Exhibit 3.6. Orthopedic Procedures

Growth in Discharges with Procedures on the Musculoskeletal System, 1993-2005

CCS Procedure Category and Name (All-listed Procedures)		Number of Discharges with a Procedure		Percent Growth in Discharges with a Procedure from 1993 to 2005
		1993	2005
All discharges with orthopedic procedures		2,761,800	3,399,600	23.1
158	Spinal fusion (correction of an unstable part of the spine by joining two or more vertebrae)	146,300	349,400	138.8
152	Arthroplasty of knee (surgical reconstruction or replacement of knee)	294,700	555,800	88.6
153	Hip replacement, total and partial	263,500	383,500	45.5
146	Treatment of fracture or dislocation of hip and femur	293,800	313,700	6.8
157	Amputation of lower extremity (leg, foot, or toe)	118,300	124,500	5.3
147	Treatment of fracture or dislocation of lower extremity (leg, other than hip or femur)	219,300	222,500	1.5
145	Treatment of fracture or dislocation of radius and ulna (lower arm)	81,000	80,800	-0.2
142	Partial excision of bone	224,500	208,900	-6.9
Standard Errors
All discharges with orthopedic procedures		69,506	99,097
158	Spinal fusion (correction of an unstable part of the spine by joining two or more vertebrae)	8,291	18,995
152	Arthroplasty of knee (surgical reconstruction or replacement of knee)	11,182	22,263
153	Hip replacement, total and partial	8,191	14,233
146	Treatment of fracture or dislocation of hip and femur	6,034	7,643
157	Amputation of lower extremity (leg, foot, or toe)	3,096	3,510
147	Treatment of fracture or dislocation of lower extremity (leg, other than hip or femur)	5,788	7,489
145	Treatment of fracture or dislocation of radius and ulna (lower arm)	2,372	2,851
142	Partial excision of bone	8,665	9,492
Source: AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 1993-2005.

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