Here are 100 benchmarks and statistics for ambulatory surgery centers based on reports from Accreditation Association for Ambulatory Health Care, Ambulatory Surgical Centers of America, Ambulatory Surgery Center Association, HealthCare Appraisers, Provista, RemitData, MedPAC, Objective Health and VMG Health.
All benchmarks and statistics on this list are averages gathered by compiling data from multiple ASCs.
Operational benchmarks
1. Administrator salary is $109,184. 1
2. Administrators in the west receive the highest salary, at $114,109 while administrators in the Midwest receive the lowest salary at $104,317.
3. Staff hours per case at ASCs is 12.8 hours.
4. Administrative hours per case is four hours.
5. Nurse hours per case in one- to two-OR centers is 5.2 hours.
6. Administrative hours at one- to two-OR centers is 3.8 hours.
7. Nurse hours at ASCs with three- to four-ORs is 6.3 hours.
8. Administrative hours at ASCs with three- to four-ORs is 4.1 hours.
9. ASCOA surgery centers have a per room goal of 10 cases per day to encourage compressed schedules. 2
10. GI and pain-driven centers with less than five clinical hours would have a total of around eight staff hours per case.
11. Centers with more complicated cases such as orthopedics and spine would have clinical hours around seven to eight hours per case and total staff hours around 10 to 12 hours per case.
12. Average room turnover time goal is seven to 10 minutes at ASCOA surgery centers, depending on the case mix.
13. 53 percent of ambulatory surgery centers maintain paper records and 23 percent track their supply chain on spreadsheets. 3
14. Typical surgery centers have 19 cases per day. 4
15. 74 percent of the cases are performed by the top five physicians at the ASC.
16. ASCs have of three surgical cases per operating room per day.
17. Total operating expenses per OR is $1.2 million.
18. Employee salary and wages per operating room is $421,820.
19. Medical and surgical expenses per OR are $375.37.
20. General and administrative expenses per OR are $259.38.
21. Total cases per center is 4,714 per year.
22. Average number of non-surgical cases per year is 1,146.
23. 765 cases are performed per operating room annually, with 4.6 cases per day.
24. ASC procedure rooms see around 1,144 non-surgical cases per room annually, with 4.6 procedures per day.
25. The top five physicians performed 54 percent of the ASC's case volume.
26. Surgery centers with more than four operating rooms performed 24 cases per day, while those with one to two operating rooms performed 12 cases per day.
27. Surgery centers with one to two operating rooms had the highest annual surgical case rate per operating room, at 782, while those with more than four operating rooms hosted 744 cases annually per operating room.
28. Non-surgical case volume per year at facilities with one to two operating rooms is 1,017 cases per procedure room.
29. Surgery centers with three to four ORs reported 769 non-surgical cases per procedure room annually, which dropped to 705 cases in centers with more than four ORs.
30. In surgery centers with more than four ORs, only 22 percent of the cases were performed by the top two physicians, while 62 percent were performed by the top 10 physicians.
31. Median operating room time per patient encounter: 50.2 minutes. 5
32. Procedure room time per patient encounter: 34.2 minutes.
33. Median rate of unscheduled direct transfers: .6 transfers per 1,000 patient encounters.
34. 34 percent of ASC leaders plan to standardize products used in their center. 6
35. 24 percent plan to evaluate their GPO.
36. 19 percent plan to implement an order management system.
37. 6 percent plan to change or join a GPO.
38. 6 percent plan to change distributors.
Revenue cycle benchmarks
39. 79.9 percent of ASCs collect between 0 to 30 days from the date of service to the check date. 7
40. 13.3 percent of ASCs receive cash collection between 31 and 60 days from the service date to the check date.
41. 20 percent of ASC claims are not collected for more than 30 days. 8
42. The top reason for ASC procedures to receive an unexpected denial is "claims or service lacks information which is needed for adjudication." The second most common reason is "duplicate claim or service" followed by "procedure or treatment is deemed experimental or investigational by the payer."
43. Commercial insurance companies have a 12 percent unexpected denial rate for the top 10 CPT codes that have unexpected denials at ASCs.
