{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:00:11Z","timestamp":1790262011298,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"\n Purpose<\/jats:title>\n 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\u2010based ambulatory surgical centers (ASCs) from 2016 to 2022.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Using the Healthcare Cost and Utilization Project National Ambulatory Surgery Sample, we identified hip arthroscopy encounters in hospital\u2010based ASCs (2016\u20102022) using Current Procedural Terminology codes across all procedure fields. Femoroacetabular impingement syndrome (FAIS)\u2010related 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\u2010adjusted charges, procedure volume, and FAIS market share were analyzed using survey\u2010weighted regression with pairwise contrasts (\n P<\/jats:italic>\n \u2009<\u2009.05).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 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\n P<\/jats:italic>\n \u2009<\u2009.001), whereas labral debridement declined (249 cases\/year;\n P<\/jats:italic>\n \u2009=\u2009.012). Median inflation\u2010adjusted charges increased from $32,745 (2016) to $45,782 (2022) (\n P<\/jats:italic>\n \u2009<\u2009.001), 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% (\n P<\/jats:italic>\n \u2009<\u2009.001). FAIS\u2010related utilization (volume of arthroscopy encounters including FAIS procedures) increased across all payer groups (1.3%\u20102.0%\/year; all\n P<\/jats:italic>\n \u2009\u2264\u2009.007). 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 (\n P<\/jats:italic>\n \u2009=\u2009.007).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Hip arthroscopy in hospital\u2010based ASCs has become more common and costly, with increasing utilization of FAIS\u2010related procedures and regional differences in adoption.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance<\/jats:title>\n These findings provide contemporary national benchmarks of outpatient hip arthroscopy utilization, procedure mix, and facility charges in hospital\u2010based ASCs, informing efforts to optimize value and equitable access to care in the United States.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/arj.70609","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:59:10Z","timestamp":1790258350000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increasing Utilization, Rising Facility Charges, and Evolving Procedure Mix in Hip Arthroscopy at United States Hospital\u2010Based Ambulatory Surgical Centers From 2016 to 2022"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-517X","authenticated-orcid":false,"given":"Paul G.","family":"Mastrokostas","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery SUNY Downstate Health Sciences University Brooklyn New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8926-3502","authenticated-orcid":false,"given":"Leonidas E.","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery SUNY Downstate Health Sciences University Brooklyn New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0207-3639","authenticated-orcid":false,"given":"Brandon","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-1497","authenticated-orcid":false,"given":"Randy M.","family":"Cohn","sequence":"additional","affiliation":[{"name":"Northwell New Hyde Park New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8340-9757","authenticated-orcid":false,"given":"Nicholas A.","family":"Sgaglione","sequence":"additional","affiliation":[{"name":"Northwell New Hyde Park New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.arth.2016.09.004","article-title":"Trends in utilization and outcomes of hip arthroscopy in the United States between 2005 and 2013","volume":"32","author":"Maradit Kremers H","year":"2017","journal-title":"J Arthroplasty"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.arth.2013.02.039","article-title":"Trends in hip arthroscopy utilization in the United States","volume":"28","author":"Bozic KJ","year":"2013","journal-title":"J Arthroplasty"},{"key":"e_1_2_7_4_1","first-page":"232596712098753","article-title":"Cost\u2010effectiveness of hip arthroscopy for treatment of femoroacetabular impingement syndrome and labral tears: A systematic review","volume":"9","author":"Go CC","year":"2021","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1016\/j.arthro.2023.03.027","article-title":"Hip arthroscopy trends: Increasing patient out\u2010of\u2010pocket costs, lower surgeon reimbursement, and cost reduction with utilization of ambulatory surgery centers","volume":"39","author":"Tiao J","year":"2023","journal-title":"Arthroscopy"},{"key":"e_1_2_7_6_1","unstructured":"NASS Overview.https:\/\/hcup\u2010us.ahrq.gov\/nassoverview.jsp#about. 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AW","year":"2018","journal-title":"J Hip Preserv Surg"},{"key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"2840","DOI":"10.1016\/j.arthro.2024.02.042","article-title":"Hip arthroscopy simulator training with immersive virtual reality has similar effectiveness to nonimmersive virtual reality","volume":"40","author":"Rahman OF","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/j.arthro.2021.12.012","article-title":"Duration of care and operative time are the primary drivers of total charges after ambulatory hip arthroscopy: A machine learning analysis","volume":"38","author":"Lu Y","year":"2022","journal-title":"Arthroscopy"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.5301\/hipint.5000149","article-title":"Hip arthroscopy for femoroacetabular impingement: A health economic analysis","volume":"24","author":"Clement ND","year":"2014","journal-title":"Hip 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