Measure Methodology

Surgery Measure (OP-36)

The Hospital Visits after Hospital Outpatient Surgery measure was developed by a team of clinical and statistical experts from Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (YNHHSC/CORE). YNHHSC/CORE developed the measure through a transparent process that included input from a national Technical Expert Panel and a public comment period.

For Calendar Year (CY) 2020 Payment Determination Measure Methodology

  • 2018 Surgery Measure Updates and Specifications Report, PDF-747 MB (09/28/18) – A report describing the background and rationale for measure development, the approach to risk model development and testing, and detailed measure specifications.
    • 2018 Surgery Measure Data Dictionary, XLS-987 KB (04/08/19) – Contains the codes used to identify the measure denominator, exclusions, numerator, and risk factors, as well as risk adjustment model weights. Shows the assignment of ICD-9 and ICD-10 codes to condition categories (CCs) used to adjust for patient risk factors in the Surgery measure.

Previous Methodology Reports

Questions and Comments

Please submit questions about the outpatient Surgery measure to the Outpatient Question and Answer tool. To ensure proper handling of inquiries, please reference the hospital’s CMS Certification Number (CCN). Do NOT email your CDR or FSR nor submit patient-identifiable information (e.g., Date of Birth, Social Security Number, Health Insurance Claim Number, dates, procedure codes) to this address. Sending screenshots and/or describing a patient listed in your FSR is considered Protected Health Information (PHI).

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