Increasing Utilization, Rising Facility Charges, and Evolving Procedure Mix in Hip Arthroscopy at United States...

To evaluate national trends in hip arthroscopy utilization and procedure mix, assess adjusted total costs by subtype, and examine regional and payer variation in case distribution among hospital-based ambulatory surgical centers (ASCs) from 2016 to 2022.

Using the Healthcare Cost and Utilization Project National Ambulatory Surgery Sample, we identified hip arthroscopy encounters in hospital-based ASCs (2016-2022) using Current Procedural Terminology codes across all procedure fields. Femoroacetabular impingement syndrome (FAIS)-related procedures were defined by femoroplasty (29914), acetabuloplasty (29915), and/or labral repair (29916), alone or with diagnostic arthroscopy, synovectomy, labral debridement, or chondroplasty. Outcomes were assessed at the index encounter. Inflation-adjusted charges, procedure volume, and FAIS market share were analyzed using survey-weighted regression with pairwise contrasts (P < .05).

A total of 107,227 unweighted procedures corresponded to 141,870 nationally weighted encounters. Femoroplasty (67.7%) and labral repair (54.2%) were most common and increased annually (828 and 704 cases/year; both P < .001), whereas labral debridement declined (249 cases/year; P = .012). Median inflation-adjusted charges increased from $32,745 (2016) to $45,782 (2022) (P < .001), with highest charges for femoroplasty alone ($58,697) and multicode FAIS procedures. Private insurance accounted for ~70% of cases, whereas Medicaid increased from 8.9% to 11.7% (P < .001). FAIS-related utilization (volume of arthroscopy encounters including FAIS procedures) increased across all payer groups (1.3%-2.0%/year; all P ≤ .007). Regional growth was steepest in the South (1.9%/year) and Northeast (1.4%/year) versus the West (0.8%/year); the South grew 1.1%/year faster than the West (P = .007).

Hip arthroscopy in hospital-based ASCs has become more common and costly, with increasing utilization of FAIS-related procedures and regional differences in adoption.

These findings provide contemporary national benchmarks of outpatient hip arthroscopy utilization, procedure mix, and facility charges in hospital-based ASCs, informing efforts to optimize value and equitable access to care in the United States.