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
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 2015 - Jun 2016 Jul 2013 - Jun 2016 Jan 2002 - Jun 2016 Number of Operations 39,272 115,239 476,587 Discharge Mortality Number of Mortalities 596 1,836 9,337 Number Eligible 39,272 115,239 441,306 Mortality Percent 1.5% 1.6% 2.1% Operative Mortality Number of Mortalities 749 2,259 11,957 Number Eligible 34,768 100,965 369,602 Mortality Percent 2.2% 2.2% 3.2% Data Summary -- 1
General Thoracic Surgery Database Period Ending 06/30/2016 Table 2: Primary Procedures Discharge Mortality, All Available Records, Jan 2002 - Jun 2016 PRIMARY PROCEDURES CHEST WALL (v2.07) Chest Wall Biopsy 343 2/288 0.7% 343 3/269 1.1% Rib Resection (single) 462 4/399 1.0% 462 5/379 1.3% First/Cervical Rib Resection 165 0/152 0.0% 165 0/150 0.0% Chest Wall Resection 1,121 11/974 1.1% 1,121 16/933 1.7% Chest Wall Reconstruction 182 0/161 0.0% 182 0/154 0.0% Thoracoplasty 46 1/30 3.3% 46 2/28 7.1% Pectus Repair 182 0/149 0.0% 182 0/141 0.0% 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 12/1,094 1.1% 1,534 15/1,041 1.4% MEDIASTINUM/NECK (v2.07) Mediastinal LN Biopsy 2,480 13/2,076 0.6% 2,480 19/1,842 1.0% Mediastinoscopy 9,965 40/8,328 0.5% 9,965 79/7,969 1.0% Anterior Mediastinotom 577 2/485 0.4% 577 5/464 1.1% Extended Cervical Mediastinoscopy 78 0/70 0.0% 78 0/61 0.0% Mediastinal Lymph Node Dissection 489 2/430 0.5% 489 3/406 0.7% Mediastinal Lymph Node Sampling 854 8/759 1.1% 854 12/744 1.6% Biopsy, Mediastinal Mass 849 11/702 1.6% 849 10/624 1.6% Resection, Mediastinal Mass 1,842 5/1,554 0.3% 1,842 8/1,471 0.5% Thymectomy 1,409 1/1,226 0.1% 1,409 1/1,147 0.1% Sympathectomy 1,857 4/1,379 0.3% 1,857 3/1,333 0.2% Thoracic duct ligation 258 4/232 1.7% 258 4/217 1.8% Other Mediastinal/Neck procedure 2,060 21/1,549 1.4% 2,060 42/1,510 2.8% TRACHEOBRONCHIAL (v2.07) Flexible Bronchoscopy 6,416 113/6,015 1.9% 6,416 169/5,883 2.9% Rigid Bronchoscopy 1,442 25/1,402 1.8% 1,442 35/1,376 2.5% Removal of Foreign Body (Tracheobronchial) 197 3/182 1.6% 197 5/180 2.8% Endobronchial ablation, Laser / PDT 1,424 23/1,364 1.7% 1,424 35/1,360 2.6% Endobronchial Ablation, Mechanical 348 3/335 0.9% 348 7/330 2.1% Tracheal/Bronchial Stent 1,091 31/1,054 2.9% 1,091 56/1,038 5.4% Discharge and Operative Mortality by Primary Procedure 2
General Thoracic Surgery Database Period Ending 06/30/2016 TRACHEOBRONCHIAL (v2.07) - continued Tracheostomy 3,210 346/3,003 11.5% 3,210 401/2,878 13.9% Tracheal Repair 107 7/101 6.9% 107 7/95 7.4% Tracheal Stricture Resection 378 2/373 0.5% 378 2/365 0.5% Tracheal Tumor Resection 116 0/108 0.0% 116 0/105 0.0% 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 6/115 5.2% 121 8/109 7.3% 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 26/1,879 1.4% 1,962 41/1,846 2.2% PULMONARY (v2.07) Wedge Resection, single 12,723 251/10,622 2.4% 12,723 258/9,816 2.6% Wedge Resection, multiple 7,970 280/6,907 4.1% 7,970 304/6,497 4.7% Segmentectomy 1,850 21/1,568 1.3% 1,850 27/1,501 1.8% Lobectomy 18,952 265/15,931 1.7% 18,952 277/14,741 1.9% Sleeve Lobectomy 382 5/371 1.3% 382 7/356 2.0% Bilobectomy 1,013 25/782 3.2% 1,013 32/733 4.4% Pneumonectomy, standard 1,130 44/933 4.7% 1,130 51/860 5.9% Pneumonectomy, Carinal 41 2/36 5.6% 41 1/33 3.0% Completion pneumonectomy 245 19/205 9.3% 245 18/190 9.5% Extrapleural pneumonectomy 211 13/198 6.6% 211 16/188 8.5% Pneumonectomy, intrapericardial 322 8/263 3.0% 322 11/259 4.2% Lung Volume Reduction 325 22/299 7.4% 325 24/284 8.5% Bullectomy / repair 1,044 16/875 1.8% 1,044 14/825 1.7% Hydatid Cyst Resection 2 0/2 0.0% 2 0/2 0.0% Single Lung Transplant 370 21/357 5.9% 370 21/352 6.0% Double Lung Transplant 629 32/599 5.3% 629 30/592 5.1% Lung Donor Harvest 16 4/16 25.0% 16 4/14 28.6% Other Lung procedure 1,416 60/1,140 5.3% 1,416 53/1,004 5.3% ESOPHAGOGASTRIC (v2.07) Esophagoscopy, flexible 4,256 29/4,120 0.7% 4,256 45/4,082 1.1% Esophagoscopy, rigid 91 1/87 1.1% 91 3/86 3.5% Discharge and Operative Mortality by Primary Procedure -- 3
