2. The average gross charges for ophthalmology cases are $5,385. The average case revenue is $1,226.
3. Surgery centers in the Southwest received the highest average net revenue per ophthalmology case with $1,356. Average net revenue was lowest in the Southeast at $1,099 per case.
4. Here are the average net revenues per ophthalmology case by the number of operating rooms in a surgery center:
- 1-2 ORs — $1,119
- 3-4 ORs — $1,216
- More than 4 ORs — $1,319
5. Here are the average net revenues per ophthalmology case by a surgery center’s total annual case volume:
- Less than 3,000 cases — $1,128
- 3,000-5,999 cases — $1,246
- More than 5,999 cases — $1,227
6. Here are the average net revenues per ophthalmology case by a surgery center’s total net revenue:
- Less than $4.5 million — $1,120
- $4.5-$7.0 million — $1,141
- More than $7.0 million — $1,356
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 two ophthalmology procedures commonly performed in ASCs.
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7. Post-cataract laser surgery (CPT 66821)
- average sub charge: $1,019
- average allow charge: $282
- average payment: $221
8. Cataract removal, insertion of lens (CPT 66984)
- average sub charge: $2,990
- average allow charge: $964
- average payment: $763
Sources:
Items 1-6: VMG Health’s 2009 Intellimarker.
Items 7-8: CMS
