Health Data CoordinatorBryan Rettig, M.S. Epidemiology Surveillance Coordinator

1

Contents INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

TABLE 1 Twenty most frequently performed outpatient surgical procedures by number and type of procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

TABLE 2 Total number of procedures performed by patient county of residence and place of service, Nebraska residents only . . . . . . . . . . . . . . . . . . . . . . . 5

TABLE 3 Total number of procedures performed by patient state of residence and place of service, non-Nebraska residents . . . . . . . . . . . . . . . . . . . . . . . 7

TABLE 4 Average billed charge by patient county of residence, Nebraska residents only . . . . . . . . . . . . . 9

TABLE 5 Average billed charge by patient state of residence non-Nebraska residents only . . . . . . . . .12

APPENDIX A Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

APPENDIX B Map - Regions of Service . . . . . . . . . . . . . . . . . . . . .16

2

The purpose of this report is to present the most recent data from the Nebraska outpatient surgical procedures database .

This report also fulfills the requirements of the legislation that established the outpatient surgical procedures database, a copy of which is presented in Appendix A . These data include outpatient surgical procedures that were performed between January 1, 2011 and December 31, 2011 at licensed hospitals and ambulatory surgical centers in Nebraska . An outpatient surgical procedure is defined as any surgical procedure that does not require an inpatient hospitalization .

The outpatient surgical procedures database was established by the Nebraska Unicameral in 2003, with three stated goals: 1) to collect and compile outpatient surgical procedure information from hospitals and ambulatory surgical centers; 2) to use and disclose such information for public health purposes; and 3) to prepare and publish an annual statistical report . All hospitals and ambulatory surgical centers within the state of Nebraska that are licensed under the Health Care Facility Licensure Act are required to report the following outpatient surgical and related information to the Nebraska Department of Health and Human Services (DHHS): 1) the name of the reporting facility; 2) the facility portion of billed charges for each patient served at the facility; 3) the county and state of residence by zip code for each patient served at the facility; 4) the primary outpatient surgical procedure performed for each patient at the facility, reported by Current Procedural

Terminology (CPT) codes or Health Care Financing Administration codes; and 5) the primary source of payment for each patient served at the facility, reported as follows: a) private sources must be reported as either self-pay, commercial insurance, or worker’s compensation; and b) public sources must be reported as either Medicaid, Medicare, or other government source . Certain procedures (collection of venous blood and capillary blood specimens, and childbirth [excluding deliveries by Cesarean section]) are exempt from the reportable list of procedures . Facilities must provide these data annually to DHHS no later than May 1 of each year for the preceding calendar year . All information obtained from the medical records of individual patients is considered confidential and cannot be disclosed by DHHS in a way that would identify an individual patient .

In addition to publishing an annual statistical report, the legislation that established the outpatient surgical procedures database also requires that certain information be included as part of this report . Specifically, the report must include: 1) the twenty most frequently performed outpatient surgical procedures by type of procedure; 2) the total number of persons served for each of the 20most frequently performed procedures; 3) the total number of persons served by county, service region, and state of residence for all procedures performed, and 4) the average billed charges for the 20 most frequently performed procedures, by county and state of residence .

Introduction

3

Results

Atotal of 262,556 outpatient surgical procedures were performed at the 126 Nebraska hospitals and ambulatory

surgical centers that reported their data for the year 2011 . Table 1 presents the 20 most frequently performed outpatient surgical procedures, by number and type of procedure (but limited to primary [i .e ., first-listed] procedures only), along with the average billed charge per type of procedure . The most frequently performed outpatient surgical procedure was a diagnostic colonoscopy, with 19,350 reported, followed by colonoscopy, with biopsy, with 14,149 reported . The average billed charge for the top 20 procedures islimited to only those cases where just one procedure was reported, as the hospitals and ambulatory surgical centers did not provide an itemized breakdown of their charges when more than one procedure was performed .

Tables 2 and 3 present the number of outpatient surgical procedures by the patient’s

place of residence and the place where these services were obtained . Table 2 presents these data for Nebraska residents, by county of residence and place of service, while Table 3 presents these data for patients who are not Nebraska residents, by state of residence and place of service . In both tables, the places where outpatient surgical procedures were obtained are grouped by county into five regions, and the counties that are included in each region are listed in the Table 3 footnote and are shown on the map in Appendix B .

Tables 4 and 5 present the average billed charges for the 20 most frequently performed outpatient surgical procedures, by the patient’s place of residence . Table 4 presents these data by county for Nebraska residents, while Table 5 presents these data by state for out-of-state residents . As in Table 1, the average billed charges reported in these two tables are limited to only those cases where just one procedure was reported .

4

2

Table 1. Twenty most frequent outpatient surgical procedures performed at Nebraska hospitals and ambulatory surgical centers, by number and type of procedure (primary procedure only), with average billed charge per type of procedure, 2011

Type of Procedure

CPT Code #

# Procedures

Average Billed Charge ($)

Diagnostic colonoscopy 45378 19,350 2,134

Colonoscopy, with biopsy 45380 14,149 3,014

Upper gastrointestinal endoscopy, with biopsy 43239 14,040 2,773

Cataract surgery with insertion of intraocular lens (one stage procedure) 66984 13,549 3,546

Lesion removal colonoscopy, by snare technique 45385 8,209 2,545

Cystoscopy 52000 7,643 1,052

Injection(s) of diagnostic or other substances, epidural or subarachnoid; lumbar or sacral (caudal) 62311 7,002 1,732

Create eardrum opening 69436 4,885 3,248

Upper gastrointestinal endoscopy, diagnostic 43235 4,052 2,613

Dental surgery procedure (unlisted procedure, dentoalveolar structures) 41899 3,978 5,063

Debride skin, subcutaneous tissue 11042 3,344 1,155

Laparoscopic cholecystectomy 47562 3,273 12,198

Abdominal lymphadenectomy, regional 38747 2,975 2,673

Knee arthroscopy/surgery 29881 2,860 7,140

Carpal Tunnel surgery 64721 2,778 4,145

Remove tonsils and adenoids 42820 2,671 5,134

Insertion of central venous access devices with subcutaneous port 36561 2,180 9,997

Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level 64483 1,995 1,630

Lithotripsy, extracorporeal shock wave 50590 1,987 14,085

Lesion removal colonoscopy, by hot biopsy forceps or bipolar cautery 45384 1,967 2,272

5

3

Table 2. Total number of outpatient surgical procedures performed at Nebraska hospitals and ambulatory surgical centers, by patient county of residence and place (region) of service, Nebraska residents only, 2011

County of Residence

Region of Service (for key to regions, see footnote at end of Table 3) TOTAL Central East North Southeast West

Adams 2,796 360 6 245 5 3,412 Antelope 27 107 762 23 0 919 Arthur 3 1 0 1 24 29 Banner 0 0 0 0 25 25 Blaine 27 7 2 4 1 41 Boone 102 151 267 39 0 559 Box Butte 2 12 0 1 1,253 1,268 Boyd 13 23 176 1 0 213 Brown 62 72 227 16 7 384 Buffalo 2,535 358 25 116 16 3,050 Burt 156 360 692 5 0 1,213 Butler 21 203 140 757 0 1,121 Cass 6 3,099 9 828 0 3,942 Cedar 3 94 386 13 0 496 Chase 36 14 0 7 367 424 Cherry 33 51 303 27 51 465 Cheyenne 3 17 0 1 769 790 Clay 470 52 1 151 0 674 Colfax 134 291 1,059 93 0 1,577 Cuming 90 197 1,221 28 0 1,536 Custer 961 89 8 78 57 1,193 Dakota 1 134 125 3 0 263 Dawes 4 3 0 3 266 276 Dawson 647 195 2 84 1,075 2,003 Deuel 6 3 0 2 119 130 Dixon 0 41 209 8 0 258 Dodge 2,569 1,863 6,881 66 0 11,379 Douglas 75 65,308 556 166 2 66,107 Dundy 39 16 0 2 133 190 Fillmore 66 75 0 640 0 781 Franklin 232 29 1 25 2 289 Frontier 41 29 0 14 116 200 Furnas 314 63 2 41 220 640 Gage 9 209 1 3,024 0 3,243 Garden 3 4 0 5 148 160 Garfield 182 39 4 15 2 242 Gosper 72 15 0 12 103 202 Grant 5 2 0 1 50 58 Greeley 233 30 23 28 0 314 Hall 6,224 515 19 355 0 7,113 Hamilton 824 139 2 126 0 1,091 Harlan 257 26 0 16 1 300 Hayes 13 6 0 3 75 97 Hitchcock 39 19 0 7 275 340 Holt 133 160 1,115 40 2 1,450 Hooker 14 11 4 5 27 61 Howard 712 57 1 47 0 817 Jefferson 2 33 0 825 0 860 Johnson 3 72 0 449 0 524

6

4

County of Residence

Region of Service (for key to regions, see footnote at end of Table 3) TOTAL Central East North Southeast West

Kearney 471 63 0 10 3 547 Keith 31 43 0 17 718 809 Keya Paha 15 5 55 1 1 77 Kimball 0 15 0 1 324 340 Knox 1 100 490 9 0 600 Lancaster 35 2,373 122 30,665 9 33,204 Lincoln 187 339 0 117 1,615 2,258 Logan 17 4 0 0 33 54 Loup 25 4 0 2 0 31 Madison 17 872 4,589 82 1 5,561 McPherson 4 0 0 0 12 16 Merrick 727 112 48 118 1 1,006 Morrill 4 1 0 0 476 481 Nance 153 108 35 31 0 327 Nemaha 0 223 0 622 0 845 Nuckolls 247 41 1 60 2 351 Otoe 1 501 0 1,364 3 1,869 Pawnee 0 57 0 254 0 311 Perkins 9 5 0 7 245 266 Phelps 957 59 0 67 17 1,100 Pierce 4 103 747 8 0 862 Platte 171 1,143 2,205 317 0 3,836 Polk 50 121 89 338 0 598 Red Willow 237 76 0 55 1,015 1,383 Richardson 1 224 0 666 0 891 Rock 23 9 99 9 0 140 Saline 5 127 1 1,802 0 1,935 Sarpy 20 20,841 121 98 2 21,082 Saunders 281 1,174 554 1,137 0 3,146 Scotts Bluff 5 29 9 12 3,503 3,558 Seward 11 115 24 1,999 0 2,149 Sheridan 3 23 0 6 283 315 Sherman 284 21 0 20 0 325 Sioux 0 0 0 0 33 33 Stanton 2 81 432 13 0 528 Thayer 62 29 4 375 0 470 Thomas 18 2 9 5 12 46 Thurston 12 243 215 16 0 486 Valley 319 68 4 24 1 416 Washington 196 1,800 1,250 15 0 3,261 Wayne 5 94 787 12 0 898 Webster 358 29 1 22 0 410 Wheeler 26 6 28 0 1 61 York 116 118 4 1,171 0 1,409 County Not Reported 7,182 9,780 16 383 3 17,364

TOTAL 32,491 115,835 26,168 50,376 13,504 238,374

7

5

Table 3. Total number of outpatient surgical procedures performed at Nebraska hospitals and ambulatory surgical centers, by patient state of residence and place (region) of service, non-Nebraska residents only, 2011

State of Residence

Region of Service (for key to regions, see footnote at end of table) TOTAL Central East North Southeast West

Alabama 1 12 1 0 0 14 Alaska 0 6 0 1 1 8 Arizona 6 51 2 10 2 71 Arkansas 0 38 2 3 0 43 California 8 35 0 7 5 55 Colorado 22 65 0 23 50 160 Connecticut 1 0 0 0 0 1 Delaware 0 1 1 0 0 2 District of Columbia 0 0 0 0 0 0

