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10 Things to Know About Orthopedics

Written by Ellie Rizzo | April 21, 2014

The following are 10 things to know about orthopedics compensation, reimbursement and case mix in an ambulatory setting.

1. In 2013, the average compensation for an orthopedist was $413,000. This is $62,000 more than the second highest compensated specialty, cardiology. Self-employed orthopedic surgeons reported earning on average $51,000 more than employed orthopedic surgeons, according to Medscape's 2014 Physician Compensation Report.

2. Orthopedic surgeons saw a 1.9 percent increase over last year's income on average. The highest average compensating region for orthopedic surgeons is the Northwest, with average compensation at $468,000 annually, according to Medscape's 2014 Physician Compensation Report.

3. 18 percent of orthopedic surgeons are currently participating in accountable care organizations, and another 10 percent plan to join an ACO in 2014, according to Medscape's 2014 Physician Compensation Report.

4. In a 2013 HealthCare Appraisers survey, orthopedics and sports medicine was the most desirable specialty in an ASC, with 100 percent of respondents saying it was desirable. It was the only specialty of those surveyed to be universally desired. According to the 2011 VMG Intellimarker survey, as a percentage of total cases, orthopedics case mix volume is 17 percent, equivalent to ophthalmology and behind GI/Endoscopy (29 percent).

5. According to the Intellimarker survey, for ASCs with between one and four operating rooms, orthopedics made up between 18 percent and 19 percent of case volume. For ASCs with 4 ORs, it made up only 14 percent of case volume. Conversely, for centers with less than 3,000 cases annually, orthopedics made up 24 percent of case volume, while in centers with 6,000 or more annual cases it made up 15 percent of case volume. Centers seeing between 3,000 and 6,000 cases each year had 17 percent orthopedic cases.

6. 47 percent of self-employed orthopedic surgeons report offering new ancillary services, in contrast with just 16 percent of employed orthopedic surgeons, according to Medscape's 2014 Physician Compensation Report.

7. On average, the gross charges per case on average for orthopedics in ASCs is $9,398, with an average net revenue per case of $2,585 and a discount to charges per case of 71.1 percent. Net revenue per case is highest in the Midwest at $2,890 and lowest in the Northeast at $2,303. In a recent CMS release of Medicare billing data, it was revealed the average surgeon reimbursement for a total joint replacement is $6,041, according to a report from nerdwallet.

8. Orthopedic surgeons are particularly conscious of reimbursements: 51 percent of orthopedic surgeons say they will drop poorly paying insurers, according to Medscape's 2014 Physician Compensation Report.

9. In surgery centers with more than 50 percent orthopedics, the average administrator salary is $112,517. Nursing staff receive an average of $33.64 per hour, and administrative staff receive around $24.38 per hour, according to the Intellimarker survey.

10. In centers with more than 50 percent orthopedics cases, centers see 735 cases per OR per year, and 2.9 cases per OR per day in about three operating rooms. Approximately half of all cases are performed by between two and five top-producing physicians, according to the Intellimarker survey.

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