Average Charge and Payment Data for 4 Spine/Pain Management Procedures Commonly Performed in ASCs

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Hospital Review: Business and Legal Issues - Hot Topics

Average Charge and Payment Data for 4 Spine/Pain Management Procedures Commonly Performed in ASCs

Written by Stephanie Wasek

Friday, 22 August 2008

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 four spine/pain management procedures commonly performed in ASCs.

1. Injection of lower back joint (HCPCS G0260)
- average sub charge: $1,290
- average allow charge $281
- average payment: $222

2. Single nerve block injection, arm nerve (CPT 64415)
- average sub charge: $1,262
- average allow charge $83
- average payment: $65

3. Multiple nerve block injections, rib nerves (CPT 64421)
- average sub charge: $1,323
- average allow charge $317
- average payment: $249

4. Injection of lower back spinal joint or nerve (CPT 64476)
- average sub charge: $1,146
- average allow charge $186
- average payment: $148