Florida 1 72 2 10 5 90 Georgia 2 15 0 3 0 20 Hawaii 0 4 0 2 0 6 Idaho 0 7 0 6 1 14 Illinois 4 42 0 12 1 59 Indiana 0 23 0 3 0 26 Iowa 16 17,716 358 155 1 18,246 Kansas 1,108 301 4 459 197 2,069 Kentucky 1 7 0 0 0 8 Louisiana 0 16 0 1 1 18 Maine 0 0 0 0 0 0 Maryland 1 6 1 0 0 8 Massachusetts 1 17 0 1 0 19 Michigan 0 14 0 3 0 17 Minnesota 5 55 3 5 3 71 Mississippi 0 3 0 3 0 6 Missouri 8 598 7 83 2 698 Montana 0 10 1 4 1 16 Nevada 2 12 0 1 2 17 New Hampshire 0 0 0 0 0 0 New Jersey 0 5 0 1 0 6 New Mexico 4 20 0 0 0 24 New York 0 12 0 4 0 16 North Carolina 0 10 0 8 1 19 North Dakota 1 17 1 0 0 19 Ohio 2 18 0 6 0 26 Oklahoma 4 45 2 0 0 51 Oregon 2 14 0 1 1 18 Pennsylvania 2 9 2 1 0 14 Rhode Island 0 1 0 0 0 1 South Carolina 0 8 0 1 0 9 South Dakota 7 318 62 20 65 472 Tennessee 3 14 1 2 0 20 Texas 8 105 39 29 5 186 Utah 0 10 1 1 0 12 Vermont 0 0 0 0 0 0 Virginia 2 8 0 4 1 15 Washington 3 15 3 2 0 23 West Virginia 1 1 0 0 0 2

8

6

State of Residence

Region of Service (for key to regions, see footnote at end of table) TOTAL Central East North Southeast West

Wisconsin 0 27 2 2 1 32 Wyoming 1 16 0 3 511 531 Unknown 0 912 1 4 7 924 TOTAL 1,227 20,711 496 884 864 24,182

NOTE: Regions of service are comprised of the following groups of counties: Central—Adams, Blaine, Buffalo, Clay, Custer, Franklin, Garfield, Greeley, Hall, Hamilton, Harlan, Howard, Kearney, Loup, Merrick, Nuckolls, Phelps, Sherman, Valley, Webster, and Wheeler Counties East—Douglas and Sarpy Counties North—Antelope, Boone, Boyd, Brown, Burt, Cedar, Cherry, Colfax, Cuming, Dakota, Dixon, Dodge, Holt, Keya Paha, Knox, Madison, Nance, Pierce, Platte, Rock, Stanton, Thurston, Washington, and Wayne Counties Southeast—Butler, Cass, Fillmore, Gage, Jefferson, Johnson, Lancaster, Nemaha, Otoe, Pawnee, Polk, Richardson, Saline, Saunders, Seward, Thayer, and York Counties West—Arthur, Banner, Box Butte, Chase, Cheyenne, Dawes, Dawson, Deuel, Dundy, Frontier, Furnas, Garden, Gosper, Grant, Hayes, Hitchcock, Hooker, Keith, Kimball, Lincoln, Logan, McPherson, Morrill, Perkins, Red Willow, Scotts Bluff, Sheridan, Sioux, and Thomas Counties

Ta

ble

4.

Ave

rag

e b

ille

d c

ha

rge

(in

do

lla

rs)

for

the

twen

ty m

ost

fre

qu

ent

ou

tpa

tien

t su

rgic

al

pro

ced

ure

s p

erfo

rmed

at

Neb

rask

a h

osp

ita

ls a

nd a

mb

ula

tory

su

rgic

al

cen

ters

, b

y p

ati

ent

cou

nty

of

resi

den

ce,

Neb

rask

a r

esid

ents

on

ly,

20

11

C

ou

nty

of

Resi

den

ce

Ty

pe o

f P

roce

du

re

(fo

r k

ey

to

pro

ced

ure c

od

es,

see f

oo

tno

te a

t en

d o

f T

ab

le 5

)

