STS General Thoracic Surgery Executive Summary January 2002 June 2016 Procedures All Patients

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1 General Thoracic Surgery January 2002 June 2016 Procedures Table 1: Number of Operations submitted, Discharge Mortality, Operative Mortality, by year Table 2: Discharge and Operative Mortality, by Primary Procedure -- i

2 General Thoracic Surgery Database Period Ending 06/30/2016 Table 1: Number of Operations submitted, discharge mortality, and operative mortality, by year Last Year Last 3 Years All Years Jul Jun 2016 Jul Jun 2016 Jan Jun 2016 Number of Operations 39, , ,587 Discharge Mortality Number of Mortalities 596 1,836 9,337 Number Eligible 39, , ,306 Mortality Percent 1.5% 1.6% 2.1% Operative Mortality Number of Mortalities 749 2,259 11,957 Number Eligible 34, , ,602 Mortality Percent 2.2% 2.2% 3.2% Data Summary -- 1

3 General Thoracic Surgery Database Period Ending 06/30/2016 Table 2: Primary Procedures Discharge Mortality, All Available Records, Jan Jun 2016 PRIMARY PROCEDURES CHEST WALL (v2.07) Chest Wall Biopsy 343 2/ % 343 3/ % Rib Resection (single) 462 4/ % 462 5/ % First/Cervical Rib Resection 165 0/ % 165 0/ % Chest Wall Resection 1,121 11/ % 1,121 16/ % Chest Wall Reconstruction 182 0/ % 182 0/ % Thoracoplasty 46 1/30 3.3% 46 2/28 7.1% Pectus Repair 182 0/ % 182 0/ % Sternectomy, complete 27 1/19 5.3% 27 1/19 5.3% Sternectomy, partial 110 2/85 2.4% 110 2/81 2.5% Muscle Flap 112 4/80 5.0% 112 5/73 6.8% Other Chest Wall Repair 1,534 12/1, % 1,534 15/1, % MEDIASTINUM/NECK (v2.07) Mediastinal LN Biopsy 2,480 13/2, % 2,480 19/1, % Mediastinoscopy 9,965 40/8, % 9,965 79/7, % Anterior Mediastinotom 577 2/ % 577 5/ % Extended Cervical Mediastinoscopy 78 0/70 0.0% 78 0/61 0.0% Mediastinal Lymph Node Dissection 489 2/ % 489 3/ % Mediastinal Lymph Node Sampling 854 8/ % / % Biopsy, Mediastinal Mass / % / % Resection, Mediastinal Mass 1,842 5/1, % 1,842 8/1, % Thymectomy 1,409 1/1, % 1,409 1/1, % Sympathectomy 1,857 4/1, % 1,857 3/1, % Thoracic duct ligation 258 4/ % 258 4/ % Other Mediastinal/Neck procedure 2,060 21/1, % 2,060 42/1, % TRACHEOBRONCHIAL (v2.07) Flexible Bronchoscopy 6, /6, % 6, /5, % Rigid Bronchoscopy 1,442 25/1, % 1,442 35/1, % Removal of Foreign Body (Tracheobronchial) 197 3/ % 197 5/ % Endobronchial ablation, Laser / PDT 1,424 23/1, % 1,424 35/1, % Endobronchial Ablation, Mechanical 348 3/ % 348 7/ % Tracheal/Bronchial Stent 1,091 31/1, % 1,091 56/1, % Discharge and Operative Mortality by Primary Procedure 2

4 General Thoracic Surgery Database Period Ending 06/30/2016 TRACHEOBRONCHIAL (v2.07) - continued Tracheostomy 3, /3, % 3, /2, % Tracheal Repair 107 7/ % 107 7/95 7.4% Tracheal Stricture Resection 378 2/ % 378 2/ % Tracheal Tumor Resection 116 0/ % 116 0/ % Carinal Resection (no lung resection) 11 0/10 0.0% 11 0/10 0.0% Bronchotomy 10 0/10 0.0% 10 0/8 0.0% Bronchial Repair 121 6/ % 121 8/ % Bronchoplasty 49 1/46 2.2% 49 1/45 2.2% Sleeve Bronchial Resection TE Fistula Repair 91 4/85 4.7% 91 5/81 6.2% Other Tracheobroncial procedure 1,962 26/1, % 1,962 41/1, % PULMONARY (v2.07) Wedge Resection, single 12, /10, % 12, /9, % Wedge Resection, multiple 7, /6, % 7, /6, % Segmentectomy 1,850 21/1, % 1,850 27/1, % Lobectomy 18, /15, % 18, /14, % Sleeve Lobectomy 382 5/ % 382 7/ % Bilobectomy 1,013 25/ % 1,013 32/ % Pneumonectomy, standard 1,130 44/ % 1,130 51/ % Pneumonectomy, Carinal 41 2/36 5.6% 41 1/33 3.0% Completion pneumonectomy / % / % Extrapleural pneumonectomy / % / % Pneumonectomy, intrapericardial 322 8/ % / % Lung Volume Reduction / % / % Bullectomy / repair 1,044 16/ % 1,044 14/ % Hydatid Cyst Resection 2 0/2 0.0% 2 0/2 0.0% Single Lung Transplant / % / % Double Lung Transplant / % / % Lung Donor Harvest 16 4/ % 16 4/ % Other Lung procedure 1,416 60/1, % 1,416 53/1, % ESOPHAGOGASTRIC (v2.07) Esophagoscopy, flexible 4,256 29/4, % 4,256 45/4, % Esophagoscopy, rigid 91 1/87 1.1% 91 3/86 3.5% Discharge and Operative Mortality by Primary Procedure -- 3