General Thoracic Surgery Database Period Ending 06/30/2016 ESOPHAGOGASTRIC (v2.07) - continued Removal of Foreign Body (Esophagogastric) 163 1/140 0.7% 163 4/136 2.9% Dilation of Esophagus 3,523 15/3,403 0.4% 3,523 37/3,373 1.1% Esophageal Tumor Ablation, Laser / PDT 235 1/204 0.5% 235 4/202 2.0% Stent Placement 554 20/515 3.9% 554 44/499 8.8% Cervical esophagostomy 81 6/66 9.1% 81 7/63 11.1% Anterior Thoracic Esophagostomy 10 0/5 0.0% 10 0/5 0.0% Zenker's Diverticulum Repair 231 1/213 0.5% 231 1/207 0.5% Myotomy, cricopharyngeal 66 0/54 0.0% 66 0/52 0.0% Myotomy, esophageal (long) 209 0/163 0.0% 209 0/157 0.0% Myotomy, cardia (short) 494 0/455 0.0% 494 1/453 0.2% Resection, intrathoracic diverticulum 85 1/75 1.3% 85 1/70 1.4% Resection, esophagus (esophagectomy) 4,393 124/3,898 3.2% 4,393 134/3,810 3.5% Resection, esophageal wall leasion 102 1/89 1.1% 102 0/81 0.0% Repair, perforation of esophagus - Iatrogenic 146 6/129 4.7% 146 8/125 6.4% Repair, perforation of esophagus - Malignant 5 0/4 0.0% 5 0/4 0.0% Repair, perforation of esophagus - Other 255 18/233 7.7% 255 20/223 9.0% Fundoplication, circumferentia 1,448 6/1,115 0.5% 1,448 8/1,101 0.7% Fundoplication, partial 418 3/374 0.8% 418 4/366 1.1% Gastroplasty 162 0/149 0.0% 162 1/149 0.7% Pyloroplasty 18 0/16 0.0% 18 0/16 0.0% Pyloromyotomy 8 0/8 0.0% 8 0/8 0.0% Gastrectomy 209 8/184 4.3% 209 7/173 4.0% Gastrostomy 381 17/350 4.9% 381 31/345 9.0% Jejunostomy 363 12/309 3.9% 363 21/307 6.8% 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 2/13 15.4% 16 2/13 15.4% Anastomosis, Chest 7 0/5 0.0% 7 0/5 0.0% Other Esophageal procedure 692 16/569 2.8% 692 18/545 3.3% Other GI procedure 785 14/663 2.1% 785 23/653 3.5% CARDIAC/PERICARDIUM/GREAT VESSELS (v2.07) Pericardial Window 2,741 176/2,080 8.5% 2,741 205/1,828 11.2% Discharge and Operative Mortality by Primary Procedure -- 4
General Thoracic Surgery Database Period Ending 06/30/2016 CARDIAC/PERICARDIUM/GREAT VESSELS (v2.07) - continued Pericardiectomy 210 7/166 4.2% 210 9/151 6.0% Repair Cardiac Laceration 33 5/28 17.9% 33 5/24 20.8% Other Pericardial Procedure 356 9/311 2.9% 356 12/304 3.9% Repair / Reconstruction, thoracic aorta 142 7/114 6.1% 142 6/95 6.3% Repair / Reconstruction, abd aorta 371 15/333 4.5% 371 1/28 3.6% Repair / Reconstruction, SVC 16 0/12 0.0% 16 0/12 0.0% Repair / Reconstruction, IVC 16 3/16 18.8% 16 3/15 20.0% Repair / Reconstruction, pulmonary artery 26 6/26 23.1% 26 6/26 23.1% 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 2/18 11.1% 20 2/16 12.5% Cardiopulmonary Bypass 15 1/13 7.7% 15 0/7 0.0% Other Cardiac procedure 918 22/480 4.6% 918 23/444 5.2% DIAPHRAGM (v2.07) Plication of Diaphragm 191 2/175 1.1% 191 2/175 1.1% Diaphragmatic Hernia Repair, acute 122 3/99 3.0% 122 4/95 4.2% Diaphragmatic Hernia Repair, chronic 456 4/397 1.0% 456 3/386 0.8% 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 2,946 117/2,375 4.9% 2,946 198/2,187 9.1% Pleural Drainage Procedure - Closed 2,314 111/1,772 6.3% 2,314 224/1,666 13.4% Pleural Biopsy 2,022 39/1,647 2.4% 2,022 73/1,570 4.6% Pleurodesis 4,017 162/3,295 4.9% 4,017 273/3,000 9.1% Pleurectomy 506 16/453 3.5% 506 15/403 3.7% Decortication 5,698 204/4,833 4.2% 5,698 248/4,398 5.6% Clagett Procedure 140 3/129 2.3% 140 7/125 5.6% Other Pleural procedure 964 24/838 2.9% 964 41/786 5.2% AIR LEAK CONTROL MEASURES (v2.07) Fibrin Glue 16 0/15 0.0% 16 0/15 0.0% Pericardial Strips 13 1/10 10.0% 13 0/8 0.0% Discharge and Operative Mortality by Primary Procedure -- 5
