To determine if the actual rate of coronary artery bypass grafting (CABG) has been decreasing in Washington state, CABG and percutaneous coronary intervention (PCI) procedure rates from 1987 to 2001 were age- and gender-adjusted and standardized to the year 2000 to normalize case rates for changes in population demographics. CABG rates remained stable through 1997, then decreased 19% from 1997 to 2001. From 1987 to 2001, PCI rates increased 128%. These changes occurred simultaneously with decentralization of cardiac surgical services.