5 General Thoracic Surgery Database Period Ending 06/30/2016 ESOPHAGOGASTRIC (v2.07) - continued Removal of Foreign Body (Esophagogastric) 163 1/ % 163 4/ % Dilation of Esophagus 3,523 15/3, % 3,523 37/3, % Esophageal Tumor Ablation, Laser / PDT 235 1/ % 235 4/ % Stent Placement / % / % Cervical esophagostomy 81 6/66 9.1% 81 7/ % Anterior Thoracic Esophagostomy 10 0/5 0.0% 10 0/5 0.0% Zenker's Diverticulum Repair 231 1/ % 231 1/ % Myotomy, cricopharyngeal 66 0/54 0.0% 66 0/52 0.0% Myotomy, esophageal (long) 209 0/ % 209 0/ % Myotomy, cardia (short) 494 0/ % 494 1/ % Resection, intrathoracic diverticulum 85 1/75 1.3% 85 1/70 1.4% Resection, esophagus (esophagectomy) 4, /3, % 4, /3, % Resection, esophageal wall leasion 102 1/89 1.1% 102 0/81 0.0% Repair, perforation of esophagus - Iatrogenic 146 6/ % 146 8/ % Repair, perforation of esophagus - Malignant 5 0/4 0.0% 5 0/4 0.0% Repair, perforation of esophagus - Other / % / % Fundoplication, circumferentia 1,448 6/1, % 1,448 8/1, % Fundoplication, partial 418 3/ % 418 4/ % Gastroplasty 162 0/ % 162 1/ % Pyloroplasty 18 0/16 0.0% 18 0/16 0.0% Pyloromyotomy 8 0/8 0.0% 8 0/8 0.0% Gastrectomy 209 8/ % 209 7/ % Gastrostomy / % / % Jejunostomy / % / % Conduit, gastric 34 1/27 3.7% 34 2/27 7.4% Conduit, colon 26 0/24 0.0% 26 0/23 0.0% Conduit, jejunum 4 0/4 0.0% 4 0/4 0.0% Conduit, other 2 0/2 0.0% 2 0/2 0.0% Anastomosis, neck 16 2/ % 16 2/ % Anastomosis, Chest 7 0/5 0.0% 7 0/5 0.0% Other Esophageal procedure / % / % Other GI procedure / % / % CARDIAC/PERICARDIUM/GREAT VESSELS (v2.07) Pericardial Window 2, /2, % 2, /1, % Discharge and Operative Mortality by Primary Procedure -- 4

6 General Thoracic Surgery Database Period Ending 06/30/2016 CARDIAC/PERICARDIUM/GREAT VESSELS (v2.07) - continued Pericardiectomy 210 7/ % 210 9/ % Repair Cardiac Laceration 33 5/ % 33 5/ % Other Pericardial Procedure 356 9/ % / % Repair / Reconstruction, thoracic aorta 142 7/ % 142 6/95 6.3% Repair / Reconstruction, abd aorta / % 371 1/28 3.6% Repair / Reconstruction, SVC 16 0/12 0.0% 16 0/12 0.0% Repair / Reconstruction, IVC 16 3/ % 16 3/ % Repair / Reconstruction, pulmonary artery 26 6/ % 26 6/ % Repair / Reconstruction, pulmonary vein(s) 5 1/5 20.0% 5 1/5 20.0% Repair / Reconstruction, left atrium 6 0/6 0.0% 6 1/6 16.7% Repair / Reconstruction, Subclavian Artery 20 2/ % 20 2/ % Cardiopulmonary Bypass 15 1/13 7.7% 15 0/7 0.0% Other Cardiac procedure / % / % DIAPHRAGM (v2.07) Plication of Diaphragm 191 2/ % 191 2/ % Diaphragmatic Hernia Repair, acute 122 3/99 3.0% 122 4/95 4.2% Diaphragmatic Hernia Repair, chronic 456 4/ % 456 3/ % Resection of Diaphragm 50 2/42 4.8% 50 2/40 5.0% Reconstruction of Diaphragm 43 0/32 0.0% 43 0/30 0.0% Other Diaphragm procedure 107 1/76 1.3% 107 1/70 1.4% PLEURA (v2.07) Pleural Drainage Procedure - Open 2, /2, % 2, /2, % Pleural Drainage Procedure - Closed 2, /1, % 2, /1, % Pleural Biopsy 2,022 39/1, % 2,022 73/1, % Pleurodesis 4, /3, % 4, /3, % Pleurectomy / % / % Decortication 5, /4, % 5, /4, % Clagett Procedure 140 3/ % 140 7/ % Other Pleural procedure / % / % AIR LEAK CONTROL MEASURES (v2.07) Fibrin Glue 16 0/15 0.0% 16 0/15 0.0% Pericardial Strips 13 1/ % 13 0/8 0.0% Discharge and Operative Mortality by Primary Procedure -- 5