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, v2.3 34 2/34 5.9% 34 2/33 6.1% Rigid Stent Removal v2.3 3 0/3 0.0% 3 0/3 0.0% Tracheostomy replacement (tube change) prior to est. of fistula tract (31502) v2.3 3 2/3 66.7% 3 2/3 66.7% Unlisted procedure, trachea, bronchi (31899) v2.081 2,443 216/2,297 9.4% 2,443 218/1,878 11.6% Tracheostomy revision simple, without flap (31613) v2.3 Bronchogenic cyst removal v2.3 8 0/8 0.0% 8 0/6 0.0% Tracheal stenosis excision and anastomosis; cervicothoracic (31781) 115 1/115 0.9% 115 2/94 2.1% Bronchial laceration suture v2.3 1 0/1 0.0% 1 0/1 0.0% Tracheal tumor or carcinoma excision; cervical (31785) 121 1/118 0.8% 121 1/108 0.9% Bronchial sleeve resection v2.3 18 0/18 0.0% 18 0/18 0.0% Tracheal tumor or carcinoma excision; thoracic (31786) 121 1/118 0.8% 121 2/112 1.8% Bronchoplasty, graft repair (31770) v2.3 3 0/3 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) v2.3 39 1/39 2.6% 39 0/37 0.0% Tracheoplasty; cervical (31750) 227 8/129 6.2% 227 11/120 9.2% Carinal reconstruction (31766) 22 1/21 4.8% 22 1/19 5.3% Tracheoplasty; intrathoracic (31760) 191 6/190 3.2% 191 7/183 3.8% Laryngectomy, partial (31370) v2.2, v2.3 4 0/4 0.0% 4 0/3 0.0% Tracheostomy revision complex, with flap (31614) v2.3 5 1/5 20.0% 5 2/5 40.0% Tracheal stenosis excision and anastomosis; cervical (31780) 684 3/676 0.4% 684 7/633 1.1% Tracheostomy mediastinal v2.3 5 0/5 0.0% 5 0/4 0.0% BRONCHOSCOPY (v2.081, v2.2, v2.3) Bronchoscopy, diagnostic, with or without cell washing (31622) 4,501 90/4,228 2.1% 4,501 114/2,036 5.6% Bronchoscopy, each additional major bronchus stented (31637) 13 1/12 8.3% 13 1/6 16.7% Bronchoscopy, navigational (31627) v2.2, v2.3 28 1/28 3.6% 28 2/24 8.3% Bronchoscopy, with bronchial alveolar lavage (BAL) (31624) 901 31/853 3.6% 901 37/508 7.3% Discharge and Operative Mortality by Primary Procedure -- 6
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 24/1,516 1.6% 1,579 33/429 7.7% Bronchoscopy, with brushing or protected brushings (31623) 327 3/316 0.9% 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 36/1,696 2.1% 1,738 70/845 8.3% Bronchoscopy, with excision of tumor (31640) 442 13/398 3.3% 442 24/216 11.1% Bronchoscopy, with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus (31636) 528 19/479 4.0% 528 34/301 11.3% 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, v2.3 1 0/1 0.0% 1 0/1 0.0% Bronchoscopy, with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required) (31631) 642 15/616 2.4% 642 30/356 8.4% Bronchoscopy, with removal of foreign body (31635) 379 12/355 3.4% 379 14/198 7.1% Bronchoscopy, with revision of tracheal or bronchial stent inserted at previous session (31638) 266 1/256 0.4% 266 4/147 2.7% Bronchoscopy, with therapeutic aspiration of tracheobronchial tree, initial (drainage of lung abscess) (31645) 162 2/127 1.6% 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 8/1,477 0.5% 1,566 14/509 2.8% 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 4/590 0.7% 597 8/136 5.9% Bronchoscopy, with transbronchial needle aspiration biopsy(s) (31629) 1,362 3/1,337 0.2% 1,362 7/192 3.6% Bronchoscopy, with transbronchial needle aspiration biopsy(s), each additional lobe (31633) 161 1/159 0.6% 161 1/20 5.0% Endobronchial ultrasound (EBUS) during bronchoscopy diagnostic or therapeutic intervention(s) (31620) 1,505 5/1,427 0.4% 1,505 11/192 5.7% Tracheobronchoscopy through established tracheostomy incision (31615) 128 4/128 3.1% 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 46/1,390 3.3% 1,513 82/1,228 6.7% Thoracoscopy, surgical; with pleurodesis (e.g., mechanical or chemical) (32650) 6,531 273/5,715 4.8% 6,531 466/5,038 9.2% Discharge and Operative Mortality by Primary Procedure -- 7