A

B

C

D

E

F

G

H

I J

K

L

M

N

O

P

Q

R

S

T

Ad

ams

2,1

45

2,7

87

2,9

88

2,3

47

2,8

00

1,2

81

1,1

49

2,9

63

2,1

32

4,1

74

2,1

13

9,1

87

6

,858

2,8

88

5,2

66

7,1

44

7,3

33

9,2

28

2,7

04

An

telo

pe

1,9

56

2,4

03

1,7

87

3,6

45

2,6

52

941

1,1

89

2,3

36

2,5

44

4,3

11

9

,040

2,5

48

5,3

65

2,8

94

3,5

20

6,8

94

1

0,0

06

1,6

10

Art

hu

r 2

,200

3,6

42

2,4

24

4,8

49

1,3

50

5,1

13

5,8

17

4,5

05

Ban

ner

1

,956

2,6

06

2,6

99

Bla

ine

1,7

11

1,4

29

5,6

42

4,1

26

1

,817

Boon

e 1

,943

1,8

55

2,6

25

3,2

38

2,1

28

1,2

40

1,0

17

2,1

88

1,7

48

4,5

21

1,1

59

8,2

17

2,0

07

5,9

64

2,3

33

4,2

42

3,4

28

7

,146

2,7

34

Box B

utt

e 2

,469

3,2

28

3,0

11

3,7

80

3,2

84

1,9

78

1,5

67

2,0

50

2,6

24

4,7

03

1

2,7

08

7

,490

4,0

69

4,3

82

6,5

44

1,3

42

18,3

13

3,3

30

Boyd

1

,766

2,2

38

1,7

37

3,6

61

8

92

2

,444

2,0

92

9

21

12,7

23

2,2

47

4,8

86

3,2

90

3,5

93

5,2

69

6

,000

1,4

56

Bro

wn

2

,794

2,9

21

3,1

59

3,4

45

1

,480

1,7

79

2,3

02

3,3

53

5,3

66

9

,893

3,4

83

2

,598

3,8

86

5,3

17

1,0

48

11,3

92

3,0

08

Bu

ffal

o

2,3

60

3,0

65

3,0

48

3,2

49

3,0

63

1,4

43

1,0

79

3,7

63

2,7

58

6,3

36

4,5

18

9,0

61

1,2

67

3,5

33

2,3

15

4,4

25

6,1

32

1,4

27

10,3

56

1,8

57

Bu

rt

2,0

49

2,2

00

2,7

93

4,0

60

1,8

91

974

1,9

22

3,3

53

2,5

23

4,8

13

597

8,7

06

1,7

54

6,8

18

2,2

36

3,6

89

13,4

00

851

6,6

15

2,0

91

Butl

er

1,7

90

1,8

30

2,4

51

3,0

05

1,7

99

1,4

22

1,0

87

2,0

01

5,5

41

4,6

80

937

9,7

20

2,6

26

5,9

39

2,3

04

4,9

03

9,6

33

1,0

50

6,8

63

2,4

96

Cas

s 2

,049

2,9

19

2,6

82

3,7

41

2,1

62

745

2,3

98

3,5

12

2,5

55

5,5

65

766

13,4

62

9

,067

5,7

70

4,7

25

11,7

69

1,9

83

13,0

95

2,0

62

Ced

ar

2,4

01

1,8

41

2,3

23

4,9

26

3,0

04

937

1,3

56

2,8

03

2,9

19

8,4

30

9

,559

2,6

00

6,5

13

3,3

44

5,5

52

11,5

04

1,7

72

Chas

e 1

,913

2,1

04

2,3

05

3,5

00

2,4

12

1,9

10

817

2

,075

5,0

99

4,2

07

9,8

56

5

,483

3,5

43

5,8

33

5,4

99

4

,044

2,3

53

Ch

erry

1

,780

1,9

40

2,7

99

3,1

24

2,7

49

420

2

,065

1,5

63

4,5

62

9

,807

4,0

61

7,8

46

3,1

79

3,4

67

5,4

37

1,0

48

10,8

30

Ch

eyen

ne

2,0

26

2,8

51

2,9

86

5,2

42

3,0

21

1,4

51

2,5

15

2,8

05

1,8

94

5,0

86

1

5,0

84

8

,263

4,7

77

4,0

97

8,7

55

1

8,4

47

2,6

58

Cla

y

2,2

52

2,6

82

2,4

66

2,6

68

2,7

05

2,0

98

1,2

68

2,9

84

3,6

74

4,4

04

1,0

34

8,6

05

4

,778

2,0

87

5,0

27

12,8

46

7

,523

2,3

88

Colf

ax

1,7

49

2,3

55

2,3

04

2,5

96

2,1

53

997

913

5,2

31

2,9

63

1,9

83

717

12,8

28

2,2

57

3,9

65

2,4

43

6,1

40

4,9

08

1,5

99

6,8

28

1,5

16

Cu

min

g

1,8

56

2,2

49

2,1

72

3,6

82

1,7

19

879

1,0

83

1,9

74

2,2

80

2,3

53

9

,080

2,3

65

5,2

45

1,7

54

3,8

76

4,6

03

6

,942

2,0

39

Cu

ster

1

,923

2,2

34

2,8

58

3,8

61

2,2

33

1,1

33

1,2

27

2,2

33

2,6

91

3,4

93

1,9

82

9,5

23

2

,939

2,0

44

2,7

02

5,6

92

1,0

48

9,8

84

2,2

33

Dak

ota

2

,039

2,4

03

3,7

89

3,4

70

2,1

37

881

2,1

53

2,8

40

2,4

43

1,7

95

8

,086

2,4

51

5,0

47

3,6

29

4

,460

Daw

es

2,1

76

3,1

24

2,7

15

4,6

61

2,5

10

5

89

2,5

32

2,3

30

5,8

12

1

3,7

70

6

,838

3,9

51

3,5

98

17,4

64

1

8,1

40

2,7

75

Daw

son

2

,006

2,9

92

2,7

79

4,1

05

2,7

47

4,0

94

1,0

89

2,5

58

2,4

61

5,6

20

2,3

27

8,9

83

4

,762

3,1

68

4,6

99

6,7

36

1,0

48

11,1

45

2,4

04

Deu

