19 Statistics About Orthopedics in Surgery Centers

1. Orthopedics accounts for around 16 percent of the total case volume mix in surgery centers, second behind GI/endoscopy (25 percent), ophthalmology (18 percent) and pain management (17 percent). The average surgery center performs 4,869 cases annually, which would average to around 779 orthopedics cases annually.

2. The average gross charges for orthopedic cases are $8,026. The average case revenue is $2,453.

3. Surgery centers in the Midwest received the highest average net revenue per orthopedics case with $2,739. Average net revenue was lowest in the Southeast at $2,111 per case.

4. Here are the average net revenues per orthopedics case by the number of operating rooms in the surgery center:

  • 1-2 ORs — $2,111
  • 3-4 ORs — $2,482
  • More than 4 ORs — $2,383

5. Here are the average net revenues per orthopedics case by a surgery center's total annual case volume:
  • Less than 3,000 cases — $2,688
  • 3,000-5,999 cases — $2,561
  • More than 5,999 cases — $2,228

6. Here are the average net revenues per orthopedics case by a surgery center's total net revenue:
  • Less than $4.5 million — $1,958
  • $4.5-$7.0 million — $2,354
  • More than $7.0 million — $2,545

Medicare charges and payments
Here is the average 2008 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient) and average payment (Medicare payments divided by allowed services, not including co-pays and deductibles paid by patient) for 14 orthopedic procedures commonly performed in ASCs.

CPT copyright 2008 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

7. Obtaining small amount of bone for graft (CPT 20900):
  • average sub charge: $2,378
  • average allow charge: $464
  • average payment: $365

8. Open surgical partial removal of collar bone (CPT 23120):
  • average sub charge: $4,052
  • average allow charge: $511
  • average payment: $400

9. Partial repair or removal of shoulder bone (CPT 23130):
  • average sub charge: $4,307
  • average allow charge: $747
  • average payment: $590

10. Open repair of rotator cuff, recent (CPT 23410):
  • average sub charge: $5,556
  • average allow charge: $950
  • average payment: $748

11. Open repair of rotator cuff, old (CPT 23412):
  • average sub charge: $6,078
  • average allow charge: $1,171
  • average payment: $924

12. Reconstruction rotator cuff, old (CPT 23420):
  • average sub charge: $6,301
  • average allow charge: $1,165
  • average payment: $925

13. Open repair elbow fracture involving ulnar bone (CPT 24685):
  • average sub charge: $4,578
  • average allow charge: $799
  • average payment: $633

14. Wrist fracture pinning through skin (CPT 25606):
  • average sub charge: $3,168
  • average allow charge: $637
  • average payment: $504

15. Open surgical treatment wrist fracture (radius) (CPT 25607):
  • average sub charge: $5,405
  • average allow charge: $1,142
  • average payment: $900

16. Shoulder scope, repair cartilage tear (CPT 29807):
  • average sub charge: $4,803
  • average allow charge: $674
  • average payment: $531

17. Shoulder scope, partial removal collar bone (CPT 29824):
  • average sub charge: $4,408
  • average allow charge: $439
  • average payment: $346

18. Shoulder scope, bone shaving (CPT 29826):
  • average sub charge: $5,207
  • average allow charge: $679
  • average payment: $535

19. Shoulder scope, rotator cuff repair (CPT 29827):
  • average sub charge: $5,906
  • average allow charge: $991
  • average payment: $781

Sources:
Items 1-6: VMG Health's 2009 Intellimarker
Items 7-20: CMS

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