Minnesota Hospital Association

Quality & Patient Safety

Invasive, High-Risk or Surgical Procedures

  • Any procedures involving skin incision
  • Any procedures involving general or regional anesthesia, monitored anesthesia care, or conscious sedation
  • Injections of any substance into a joint space or body cavity
  • Percutaneous aspiration of body fluids or air through the skin (e.g., arthrocentesis, bone marrow aspiration, lumbar puncture, paracentesis, thoracentesis, suprapubic catheterization, chest tube)
  • Biopsy (e.g., bone marrow, breast, liver, muscle, kidney, genitourinary, prostate, bladder, skin)
  • Cardiac procedures (e.g., cardiac catheterization, cardiac pacemaker implantation, angioplasty, stent implantation, intra-aortic balloon catheter insertion, elective cardioversion)
  • Endoscopy (e.g., colonoscopy, bronchoscopy, esophagogastric endoscopy, cystoscopy, percutaneous endoscopic gastrostomy, J-tube placements, nephrostomy tube placements)
  • Laparoscopic procedures (e.g., laparoscopic cholecystectomy, laparoscopic nephrectomy)
  • Invasive radiological procedures (e.g., angiography, angioplasty, percutaneous biopsy)
  • Dermatology procedures (biopsy, excision and deep cryotherapy for malignant lesions – excluding cryotherapy for benign lesions)
  • Invasive ophthalmic procedures, including miscellaneous procedures involving implants
  • Oral procedures including tooth extraction and gingival biopsy
  • Podiatric invasive procedures (removal of ingrown toenail, etc.)
  • Skin or wound debridement performed in an operating/procedure room
  • Electroconvulsive treatment
  • Radiation oncology procedures
  • Central line placement • Kidney stone lithotripsy
  • Colposcopy, and/or endometrial biopsy

Procedures NOT considered surgical, high-risk or invasive include the following:

  • Electrocautery of lesion
  • Venipuncture
  • Manipulation and reductions
  • Chemotherapy/oncology procedure
  • Intravenous therapy
  • Nasogastric tube insertion
  • Foley catheter insertion
  • Flexible sigmoidoscopy
  • Vaginal exams (Pap smear)

This list is not meant to be comprehensive and was drawn from the United States Department of Veterans Affairs. Source: Institute for Clinical Systems Improvement,  Perioperative Protocol, Fourth Edition/November 2012.