Metric 12

Use of Minimally Invasive Lung Surgery for Lung Cancer

Metric Category: Appropriateness

About the Metric


The percentage of all lung and thymus resection procedures performed that were minimally invasive.


Minimally Invasive surgery (MIS) is a safe and effective option for lung and thymus surgery. Minimally invasive lobectomy and thymectomy procedures performed through a video-assisted thoracoscopic surgical approach are associated with fewer postoperative complications and a shorter length of stay compared to open resection. Minimally invasive surgeries may also be associated with lower costs, a shorter hospital stay, reduced opiate use, and an overall quicker recovery.

Metric Ratings

Expert Consensus
Clinician Buy-in
Economic Impact
Reduction in Avoidable Harm
Applicability to Medicare Data
Applicability to Medicaid

Applicable to EHR Data?

Requires Pharmacy Data?

How It Works


The number of procedures from the denominator that were minimally invasive lung resection procedures (CPT codes: 32663, 32666, 32667, 32668, 32669, 32670, 32671) or minimally invasive thymus resection procedures (CPT codes: 32673)


The number of all lung resection procedures (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669) or thymus resection procedures (CPT codes: 60521, 60522) by a given physician during the study period.

Inclusion Criteria

All patients who underwent a lung or thymus resection procedure.

Exclusion Criteria

1. If a look back period of data is available prior to the study period, exclude patients who had any history of a lung or thymus resection (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669, 32670, 32671, 32482, 32488) prior to the study period.


Surgeon performing the procedure

GAM Thresholds™

GAM establishes clinical thresholds using the input of key physician leaders within a specialty and the GAM clinical team. GAM utilizes an elaborate consensus building process with final adjudication by our leadership team.

  • Sample Size: 11+

    This threshold applies to a clinician with a minimum of 11 cases.

  • Outlier: <30%

    This constitutes the clinical threshold for an "outlier".

Cases Outlier