Here are 28 interesting facts about orthopedics in ASCs and orthopedic surgeons.
1. Orthopedics was fourth among identified specialties represented at single-specialty centers, tied with pain management, and was represented in 5 percent of all single-specialty ASCs.
2. Orthopedics was the fourth most-represented surgical specialty and was represented in 36 percent of all (single- and multi-specialty) centers in 2007, behind plastic surgery, ophthalmology and gastroenterology.
3. Orthopedics represented 8 percent of the total case volume at surgery centers, ranking it fourth behind gastroenterology, ophthalmology and pain management.
4. The average net revenue for an orthopedic procedure was $2,192 in 2008.
5. Here is the average net revenue for orthopedic procedures by region:
- West: $2,265
- Southwest: $2,312
- Midwest: $2,182
- Southeast: $1,865
- Northeast: $1,813
6. Here is the average net revenue for orthopedic procedures by an ASC's number of operating rooms:
- 1-2 ORs: $1,935
- 3-4 ORs: $2,155
- More than 4 ORs: $2,261
7. Here is the average net revenue for orthopedic procedures by an ASC's total number of cases:
- Less than 3,000: $2,136
- 3,000-5,999: $2,313
- More than 5,999: $2,031
8. Here is the average net revenue for orthopedic procedures by an ASC's total net revenue:
- Less than $4.5 million: $1,645
- $4.5-$7 million: $2,179
- More than $7 million: $2,512
9. In surgery centers with more than 50 percent of cases in orthopedics, the average net revenue for an orthopedic procedure was $2,328.
10. Here is the 2008 cash compensation earned by orthopedic surgeons by percentile and region:
20-25th percentile
- National: $335,000
- North: $360,000
- South: $282,000
- East: $294,000
- West: $356,000
50th percentile
- National: $437,000
- North: $475,000
- South: $369,000
- East: $383,000
- West: $444,000
75-80th percentile
- National: $561,000
- North: $606,000
- South: $562,000
- East: $518,000
- West: $530,000
90th percentile
- National: $706,000
- North: $730,000
- South: $668,000
- East: $669,000
- West: $699,000
Medicare charges and payments
Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not including co-pays and deductibles paid by patient) for 14 orthopedic procedures commonly performed in ASCs.
11. Obtaining small amount of bone for graft (CPT 20900):
- average sub charge: $2,060
- average allow charge: $294
- average payment: $231
12. Open surgical partial removal of collar bone (CPT 23120):
- average sub charge: $3,793
- average allow charge: $477
- average payment: $376
13. Partial repair or removal of shoulder bone (CPT 23130):
- average sub charge: $4,027
- average allow charge: $478
- average payment: $377
14. Open repair of rotator cuff, recent (CPT 23410):
- average sub charge: $4,947
- average allow charge: $671
- average payment: $530
15. Open repair of rotator cuff, old (CPT 23412):
- average sub charge: $5,556
- average allow charge: $984
- average payment: $777
16. Reconstruction rotator cuff, old (CPT 23420):
- average sub charge: $5,653
- average allow charge: $984
- average payment: $777
17. Open repair elbow fracture involving ulnar bone (CPT 24685):
- average sub charge: $3,965
- average allow charge: $502
- average payment: $396
18. Wrist fracture pinning through skin (CPT 25606):
- average sub charge: $2,886
- average allow charge: $487
- average payment: $386
19. Open surgical treatment wrist fracture (radius) (CPT 25607):
- average sub charge: $4,240
- average allow charge: $706
- average payment: $560
20. Shoulder scope, repair cartilage tear (CPT 29807):
- average sub charge: $4,426
- average allow charge: $309
- average payment: $241
21. Shoulder scope, partial removal collar bone (CPT 29824):
- average sub charge: $4,605
- average allow charge: $562
- average payment: $442
22. Shoulder scope, bone shaving (CPT 29826):
- average sub charge: $4,680
- average allow charge: $409
- average payment: $244
23. Shoulder scope, rotator cuff repair (CPT 29827):
- average sub charge: $5,272
- average allow charge: $693
- average payment: $547
24. Injection of lower back joint (HCPCS G02060):
- average sub charge: $1,290
- average allow charge: $281
- average payment: $222
Average implant costs for four orthopedic procedures in hospitals
Here are four interesting statistics about orthopedic implants from a study presented at the May 2008 IHA CHA Medical Device Conference that was carried out by James C. Robinson, PhD, a professor of health economics at the University of California Berkeley.
25. Average total knee replacement (DRG 544) implant cost per case ranged from $3,321-$8,987, according to information from 11 hospitals (the national benchmark is about $4,700).
26. Total knee implant cost as a percentage of average reimbursement ranged from 25-51 percent, according to information from 11 hospitals.
27. Average lumbar fusion (DRG 498) implant cost per case ranged from $6,959-$14,689, according to information from 11 hospitals (the national benchmark is about $7,600).
28. Lumbar fusion implant cost as a percentage of average reimbursement ranged from 15 percent-52 percent, according to information from 11 hospitals.
Note: CPT codes are copyrighted by the AMA.
Sources:
Items 1-3: SDI's 2008 Outpatient Surgery Center Market Report. Learn more at www.sdihealth.com.
Items 4-9: VMG Health 2008 Intellimarker. Learn more at www.vmghealth.com.
Item 10: Integrated Healthcare Strategies 2008 Healthcare Executive Compensation Survey and supplementary IHS statistics. Learn more at www.ihstrategies.com.
Items 11-24: CMS.
Items 25-28: IHA CHA Medical Device Conference (pdf).