el

2,4

46

2,0

66

2,4

75

4,8

82

2,3

80

888

2

,557

1,8

55

4,7

69

1

4,8

28

2

,697

5,0

25

9,5

90

6,7

89

2,6

23

Dix

on

2

,189

3,9

91

2,1

84

4,2

32

2,6

62

1

,479

3,3

48

2,2

14

1,7

95

9

,319

2,7

72

5,7

17

2,8

63

5,0

43

4,8

49

Dod

ge

1,6

44

2,0

38

2,1

61

2,7

31

1,7

31

887

902

2,0

09

2,3

17

2,5

72

6,9

67

13,8

00

2,8

73

4,2

25

1,8

88

2,7

74

8,5

09

894

6,6

90

1,6

44

Dou

gla

s 2

,146

2,6

90

2,8

39

5,1

27

2,5

62

2,4

29

1,8

60

3,3

29

2,5

36

5,3

84

9,6

94

15,2

41

1,5

32

9,6

64

6,1

68

6,7

60

11,8

83

1,8

31

17,7

81

2,8

37

Du

nd

y

1,6

16

2,7

40

1,7

67

3,2

59

2,0

80

1

,749

6,5

85

22,5

31

9,4

28

2,5

50

3,6

08

6,3

14

Fil

lmore

2

,044

2,1

93

2,2

66

3,1

99

1,9

06

1,7

48

599

2,8

01

2,6

24

6,8

19

691

10,1

72

5

,842

3,0

66

4,4

15

7,8

39

9

,104

2,4

02

Fra

nk

lin

1,8

87

3,2

00

2,9

02

4,2

79

2,6

49

1

,312

2,4

69

2,5

02

4,7

61

2,3

43

9,4

24

2

,697

3,3

15

5,1

61

5,9

21

1,0

48

7,2

51

2,7

89

10

8

Cou

nty

of

Res

iden

ce

Typ

e of

Pro

cedu

re (f

or k

ey to

pro

cedu

re c

odes

, see

foot

note

at e

nd o

f Tab

le 5

) A

B

C

D

E

F

G

H

I J

K

L

M

N

O

P Q

R

S

T

Fron

tier

2,06

7 2,

335

2,58

0 4,

055

2,56

4

715

2,00

9 2,

235

6,15

9

10,2

90

4,84

9 3,

769

5,27

1 1,

048

10,9

77

2,77

9 Fu

rnas

2,

237

2,13

5 2,

421

3,93

0 4,

027

1,92

2 78

7 2,

206

2,53

8 5,

267

845

10,5

65

3,

938

3,31

9 4,

071

5,67

8 4,

447

9,20

4 2,

908

Gag

e 2,

171

2,47

2 2,

329

4,50

0 2,

096

775

1,33

7 2,

744

2,48

9 7,

145

712

10,6

10

6,

444

3,43

6 3,

461

9,71

5 1,

365

10,0

09

2,35

7 G

arde

n 1,

809

2,71

8 2,

699

4,79

6 2,

249

1,46

7

1,

766

5,29

6 7,

226

13,9

40

7,

471

6,47

3

18,3

23

3,34

1 G

arfie

ld

1,85

7 1,

984

2,17

8 3,

422

2,91

3 1,

236

1,32

8 1,

200

7,

401

1,30

0 9,

928

6,

894

2,69

0 3,

445

11,9

98

3,36

0 G

ospe

r 1,

757

1,97

5 2,

446

3,87

1 2,

679

5,29

9 64

7 2,

906

1,72

4 5,

060

10

,771

4,

355

4,29

1 6,

632

2,39

2 G

rant

2,

085

2,98

7 2,

541

4,66

6 2,

564

2,

926

7,

593

11,4

66

5,

049

6,

725

98

5

G

reel

ey

1,67

9 2,

084

2,46

0 2,

727

2,55

8 76

8

1,20

0

5,84

1

8,06

2 30

,887

6,

026

1,10

0 2,

408

4,75

2

6,00

0 1,

309

Hal

l 1,

324

1,49

7 1,

990

2,99

4 1,

382

3,23

5 99

6 1,

733

2,35

7 2,

190

1,49

1 9,

242

1,28

8 2,

962

1,29

1 3,

527

5,29

8 88

0 8,

813

1,26

5 H

amilt

on

1,92

7 1,

913

1,82

0 3,

303

2,50

1 78

8 1,

258

1,75

2 4,

566

5,45

8 66

9 10

,166

1,

225

2,70

0 1,

215

4,46

6 4,

271

1,53

8 7,

791

1,69

8 H

arla

n 1,

742

2,12

3 2,

810

4,81

5 1,

437

1,

108

1,20

0 3,

350

9,46

6

10,8

04

3,

131

2,68

0 7,

814

7,60

4

19,4

18

2,02

9 H

ayes

2,

424

2,74

9 2,

552

3,40

2 1,

544

1,

142

2,

770

4,78

4

3,

533

10

,613

2,

840

Hitc

hcoc

k 2,

192

2,92

1 3,

468

3,15

9 2,

166

1,98

8 1,

693

4,47

1 2,

779

6,64

2 5,

021

9,50

5

4,41

4 2,

943

4,20

3 5,

946

1,04

8

3,02

2 H

olt

1,88

5 1,

869

1,88

4 3,

731

3,06

9 1,

121

1,22

6 2,

158

2,23

9 3,

265

760

10,2

22

2,68

2 5,

831

3,07

9 3,

489

5,26

6 1,

048

7,19

3 2,

347

Hoo

ker

2,09

5 2,

394

2,14

5

2,

867

10

,079

6,21

0 5,

068

10

,499

How

ard

1,75

3 2,

182

2,16

0 2,

734

2,11

0 73

6 1,

514

1,58

9 3,

419

1,98

6 7,

135

7,49

7

3,41

0 2,

071

4,13

0 6,

004

1,04

8 10

,456

1,

569

Jeffe

rson

1,

794

2,31

5 2,

611

3,98

9 1,

384

1,05

2 1,

283

1,43

3 2,

693

5,83

9 77

4 9,

028

5,

335

2,62

0 2,

