2. The average gross charges for ENT cases are $6,975. The median case revenue is $1,725.
3. Surgery centers in the Southwest received the highest average net revenue per ENT case with $1,999. Average net revenue was lowest in the Southeast at $1,320 per case.
4. Here are the average net revenues per ENT case by the number of operating rooms in a surgery center:
- 1-2 ORs — $1,799
- 3-4 ORs — $1,793
- More than 4 ORs — $1,749
5. Here are the average net revenues per ENT case by a surgery center’s total annual case volume:
- Less than 3,000 cases — $2,000
- 3,000-5,999 cases — $1,903
- More than 5,999 cases — $1,601
6. Here are the average net revenues per ENT case by a surgery center’s total net revenue:
- Less than $4.5 million — $1,365
- $4.5-$7.0 million — $1,592
- More than $7.0 million — $1,940
Medicare payment data
Here is national Medicare unadjusted average ASC payment for 29 ENT procedures for calendar year 2009.
7. Myringotomy including aspiration and/or eustachian tube inflation (HCPCS 69420): $117
8. Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia (HCPCS 69421) — $597
9. Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia (HCPCS 69433) — $117
10. Tympanostomy (requiring insertion of ventilating tube), general anesthesia (HCPCS 69436) — $597
11. Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material (HCPCS 69660) — $1,195
12. Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out (HCPCS 69662) — $1,195
13. Excision or destruction (eg, laser), intranasal lesion; internal approach (HCPCS 30117) —$597
14. Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy) (HCPCS 30118) — $748
15. Excision or surgical planing of skin of nose for rhinophyma (HCPCS 30120) — $510
16. Excision inferior turbinate, partial or complete, any method (HCPCS 30130) — $597
17. Submucous resection inferior turbinate, partial or complete, any method (HCPCS 30140) — $717
18. Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft (HCPCS 30520) —$807
19. Repair choanal atresia; intranasal (HCPCS 30540) — $1,195
20. Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; superficial (HCPCS 30801) — $314
21. Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; intramural (HCPCS 30802) — $314
22. Laryngotomy (thyrotomy, laryngofissure); with removal of tumor or laryngocele, cordectomy (HCPCS 31300) — $849
23. Epiglottidectomy (HCPCS 31420) — $1,063
24. Laryngoscopy, indirect; with removal of lesion (HCPCS 31512) — $589
25. Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis (HCPCS 31540) — $721
26. Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s) (HCPCS 31545) — $779
27. Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope (HCPCS 31561) — $822
28. Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical) (HCPCS 40820) — $180
29. Uvulectomy, excision of uvula (HCPCS 42140) —$369
30. Destruction of lesion, palate or uvula (thermal, cryo or chemical) (HCPCS 42160) — $141
31. Tonsillectomy and adenoidectomy; under age 12 (HCPCS 42820) — $748
32. Tonsillectomy and adenoidectomy; age 12 or over (HCPCS 42821) — $849
33. Tonsillectomy, primary or secondary; under age 12 (HCPCS 42825) — $807
34. Tonsillectomy, primary or secondary; age 12 or over (HCPCS 42826) — $807
35. Excision or destruction lingual tonsil, any method (separate procedure) (HCPCS 42870) — $748
Sources:
Items 1-6: VMG Health’s 2009 Intellimarker.
Items 7-35: Federal Registrar 73:223, Nov. 18, 2008 (pdf). Note: ASC payment data begins on page 340.
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