7 General Thoracic Surgery Database Period Ending 06/30/2016 AIR LEAK CONTROL MEASURES (v2.07) - continued Lung Sealant 15 0/11 0.0% 15 0/9 0.0% Pleural Tent 16 0/14 0.0% 16 0/11 0.0% Other Air Leak Control Measures 79 1/63 1.6% 79 1/54 1.9% TRACHEA, BRONCHI AND LARYNX (v2.081, v2.2 and v2.3) Tracheostomy, planned (31600) v2.2, v /34 5.9% 34 2/33 6.1% Rigid Stent Removal v /3 0.0% 3 0/3 0.0% Tracheostomy replacement (tube change) prior to est. of fistula tract (31502) v /3 66.7% 3 2/3 66.7% Unlisted procedure, trachea, bronchi (31899) v , /2, % 2, /1, % Tracheostomy revision simple, without flap (31613) v2.3 Bronchogenic cyst removal v /8 0.0% 8 0/6 0.0% Tracheal stenosis excision and anastomosis; cervicothoracic (31781) 115 1/ % 115 2/94 2.1% Bronchial laceration suture v /1 0.0% 1 0/1 0.0% Tracheal tumor or carcinoma excision; cervical (31785) 121 1/ % 121 1/ % Bronchial sleeve resection v /18 0.0% 18 0/18 0.0% Tracheal tumor or carcinoma excision; thoracic (31786) 121 1/ % 121 2/ % Bronchoplasty, graft repair (31770) v /3 0.0% 3 0/3 0.0% Tracheal wound or injury suture repair; cervical (31800) 42 3/41 7.3% 42 2/35 5.7% Bronchoplasty; excision stenosis and anastomosis (31775) 75 2/60 3.3% 75 3/57 5.3% Tracheal wound or injury suture repair; intrathoracic (31805) 72 5/71 7.0% 72 4/64 6.3% Bronchopleural fistula closure (32906) v /39 2.6% 39 0/37 0.0% Tracheoplasty; cervical (31750) 227 8/ % / % Carinal reconstruction (31766) 22 1/21 4.8% 22 1/19 5.3% Tracheoplasty; intrathoracic (31760) 191 6/ % 191 7/ % Laryngectomy, partial (31370) v2.2, v /4 0.0% 4 0/3 0.0% Tracheostomy revision complex, with flap (31614) v /5 20.0% 5 2/5 40.0% Tracheal stenosis excision and anastomosis; cervical (31780) 684 3/ % 684 7/ % Tracheostomy mediastinal v /5 0.0% 5 0/4 0.0% BRONCHOSCOPY (v2.081, v2.2, v2.3) Bronchoscopy, diagnostic, with or without cell washing (31622) 4,501 90/4, % 4, /2, % Bronchoscopy, each additional major bronchus stented (31637) 13 1/12 8.3% 13 1/6 16.7% Bronchoscopy, navigational (31627) v2.2, v /28 3.6% 28 2/24 8.3% Bronchoscopy, with bronchial alveolar lavage (BAL) (31624) / % / % Discharge and Operative Mortality by Primary Procedure -- 6

8 General Thoracic Surgery Database Period Ending 06/30/2016 BRONCHOSCOPY (v2.081, v2.2, v2.3) - continued Bronchoscopy, with bronchial or endobronchial biopsy(s), single or multiple sites (31625) 1,579 24/1, % 1,579 33/ % Bronchoscopy, with brushing or protected brushings (31623) 327 3/ % 327 3/90 3.3% Bronchoscopy, with destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy) (31641) 1,738 36/1, % 1,738 70/ % Bronchoscopy, with excision of tumor (31640) / % / % Bronchoscopy, with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus (31636) / % / % Bronchoscopy, with placement of catheter(s) for intracavitary radioelement application (31643) 64 1/64 1.6% 64 1/13 7.7% Bronchoscopy, with placement of Fiducial markers (31626) v2.2, v /1 0.0% 1 0/1 0.0% Bronchoscopy, with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required) (31631) / % / % Bronchoscopy, with removal of foreign body (31635) / % / % Bronchoscopy, with revision of tracheal or bronchial stent inserted at previous session (31638) 266 1/ % 266 4/ % Bronchoscopy, with therapeutic aspiration of tracheobronchial tree, initial (drainage of lung abscess) (31645) 162 2/ % 162 4/90 4.4% Bronchoscopy, with therapeutic aspiration of tracheobronchial tree, subsequent (31646) 43 1/42 2.4% 43 1/37 2.7% Bronchoscopy, with tracheal/bronchial dilation or closed reduction of fracture (31630) 1,566 8/1, % 1,566 14/ % Bronchoscopy, with transbronchial lung biopsy(s), each additional lobe (31632) 54 1/52 1.9% 54 1/15 6.7% Bronchoscopy, with transbronchial lung biopsy(s), single lobe (31628) 597 4/ % 597 8/ % Bronchoscopy, with transbronchial needle aspiration biopsy(s) (31629) 1,362 3/1, % 1,362 7/ % Bronchoscopy, with transbronchial needle aspiration biopsy(s), each additional lobe (31633) 161 1/ % 161 1/20 5.0% Endobronchial ultrasound (EBUS) during bronchoscopy diagnostic or therapeutic intervention(s) (31620) 1,505 5/1, % 1,505 11/ % Tracheobronchoscopy through established tracheostomy incision (31615) 128 4/ % 128 5/78 6.4% PLEURAL SPACE AND LUNG (v2.081, v2.2 and v2.3) Thoracoscopy, diagnostic lungs and pleural space, without biopsy (32601) 1,513 46/1, % 1,513 82/1, % Thoracoscopy, surgical; with pleurodesis (e.g., mechanical or chemical) (32650) 6, /5, % 6, /5, % Discharge and Operative Mortality by Primary Procedure -- 7