624

6,75

1 1,

339

7,86

5 2,

003

John

son

1,90

1 2,

275

2,51

1 3,

447

2,36

4 73

6 1,

812

1,67

1 1,

903

5,94

7 68

9 8,

591

4,

000

2,39

2 2,

430

10,5

19

7,

531

2,26

6 K

earn

ey

1,95

0 2,

660

2,50

2 4,

001

3,09

9 2,

503

980

8,89

5 2,

162

4,92

7 6,

674

10,1

40

3,

806

2,36

8 4,

112

6,70

0 1,

048

2,

555

Kei

th

2,24

9 3,

850

3,03

5 4,

721

3,89

9 4,

745

842

6,24

2 2,

072

5,55

2 1,

270

11,2

23

9,

226

4,90

5 10

,651

7,

133

10

,684

2,

852

Key

a Pa

ha

2,42

2 2,

036

2,09

5 3,

461

35

6 1,

378

8,55

4

1,

456

1,29

8 K

imba

ll 2,

288

2,52

4 2,

703

6,79

8 2,

803

1,10

0 1,

424

3,07

3 3,

449

8,18

0

12,5

70

7,

937

5,05

5 4,

039

9,22

8

18,2

24

2,68

5 K

nox

2,43

5 2,

349

2,37

7 3,

472

2,89

3 1,

175

959

3,

319

5,53

3 91

3 13

,950

2,

659

6,18

2 3,

103

1,44

4 12

,661

8,28

0 1,

456

Lanc

aste

r 1,

328

1,63

4 1,

934

2,89

8 1,

312

830

1,88

2 2,

160

2,44

5 6,

206

734

11,6

93

3,11

8 5,

067

2,72

9 3,

647

8,90

5 1,

528

9,67

1 2,

922

Linc

oln

2,13

1 2,

689

3,87

8 4,

942

3,25

3 1,

701

1,70

8 3,

171

2,35

0 5,

508

2,91

8 11

,171

7,67

2 2,

698

4,91

4 5,

887

3,13

8 11

,083

Loga

n 2,

109

2,59

2

3,

230

7,88

6

4,99

5 1,

468

10

,427

Loup

1,

451

2,

028

3,92

2 1,

885

736

9,

538

4,89

0

Mad

ison

1,

540

1,60

1 1,

779

2,40

1 2,

493

1,44

3 1,

061

2,59

0 2,

837

4,37

6 92

5 9,

298

2,70

5 6,

395

4,22

7 4,

684

4,51

1

10,2

94

1,44

5 M

cPhe

rson

3,

375

6,02

4

M

erric

k 1,

397

1,84

8 2,

026

3,73

6 1,

572

2,01

6 97

3 1,

938

3,14

0 3,

498

3,68

4 8,

296

1,65

0 4,

092

2,29

9 3,

925

6,15

9 75

0 9,

211

1,34

2 M

orril

l 1,

962

2,75

3 3,

072

3,75

6 3,

825

2,42

7 2,

152

3,80

6 1,

736

6,97

1

14,4

21

8,

587

4,45

1 4,

001

1,

608

18,4

39

3,30

8 N

ance

1,

421

2,28

8 2,

079

3,00

1 1,

934

1,45

2 92

7 1,

200

3,70

8 5,

521

17,0

15

9,83

2 1,

271

2,70

0 1,

100

2,80

1 5,

437

6,

857

1,72

5 N

emah

a 2,

025

2,53

8 2,

479

3,43

8 2,

194

736

1,37

7 2,

801

2,71

0 6,

711

847

8,65

8

11,7

68

2,82

8 6,

184

7,13

0

11,3

27

2,12

9

11

9

Cou

nty

of

Res

iden

ce

Typ

e of

Pro

cedu

re (f

or k

ey to

pro

cedu

re c

odes

, see

foot

note

at e

nd o

f Tab

le 5

) A

B

C

D

E

F

G

H

I J

K

L

M

N

O

P Q

R

S

T

Nuc

kolls

2,

915

2,33

6 2,

346

2,60

5 95

3 1,

609

1,11

9 2,

735

4,15

8 3,

746

4,

747

3,25

2 5,

290

6,50

8

9,35

4

Oto

e 1,

330

2,24

8 2,

367

3,45

2 1,

915

736

2,87

3 3,

072

1,85

0 5,

522

665

7,81

6

4,08

2 2,

534

3,71

8 12

,201

1,

364

9,88

7 1,

409

Paw

nee

2,00

1 3,

317

2,70

0 3,

813

1,78

5 1,

069

4,

930

1,82

5 8,

998

615

9,57

6

6,59

3 2,

922

3,80

8 5,

380

11

,527

2,

585

Perk

ins

2,23

1 2,

852

2,70

3 4,

467

2,68

3

2,05

6 5,

865

9,

185

8,

897

3,

951

4,75

3

10,9

83

2,76

6 Ph

elps

1,

697

2,27

4 2,

400

3,44

4 3,

158

5,70

7 50

5 3,

271

1,72

6 5,

237

1,88

0 11

,370

6,22

3 3,

127

5,34

6 9,

124

1,04

8 9,

613

2,36

6 Pi

erce

2,

030

1,82

2 2,

162

4,75

3 2,

809

936

991

2,70

7 3,

478

5,04

3 5,

102

11,3

72

2,69

8 6,

901

2,86

1 5,

031

6,11

0

8,28

0 1,

435

Plat

te

1,82

9 2,

259

2,54

6 2,

391

2,04

5 2,

066

1,00

8 2,

451

2,42

7 2,

814

762

9,41

3 2,

605

5,32

2 2,

552

3,56

7 5,

802

9,

237

2,13

5 Po

lk

1,82

6 1,

905

2,20

5 2,

590

2,40

4 94

1 89

5 2,

445

2,24

9 3,

369

597

9,66

7

6,25

2 3,

212

5,39

8 15

,373

97

5 17

,239

2,

686

Red

W

illow

2,

458

3,55

9 3,

363

3,15

5 2,

563

736

1,34

9 2,

