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12 Things to Know About Spine in ASCs

Written by Laura Dyrda | April 21, 2014

Here are 12 things to know about spine in ambulatory surgery centers.

1. Total annual compensation for neurosurgeons is $828,658 on average, according to physician staffing firm Jackson & Coker ("Jackson & Coker 2014 Physician Salary Calculator").

2. Benefits awarded to full-time neurosurgeons amount to $138,110, according to the Jackson & Coker report.

3. Single-level minimally invasive instrumented posterior lumbar fusion at an ambulatory surgery center total billed charges were $42,500 — compared to total billed charges for the same procedure in a hospital at $75,663, according to data from the Microsurgical Spine Center.

4. Not withstanding that ASCs are paid much less for spine surgery than hospitals, many ASCs still struggle to gain contracts for spine surgery. Thus a good deal of spine surgery is performed out-of-network in ASCs.

5. Outpatient spine surgery is largely not reimbursed by Medicare in ASCs. Spine surgeons largely struggle to meet the ASC safe harbor due to this fact. Little Medicare spine work is done in ASCs.

6. Some of the most hotly debated issues in spine surgery include minimally invasive versus open spine procedures. There has been an increase in minimally invasive spine procedures performed over the last decade with evidence-based medicine to support new techniques, leading some surgeons to believe MIS is where the future is headed.

7. Average insurance payment for the outpatient ASCs was $23,208, compared with the insurance payment to the hospital at $26,711, according to Microsurgical Spine Center data. In many ASCs, when compared with hospitals, this difference is much larger in favor of hospitals.

8. Discectomies are the most often reimbursed neurosurgery procedures in many centers.
9. The contribution margin per OR minute for neurological surgery is $48, according to a large Q2 to Q3 2010 data of diversified Regent Surgical Health facilities ("Adding Orthopedics and Spine to an Existing ASC"). This is somewhat dated but provides some sense of reimbursement in ASCs and potential profitability.
10. NeuroSouce/NeuStrategy projected outpatient spine surgery volume to reach 284,850 by 2015 ("Getting Comfortable With Outpatient Spine Surgeries").
11. 22.1 percent of laminectomies are performed in the ambulatory setting, according to an AHRQ report ("Hospital-Based Ambulatory Surgery, 2007").
12. Setting up a spine service at ASCs can cost up to $360,000, according to a report on establishing ASCs.

Learn more about spine surgery in ambulatory surgery centers at the 12th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine. Click here to register.

More Articles on Surgery Centers:
ASC M&A Activity: 4 Big Trends for 2014

10 Things to Know About Orthopedics

OIG Report: ASCs Save Medicare, Beneficiaries Billions

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