There are some commonly done procedures in the hospitals out of which some are in the Medicare Inpatient Only List. It is good to know them so that it will save time when you see such cases. We sometimes may even leave them in Out Patient in Bed [OPIB] status without realizing that they are listed in IPO list. Below this is a table which lists Medicare IPO procedures that we commonly see in hospitals.
Here are some of the Most Commonly Performed Surgeries in Hospitals.
1. Appendectomy
An appendectomy is the surgical removal of the appendix. It is typically performed to treat appendicitis, an inflammation of the appendix. CPT code: 44950.-It is not a Medicare Inpatient Only Procedure.
2. Cholecystectomy
Laparoscopic Cholecystectomy is the surgical removal of the gallbladder. It is commonly performed to treat gallstones or gallbladder disease. CPT code: 47562.-It is not a Medicare Inpatient Only Procedure.
3. Cesarean Section [global care]
A cesarean section, also known as a C-section, is a surgical procedure to deliver a baby through an incision in the mother’s abdomen and uterus. It is performed when vaginal delivery may pose risks to the mother or baby. CPT code: 59510.-It is not a Medicare Inpatient Only Procedure [but CPT Code 59514, Cesarean Delivery Only is in Medicare Inpatient Only list].
4. Hysterectomy
A Total hysterectomy involves the surgical removal of the uterus. It may be performed for various reasons, such as treating uterine fibroids, endometriosis, or certain types of cancer. CPT code: 58150.-It is a Medicare Inpatient Only Procedure.
5. Knee Arthroscopy
Knee arthroscopy is a minimally invasive surgical procedure used to diagnose and treat problems in the knee joint. It involves inserting a small camera and surgical instruments through small incisions in the knee. CPT code: 29881.-It is not a Medicare Inpatient Only Procedure.
6. Hernia Repair
Hernia repair is a surgical procedure to correct a hernia, which occurs when an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue. CPT code: 49505.-It is not a Medicare Inpatient Only Procedure.
7. Hip Replacement
Hip replacement surgery is a procedure in which a damaged or diseased hip joint is replaced with an artificial joint. It is commonly performed to relieve pain and improve mobility in individuals with hip arthritis. CPT code: 27130.-It is not a Medicare Inpatient Only Procedure.
8. Coronary Artery Bypass Graft (CABG)
Coronary artery bypass grafting is a surgical procedure used to treat blocked or narrowed coronary arteries. It involves creating new pathways for blood to flow to the heart muscle, bypassing the blocked or narrowed arteries. CPT code: 33533.–It’s an INPATIENT PROCEDURE
9. Mastectomy
Simple complete Mastectomy is the surgical removal of one or both breasts. It is often performed as a treatment for breast cancer or as a preventive measure in individuals at high risk of developing breast cancer. CPT code: 19303.-It is not a Medicare Inpatient Only Procedure.
10. Prostatectomy
Laparoscopic Simple Prostatectomy is the surgical removal of all or part of the prostate gland. It may be performed to treat prostate cancer or relieve symptoms associated with an enlarged prostate. CPT code: 55867.-It is not a Medicare Inpatient Only Procedure unless its perineal or suprapubic or retropubic Prostatectomy.
11. Colonoscopy
Colonoscopy is a procedure that allows a doctor to examine the inside of the colon and rectum for abnormalities or signs of disease. It involves inserting a flexible tube with a camera through the anus. CPT code: 45378.-It is not a Medicare Inpatient Only Procedure.
12. Lumbar Discectomy
Lumbar discectomy is a surgical procedure to remove a herniated or damaged disc in the lower back. It is performed to relieve pain and other symptoms caused by the compressed spinal nerves. CPT code: 63030.-It is not a Medicare Inpatient Only Procedure.
13. Spinal Fusion
Spinal fusion is a surgical procedure used to join two or more vertebrae in the spine. It is performed to treat conditions such as spinal instability, degenerative disc disease, or spinal fractures. CPT code: 22612.-It is not a Medicare Inpatient Only Procedure.
14. Transurethral Resection of the Prostate (TURP)
Transurethral resection of the prostate is a surgical procedure to treat urinary symptoms caused by an enlarged prostate. It involves removing excess prostate tissue through the urethra. CPT code: 52601.-It is not a Medicare Inpatient Only Procedure.
15. Thoracentesis
CPT code: 32554. -It is not a Medicare Inpatient Only Procedure.
16. Bronchoscopy
CPT code: 31640. -It is not a Medicare Inpatient Only Procedure.
17. Percutaneous Kyphoplasty
CPT code: 22513. -It is not a Medicare Inpatient Only Procedure.
18. Laminectomy [simple without any complications]
CPT code: 63030. -It is not a Medicare Inpatient Only Procedure.
The same above procedures which are not in Medicare inpatient only list can be inpatient status if there are complications and patient ends up staying more than two midnights. So, it is important to take each patient case individually when determining the status of it’s admission.
Below is a list of Medicare Inpatient Only procedures by Organ: [More will be added]
| Organ in alphabetical order | Procedure | CPT Code |
| Abdomen | Exploration for postoperative hemorrhage, thrombosis or infection | 35840 |
| Appendix | Appendectomy; for ruptured appendix with abscess or generalized peritonitis | 44960 |
| Breast | Breast reconstruction with muscle flap [not tissue expander] | 19361 |
| Mastectomy, radical | ||
| Blood vessels | Arterial bypass graft | |
| Venous anastomosis, open; | ||
| Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal incision and leg incision | 34451 | |
| Thromboendarterectomy, including patch graft | ||
| Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, | ||
| Exploration of artery not followed by surgical repair | ||
| Repair blood vessel | ||
| Chest | Exploration for postoperative hemorrhage, thrombosis or infection | |
| Thoracostomy; with open flap drainage for empyema | 32036 | |
| Esophagus | Ligation, direct, esophageal varices | |
| Femur | Open treatment of femoral shaft fracture, | |
| Fistula | Fistula closures | |
| Foot | Amputation, foot; midtarsal (eg, Chopart type procedure) [NOT TRANSMETATARSAL] | |
| Heart | Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), | |
| Pericardial drainage with insertion of indwelling catheter, | 33017 | |
| Hip | Revision of total hip arthroplasty; | 27134 |
| Hemiarthroplasty, hip, partial | 27125 | |
| Kidney | Laparoscopic Radical Nephrectomy | 50545 |
| Nephrostomy | ||
| Nephrotomy | ||
| Nephrolithotomy | ||
| Knee | Revision of total knee arthroplasty, | |
| Liver | Insertion of TIPS | 37182 |
| Penis | Penile revascularization, artery, with or without vein graft | 37788 |
| Prostate | Prostatectomy, perineal or suprapubic or retropubic | |
| Skin | Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection | 11004 |
| Spine | Posterior Thoracic Instrumentation and Arthodesis T6-T7, T7-T8 | 22610 |
| Exploration of spinal fusion | 22830 | |
| Ureter | Ureterolithotomy | |
| Uterus | Cesarean delivery only; | 59514 |
Obviously, this page has only a minute portion of the IPO procedures. When in doubt, always check if a particular procedure is listed under Medicare Inpatient Only procedure or not. I will keep adding more surgeries to get an idea for the most commonly done procedures in the hospital.