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) 811 21/744 2.8% 811 34/683 5.0% Thoracoscopy, diagnostic: with biopsy(ies) of lung infiltrate(s) (eg wedge), unilateral (32607) v2.2, v2.3 445 11/439 2.5% 445 11/352 3.1% Thoracoscopy, diagnostic: with biopsy(ies) of lung nodule(s) or mass(es) (eg incisional), unilateral (32608) v2.2, v2.3 286 3/284 1.1% 286 6/254 2.4% Thoracoscopy, diagnostic: with biopsy(ies) of pleura (32609) v2.2, v2.3 139 4/137 2.9% 139 7/116 6.0% Thoracostomy; with rib resection for empyema (32035) 207 15/192 7.8% 207 18/180 10.0% Thoracostomy; with open flap drainage for empyema (32036) 379 20/337 5.9% 379 24/303 7.9% Thoracotomy with biopsy(ies) lung infiltrate(s) (eg wedge), unilateral (32096) 120 9/119 7.6% 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) 3,069 167/2,887 5.8% 3,069 340/2,158 15.8% 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 2/112 1.8% 125 3/103 2.9% 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 0.0% 115 1/87 1.1% Unlisted procedure, lung (32999) 742 22/707 3.1% 742 32/414 7.7% Thoracoscopy, surgical; with partial pulmonary decortication (32651) 6,399 218/6,106 3.6% 6,399 314/5,443 5.8% Thoracoscopy, surgical; with total pulmonary decortication (32652) 11,311 321/10,946 2.9% 11,311 420/9,514 4.4% Thoracoscopy, surgical; with control of traumatic hemorrhage (32654) 943 40/909 4.4% 943 45/815 5.5% Thoracoscopy, surgical; with excision-plication of bullae, including any pleural procedure (32655) 6,291 49/6,141 0.8% 6,291 60/5,376 1.1% Thoracoscopy, surgical; with parietal pleurectomy (32656) 1,682 30/1,657 1.8% 1,682 61/1,421 4.3% Thoracoscopy, surgical; with lobectomy (32663) 38,154 232/37,592 0.6% 38,154 311/33,392 0.9% Thoracoscopy with therapeutic wedge resection (eg mass or nodule, initial, unilateral (32666) v2.2, v2.3 22,194 107/21,930 0.5% 22,194 162/19,300 0.8% Thoracoscopy with therapeutic wedge resection(eg mass or nodule) each additional resection, ipsilateral (32667) v2.2, v2.3 1,327 14/1,271 1.1% 1,327 18/1,185 1.5% Thoracoscopy with diagnostic wedge resection followed by anatomic lung resection (32668) v2.2, v2.3 625 13/610 2.1% 625 14/532 2.6% Discharge and Operative Mortality by Primary Procedure -- 8
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 17/3,689 0.5% 3,722 21/3,362 0.6% Thoracoscopy with removal of two lobes (bilobectomy) (32670) v2.2, v2.3 646 8/639 1.3% 646 11/560 2.0% Thoracoscopy with removal of lung, pneumonectomy (32671) v2.2, v2.3 232 8/229 3.5% 232 9/203 4.4% Thoracoscopy with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction- LVRS, unilateral including any pleural procedure (32672) v2.2, v2.3 462 9/454 2.0% 462 8/379 2.1% Thoracotomy with therapeutic wedge resection (eg mass nodule) initial (32505) v2.2, v2.3 3,916 42/3,891 1.1% 3,916 54/3,532 1.5% Thoracotomy with therapeutic wedge resection (eg mass nodule) each additional resection, ipsilateral (+32506) v2.2, v2.3 587 12/578 2.1% 587 13/514 2.5% Thoracotomy with diagnostic wedge resection followed by anatomic lung resection (+32507) v2.2, v2.3 209 4/204 2.0% 209 4/186 2.2% Thoracotomy, limited, for biopsy of lung or pleura (i.e.; open lung biopsy) (32095) v2.081 870 88/695 12.7% 870 92/600 15.3% Thoracotomy, with exploration (32100) 2,577 109/2,383 4.6% 2,577 122/2,047 6.0% Thoracotomy, major; with control of traumatic hemorrhage and/or repair of lung tear (32110) 843 140/809 17.3% 843 126/704 17.9% Thoracotomy, major; for postoperative complications (32120) 1,317 41/1,267 3.2% 1,317 37/1,102 3.4% Thoracotomy, major; with cyst(s) removal, with