50 New Statistics on Surgery Center Payor Mix

Here are 50 new benchmarks on payor mix as a percent of gross charges in surgery centers, based on data from VMG Health’s Multi-Specialty ASC Intellimarker 2011.

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All surgery centers

Medicare: 25 percent
Medicaid: 5 percent
Commercial: 58 percent
Workers’ comp: 5 percent
Self-pay: 4 percent
Other: 7 percent

Orthopedic-driven surgery centers

Medicare: 17 percent
Medicaid: 4 percent
Commercial: 67 percent
Workers’ comp: 12 percent
Self-pay: 1 percent
Other: 5 percent

Based on region


Western United States

Medicare: 22 percent
Medicaid: 3 percent
Commercial: 56 percent
Workers’ comp: 6 percent
Self-pay: 2 percent
Other: 4 percent

Southwestern United States

Medicare: 24 percent
Medicaid: 2 percent
Commercial: 61 percent
Workers’ comp: 2 percent
Self-pay: 2 percent
Other: 4 percent

Midwest United States

Medicare: 20 percent
Medicaid: 3 percent
Commercial: 63 percent
Workers’ comp: 5 percent
Self-pay: 1 percent
Other: 3 percent

Southeast United States

Medicare: 32 percent
Medicaid: 4 percent
Commercial: 51 percent
Workers’ comp: 2 percent
Self-pay: 2 percent
Other: 2 percent

Northeast United States

Medicare: 26 percent
Medicaid: 3 percent
Commercial: 64 percent
Workers’ comp: 4 percent
Self-pay: 1 percent
Other: 4 percent

Based on size

1-2 ORs
Medicare: 29 percent
Medicaid: 3 percent
Commercial: 54 percent
Workers’ comp: 4 percent
Self-pay: 2 percent
Other: 6 percent

3-4 ORs
Medicare: 22 percent
Medicaid: 3 percent
Commercial: 61 percent
Workers’ comp: 4 percent
Self-pay: 1 percent
Other: 4 percent

More than 4 ORs
Medicare: 22 percent
Medicaid: 3 percent
Commercial: 64 percent
Workers’ comp: 3 percent
Self-pay: 2 percent
Other: 4 percent

Learn more about VMG Health publications at the VMG Health website.

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