Compensation comparison: ASC vs. HOPDs

Financials are important at any business — and ASCs are no exception. However, despite providing the same services, ASCs face unique challenges, such as persistent compensation disparities between ASCs and hospital outpatient departments.

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Below is the average Medicare-approved reimbursement for five of the most common procedures done in ASCs, according to an analysis by healthcare market intelligence company Definitive Healthcare and using CMS’ procedure price lookup tool.

 CPT code 

Procedure

 Avg. reimbursement in ASCs 

 Avg. reimbursement in HOPDs 

64483

 Injection(s), anesthetic agent and/or steroid, lumbar/sacral 

$580

$976

64635

Destruction of lumbar/sacral facet joint(s) by neurolytic

$1,085

$2,027

69436

Incision of eardrum to create opening

$824

$1,611

G0121

Screening colonoscopy, not high risk individual

$652

$1,048

62323

Injection, interlaminar lumbar/sacral spine, epidural

$454

$754

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

160 ambulatory leaders just ranked the EHR as the single system most overdue for AI reinvention

Tuesday, August 11
12:00 PM - 1:00 PM CDT

Presenter: Gautam Shah, MBA, FACHDM, NextGen Healthcare

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