or without a pleural procedure (32140) 248 0/226 0.0% 248 0/199 0.0% Thoracotomy, major; with excision-plication of bullae, with or without any pleural procedure (32141) 602 16/569 2.8% 602 14/495 2.8% Thoracotomy, major; with removal of intrapleural foreign body or hematoma (32150) 927 54/884 6.1% 927 56/772 7.3% Thoracotomy with open intrapleural pneumolysis (32124) v2.3 46 4/46 8.7% 46 2/40 5.0% Decortication, pulmonary, total (32220) 7,378 252/6,999 3.6% 7,378 282/5,904 4.8% Decortication, pulmonary, partial (32225) 2,126 84/2,013 4.2% 2,126 90/1,715 5.2% Pleurectomy, parietal (32310) 386 8/377 2.1% 386 13/360 3.6% Decortication and parietal pleurectomy (32320) 1,572 55/1,532 3.6% 1,572 65/1,369 4.7% Thoracotomy, with biopsy of pleura (32098) (v2.081, v2.2) 127 4/114 3.5% 127 9/84 10.7% Removal of lung, total pneumonectomy; (32440) 3,284 131/3,172 4.1% 3,284 159/2,900 5.5% Removal of lung, sleeve (carinal) pneumonectomy (32442) 114 5/106 4.7% 114 6/98 6.1% Removal of lung, total pneumonectomy; extrapleural (32445) 533 34/523 6.5% 533 42/494 8.5% Removal of lung, single lobe (lobectomy) (32480) 27,499 412/26,076 1.6% 27,499 507/23,465 2.2% Discharge and Operative Mortality by Primary Procedure -- 9
General Thoracic Surgery Database Period Ending 06/30/2016 PLEURAL SPACE AND LUNG - continued Removal of lung, two lobes (bilobectomy) (32482) 2,494 70/2,400 2.9% 2,494 87/2,159 4.0% Removal of lung, single segment (segmentectomy) (32484) 2,552 27/2,456 1.1% 2,552 38/2,325 1.6% Removal of lung, sleeve lobectomy (32486) 1,334 13/1,312 1.0% 1,334 17/1,226 1.4% Removal of lung, completion pneumonectomy (32488) 639 49/614 8.0% 639 46/550 8.4% Removal of lung, excision-plication of emphysematous lung(s) for lung volume reduction (LVRS) (32491) 372 14/370 3.8% 372 15/342 4.4% 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 5/379 1.3% 389 11/343 3.2% Resection of apical lung tumor (e.g., Pancoast tumor), including chest wall resection, with chest wall reconstruction (32504) 264 4/255 1.6% 264 6/242 2.5% Removal of lung, wedge resection, single or multiple(32500) v2.081 4,255 122/3,755 3.2% 4,255 126/3,399 3.7% Extrapleural enucleation of empyema(empyemectomy) (32540) v2.081 129 5/121 4.1% 129 5/114 4.4% Thoracoscopy, diagnostic lungs and pleural space, with biopsy (32602) v2.081 4,676 148/4,140 3.6% 4,676 210/3,602 5.8% Thoracoscopy, diagnostic pericardial sac, without biopsy (32603) v2.081 23 0/18 0.0% 23 0/15 0.0% Thoracoscopy, surgical; with wedge resection of lung, single or multiple (32657) v2.081 17,869 314/16,919 1.9% 17,869 358/15,180 2.4% LUNG OTHER (v2.081, v2.2 and v2.3) Open closure of major bronchial fistula (32815) 388 23/373 6.2% 388 28/339 8.3% Thoracoplasty with closure of bronchopleural fistula (32906) 171 12/162 7.4% 171 13/152 8.6% Single lung transplant (32851) 964 43/964 4.5% 964 40/807 5.0% Single lung transplant with CPB (32852) 355 27/355 7.6% 355 28/313 8.9% Double lung transplant (32853) 1,472 38/1,472 2.6% 1,472 35/1,316 2.7% Double lung transplant with CPB (32854) 1,960 120/1,960 6.1% 1,960 115/1,828 6.3% MEDIASTINUM AND DIAPHRAGM (v2.081, v2.2 and v2.3) Thoracoscopy, diagnostic; mediastinal space, with biopsy (32606) 873 9/821 1.1% 873 14/669 2.1% Mediastinotomy with exploration or biopsy; cervical approach (39000) 1,110 4/952 0.4% 1,110 6/222 2.7% Mediastinotomy with exploration or biopsy; transthoracic approach (39010) 779 8/709 1.1% 779 10/435 2.3% Mediastinoscopy, with or without biopsy (39400) 10,529 41/9,640 0.4% 10,529 62/1,993 3.1% Unlisted procedure, mediastinum (39499) 566 8/499 1.6% 566 9/245 3.7% Unlisted procedure, diaphragm (39599) 730 9/721 1.2% 730 11/693 1.6% Discharge and Operative Mortality by Primary Procedure -- 10
