The tool shows national averages for the amount Medicare pays an ASC or hospital, and the national average copayment a patient without Medicare supplemental insurance owes in each setting.
Here’s what 10 gastroenterology procedures cost at ASCs and hospital outpatient departments:
1. Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) (Code: 43653)
ASC
Total Cost: $2,902
Medicare pays: $2,322
Patient pays: $580
HOPD
Total cost: $5,657
Medicare pays: $4,526
Patient pays: $1,131
2. Closure of gastrostomy, surgical
ASC
Total Cost: $2,107
Medicare pays: $1,685
Patient pays: $420
HOPD
Total cost: $3,813
Medicare pays: $3,050
Patient pays: $762
3. Gastrocnemius recession (Code: 27687)
ASC
Total Cost: $1,794
Medicare pays: $1,434
Patient pays: $358
HOPD
Total cost: $3,296
Medicare pays: $2,636
Patient pays: $659
4. Colonoscopy, flexible; with endoscopic mucosal resection (Code: 45390)
ASC
Total Cost: $1,484
Medicare pays: $1,186
Patient pays: $296
HOPD
Total cost: $2,780
Medicare pays: $2,223
Patient pays: $555
5. Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure) (Code: 43830)
ASC
Total Cost: $1,415
Medicare pays: $1,131
Patient pays: $282
HOPD
Total cost: $2,351
Medicare pays: $1,881
Patient pays: $470
6. Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseau-Barbin) (Code: 43510)
ASC
Total Cost: $1,390
Medicare pays: $1,112
Patient pays: $277
HOPD
Total cost: $1,790
Medicare pays: $1,432
Patient pays: $357
7. Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report (Code: 49440)
ASC
Total Cost: $894
Medicare pays: $715
Patient pays: $178
HOPD
Total cost: $1,830
Medicare pays: $1,464
Patient pays: $366
8. Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)
ASC
Total Cost: $844
Medicare pays: $675
Patient pays: $168
HOPD
Total cost: $1,780
Medicare pays: $1,424
Patient pays: $356
9. Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed (Code: 45393)
ASC
Total Cost: $781
Medicare pays: $624
Patient pays: $155
HOPD
Total cost: $1,293
Medicare pays: $1,034
Patient pays: $258
10. Colonoscopy, flexible; with biopsy, single or multiple (Code: 45380)
ASC
Total Cost: $728
Medicare pays: $582
Patient pays: $144
HOPD
Total cost: $1,240
Medicare pays: $992
Patient pays: $246
