WASHINGTON – This is a routine procedure for Johns Hopkins Hospital.

The Baltimore hospital reclaimed the distinction of U.S. News & World Report‘s top-ranked medical center.

After falling to Massachusetts General Hospital last year, Johns Hopkins assumed the position it held for the previous 21 years – No. 1.

The report highlights nearly 100 metro areas, including rankings in Washington.

The best hospitals in the region:

• 1. Inova Fairfax Hospital
• 2. MedStar Washington Hospital Center
• 3. MedStar National Rehabilitation Hospital
• 4. Holy Cross Hospital (tied for fourth)
• 4. MedStar Georgetown University Hospital (tied for fourth)

The rankings cover close to 5,000 medical centers, but just 18 of those make the honor roll.

None is in the immediate Washington region.

“I’ve always been puzzled why the nation’s capital doesn’t have more hospitals that we would think of automatically as world class,” said Avery Comarow, the health rankings editor.

“What we have is a number of good – and a couple of very good – hospitals,” he said.

Nation’s top-ranked hospitals:

1. Johns Hopkins Hospital
2. Massachusetts General Hospital
3. Mayo Clinic
4. Cleveland Clinic

U.S. News & World Report also breaks down the listing of the best hospitals by specialties.

Johns Hopkins took the top spot for the following specialties:

• Ear, Nose and Throat;
• Geriatrics;
• Neurology and Neurosurgery;
• Rheumatology;
• Urology.

Follow @WTOP and @WTOPliving on Twitter.