9 General Thoracic Surgery Database Period Ending 06/30/2016 PLEURAL SPACE AND LUNG (v2.081, v2.2 and v2.3) - continued Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit (32653) / % / % Thoracoscopy, diagnostic: with biopsy(ies) of lung infiltrate(s) (eg wedge), unilateral (32607) v2.2, v / % / % Thoracoscopy, diagnostic: with biopsy(ies) of lung nodule(s) or mass(es) (eg incisional), unilateral (32608) v2.2, v / % 286 6/ % Thoracoscopy, diagnostic: with biopsy(ies) of pleura (32609) v2.2, v / % 139 7/ % Thoracostomy; with rib resection for empyema (32035) / % / % Thoracostomy; with open flap drainage for empyema (32036) / % / % Thoracotomy with biopsy(ies) lung infiltrate(s) (eg wedge), unilateral (32096) 120 9/ % 120 8/96 8.3% Thoracotomy with biopsy(ies) lung nodule(s) or masses (eg incisional), unilateral (32097) 77 2/75 2.7% 77 2/62 3.2% Thoracotomy with biopsy(ies) of pleura (32098) 56 1/55 1.8% 56 3/43 7.0% Thoracotomy with cardiac massage (32160) 10 5/9 55.6% 10 4/7 57.1% Pleural scarification for repeat pneumothorax (32215) 97 4/68 5.9% 97 3/62 4.8% Insertion indwelling tunneled pleural catheter (32550) 3, /2, % 3, /2, % Repair lung hernia through chest wall (32800) 93 0/89 0.0% 93 0/81 0.0% Closure of chest wall following open flap drainage for empyema (Clagett type procedure) (32810) 125 2/ % 125 3/ % Total lung lavage (for alveolar proteinosis) (32997) 65 0/65 0.0% 65 1/43 2.3% Radio-frequency ablation (RFA) lung tumor (32998) 115 0/ % 115 1/87 1.1% Unlisted procedure, lung (32999) / % / % Thoracoscopy, surgical; with partial pulmonary decortication (32651) 6, /6, % 6, /5, % Thoracoscopy, surgical; with total pulmonary decortication (32652) 11, /10, % 11, /9, % Thoracoscopy, surgical; with control of traumatic hemorrhage (32654) / % / % Thoracoscopy, surgical; with excision-plication of bullae, including any pleural procedure (32655) 6,291 49/6, % 6,291 60/5, % Thoracoscopy, surgical; with parietal pleurectomy (32656) 1,682 30/1, % 1,682 61/1, % Thoracoscopy, surgical; with lobectomy (32663) 38, /37, % 38, /33, % Thoracoscopy with therapeutic wedge resection (eg mass or nodule, initial, unilateral (32666) v2.2, v2.3 22, /21, % 22, /19, % Thoracoscopy with therapeutic wedge resection(eg mass or nodule) each additional resection, ipsilateral (32667) v2.2, v2.3 1,327 14/1, % 1,327 18/1, % Thoracoscopy with diagnostic wedge resection followed by anatomic lung resection (32668) v2.2, v / % / % Discharge and Operative Mortality by Primary Procedure -- 8

