Physician, ASC & HOPD Payment: 24 Statistics on GI Biopsy Procedure Reimbursement

Share on Facebook
Here are 24 statistics on physician, ambulatory surgery center and hospital Medicare reimbursement for GI hot biopsy procedures, according to Boston Scientific's 2014 Procedural Reimbursement Guide for Endoscopy.

EGD, flexible transoral with removal of tumor(s), polyp(s) or other lesion(s) with hot biopsy forceps or bipolar cautery (CPT 43250)

•    Physician office payment: $466
•    Physician facility payment: $187
•    HOPD payment: $1,013
•    ASC payment: $560

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum with removal of tumor(s), polyp(s) or other lesion(s) with hot biopsy forceps or bipolar cautery (CPT 44365)

•    Physician office payment: $200
•    Physician facility payment: $200
•    HOPD payment: $1,233
•    ASC payment: $681

Colonoscopy through stroma, with removal of tumor(s), polyp(s) or other lesion(s) with hot biopsy forceps or bipolar cautery (CPT 44392)

•    Physician office payment: $446
•    Physician facility payment: $226
•    HOPD payment: $737
•    ASC payment: $407

Proctosigmoidoscopy, rigid, with removal of single tumor, polyp or other lesion with hot biopsy forceps or bipolar cautery (CPT 45308)

•    Physician office payment: $221
•    Physician facility payment: $90
•    HOPD payment: $779
•    ASC payment: $431

Sigmoidoscopy, flexible, with removal of tumor(s), polyp(s) or other lesion(s) with hot biopsy forceps or bipolar cautery (CPT 45333)

•    Physician office payment: $301
•    Physician facility payment: $113
•    HOPD payment: $461
•    ASC payment: $255

Colonoscopy, flexible, proximal to splenic flexure, with removal of tumor(s), polyp(s) or other lesion(s) with hot biopsy forceps or bipolar cautery (CPT 45384)

•    Physician office payment: $471
•    Physician facility payment: $277
•    HOPD payment: $737
•    ASC payment: $407

CPT copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

More Articles on Gastroenterology:
5 GI/Endoscopy Devices Receive FDA 510(k) Clearance in May
GI in the News: 5 Gastroenterologist Moves & Honors
How EHR Contributes to GI Center Value: Clinical Quality & Profitability

© Copyright ASC COMMUNICATIONS 2012. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

New from Becker's ASC Review

Colorectal cancer therapy market to hold steady at $7.7B

Read Now