ASCs vs. HOPDs: 21 Statistics on 2013 Medicare Reimbursement for Colonoscopy

Medicare reimbursement for ambulatory surgery centers in comparison to hospital outpatient departments has been steadily declining for several years.  

Here are 21 statistics on Medicare facility fees and Medicare fee schedule physician payments for colonoscopies performed in ASCs and HOPDs in 2013, according to the American College of Gastroenterology.

Facility fees and physician payment

Diagnostic colonoscopy (HCPCS 45378)
•    ASC: $380.16
•    HOPD: $677.49
•    Physician: $216.15

Colonoscopy and biopsy (HCPCS 45380)
•    ASC: $380.16
•    HOPD: $677.49
•    Physician: $258. 51

Colonoscopy and submucous inj. (HCPCS 45831)
•    ASC: $380.16
•    HOPD: $677.49
•    Physician: $245.18

Colonoscopy/control bleeding (HCPCS 45382)
•    ASC: $370.50
•    HOPD: $677.49
•    Physician: $329.23

Lesion removal colonoscopy (HCPCS 45383)
•    ASC: $380.16
•    HOPD: $677.49
•    Physician: $334.24

Lesion removal colonoscopy (HCPCS 45384)
•    ASC: $380.16
•    HOPD: $677.49
•    Physician: $269.52

Lesion removal colonoscopy (HCPCS 45385)
•    ASC: $380.16
•    HOPD: $677.49
•    Physician: $306.55

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