Thirty-nine Surgical Procedures Ranked According to Their Index of Variation (I95), Canada, Apr. 1, 1988 to Mar. 31, 1990
| Procedure (CCP code) | Degree of discretion | I951 | Rank using I95 (I100)2 | No. of outliers | Rate3 |
|---|---|---|---|---|---|
| Tonsillectomy with adenoidectomy (40.2)* | D | 37.85 | 1 | 12 | 122.2 |
| Extraction of lens (27.2–27.6)*4 | D | 30.40 | 2 | 15 | 198.3 |
| Tonsillectomy without adenoidectomy (40.1)* | D | 25.55 | 3 (5) | 16 | 77.4 |
| Hysterectomy (80.2–80.6), F | D | 22.01 | 4 (3) | 26 | 457.4 |
| Excision of semilunar cartilage of knee (92.32)* | D | 18.46 | 5 (15) | 10 | 33.8 |
| Cesarean section (86.0–86.2, 86.8–86.9), F | D | 18.39 | 6 (14) | 10 | 557.0 |
| Excision of intervetebral disc (92.31) | D | 17.10 | 7 (4) | 15 | 48.9 |
| Adenoidectomy without tonsillectomy (40.5)* | D | 16.75 | 8 (9) | 13 | 19.5 |
| Cholecystectomy (63.1) | D | 15.99 | 9 (6) | 13 | 231.7 |
| Prostatectomy (72.1–72.5), M | D | 15.58 | 10 (8) | 9 | 325.2 |
| Total knee replacement (93.41) | D | 14.27 | 11 | 11 | 29.2 |
| Excision of hemorrhoids (61.36)* | D | 13.68 | 12 (17) | 14 | 43.7 |
| Total hip replacement (93.5) | D | 13.19 | 13 (7) | 8 | 49.7 |
| Spinal fusion (93.0)5 | I | 13.04 | 14 (12) | 11 | 20.6 |
| Appendectomy (59.0)4 | I | 12.97 | 15 (24) | 15 | 119.4 |
| Exploration and decompression of spinal canal (16.0)6 | I | 12.95 | 16 | 15 | 26.1 |
| Implantation of cardiac pacemaker system (49.7)*4 | N | 12.71 | 17 (18) | 9 | 38.2 |
| Repair of inguinal hernia (65.01–65.03, 65.11–65.13, 65.21–65.24, 65.31–65.34)* | D | 12.41 | 18 (10) | 12 | 202.2 |
| Ligation and stripping of varicose veins — lower limb vessels (50.48)* | D | 11.25 | 19 (13) | 14 | 40.0 |
| Skin graft (98.4–98.63)*6 | N | 10.67 | 20 (25) | 7 | 37.3 |
| Carotid endarterectomy (50.12) | I | 10.38 | 21 | 11 | 8.2 |
| Other excision of aorta (50.54)7 | N | 9.62 | 22 | 14 | 1.7 |
| Coronary artery bypass (48.1)6 | I | 9.42 | 23 (20) | 6 | 47.4 |
| Thyroidectomy — complete and partial (19.1–19.5)5 | I | 8.66 | 24 (23) | 9 | 19.3 |
| Radical and modified radical mastectomy (97.14–97.19), F | I | 8.45 | 25 (19) | 9 | 50.0 |
| Amputation of lower limb (96.1) | N | 8.33 | 26 | 5 | 24.4 |
| Gastrectomy — partial and total (55.5–55.9) | N | 7.48 | 27 | 7 | 14.4 |
| Resection of aorta with replacement (50.34)6 | N | 7.25 | 28 (30) | 14 | 13.8 |
| Lung lobectomy or pneumonectomy — partial and complete (44.3–44.5) | N | 7.04 | 29 | 10 | 17.0 |
| Resection of large bowel (57.5–57.6, 60.3–60.5) | N | 6.67 | 30 (31) | 2 | 84.1 |
| Colectomy — partial and total (57.5–57.6) | N | 6.66 | 31 (32) | 5 | 61.0 |
| Radical mastectomy (97.16–97.19), F | I | 6.18 | 32 (28) | 9 | 3.5 |
| Valvotomy or valvuloplasty with or without replacement of heart valve (47.0–47.2)6 | N | 5.76 | 33 (35) | 2 | 13.4 |
| Excision or destruction of brain tissue (14.42–14.49)8 | N | 5.62 | 34 (33) | 4 | 11.4 |
| Splenectomy (53.3)4 | N | 5.32 | 35 (36) | 4 | 9.7 |
| Resection of aorta with anastomosis (50.24)9 | N | 5.10 | 36 (34) | 15 | 1.3 |
| Nephrectomy — partial and total (67.3–67.4)10 | N | 4.86 | 37 | 5 | 14.8 |
| Transplantation of kidney (67.5)10 | N | 4.60 | 38 | 11 | 3.4 |
| Repair of atrial and ventricular septa (47.5–47.7)6 | N | 3.96 | 39 | 3 | 3.9 |
CCP = Canadian Classification of Procedures, M = rates calculated for males only, F = rates calculated for females only, D = primarily discretionary, N = primarily nondiscretionary, I = intermediate
↵* May sometimes be performed on an outpatient basis, in which case the operation was not counted.
↵1 Index calculated from all 255 census divisions (CDs) unless otherwise indicated
↵2 Rank using I100 is shown in parentheses if different from rank using I95
↵3 Annual all-CD crude rate per 100 000 population
↵4 Index calculated from 232 CDs (Manitoba CDs omitted)
↵5 Index calculated from 240 CDs (New Brunswick CDs omitted)
↵6 Index calculated from 217 CDs (Manitoba and New Brunswick CDs omitted)
↵7 Index calculated from 222 CDs (New Brunswick and Nova Scotia CDs omitted)
↵8 Index calculated from 181 CDs (Manitoba, New Brunswick, Nova Scotia and Saskatchewan CDs omitted)
↵9 Index calculated from 237 CDs (Saskatchewan CDs omitted)
↵10 Index calculated from 207 CDs (Manitoba, New Brunswick and Newfoundland CDs omitted).