1. Urology represents 2 percent of the average case volume in surgery centers. The average surgery center performs 4,869 cases annually, which would average to around 97 urology cases annually.
2. The average gross charges for urology cases are $4,711. The median case revenue is $1,196.
3. Surgery centers in the West received the highest average net revenue per urology case with $1,557. Average net revenue was lowest in the Northeast at $1,011 per case.
4. Here are the average net revenues per urology case by the number of operating rooms in a surgery center:
- 1-2 ORs — $1,059
- 3-4 ORs — $1,242
- More than 4 ORs — $1,184
5. Here are the average net revenues per urology case by a surgery center’s total annual case volume:
- Less than 3,000 cases — $1,248
- 3,000-5,999 cases — $1,210
- More than 5,999 cases — $1,184
6. Here are the average net revenues per urology case by a surgery center’s total net revenue:
- Less than $4.5 million — $1,077
- $4.5-$7.0 million — $1,301
- More than $7.0 million — $1,342
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 20 urology procedures commonly performed in ASCs.
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7. Bladder pressure measurement during filling (CPT 51726)
- average sub charge: $649
- average allow charge: $177
- average payment: $140
8. Prostate needle biopsy, any approach (CPT 55700)
- average sub charge: $1,476
- average allow charge $368
- average payment: $288
9. Scope of bladder and urethra, for diagnosis (CPT 52000)
- average sub charge: $998
- average allow charge: $307
- average payment: $241
10. Scope bladder, insert tube for injection (CPT 52005)
- average sub charge: $2,469
- average allow charge: $472
- average payment: $373
11. Scope bladder and urethra, with biopsy (CPT 52204)
- average sub charge: $2,291
- average allow charge: $506
- average payment: $400
12. Scope bladder, destruction of lesions (CPT 52214)
- average sub charge: $2,623
- average allow charge: $574
- average payment: $457
13. Scope bladder, removal of tumors, small (CPT 52234)
- average sub charge: $2,772
- average allow charge: $583
- average payment: $460
14. Scope bladder, removal of tumors, medium (CPT 52235)
- average sub charge: $2,843
- average allow charge: $633
- average payment: $502
15. Scope bladder, removal of tumors, large (CPT 52240)
- average sub charge: $3,336
- average allow charge: $636
- average payment: $505
16. Scope bladder, opening of bladder (CPT 52260)
- average sub charge: $2,356
- average allow charge: $506
- average payment: $396
17. Scope bladder, open narrowed female urethra (CPT 52285)
- average sub charge: $1,176
- average allow charge: $512
- average payment: $404
18. Scope bladder, simple removal stone, stent (CPT 52310)
- average sub charge: $1,720
- average allow charge: $472
- average payment: $373
19. Scope bladder, complex removal stone, stent (CPT 52315)
- average sub charge: $2,558
- average allow charge: $593
- average payment: $469
20. Scope bladder & ureter, insert stent into ureter (CPT 52332)
- average sub charge: $2,821
- average allow charge: $510
- average payment: $402
21. Scope bladder & ureter, remove or move stones (CPT 52352)
- average sub charge: $3,408
- average allow charge: $695
- average payment: $547
22. Scope bladder & ureter, break up kidney stone (CPT 52353)
- average sub charge: $4,258
- average allow charge: $835
- average payment: $659
23. Surgery on bladder neck through urethra (CPT 52500)
- average sub charge: $2,790
- average allow charge: $627
- average payment: $492
24. Opening of postoperative bladder neck narrowing (CPT 52640)
- average sub charge: $2,817
- average allow charge: $581
- average payment: $458
25. Laser coagulation of prostate for urine flow (CPT 52647)
- average sub charge: $4,965
- •average allow charge: $1,407
- average payment: $1,060
26. Laser vaporization of prostate for urine flow (CPT 52648)
- average sub charge: 4,967
- average allow charge: 1,442
- average payment: $1,139
Sources:
Items 1-6: VMG Health’s 2009 Intellimarker.
Items 7-26: CMS
