Becker's Spine Review

Becker's March/April 2021 Spine Review

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12 SPINE SURGEONS CMS pay for 10 orthopedic procedures at ASCs vs. HOPDs By Alan Condon C MS' procedure price lookup tool enables users to compare average pay for several procedures in ASCs and hospital outpatient departments. e tool shows national averages for the amount Medicare pays an ASC or hospital, as well as the national average copayment a patient without Medicare supplemental in- surance owes in each setting. Here's what 10 common orthopedic procedures cost at ASCs and hospital outpatient departments: Editorial note: is is not an exhaustive list. Prices include facility and physician fees. 1. Repair of shoulder rotator cuff using an endoscope (29827) ASC Total cost: $3,918 Medicare pays: $3,134 Patient pays: $783 HOPD Total cost: $7,096 Medicare pays: $5,677 Patient pays: $1,419 2. Removal of bone cyst or growth of hip or pelvic bone with patient-derived bone gra (27067) ASC Total cost: $3,881 Medicare pays: $3,104 Patient pays: $775 HOPD Total cost: $7,059 Medicare pays: $5,647 Patient pays: $1,411 3. Removal or shaving of hip joint socket cartilage using an endoscope (29862) ASC Total cost: $3,649 Medicare pays: $2,919 Patient pays: $729 HOPD Total cost: $6,827 Medicare pays: $5,462 Patient pays: $1,365 4. Arthroscopy, knee, surgical; with menis- cus repair (medial or lateral) (29882) ASC Total cost: $2,007 Medicare pays: $1,605 Patient pays: $401 HOPD Total cost: $3,458 Medicare pays: $2,765 Patient pays: $691 5. Incision to repair shoulder joint (23040) ASC Total cost: $2,033 Medicare pays: $1,626 Patient pays: $406 HOPD Total cost: $3,484 Medicare pays: $2,786 Patient pays: $696 6. Arthroscopy, knee, surgical; abrasion ar- throplasty (includes chondroplasty where necessary) or multiple drilling or microf- racture (29879) ASC Total cost: $1,974 Medicare pays: $1,580 Patient pays: $394 HOPD Total cost: $3,425 Medicare pays: $2,740 Patient pays: $684 7. Removal of tissue and/or bone at elbow with tendon repair, open procedure (24359) ASC Total cost: $1,974 Medicare pays: $1,580 Patient pays: $394 HOPD Total cost: $3,425 Medicare pays: $2,740 Patient pays: $684 8. Removal of both knee cartilages using an endoscope (29880) ASC Total cost: $1,870 Medicare pays: $1,496 Patient pays: $373 HOPD Total cost: $3,321 Medicare pays: $2,656 Patient pays: $663 9. Arthroscopy, ankle (tibiotalar and fibu- lotalar joints), surgical; synovectomy, par- tial (29895) ASC Total cost: $1,769 Medicare pays: $1,415 Patient pays: $353 HOPD Total cost: $3,220 Medicare pays: $2,575 Patient pays: $643 10. Release and/or relocation of median nerve of hand (64721) ASC Total cost: $1,242 Medicare pays: $994 Patient pays: $248 HOPD Total cost: $2,165 Medicare pays: $1,732 Patient pays: $432 n

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