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 10/3,521 0.3% 3,605 14/3,107 0.5% Thoracoscopy, diagnostic mediastinal space, without biopsy (32605) v2.081 74 2/69 2.9% 74 3/60 5.0% Thoracoscopy with mediastinal and regional lymphadectomy (+32674) v2.2, v2.3 325 0/320 0.0% 325 0/273 0.0% Thoracic lymphadenectomy, regional, including mediastinal and peritracheal nodes (38746) 886 3/836 0.4% 886 4/527 0.8% Mediastinal cyst, excision, open, Transthoracic approach (39200) 527 4/502 0.8% 527 6/433 1.4% Mediastinal tumor, excision, open, Transthoracic approach (39220) 2,626 11/2,552 0.4% 2,626 20/2,280 0.9% Thoracoscopy with resection of thymus, unilateral or bilateral (32673) v2.2, v2.3 1,228 2/1,224 0.2% 1,228 5/1,031 0.5% Thymectomy, transcervical approach (60520) 430 1/411 0.2% 430 3/368 0.8% Thymectomy, transthoracic approach (60521) 2,196 4/2,128 0.2% 2,196 6/1,872 0.3% Thymectomy, transthoracic approach, with radical mediastinal dissection (60522) 1,067 5/1,036 0.5% 1,067 5/931 0.5% VATS thymectomy (605XX) v2.081 402 0/394 0.0% 402 0/360 0.0% Diaphragm, laceration repair, any approach (39501) 142 9/141 6.4% 142 9/114 7.9% Repair of paraesophageal hiatus hernia, transabdominal with or without fundoplasty (39502) v2.081 1,019 9/957 0.9% 1,019 17/931 1.8% Diaphragmatic hernia repair (other than neonatal), traumatic; acute (39540) 320 2/309 0.6% 320 3/281 1.1% Diaphragmatic hernia repair (other than neonatal), traumatic; chronic (39541) 791 7/767 0.9% 791 6/696 0.9% Diaphragm Imbrication (i.e., plication) (39545) 1,326 6/1,307 0.5% 1,326 8/1,177 0.7% Diaphragm; resection with simple repair (e.g., primary suture) (39560) 229 3/225 1.3% 229 3/208 1.4% Diaphragm; resection with complex repair (e.g., prosthetic material, local muscle flap) (39561) 226 3/222 1.4% 226 3/204 1.5% ESOPHAGOSCOPY (v2.081, v2.2, v2.3) Esophagoscopy (43200) 1,118 22/1,098 2.0% 1,118 26/490 5.3% Esophagoscopy with biopsy (43202) 643 5/626 0.8% 643 8/107 7.5% Esophagoscopy with removal of foreign body (43215) 377 11/367 3.0% 377 14/205 6.8% Esophagoscopy with insertion of stent (43219) 803 30/761 3.9% 803 51/529 9.6% Esophagoscopy with balloon dilation (43220) 704 3/695 0.4% 704 3/115 2.6% Esophagoscopy with insertion of guide wire followed by dilation over guide wire (43226) 1,898 1/1,857 0.1% 1,898 10/351 2.8% Esophagoscopy with ablation of tumor (43228) 388 2/388 0.5% 388 3/103 2.9% Discharge and Operative Mortality by Primary Procedure -- 11
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 16/1,453 1.1% 1,496 19/425 4.5% 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 3/2,564 0.1% 2,580 3/137 2.2% Upper gastrointestinal endoscopy with dilation of gastric outlet for obstruction (43245) 326 3/322 0.9% 326 5/104 4.8% Upper gastrointestinal endoscopy with directed placement of percutaneous gastrostomy tube (43246) 632 36/623 5.8% 632 48/522 9.2% Upper gastrointestinal endoscopy with removal of foreign body (43247) 312 5/306 1.6% 312 7/155 4.5% Upper gastrointestinal endoscopy with insertion of guide wire followed by dilation of esophagus (43248) 3,315 8/3,303 0.2% 3,315 16/531 3.0% Upper gastrointestinal endoscopy with balloon dilation of esophagus (43249) 726 2/695 0.3% 726 3/86 3.5% Upper gastrointestinal endoscopy with transendoscopic stent placement (43256) 624 24/618 3.9% 624 47/403 11.7% Upper gastrointestinal endoscopy with ablation of tumor (43258) 359 1/358 0.3% 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 74/3,059 2.4% 3,101 79/2,846 2.8% Three hole-total esophagectomy with thoracotomy; with cervical esophagogastrostomy (43112) 1,550 57/1,505 3.8% 1,550 67/1,413 4.7% Ivor Lewis-Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision (43117) 4,637 142/4,534 3.1% 4,637 157/4,217 3.7% Thoracoabdominal-Partial esophagectomy, thoracoabdominal approach (43122) 362 12/342 3.5% 362 14/327 4.3% Minimally invasive three hole esophagectomy v2.2, v2.3 712 17/703 2.4% 712 18/642 2.8% Minimally invasive esophagectomy, Ivor Lewis approach 2,664 54/2,656 2.0% 2,664 56/2,494 2.2% Minimally invasive esophagectomy, Abdominal and neck approach 537 20/530 3.8% 537 20/449 4.5% 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