344

2,41

8 6,

123

6,29

7 10

,291

8,33

2 2,

929

4,19

6 5,

861

1,93

1 10

,425

3,

006

Ric

hard

son

2,09

9 2,

550

2,24

6 3,

917

2,00

1 85

3 1,

475

4,93

1 2,

287

6,51

7 74

2 8,

337

4,

499

2,51

3 4,

273

8,04

2 1,

564

11,1

25

2,74

2 R

ock

2,65

6 2,

119

2,06

1 3,

302

953

881

1,

754

9,

077

2,80

0 5,

174

2,75

5 3,

702

1,45

6 1,

364

Salin

e 1,

548

2,08

5 1,

819

4,00

2 1,

413

809

1,52

6 1,

918

1,62

9 6,

900

657

7,08

6

5,42

7 2,

888

3,43

3 5,

687

2,91

7 7,

873

2,15

6 Sa

rpy

2,42

5 3,

082

3,23

7 4,

435

2,93

3 2,

080

2,25

3 3,

455

2,78

5 6,

223

5,52

5 15

,032

10,8

17

7,01

7 6,

254

11,8

98

1,99

8 17

,732

3,

179

Saun

ders

1,

863

2,14

0 2,

188

3,10

2 1,

572

939

1,41

4 2,

662

2,52

1 5,

474

1,03

3 13

,262

5,67

7 2,

738

4,23

2 12

,010

1,

145

11,4

03

1,71

3 Sc

otts

Blu

ff

1,89

6 2,

675

2,75

7 6,

611

2,64

6 3,

322

1,44

9 4,

456

2,01

8 6,

919

6,96

0 13

,989

7,85

5 4,

776

3,94

0 8,

226

1,54

0 18

,544

Sew

ard

1,73

3 1,

962

2,02

0 3,

376

1,62

2 78

4 1,

165

1,70

8 2,

018

6,54

2 67

4 9,

954

4,

642

3,23

1 3,

344

6,51

9 92

7 7,

823

2,40

5 Sh

erid

an

2,57

5 2,

733

3,10

4 3,

881

2,43

6 84

4 65

5

2,61

2 3,

748

12

,022

6,51

6 2,

983

4,70

6 12

,307

1,

130

18,5

60

3,12

6 Sh

erm

an

1,74

3 1,

872

2,05

7 3,

023

1,74

1 1,

518

1,25

3 1,

200

4,23

1 5,

033

9,

547

2,

699

1,88

5 3,

002

10,6

48

10

,755

1,

252

Siou

x 1,

969

2,46

5 3,

637

3,96

0 2,

465

1,

739

7,65

2

3,42

9

St

anto

n 1,

689

1,54

0 1,

964

2,74

2 1,

503

1,39

3 96

8

2,93

5 1,

400

7,

587

2,54

3 6,

714

6,64

2

7,81

9

8,28

0 1,

437

Thay

er

2,52

4 1,

995

2,56

0 3,

353

1,74

6 1,

288

2,

602

1,98

2 5,

165

597

11,3

97

2,25

9 4,

074

5,41

9

14,2

20

2,42

7 Th

omas

1,

320

2,90

2 2,

079

3,88

8

4,58

7

4,38

7

10,9

64

1,79

0

9,69

1

7,86

8

Thur

ston

2,

283

2,28

2 2,

652

4,02

7 2,

416

881

1,57

3 3,

246

2,88

6 2,

139

9,

105

2,57

2

2,80

8 5,

096

7,21

5

6,61

5 2,

484

Val

ley

1,98

1 2,

460

2,31

7 3,

611

2,55

5

1,30

9 2,

423

3,

727

1,44

4 8,

151

6,14

9 4,

287

1,95

7 3,

465

6,05

6 1,

048

6,00

0 1,

926

Was

hing

ton

2,11

1 2,

633

2,88

1 5,

068

2,12

9 97

6 1,

933

2,61

3 2,

439

3,42

2 11

,009

12

,113

7,02

7 4,

467

6,10

2 10

,220

1,

899

10,8

06

2,47

9 W

ayne

2,

238

2,76

5 2,

367

4,26

2 2,

801

1,

459

2,40

5 2,

673

1,40

0 1,

422

9,43

4 2,

967

6,31

5 2,

784

5,38

6 6,

868

1,19

8 11

,780

1,

456

Web

ster

2,

304

2,85

4 2,

948

2,57

8 2,

670

1,

188

3,34

2 2,

352

4,18

7 4,

068

10,4

78

2,

328

3,46

0 5,

024

11,0

70

10

,001

2,

598

Whe

eler

1,

900

1,29

0 1,

644

3,62

0 1,

409

4,02

2

10,7

96

1,50

2 4,

477

5,75

5

4,28

5

Yor

k 1,

844

1,96

5 2,

155

2,59

6 1,

914

1,04

4 1,

242

2,44

7 2,

489

5,75

3 1,

002

8,63

6

5,87

1 2,

613

4,04

9 7,

567

727

7,64

3 2,

584

Cou

nty

Not

R

epor

ted

2,05

3 3,

155

5,61

4

11

,588

6,10

8

6,30

5

10

,230

NO

TE: A

vera

ge b

illed

cha

rges

in b

old

are

base

d on

five

or f

ewer

pro

cedu

res

12

10

Tabl

e 5.

Ave

rage

bill

ed c

harg

e (i

n do

llars

) fo

r th

e tw

enty

mos

t fre

quen

t out

patie

nt s

urgi

cal p

roce

dure

s pe

rfor

med

at N

ebra

ska

hosp

itals

and

am

bula

tory

sur

gica

l ce

nter

s, b

y pa

tient

sta

te o

f res

iden

ce, n

on-N

ebra

ska

resi

dent

s on

ly, 2

011

St

ate

of

Res

iden

ce

Typ

e of

Pro

cedu

re (f

or k

ey to

pro

cedu

re c

odes

, see

foot

note

at e

nd o

f tab

le)

