Differences in reimbursement between ASCs and HOPDs are an ongoing pain point for surgery centers. However, many opportunities to profit off of specialty procedures remain, regardless.
Here are the average costs of three common procedures across three ASC specialties — cardiology, orthopedics and gastroenterology, using Medicare's procedure price lookup tool.
Cardiology (data from Banner Health)
|
Code |
Procedure |
Avg. cost in ASCs |
Avg. cost in HOPDs |
|
33206 |
Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial. |
$7,657 |
$10,613 |
|
33249 |
Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber |
$25,700 |
$32,224 |
|
33264 |
Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system |
$25,393 |
$31,734 |
|
Code |
Procedure |
Avg. cost at ASCs |
Avg. cost at HOPDs |
|
45385 |
Colonoscopy, with removal of lesion(s) |
$857 |
$1,369 |
|
45380 |
Colonoscopy, with biopsy, single/multiple |
$805 |
$1,317 |
|
43239 |
Esophagogastroduodenoscopy, biopsy, single/multiple |
$604 |
$997 |
|
Code |
Procedure |
Avg. cost at ASCs |
Avg. cost at HOPDs |
|
29881 |
Arthroscopic medial or lateral meniscectomy |
$2,058 |
$3,624 |
|
29827 |
Arthroscopy rotator cuff repair |
$4,448 |
$7,872 |
|
29888 |
Arthroscopic ACL repair |
$5,460 |
$7,779 |