10 General Thoracic Surgery Database Period Ending 06/30/2016 PLEURAL SPACE AND LUNG - continued Thoracoscopy with removal of a single lung segment (segmentectomy) (32669) v2.2, v2.3 3,722 17/3, % 3,722 21/3, % Thoracoscopy with removal of two lobes (bilobectomy) (32670) v2.2, v / % / % Thoracoscopy with removal of lung, pneumonectomy (32671) v2.2, v / % 232 9/ % Thoracoscopy with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction- LVRS, unilateral including any pleural procedure (32672) v2.2, v / % 462 8/ % Thoracotomy with therapeutic wedge resection (eg mass nodule) initial (32505) v2.2, v2.3 3,916 42/3, % 3,916 54/3, % Thoracotomy with therapeutic wedge resection (eg mass nodule) each additional resection, ipsilateral (+32506) v2.2, v / % / % Thoracotomy with diagnostic wedge resection followed by anatomic lung resection (+32507) v2.2, v / % 209 4/ % Thoracotomy, limited, for biopsy of lung or pleura (i.e.; open lung biopsy) (32095) v / % / % Thoracotomy, with exploration (32100) 2, /2, % 2, /2, % Thoracotomy, major; with control of traumatic hemorrhage and/or repair of lung tear (32110) / % / % Thoracotomy, major; for postoperative complications (32120) 1,317 41/1, % 1,317 37/1, % Thoracotomy, major; with cyst(s) removal, with or without a pleural procedure (32140) 248 0/ % 248 0/ % Thoracotomy, major; with excision-plication of bullae, with or without any pleural procedure (32141) / % / % Thoracotomy, major; with removal of intrapleural foreign body or hematoma (32150) / % / % Thoracotomy with open intrapleural pneumolysis (32124) v /46 8.7% 46 2/40 5.0% Decortication, pulmonary, total (32220) 7, /6, % 7, /5, % Decortication, pulmonary, partial (32225) 2,126 84/2, % 2,126 90/1, % Pleurectomy, parietal (32310) 386 8/ % / % Decortication and parietal pleurectomy (32320) 1,572 55/1, % 1,572 65/1, % Thoracotomy, with biopsy of pleura (32098) (v2.081, v2.2) 127 4/ % 127 9/ % Removal of lung, total pneumonectomy; (32440) 3, /3, % 3, /2, % Removal of lung, sleeve (carinal) pneumonectomy (32442) 114 5/ % 114 6/98 6.1% Removal of lung, total pneumonectomy; extrapleural (32445) / % / % Removal of lung, single lobe (lobectomy) (32480) 27, /26, % 27, /23, % Discharge and Operative Mortality by Primary Procedure -- 9

11 General Thoracic Surgery Database Period Ending 06/30/2016 PLEURAL SPACE AND LUNG - continued Removal of lung, two lobes (bilobectomy) (32482) 2,494 70/2, % 2,494 87/2, % Removal of lung, single segment (segmentectomy) (32484) 2,552 27/2, % 2,552 38/2, % Removal of lung, sleeve lobectomy (32486) 1,334 13/1, % 1,334 17/1, % Removal of lung, completion pneumonectomy (32488) / % / % Removal of lung, excision-plication of emphysematous lung(s) for lung volume reduction (LVRS) (32491) / % / % Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (32501) 51 1/51 2.0% 51 1/46 2.2% Resection of apical lung tumor (e.g., Pancoast tumor), including chest wall resection, without chest wall reconstruction(s) (32503) 389 5/ % / % Resection of apical lung tumor (e.g., Pancoast tumor), including chest wall resection, with chest wall reconstruction (32504) 264 4/ % 264 6/ % Removal of lung, wedge resection, single or multiple(32500) v , /3, % 4, /3, % Extrapleural enucleation of empyema(empyemectomy) (32540) v / % 129 5/ % Thoracoscopy, diagnostic lungs and pleural space, with biopsy (32602) v , /4, % 4, /3, % Thoracoscopy, diagnostic pericardial sac, without biopsy (32603) v /18 0.0% 23 0/15 0.0% Thoracoscopy, surgical; with wedge resection of lung, single or multiple (32657) v , /16, % 17, /15, % LUNG OTHER (v2.081, v2.2 and v2.3) Open closure of major bronchial fistula (32815) / % / % Thoracoplasty with closure of bronchopleural fistula (32906) / % / % Single lung transplant (32851) / % / % Single lung transplant with CPB (32852) / % / % Double lung transplant (32853) 1,472 38/1, % 1,472 35/1, % Double lung transplant with CPB (32854) 1, /1, % 1, /1, % MEDIASTINUM AND DIAPHRAGM (v2.081, v2.2 and v2.3) Thoracoscopy, diagnostic; mediastinal space, with biopsy (32606) 873 9/ % / % Mediastinotomy with exploration or biopsy; cervical approach (39000) 1,110 4/ % 1,110 6/ % Mediastinotomy with exploration or biopsy; transthoracic approach (39010) 779 8/ % / % Mediastinoscopy, with or without biopsy (39400) 10,529 41/9, % 10,529 62/1, % Unlisted procedure, mediastinum (39499) 566 8/ % 566 9/ % Unlisted procedure, diaphragm (39599) 730 9/ % / % Discharge and Operative Mortality by Primary Procedure -- 10