A

B

C

D

E

F G

H

I

J K

L

M

N

O

P

Q

R

S T

A

laba

ma

4,25

5 1,

700

19,1

95

A

lask

a

2,

700

1,24

3 A

rizon

a 4,

417

1,15

2 2,

611

4,25

4

4,53

2 2,

622

2,

075

19,1

81

5,

157

3,79

0

Ark

ansa

s

7,44

0 4,

899

2,

980

3,

185

11

,290

Cal

iforn

ia

1,10

0 4,

838

4,51

6

1,55

0 91

4 1,

087

92

1

9,54

7

7,11

0

Col

orad

o 2,

205

3,98

5 3,

142

4,06

7 2,

871

736

2,

376

953

5,23

7

15,9

61

4,

444

5,08

6

8,17

5

19,7

01

C

onne

ctic

ut

Del

awar

e

D

istri

ct o

f C

olum

bia

Flor

ida

3,46

8 2,

657

1,59

7 1,

700

79

5 97

5 6,

526

2,27

9

8,

386

7,78

0

Geo

rgia

1,

014

5,

781

855

7,

292

Haw

aii

73

6

Id

aho

2,38

6

953

736

Illin

ois

2,65

7 3,

268

2,46

9

3,17

0

7,

859

8,46

8

13,3

18

In

dian

a

8,

223

Io

wa

2,30

1 2,

762

3,31

2 3,

037

2,95

6 1,

124

2,07

2 3,

743

2,81

4 6,

880

6,81

2 13

,833

1,

403

9,57

3 6,

048

6,55

1 12

,405

3,

167

18,8

69

2,45

0 K

ansa

s 1,

820

1,91

5 2,

489

3,07

3 2,

103

3,02

8 93

9 1,

995

2,25

4 3,

492

915

9,75

7

4,41

3 2,

734

4,04

9 5,

243

1,25

5 8,

700

2,33

3 K

entu

cky

2,60

1

2,09

1

Loui

sian

a

4,

442

12,9

42

Mai

ne

Mar

ylan

d

M

assa

chus

etts

6,88

6

17

,522

Mic

higa

n

5,31

7 4,

403

M

inne

sota

1,

164

1,35

0 1,

819

3,

195

825

1,98

1

16

,209

9,17

5

2,21

4

M

issi

ssip

pi

4,69

1

Mis

sour

i 2,

368

3,91

5 3,

679

4,30

2 2,

874

1,42

1 1,

744

5,61

7 2,

607

2,

402

10,5

49

8,

705

3,36

5 3,

799

10,5

50

330

20,7

17

2,13

1 M

onta

na

10,9

83

5,

066

1,

908

10,9

00

2,

405

Nev

ada

1,55

0

1,55

0

30

,521

10

,230

2,

157

New

H

amps

hire

13

11

Stat

e of

R

esid

ence

T

ype

of P

roce

dure

(for

key

to p

roce

dure

cod

es, s

ee fo

otno

te a

t end

of t

able

) A

B

C

D

E

F

G

H

I J

K

L

M

N

O

P Q

R

S

T

New

Jers

ey

2,

000

73

6

N

ew M

exic

o

5,

719

5,

682

15,7

70

1,

163

New

Yor

k

95

3 1,

700

4,56

0

1,

959

Nor

th

Car

olin

a

1,35

0 3,

211

95

3

10

,763

2,

500

14

,886

Nor

th D

akot

a 1,

350

1,35

0 5,

278

O

hio

95

3 95

3

1,

163

Okl

ahom

a 3,

563

5,57

6 5,

356

3,

403

O

rego

n 1,

400

95

3

1,35

0

712

4,

192

1,17

9

Pe

nnsy

lvan

ia

3,21

4 95

3

3,00

0 1,

350

1,

853

R

hode

Isla

nd

Sout

h C

arol

ina

953

13

,814

Sout

h D

akot

a 2,

470

2,81

1 3,

657

3,19

8 2,

094

813

1,15

3 1,

910

3,06

2 9,

491

633

8,63

6 2,

569

9,61

4 2,

027

14

,869

18,9

08

2,39

5 Te

nnes

see

2,19

9

2,99

8 17

,835

18,3

18

3,

186

Texa

s 2,

207

2,12

6 7,

773

2,47

9 3,

549

868

975

2,

138

3,39

7

U

tah

1,

350

4,62

4

Virg

inia

2,

479

1,

100

914

1,47

5

Was

hing

ton

2,

590

4,

125

826

2,

800

4,45

6

W

est V

irgin

ia

1,35

0

5,

303

Wis

cons

in

2,79

6 2,

000

5,

797

Wyo

min

g 1,

854

2,99

7 3,

499

2,

676

3,

764

3,42

9 1,

713

6,33

1

14,9

51

9,

315

5,22

0 4,

032

7,52

7 1,

424

19,3

47

U

nkno

wn

2,21

6

NO

TE: A

vera

ge b

illed

cha

rges

in b

old

are

base

d on

five

or f

ewer

pro

cedu

res

A: D

iagn

ostic

col

onos

copy

B

: Col

onos

copy

, with

bio

psy

C: U

pper

gas

troin

test

inal

end

osco

py, w

ith b

iops

y D

: Cat

arac

t sur

gery

with

inse

rtion

of i

ntra

ocul

ar le

ns (o

ne st

age

proc

edur

e)

E: L

esio

n re

mov

al c

olon

osco

py, b

y sn

are

tech

niqu

e F:

Cys

tosc

opy

G: I

njec

tion(

s) o

f dia

gnos

tic o

r oth

er su

bsta

nces

, epi

dura

l or s

ubar

achn

oid;

lum

bar o

r sac

ral (

caud

al)

H: C

reat

e ea

rdru

m o

peni

ng

I: U

pper

gas

troin

test

inal

end

osco

py, d

iagn

ostic

12

J: D

enta

l sur

gery

pro

cedu

re (u

nlis

ted

proc

edur

e, d

ento

alve

olar

stru

ctur

es)

K: D

ebrid

e sk

in, s

ubcu

tane

ous t

issu

e L:

Lap

aros

copi

c ch

olec

yste

ctom

y M

: Abd

omin

al ly

mph

aden

ecto

my,

regi

onal

N

: Kne

e ar

thro

scop

y/su

rger

y O

: Car

pal T

unne

l sur

gery

P:

Rem

ove

tons

ils a

nd a

deno

ids

Q: I

nser

tion

of c

entra

l ven

ous a

cces

s dev

ices

with

subc

utan

eous

por

t R

: Inj

ectio

n, a

nest

hetic

age

nt a

nd/o

r ste

roid

, tra

nsfo

ram

inal

epi

dura

l; lu

mba

r or s

acra

l, si

ngle

leve

l S:

Lith

otrip

sy, e

xtra

corp

orea

l sho

ck w

ave

T: L

esio

n re

mov

al c

olon

osco

py, b

y ho

t bio

psy

forc

eps o

r bip

olar

cau

tery

14

15

Appendix A: Legislation

1516

16

Cher

ryHo

lt

Cust

er

Siou

x

Linc

oln

Sher

idan

Gard

en

Knox

Keith

Rock

Daw

es

Mor

rill

Brow

n

Gage

Chas

eCl

ay

Hall

Dund

y

Gran

t

Buffa

loYo

rk

Ceda

r

Daw

son

Kim

ball

Cass

Oto

e

Fron

tier

Haye

s

Chey

enne

Perk

ins

Plat

te

Loup

Blai

neBu

rt

Box

Butt

e

Arth

ur

Boyd

Boon

e

Bann

er

Polk

Furn

as

Hook

er

Salin

e

Butle

r

Loga

n

Pier

ce

Valle

y

Ante

lope

Thom

as

Lanc

aste

r

Dixo

n

Adam

s

Harla

nTh

ayer

Phel

ps

Dodg

e

Saun

ders

Cum

ing

Sew

ard

McP

hers

on

Deue

l

Keya

Pah

a

Gree

ley

How

ard

Hitc

hcoc

k

Fillm

ore

Garf

ield

Nan

ce

Fran

klin

Web

ster

Colfa

x

Nuc

kolls

Whe

eler

Mad

ison

Gosp

er

Scot

ts B

luff

Jeffe

rson

Sher

man

Kear

ney

Way

ne

Mer

rick

Red

Will

ow

Ham

ilton

Paw

nee

Stan

ton

Rich

ards

on

Nem

aha

John

son

Thur

ston

Doug

las

Sarp

y

Dako

ta

Was

hing

ton

Ap

pen

dix

B.

Reg

ion

s o

f S

ervi

ceN

ebra

ska

Ou

tpat

ien

t S

urg

ical

Pro

ced

ure

s D

atab

ase

Reg

ion

s

Cen

tral

Eas

t

Nor

th

Sou

thea

st

Wes

t

The Nebraska Department of Health and Human Services is committed to affirmative action/equal opportunity employment and does not discriminate in delivering benefits or services . ADA/EOE/AA

PHA-PB-14 11/11 (34555)