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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At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