12 General Thoracic Surgery Database Period Ending 06/30/2016 MEDIASTINUM AND DIAPHRAGM (v2.081, v2.2 and v2.3) - continued Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass (32662) 3,605 10/3, % 3,605 14/3, % Thoracoscopy, diagnostic mediastinal space, without biopsy (32605) v /69 2.9% 74 3/60 5.0% Thoracoscopy with mediastinal and regional lymphadectomy (+32674) v2.2, v / % 325 0/ % Thoracic lymphadenectomy, regional, including mediastinal and peritracheal nodes (38746) 886 3/ % 886 4/ % Mediastinal cyst, excision, open, Transthoracic approach (39200) 527 4/ % 527 6/ % Mediastinal tumor, excision, open, Transthoracic approach (39220) 2,626 11/2, % 2,626 20/2, % Thoracoscopy with resection of thymus, unilateral or bilateral (32673) v2.2, v2.3 1,228 2/1, % 1,228 5/1, % Thymectomy, transcervical approach (60520) 430 1/ % 430 3/ % Thymectomy, transthoracic approach (60521) 2,196 4/2, % 2,196 6/1, % Thymectomy, transthoracic approach, with radical mediastinal dissection (60522) 1,067 5/1, % 1,067 5/ % VATS thymectomy (605XX) v / % 402 0/ % Diaphragm, laceration repair, any approach (39501) 142 9/ % 142 9/ % Repair of paraesophageal hiatus hernia, transabdominal with or without fundoplasty (39502) v ,019 9/ % 1,019 17/ % Diaphragmatic hernia repair (other than neonatal), traumatic; acute (39540) 320 2/ % 320 3/ % Diaphragmatic hernia repair (other than neonatal), traumatic; chronic (39541) 791 7/ % 791 6/ % Diaphragm Imbrication (i.e., plication) (39545) 1,326 6/1, % 1,326 8/1, % Diaphragm; resection with simple repair (e.g., primary suture) (39560) 229 3/ % 229 3/ % Diaphragm; resection with complex repair (e.g., prosthetic material, local muscle flap) (39561) 226 3/ % 226 3/ % ESOPHAGOSCOPY (v2.081, v2.2, v2.3) Esophagoscopy (43200) 1,118 22/1, % 1,118 26/ % Esophagoscopy with biopsy (43202) 643 5/ % 643 8/ % Esophagoscopy with removal of foreign body (43215) / % / % Esophagoscopy with insertion of stent (43219) / % / % Esophagoscopy with balloon dilation (43220) 704 3/ % 704 3/ % Esophagoscopy with insertion of guide wire followed by dilation over guide wire (43226) 1,898 1/1, % 1,898 10/ % Esophagoscopy with ablation of tumor (43228) 388 2/ % 388 3/ % Discharge and Operative Mortality by Primary Procedure -- 11

13 General Thoracic Surgery Database Period Ending 06/30/2016 ESOPHAGOSCOPY (v2.081, v2.2, v2.3) - continued Esophagoscopy with endoscopic ultrasound examination (EUS) (43231) 62 1/61 1.6% 62 1/4 25.0% Esophagoscopy with transendoscopic ultrasound-guided fine needle aspiration (43232) 26 0/26 0.0% 26 0/3 0.0% Upper gastrointestinal endoscopy, diagnostic (43235) 1,496 16/1, % 1,496 19/ % Upper gastrointestinal endoscopy with endoscopic ultrasound examination limited to the esophagus (43237) 90 0/89 0.0% 90 0/3 0.0% Upper gastrointestinal endoscopy with transendoscopic ultrasound-guided FNA (43238) 43 0/43 0.0% 43 0/3 0.0% Upper gastrointestinal endoscopy with biopsy (43239) 2,580 3/2, % 2,580 3/ % Upper gastrointestinal endoscopy with dilation of gastric outlet for obstruction (43245) 326 3/ % 326 5/ % Upper gastrointestinal endoscopy with directed placement of percutaneous gastrostomy tube (43246) / % / % Upper gastrointestinal endoscopy with removal of foreign body (43247) 312 5/ % 312 7/ % Upper gastrointestinal endoscopy with insertion of guide wire followed by dilation of esophagus (43248) 3,315 8/3, % 3,315 16/ % Upper gastrointestinal endoscopy with balloon dilation of esophagus (43249) 726 2/ % 726 3/86 3.5% Upper gastrointestinal endoscopy with transendoscopic stent placement (43256) / % / % Upper gastrointestinal endoscopy with ablation of tumor (43258) 359 1/ % 359 4/93 4.3% ESOPHAGUS RESECTION (v2.081, v2.2 and v2.3) Transhiatal-Total esophagectomy, without thoracotomy, with cervical esophagogastrostomy (43107) 3,101 74/3, % 3,101 79/2, % Three hole-total esophagectomy with thoracotomy; with cervical esophagogastrostomy (43112) 1,550 57/1, % 1,550 67/1, % Ivor Lewis-Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision (43117) 4, /4, % 4, /4, % Thoracoabdominal-Partial esophagectomy, thoracoabdominal approach (43122) / % / % Minimally invasive three hole esophagectomy v2.2, v / % / % Minimally invasive esophagectomy, Ivor Lewis approach 2,664 54/2, % 2,664 56/2, % Minimally invasive esophagectomy, Abdominal and neck approach / % / % Total esophagectomy without thoracotomy; with colon interposition or small intestine reconstruction (43108) 74 5/74 6.8% 74 3/67 4.5% Discharge and Operative Mortality by Primary Procedure 12