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 2/15 13.3% 16 2/13 15.4% 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 5/102 4.9% 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) 334 29/325 8.9% 334 29/290 10.0% Conduit revision s/p esophagectomy v2.3 23 1/23 4.3% 23 1/21 4.8% ESOPHAGUS OTHER PROCEDURES (v2.081, v2.2 and v2.3) Cricopharyngeal myotomy (43030) 156 0/126 0.0% 156 0/100 0.0% Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach (43130) 271 3/257 1.2% 271 6/238 2.5% 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, v2.3 4 0/4 0.0% 4 0/3 0.0% Trans oral fundoplication v2.3 Unlisted laparoscopy, esophagus (43289) v2.2, v2.3 141 0/139 0.0% 141 2/120 1.7% Unlisted procedure, esophagus (43499) 1,188 16/1,123 1.4% 1,188 18/953 1.9% Per oral endoscopic myotomy (POEM) v2.3 182 0/182 0.0% 182 0/162 0.0% Laparoscopy, surgical with repair of paraesophageal hernia (fundoplasty) without mesh (43281) v2.2, v2.3 4,053 18/4,047 0.4% 4,053 31/3,576 0.9% Laparoscopy, surgical with repair of paraesophageal hernia (fundoplasty) with mesh (43282) v2.2, v2.3 2,110 10/2,104 0.5% 2,110 14/1,859 0.8% Laparoscopy, surgical, esophageal lengthening procedure (Collis) (43283) Secondary Procedure code v2.2, v2.3 9 0/9 0.0% 9 0/8 0.0% Laparoscopy, surgical, esophagogastric fundoplasty (e.g., Nissen, Toupet procedures) (43280) 5,818 11/5,747 0.2% 5,818 14/5,135 0.3% Discharge and Operative Mortality by Primary Procedure -- 13
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 2/2,918 0.1% 2,946 5/2,653 0.2% Thoracoscopy, surgical; with esophagomyotomy (Heller type) (32665) - v2.081 200 3/194 1.5% 200 2/171 1.2% Nissen fundoplasty- laparotomy (includes partial fundoplication/ wrap) (43327) v2.2, v2.3 217 2/217 0.9% 217 2/191 1.0% Transthoracic Fundoplication- open thoracotomy (includes Belsey/ Nissen) (43328) v2.2, v2.3 316 2/316 0.6% 316 4/292 1.4% Repair, paraesophageal hiatal hernia via laparotomy without mesh (43332) v2.2, v2.3 622 6/621 1.0% 622 8/588 1.4% Repair, paraesophageal hiatal hernia via laparotomy with mesh (43333) v2.2, v2.3 128 0/128 0.0% 128 1/123 0.8% Repair, paraesophageal hiatal hernia via thoracotomy without mesh (43334) v2.2, v2.3 608 8/607 1.3% 608 6/557 1.1% Repair, paraesophageal hiatal hernia via thoracotomy with mesh 155 1/155 0.6% 155 1/120 0.8% (43335) v2.2, v2.3 155 1/155 0.6% 155 1/120 0.8% Repair, paraesophageal hiatal hernia via thoracoabdominal approach without mesh (43336) v2.2, v2.3 90 3/90 3.3% 90 3/72 4.2% Repair, paraesophageal hiatal hernia via thoracoabdominal approach with mesh (43337) v2.2, v2.3 34 0/34 0.0% 34 0/29 0.0% Esophageal lengthening procedure - open (Collis) Secondary Procedure code (43338) v2.2, v2.3 11 0/11 0.0% 11 0/10 0.0% Diverticulectomy of esophagus, with or without myotomy; thoracic approach (43135) 462 5/453 1.1% 462 9/408 2.2% Excision Esophageal lesion with primary repair, thoracic approach (eg: leiomyoma) (43101) v2.2, v2.3 237 0/234 0.0% 237 0/211 0.0% Esophagoplasty with repair of TEF, cervical approach (43305) v2.2, v2.3 46 3/45 6.7% 46 5/43 11.6% Esophagoplasty with repair TEF, thoracic approach (43312) v2.2, v2.3 86 5/85 5.9% 86 4/75 5.3% Esophagomyotomy (Heller