LAUSR

NSQIP = National Surgical Quality Improvement Program In the United States radical nephrectomy is reimbursed as an inpatient surgery under the CMS Part A program, while its increasingly common counterpart, partial nephrectomy or nephron sparing surgery, is reimbursed as an outpatient surgery under the CMS Part B program. The rule seems counterintuitive, as partial nephrectomy is recognized to be, on average, significantly more complex. We sought to evaluate whether there were differences in the complication and adverse event profiles of the 2 procedures warranting the classification and reimbursement of one as an inpatient surgery and the other an outpatient surgery. Data on patients 66 years old or older undergoing radical or partial nephrectomy for an oncologic indication (ICD-9 code 189.0) were abstracted using ACS-NSQIP participant user files. The ACS-NSQIP database is a multi-institutional consortium that provides a unique opportunity to evaluate 30-day outcomes following surgery and has been shown to detect complications more reliably than administrative databases or institutional series. All patients who underwent surgery between 2005 and 2013 were included in the analysis. Nonparsimonious propensity score methods were used to construct a matched pair cohort of patients undergoing