14 General Thoracic Surgery Database Period Ending 06/30/2016 ESOPHAGUS RESECTION (v2.081, v2.2 and v2.3) - continued Total esophagectomy with thoracotomy; with colon interposition or small intestine reconstruction (43113) 66 5/63 7.9% 66 5/58 8.6% Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis (43116) 16 2/ % 16 2/ % Partial esophagectomy, with thoracotomy and separate abdominal incision with colon interposition or small intestine (43118) 63 5/58 8.6% 63 5/55 9.1% Partial esophagectomy, distal two-thirds, with thoracotomy only (43121) 111 5/ % 111 5/95 5.3% Partial esophagectomy, thoracoabdominal with colon interposition or small intestine (43123) 61 2/57 3.5% 61 2/50 4.0% Total or partial esophagectomy, without reconstruction with cervical esophagostomy (43124) / % / % Conduit revision s/p esophagectomy v /23 4.3% 23 1/21 4.8% ESOPHAGUS OTHER PROCEDURES (v2.081, v2.2 and v2.3) Cricopharyngeal myotomy (43030) 156 0/ % 156 0/ % Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach (43130) 271 3/ % 271 6/ % Esophagostomy, fistulization of esophagus, external; cervical approach (43352) 94 7/90 7.8% 94 8/86 9.3% Closure of esophagostomy or fistula; cervical approach (43420) 58 2/53 3.8% 58 2/41 4.9% Excision esophageal lesion with primary repair, cervical approach (43100) v2.2, v /4 0.0% 4 0/3 0.0% Trans oral fundoplication v2.3 Unlisted laparoscopy, esophagus (43289) v2.2, v / % 141 2/ % Unlisted procedure, esophagus (43499) 1,188 16/1, % 1,188 18/ % Per oral endoscopic myotomy (POEM) v / % 182 0/ % Laparoscopy, surgical with repair of paraesophageal hernia (fundoplasty) without mesh (43281) v2.2, v2.3 4,053 18/4, % 4,053 31/3, % Laparoscopy, surgical with repair of paraesophageal hernia (fundoplasty) with mesh (43282) v2.2, v2.3 2,110 10/2, % 2,110 14/1, % Laparoscopy, surgical, esophageal lengthening procedure (Collis) (43283) Secondary Procedure code v2.2, v /9 0.0% 9 0/8 0.0% Laparoscopy, surgical, esophagogastric fundoplasty (e.g., Nissen, Toupet procedures) (43280) 5,818 11/5, % 5,818 14/5, % Discharge and Operative Mortality by Primary Procedure -- 13

15 General Thoracic Surgery Database Period Ending 06/30/2016 ESOPHAGUS OTHER PROCEDURES (v2.081, v2.2 and v2.3) - continued Laparoscopic esophageal myotomy (Heller Myotomy, with or without fundoplication ) (43279) v2.2, v2.3 2,946 2/2, % 2,946 5/2, % Thoracoscopy, surgical; with esophagomyotomy (Heller type) (32665) - v / % 200 2/ % Nissen fundoplasty- laparotomy (includes partial fundoplication/ wrap) (43327) v2.2, v / % 217 2/ % Transthoracic Fundoplication- open thoracotomy (includes Belsey/ Nissen) (43328) v2.2, v / % 316 4/ % Repair, paraesophageal hiatal hernia via laparotomy without mesh (43332) v2.2, v / % 622 8/ % Repair, paraesophageal hiatal hernia via laparotomy with mesh (43333) v2.2, v / % 128 1/ % Repair, paraesophageal hiatal hernia via thoracotomy without mesh (43334) v2.2, v / % 608 6/ % Repair, paraesophageal hiatal hernia via thoracotomy with mesh 155 1/ % 155 1/ % (43335) v2.2, v / % 155 1/ % Repair, paraesophageal hiatal hernia via thoracoabdominal approach without mesh (43336) v2.2, v /90 3.3% 90 3/72 4.2% Repair, paraesophageal hiatal hernia via thoracoabdominal approach with mesh (43337) v2.2, v /34 0.0% 34 0/29 0.0% Esophageal lengthening procedure - open (Collis) Secondary Procedure code (43338) v2.2, v /11 0.0% 11 0/10 0.0% Diverticulectomy of esophagus, with or without myotomy; thoracic approach (43135) 462 5/ % 462 9/ % Excision Esophageal lesion with primary repair, thoracic approach (eg: leiomyoma) (43101) v2.2, v / % 237 0/ % Esophagoplasty with repair of TEF, cervical approach (43305) v2.2, v /45 6.7% 46 5/ % Esophagoplasty with repair TEF, thoracic approach (43312) v2.2, v /85 5.9% 86 4/75 5.3% Esophagomyotomy (Heller type); thoracic approach (43331) v2.2, v / % 121 2/ % Esophagogastric fundoplasty (e.g., Nissen, Belsey IV,Hill procedures) (43324) v / % 693 3/ % Esophagogastric fundoplasty; with gastroplasty (e.g.,collis) (43326) v / % 569 5/ % Esophagomyotomy (Heller type); thoracic approach (43331) v / % 284 6/ % Gastrointestinal reconstruction for previous esophagectomy with stomach (43360) 175 2/ % 175 2/ % Gastrointestinal reconstruction for previous esophagectomy with colon interposition or small intestine (43361) 184 8/ % 184 7/ % Discharge and Operative Mortality by Primary Procedure -- 14

