The Procedure Price Lookup Tool shows the national averages for the amount Medicare pays an ASC or hospital, as well as the national average copayment amount a patient without Medicare supplemental insurance owes in each setting.
Here are how six orthopedic procedure costs compare in HOPDs and ASCs:
1. Arthroplasty, knee, tibial plateau (27440)
ASC:
• Average Medicare pays: $5,835
• Average total cost: $7,294
• Amount patient pays on average: $1,459
HOPD:
• Average Medicare pays: $8,783
• Average total cost: $10,123
• Amount patient pays on average: $1,340
2. Arthroscopy, knee, surgical; with meniscus repair (29882)
ASC:
• Average Medicare pays: $1,024
• Average total cost: $1,280
• Amount patient pays on average: $256
HOPD:
• Average Medicare pays: $2,116
• Average total cost: $2,645
• Amount patient pays on average: $529
3. Insertion of artificial upper spine disc, anterior approach (22856)
ASC:
• Average Medicare pays: $8,970
• Average total cost: $11,213
• Amount patient pays on average: $2,243
HOPD:
• Average Medicare pays: $14,031
• Average total cost: $15,371
• Amount patient pays on average: $1,340
4. Sacroiliac joint fusion (27279)
ASC:
• Average Medicare pays: $9,965
• Average total cost: $12,456
• Amount patient pays on average: $2,491
HOPD:
• Average Medicare pays: $14,031
• Average total cost: $15,371
• Amount patient pays on average: $1,340
5. Anterior cervical discectomy (22551)
ASC:
• Average Medicare pays: $5,870
• Average total cost: $7,337
• Amount patient pays on average: $1,467
HOPD:
• Average Medicare pays: $8,783
• Average total cost: $10,123
• Amount patient pays on average: $1,340
6. Laminotomy foraminotomy decompression (63030)
ASC:
• Average Medicare pays: $2,177
• Average total cost: $2,721
• Amount patient pays on average: $544
HOPD:
• Average Medicare pays: $4,485
• Average total cost: $5,606
• Amount patient pays on average: $1,121
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