44. Medicare's unexpected denial rate is 6 percent for the top 10 CPT codes that have unexpected denials at ASCs.
45. Medicaid has a 26 percent denial rate for the top 10 CPT codes that have unexpected denials at ASCs.
46. Around 47 percent of ASCs with fewer than 3,000 cases have 0 to 30 A/R days, while 18.7 percent have 31 to 60 A/R days. 9
47. Most ASCs with at least 6,000 cases annually have 0 to 30 A/R days.
48. Of all ASCs, about 15.9 percent have more than 120 A/R days.
49. For ASCs with three to four ORs, average ENT revenue is $1,734 per case.
50. Average GI/endoscopy revenue per case for medium-sized ASCs is $776.
51. Orthopedics revenue per case for three- to four-OR ASCs is $2,617.
52. Average general surgery revenue per case for medium sized ASCs is $1,721.
53. For ASCs with three to four ORs, average ophthalmology revenue is $1,249 per case.
54. Average plastic surgery revenue per case for medium-sized ASCs is $1,516.
55. Podiatry revenue per case for three- to four-OR ASCs is $2,021.
56. For medium sized ASCs, average OB/GYN revenue per case is $1,958.
57. Average pain management revenue per case for three- to four-OR ASCs is $890.
58. Revenue per case for urology procedures in medium-sized ASCs is $1,476.
59. ASCOA centers have a goal of low-to-mid 30s for A/R days out. 10
Clinical benchmarks
60. 89 percent of patients wait at least a month after scheduling cataract surgery before undergoing the procedure. 11
61. 96 percent of patients are able to schedule their cataract surgery at their desired time in the ASC.
62. 94 percent of patients resume daily living within a week of undergoing cataract surgery.
63. 94 percent of patients reported improved vision after cataract surgery in an ASC.
64. 98 percent of patients say they're comfortable while undergoing cataract surgery in the ASC and 99 percent are comfortable after discharge.
65. 99 percent of patients report they would recommend cataract surgery after undergoing the procedure in an ASC.
66. Pre-procedure time is 81 minutes for cataract surgeries.
67. Procedure time for cataract surgeries in ASCs is 14 minutes.
68. Discharge time for cataract surgeries is 21 minutes.
69. 77 percent of colonoscopy patients report little or no discomfort during bowel preparation. 12
70. 81 percent of colonoscopy patients wait less than a month between scheduling their colonoscopy and having the procedure.
71. 98 percent of colonoscopy patients report being comfortable after discharge.
72. 99 percent of colonoscopy patients report little or no discomfort during the procedure and would recommend it to others.
73. 100 percent of colonoscopy patients report understanding the procedure.
74. Colonoscopy procedure time is nine to 29 minutes.
75. Pre-procedure time for colonoscopy is 17 to 129 minutes, covering patient check-in to scope insertion.
76. Colonoscopy discharge time is 15 to 75 minutes for ASCs.
77. Pre-procedure time for knee arthroscopy is 88 minutes, and organizations with shortest times attribute results to calling patients the day before to remind them of the appointment and pre-procedure requirements.13
78. Knee arthroscopy procedure time is 28 minutes in the ASC.
79. Discharge time for knee arthroscopy is 75 minutes in the ASC, and organizations with short discharge times attribute results to having patients leave the operating room as they are waking up to assess their comfort level as soon as possible.
80. 75 percent of knee arthroscopy patients wait less than a month for their procedure after scheduling.
81. 89 percent of knee arthroscopy patients are able to schedule the procedure as soon as they wanted in the ASC.
82. 99 percent of knee arthroscopy patients say they are comfortable post-discharge in the ASC.
83. Pre-procedure time for low back injections is 43 minutes, and organizations with the shortest discharge times attribute results to not using or using low levels of sedation or controlling the type and amount of medication administered. 83
84. Procedure time is seven minutes for low back injections in the surgery center.
85. Discharge time after low back injections in the ASC is 22 minutes, with a range of one to 42 minutes.
86. 90 percent of patients wait less than a month from scheduling their low back injection to undergoing the procedure in the ASC.
87. 93 percent of patients say they are able to schedule their low back injections in an ASC within a "reasonable" period to time.
88. 85 percent of patients report returning to daily activities after undergoing low back injections in ASCs.
89. 80 percent of patients say they experienced less pain after the low back injections, and 50 percent reduced pain medications after the procedure.
Growth benchmarks
90. 100 percent of surgery center management companies in the HealthCare Appraisers 2013 ASC Valuation Survey found orthopedics/sports medicine a desirable specialty. 15
91. 94 percent of ASC management companies find orthopedic spine a desirable specialty in 2013.
92. 94 percent of ASC management companies find ENT desirable in 2013.
93. 88 percent of ASC management companies find general surgery desirable in 2013
94. 88 percent of ASC management companies find pain management desirable in 2013.
