Surgical Volume

Based on the research by Dartmouth-Hitchcock Medical Center, Michigan Medicine, and Johns Hopkins Medicine, as well as guidance from Leapfrog’s National Surgical Volume Expert Panel, Leapfrog has identified eight high-risk procedures for which there is a strong volume-outcome relationship.

The procedures with their corresponding minimum hospital volumes and minimum surgeon volumes for credentialing are shown in the table below.

Procedure Minimum hospital volume standard Minimum surgeon volume standard
Bariatric surgery for weight loss 50 20
Esophageal resection for cancer 20 7
Lung resection for cancer 40 15
Pancreatic resection for cancer 20 10
Rectal cancer surgery 16 6
Carotid endarterectomy 20 10
Open aortic procedures 10 7
Mitral valve repair and replacement 40 20
Total knee replacement* 50 25
Total hip replacement* 50 25
Norwood procedure* 8 5

     *New in 2020. Information will not be scored or publicly reported.

For each procedure, hospitals are asked to report on their total hospital volume over a 12-month period or their annual average over a 24-month period. To achieve Leapfrog’s Surgical Volume Standard for a procedure, a hospital must meet the established minimum volume for the listed high-risk procedures that the hospital electively performs.

Additionally, Leapfrog asks hospitals about whether their privileging process for surgeons requires that the surgeon meet or exceed the minimum surgeon volume standards established for each of the eight high-risk procedures. This new structural measure challenges hospitals and health systems across the country to hold themselves accountable for minimum surgical volume standards known to improve the odds of a safer surgery for their patients. 

View Leapfrog Hospital Survey Results here.

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