3 reimbursement differentials for HOPDs & ASCs — Arthroplasty, spine fusion & more

Procedures such as lumbar spine fusions or pacemaker implants, which were recently approved for ASC reimbursement, could significantly impact hospitals' revenue as outmigration continues, according to an Advisory Board report.

The report provided a snapshot of reimbursement across care settings for three procedures:

1. Partial knee arthroplasty

Inpatient: $13,850
Hospital outpatient department: $10,617
ASC: $7,374
HOPD and ASC reimbursement gap: $3,243

2. Lumbar spine fusion

Inpatient: $26,190
HOPD: $10,617
ASC: $5,070
HOPD and ASC reimbursement gap: $5,547

3. Pacemaker implant

Inpatient: $14,540
HOPD: $7,731
ASC: $3,721
HOPD and ASC reimbursement gap: $4,010

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