95. 82 percent of ASC management companies find gastroenterology a desirable specialty in 2013.16
96. There were 113 new Medicare-certified ambulatory surgery centers in 2012.
97. Medicare made $3.5 billion in payments to ambulatory surgery centers in 2011.
98. There were 5,344 Medciare-certified ambulatory surgery centers in 2011, up 1.8 percent over the previous year. 17
99. Between 2001 and 2011, the number of ambulatory surgery center operating rooms doubled in the United States and in 2011, 60 percent of hospitals had an ASC within five minutes of their facility. 18
100. Objective Health predicts that procedure volumes for cases such as shoulder arthroscopy, which Medicare paid ASCs 42 percent lower than hospital outpatient departments in 2012, will continue to increase in ASCs.
Endnotes:
1. VMG Multispecialty ASC Intellimarker 2011.
2. Based on benchmarks provided by ASCOA
3. 2011 supply chain survey from Provista.
4. 10 Statistics on Surgery Center Case Volume based on VMG Multispecialty ASC Intellimarker 2011.
5. ASC Association's Outcomes Monitoring Project 2nd Quarter 2010 Report
6. 2011 supply chain survey from Provista.
7. RemitData, based on 25 percent of all national outpatient remittances from September 2012.
8. RemitData, based on data collected between Nov. 5, 2012 to Feb. 11, 2013.
9. VMG Multi-Specialty ASC Study 2011 Intellimarker
10. Benchmarks provided by ASCOA
11. Benchmarking study from AAAHC based on clinical studies of cataract extraction surgeries with lens insertions. The study includes 92 organizations with a combined 170,000 cataract surgeries per year.
12. Benchmarking study from AAAHC on clinical findings for colonoscopy from 100 organizations performing 353,300 colonoscopies between July and December 2012.
13. Benchmarking study from AAAHC on clinical findings for knee arthroscopy in the ASC based on data from 41 organizations that perform a combined total of 9,190 knee arthroscopies annually. The study was conducted between July and December 2012.
14. Benchmarking study from AAAHC on clinical findings for low back pain in ambulatory care settings based on data from 31 organizations that perform a combined total of more than 64,890 low back injections annually. The data was collected between July and December of 2012.
15. HealthCare Appraisers 2010 ASC Valuation Survey and 2013 ASC Valuation Survey.
16. MedPAC Health Care Spending and the Medicare Program June 2013 Report.
17. March 2013 Report to the Congress: Medicare Payment Policy.
18. Objective Health Infographic: The Increased Competition of Ambulatory Surgery Centers (ASCs) to US Hospitals.
More Articles on ASC Issues:
Is SGR Repeal Still Possible in 2013?
4 Tips for Saving Money This ASC Budget Season
The Power of the Checklist: How to Create a Culture of Patient Safety at ASCs
All benchmarks and statistics on this list are averages gathered by compiling data from multiple ASCs.
Operational benchmarks
1. Administrator salary is $109,184. 1
2. Administrators in the west receive the highest salary, at $114,109 while administrators in the Midwest receive the lowest salary at $104,317.
3. Staff hours per case at ASCs is 12.8 hours.
4. Administrative hours per case is four hours.
5. Nurse hours per case in one- to two-OR centers is 5.2 hours.
6. Administrative hours at one- to two-OR centers is 3.8 hours.
7. Nurse hours at ASCs with three- to four-ORs is 6.3 hours.
8. Administrative hours at ASCs with three- to four-ORs is 4.1 hours.
9. ASCOA surgery centers have a per room goal of 10 cases per day to encourage compressed schedules. 2
10. GI and pain-driven centers with less than five clinical hours would have a total of around eight staff hours per case.
11. Centers with more complicated cases such as orthopedics and spine would have clinical hours around seven to eight hours per case and total staff hours around 10 to 12 hours per case.
12. Average room turnover time goal is seven to 10 minutes at ASCOA surgery centers, depending on the case mix.
13. 53 percent of ambulatory surgery centers maintain paper records and 23 percent track their supply chain on spreadsheets. 3
14. Typical surgery centers have 19 cases per day. 4
15. 74 percent of the cases are performed by the top five physicians at the ASC.
16. ASCs have of three surgical cases per operating room per day.
17. Total operating expenses per OR is $1.2 million.
18. Employee salary and wages per operating room is $421,820.
19. Medical and surgical expenses per OR are $375.37.
20. General and administrative expenses per OR are $259.38.
21. Total cases per center is 4,714 per year.
22. Average number of non-surgical cases per year is 1,146.
23. 765 cases are performed per operating room annually, with 4.6 cases per day.
24. ASC procedure rooms see around 1,144 non-surgical cases per room annually, with 4.6 procedures per day.
25. The top five physicians performed 54 percent of the ASC's case volume.
26. Surgery centers with more than four operating rooms performed 24 cases per day, while those with one to two operating rooms performed 12 cases per day.