16 General Thoracic Surgery Database Period Ending 06/30/2016 ESOPHAGUS OTHER PROCEDURES (v2.081, v2.2 and v2.3) - continued Ligation or stapling at gastroesophageal junction for esophageal perforation (43405) / % / % Suture of esophageal wound or injury; cervical approach (43410) / % / % Suture of esophageal wound or injury; transthoracic or transabdominal approach (43415) / % / % Free jejunum transfer with microvascular anastomosis (43496) 9 0/9 0.0% 9 0/9 0.0% Total gastrectomy with esophagoenterostomy (43620) 51 3/50 6.0% 51 4/43 9.3% Total gastrectomy with Roux-en-Y reconstruction (43621) 514 9/ % / % CHEST WALL AND NECK (v2.081, v2,2 and v2.3) Excision tumor, soft tissue of neck or thorax; subcutaneous (21555) 237 2/ % 237 2/72 2.8% Excision tumor, soft tissue of neck or thorax; deep, subfascial, intramuscular (21556) 396 1/ % 396 6/ % Excision of rib, partial (21600) 377 3/ % 377 3/ % Excision first and/or cervical rib (21615) 317 0/ % 317 0/ % Excision first and/or cervical rib; with sympathectomy (21616) 18 0/17 0.0% 18 0/7 0.0% Division of scalenus anticus; without resection of cervical rib (21700) 7 0/7 0.0% 7 0/5 0.0% Division of scalenus anticus; with resection of cervical rib (21705) 31 0/30 0.0% 31 0/26 0.0% Open treatment of sternum fracture with or without skeletal fixation (21825) 93 0/82 0.0% 93 0/72 0.0% Hyoid myotomy and suspension (21685) secondary procedure code 1 0/1 0.0% 1 0/1 0.0% Removal of sternal wire(s) v /2 0.0% 2 0/2 0.0% Unlisted procedure, neck or thorax (21899) 2,885 36/2, % 2,885 51/1, % Major reconstruction, chest wall (posttraumatic) (32820) 213 1/ % 213 2/ % Muscle flap, neck (15732) 36 4/ % 36 3/ % Muscle flap; trunk (i.e., intercostal, pectoralis or serratus muscle) (15734) 329 6/ % 329 9/ % Excision of chest wall tumor including ribs (19260) 877 8/ % / % Excision of chest wall tumor involving ribs, with reconstruction (19271) 1,551 9/1, % 1,551 12/1, % Radical resection of tumor (e.g., malignant neoplasm), soft tissue of neck or thorax (21557) 233 5/ % 233 6/ % Radical resection of sternum (21630) 207 6/ % 207 8/ % Radical resection of sternum; with mediastinal lymphadenectomy (21632) 37 1/37 2.7% 37 1/33 3.0% Reconstructive repair of pectus excavatum or carinatum; open (21740) 664 0/ % 664 2/ % Reconstructive repair of pectus, minimally invasive approach (Nuss procedure), without thoracoscopy (21742) 105 0/ % 105 0/77 0.0% Discharge and Operative Mortality by Primary Procedure -- 15

17 General Thoracic Surgery Database Period Ending 06/30/2016 CHEST WALL AND NECK (v2.081, v2,2 and v2.3) - continued Reconstructive repair of pectus, minimally invasive approach (Nuss procedure), with thoracoscopy (21743) 524 0/ % 524 0/ % MISCELLANEOUS (v2.081, v2,2 and v2.3) Thoracoscopy, diagnostic pericardial sac, with biopsy (32604) 87 0/79 0.0% 87 2/71 2.8% Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac (32658) 82 1/74 1.4% 82 1/71 1.4% Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage (32659) / % / % Tube pericardiostomy (33015) 91 5/65 7.7% 91 8/ % Pericardial window (33025) 3, /2, % 3, /2, % Thoracoscopy, surgical; with thoracic sympathectomy (32664) 984 0/ % 984 1/ % Removal substernal thyroid, cervical approach (60271) 105 0/90 0.0% 105 0/81 0.0% Application of wound vac (97605, 97606) v2.2, v /19 0.0% 19 0/18 0.0% Stereotactic radiosurgery (SRS) and stereotacitic body radiotherapy (SBRT) surgeon participation (32701) v2.2, v2.3 Other Minor Procedure v2.2, v /33 3.0% 33 2/32 6.3% Thoracoscopy, surgical; with total pericardiectomy (32660) 88 5/86 5.8% 88 4/74 5.4% Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass (32661) 319 1/ % 319 2/ % Ligation thoracic duct (38381) 832 8/ % / % Intraoperative jejunostomy (44015) 1,113 40/1, % 1,113 71/ % Omental flap (49904) 50 7/ % 50 6/ % Transthoracic thyroidectomy (60270) 169 3/ % 169 3/ % SVC resection and reconstruction (34502) 26 0/23 0.0% 26 0/20 0.0% Other 6, /6, % 6, /4, % MISSING DATA [Missing data] 3,958 29/1, % 3,958 34/1, % Discharge and Operative Mortality by Primary Procedure -- 16

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