type); thoracic approach (43331) v2.2, v2.3 121 2/118 1.7% 121 2/102 2.0% Esophagogastric fundoplasty (e.g., Nissen, Belsey IV,Hill procedures) (43324) v2.081 693 3/584 0.5% 693 3/556 0.5% Esophagogastric fundoplasty; with gastroplasty (e.g.,collis) (43326) v2.081 569 4/519 0.8% 569 5/511 1.0% Esophagomyotomy (Heller type); thoracic approach (43331) v2.081 284 4/261 1.5% 284 6/252 2.4% Gastrointestinal reconstruction for previous esophagectomy with stomach (43360) 175 2/173 1.2% 175 2/160 1.3% Gastrointestinal reconstruction for previous esophagectomy with colon interposition or small intestine (43361) 184 8/178 4.5% 184 7/167 4.2% Discharge and Operative Mortality by Primary Procedure -- 14
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) 128 12/126 9.5% 128 11/114 9.6% Suture of esophageal wound or injury; cervical approach (43410) 160 10/156 6.4% 160 11/143 7.7% Suture of esophageal wound or injury; transthoracic or transabdominal approach (43415) 854 56/820 6.8% 854 60/763 7.9% 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 9/510 1.8% 514 10/487 2.1% CHEST WALL AND NECK (v2.081, v2,2 and v2.3) Excision tumor, soft tissue of neck or thorax; subcutaneous (21555) 237 2/218 0.9% 237 2/72 2.8% Excision tumor, soft tissue of neck or thorax; deep, subfascial, intramuscular (21556) 396 1/377 0.3% 396 6/208 2.9% Excision of rib, partial (21600) 377 3/356 0.8% 377 3/271 1.1% Excision first and/or cervical rib (21615) 317 0/288 0.0% 317 0/265 0.0% 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) v2.3 2 0/2 0.0% 2 0/2 0.0% Unlisted procedure, neck or thorax (21899) 2,885 36/2,592 1.4% 2,885 51/1,468 3.5% Major reconstruction, chest wall (posttraumatic) (32820) 213 1/209 0.5% 213 2/194 1.0% Muscle flap, neck (15732) 36 4/34 11.8% 36 3/26 11.5% Muscle flap; trunk (i.e., intercostal, pectoralis or serratus muscle) (15734) 329 6/314 1.9% 329 9/271 3.3% Excision of chest wall tumor including ribs (19260) 877 8/853 0.9% 877 11/722 1.5% Excision of chest wall tumor involving ribs, with reconstruction (19271) 1,551 9/1,514 0.6% 1,551 12/1,403 0.9% Radical resection of tumor (e.g., malignant neoplasm), soft tissue of neck or thorax (21557) 233 5/222 2.3% 233 6/191 3.1% Radical resection of sternum (21630) 207 6/204 2.9% 207 8/178 4.5% 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 0/653 0.0% 664 2/594 0.3% Reconstructive repair of pectus, minimally invasive approach (Nuss procedure), without thoracoscopy (21742) 105 0/105 0.0% 105 0/77 0.0% Discharge and Operative Mortality by Primary Procedure -- 15
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 0.0% 524 0/482 0.0% 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) 692 36/658 5.5% 692 47/548 8.6% Tube pericardiostomy (33015) 91 5/65 7.7% 91 8/59 13.6% Pericardial window (33025) 3,242 201/2,785 7.2% 3,242 272/2,383 11.4% Thoracoscopy, surgical; with thoracic sympathectomy (32664) 984 0/928 0.0% 984 1/228 0.4% Removal substernal thyroid, cervical approach (60271) 105 0/90 0.0% 105 0/81 0.0% Application of wound vac (97605, 97606) v2.2, v2.3 19 0/19 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, v2.3 33 1/33 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 1/311 0.3% 319 2/271 0.7% Ligation thoracic duct (38381) 832 8/815 1.0% 832 11/719 1.5% Intraoperative jejunostomy (44015) 1,113 40/1,088 3.7% 1,113 71/987 7.2% Omental flap (49904) 50 7/49 14.3% 50 6/41 14.6% Transthoracic thyroidectomy (60270) 169 3/163 1.8% 169 3/137 2.2% SVC resection and reconstruction (34502) 26 0/23 0.0% 26 0/20 0.0% Other 6,447 132/6,177 2.1% 6,447 152/4,379 3.5% MISSING DATA [Missing data] 3,958 29/1,845 1.6% 3,958 34/1,374 2.5% Discharge and Operative Mortality by Primary Procedure -- 16