27. Surgery centers with one to two operating rooms had the highest annual surgical case rate per operating room, at 782, while those with more than four operating rooms hosted 744 cases annually per operating room.
28. Non-surgical case volume per year at facilities with one to two operating rooms is 1,017 cases per procedure room.
29. Surgery centers with three to four ORs reported 769 non-surgical cases per procedure room annually, which dropped to 705 cases in centers with more than four ORs.
30. In surgery centers with more than four ORs, only 22 percent of the cases were performed by the top two physicians, while 62 percent were performed by the top 10 physicians.
31. Median operating room time per patient encounter: 50.2 minutes. 5
32. Procedure room time per patient encounter: 34.2 minutes.
33. Median rate of unscheduled direct transfers: .6 transfers per 1,000 patient encounters.
34. 34 percent of ASC leaders plan to standardize products used in their center. 6
35. 24 percent plan to evaluate their GPO.
36. 19 percent plan to implement an order management system.
37. 6 percent plan to change or join a GPO.
38. 6 percent plan to change distributors.
Revenue cycle benchmarks
39. 79.9 percent of ASCs collect between 0 to 30 days from the date of service to the check date. 7
40. 13.3 percent of ASCs receive cash collection between 31 and 60 days from the service date to the check date.
41. 20 percent of ASC claims are not collected for more than 30 days. 8
42. The top reason for ASC procedures to receive an unexpected denial is "claims or service lacks information which is needed for adjudication." The second most common reason is "duplicate claim or service" followed by "procedure or treatment is deemed experimental or investigational by the payer."
43. Commercial insurance companies have a 12 percent unexpected denial rate for the top 10 CPT codes that have unexpected denials at ASCs.
44. Medicare's unexpected denial rate is 6 percent for the top 10 CPT codes that have unexpected denials at ASCs.
45. Medicaid has a 26 percent denial rate for the top 10 CPT codes that have unexpected denials at ASCs.
46. Around 47 percent of ASCs with fewer than 3,000 cases have 0 to 30 A/R days, while 18.7 percent have 31 to 60 A/R days. 9
47. Most ASCs with at least 6,000 cases annually have 0 to 30 A/R days.
48. Of all ASCs, about 15.9 percent have more than 120 A/R days.
49. For ASCs with three to four ORs, average ENT revenue is $1,734 per case.
50. Average GI/endoscopy revenue per case for medium-sized ASCs is $776.
51. Orthopedics revenue per case for three- to four-OR ASCs is $2,617.
52. Average general surgery revenue per case for medium sized ASCs is $1,721.
53. For ASCs with three to four ORs, average ophthalmology revenue is $1,249 per case.
54. Average plastic surgery revenue per case for medium-sized ASCs is $1,516.
55. Podiatry revenue per case for three- to four-OR ASCs is $2,021.
56. For medium sized ASCs, average OB/GYN revenue per case is $1,958.
57. Average pain management revenue per case for three- to four-OR ASCs is $890.
58. Revenue per case for urology procedures in medium-sized ASCs is $1,476.
59. ASCOA centers have a goal of low-to-mid 30s for A/R days out. 10
Clinical benchmarks
60. 89 percent of patients wait at least a month after scheduling cataract surgery before undergoing the procedure. 11
61. 96 percent of patients are able to schedule their cataract surgery at their desired time in the ASC.
62. 94 percent of patients resume daily living within a week of undergoing cataract surgery.
63. 94 percent of patients reported improved vision after cataract surgery in an ASC.
64. 98 percent of patients say they're comfortable while undergoing cataract surgery in the ASC and 99 percent are comfortable after discharge.
65. 99 percent of patients report they would recommend cataract surgery after undergoing the procedure in an ASC.
66. Pre-procedure time is 81 minutes for cataract surgeries.
67. Procedure time for cataract surgeries in ASCs is 14 minutes.
68. Discharge time for cataract surgeries is 21 minutes.
69. 77 percent of colonoscopy patients report little or no discomfort during bowel preparation. 12
70. 81 percent of colonoscopy patients wait less than a month between scheduling their colonoscopy and having the procedure.
71. 98 percent of colonoscopy patients report being comfortable after discharge.
72. 99 percent of colonoscopy patients report little or no discomfort during the procedure and would recommend it to others.
73. 100 percent of colonoscopy patients report understanding the procedure.
74. Colonoscopy procedure time is nine to 29 minutes.
75. Pre-procedure time for colonoscopy is 17 to 129 minutes, covering patient check-in to scope insertion.
76. Colonoscopy discharge time is 15 to 75 minutes for ASCs.
77. Pre-procedure time for knee arthroscopy is 88 minutes, and organizations with shortest times attribute results to calling patients the day before to remind them of the appointment and pre-procedure requirements.13
78. Knee arthroscopy procedure time is 28 minutes in the ASC.
79. Discharge time for knee arthroscopy is 75 minutes in the ASC, and organizations with short discharge times attribute results to having patients leave the operating room as they are waking up to assess their comfort level as soon as possible.
80. 75 percent of knee arthroscopy patients wait less than a month for their procedure after scheduling.
81. 89 percent of knee arthroscopy patients are able to schedule the procedure as soon as they wanted in the ASC.
82. 99 percent of knee arthroscopy patients say they are comfortable post-discharge in the ASC.
83. Pre-procedure time for low back injections is 43 minutes, and organizations with the shortest discharge times attribute results to not using or using low levels of sedation or controlling the type and amount of medication administered. 83
84. Procedure time is seven minutes for low back injections in the surgery center.
85. Discharge time after low back injections in the ASC is 22 minutes, with a range of one to 42 minutes.
86. 90 percent of patients wait less than a month from scheduling their low back injection to undergoing the procedure in the ASC.
87. 93 percent of patients say they are able to schedule their low back injections in an ASC within a "reasonable" period to time.
88. 85 percent of patients report returning to daily activities after undergoing low back injections in ASCs.
89. 80 percent of patients say they experienced less pain after the low back injections, and 50 percent reduced pain medications after the procedure.
Growth benchmarks
90. 100 percent of surgery center management companies in the HealthCare Appraisers 2013 ASC Valuation Survey found orthopedics/sports medicine a desirable specialty. 15
91. 94 percent of ASC management companies find orthopedic spine a desirable specialty in 2013.
92. 94 percent of ASC management companies find ENT desirable in 2013.
93. 88 percent of ASC management companies find general surgery desirable in 2013
94. 88 percent of ASC management companies find pain management desirable in 2013.
95. 82 percent of ASC management companies find gastroenterology a desirable specialty in 2013.16
96. There were 113 new Medicare-certified ambulatory surgery centers in 2012.
97. Medicare made $3.5 billion in payments to ambulatory surgery centers in 2011.
98. There were 5,344 Medciare-certified ambulatory surgery centers in 2011, up 1.8 percent over the previous year. 17
99. Between 2001 and 2011, the number of ambulatory surgery center operating rooms doubled in the United States and in 2011, 60 percent of hospitals had an ASC within five minutes of their facility. 18
100. Objective Health predicts that procedure volumes for cases such as shoulder arthroscopy, which Medicare paid ASCs 42 percent lower than hospital outpatient departments in 2012, will continue to increase in ASCs.
Endnotes:
1. VMG Multispecialty ASC Intellimarker 2011.
2. Based on benchmarks provided by ASCOA
3. 2011 supply chain survey from Provista.
4. 10 Statistics on Surgery Center Case Volume based on VMG Multispecialty ASC Intellimarker 2011.
5. ASC Association's Outcomes Monitoring Project 2nd Quarter 2010 Report
6. 2011 supply chain survey from Provista.
7. RemitData, based on 25 percent of all national outpatient remittances from September 2012.
8. RemitData, based on data collected between Nov. 5, 2012 to Feb. 11, 2013.
9. VMG Multi-Specialty ASC Study 2011 Intellimarker
10. Benchmarks provided by ASCOA
11. Benchmarking study from AAAHC based on clinical studies of cataract extraction surgeries with lens insertions. The study includes 92 organizations with a combined 170,000 cataract surgeries per year.
12. Benchmarking study from AAAHC on clinical findings for colonoscopy from 100 organizations performing 353,300 colonoscopies between July and December 2012.
13. Benchmarking study from AAAHC on clinical findings for knee arthroscopy in the ASC based on data from 41 organizations that perform a combined total of 9,190 knee arthroscopies annually. The study was conducted between July and December 2012.
14. Benchmarking study from AAAHC on clinical findings for low back pain in ambulatory care settings based on data from 31 organizations that perform a combined total of more than 64,890 low back injections annually. The data was collected between July and December of 2012.
15. HealthCare Appraisers 2010 ASC Valuation Survey and 2013 ASC Valuation Survey.
16. MedPAC Health Care Spending and the Medicare Program June 2013 Report.
17. March 2013 Report to the Congress: Medicare Payment Policy.
18. Objective Health Infographic: The Increased Competition of Ambulatory Surgery Centers (ASCs) to US Hospitals.
More Articles on ASC Issues:
Is SGR Repeal Still Possible in 2013?
4 Tips for Saving Money This ASC Budget Season
The Power of the Checklist: How to Create a Culture of Patient Safety at ASCs