Becker's Spine Review

9 SPINE SURGEONS CMS pay for 10 spine 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 spine procedures cost at ASCs and hospital outpatient depart- ments: Editorial note: is is not an exhaustive list. Prices include facility and physician fees. 1. Insertion of stabilizing or separating device into lower spine at single level with open decompression (22867) ASC Total cost: $13,265 Medicare pays: $10,612 Patient pays: $2,653 HOPD Total cost: $16,966 Medicare pays: $15,354 Patient pays: $1,612 2. Insertion of artificial upper spine disc, anterior approach (22856) ASC Total cost: $13,515 Medicare pays: $10,812 Patient pays: $2,702 HOPD Total cost: $17,655 Medicare pays: $15,905 Patient pays: $1,749 3. Insertion of stabilizing or separating de- vice into lower spine at single level (22869) ASC Total cost: $10,337 Medicare pays: $8,270 Patient pays: $2,066 HOPD Total cost: $12,363 Medicare pays: $10,863 Patient pays: $1,500 4. Fusion of lower spine bones, posterior or posterolateral approach (22612) ASC Total cost: $10,267 Medicare pays: $8,214 Patient pays: $2,053 HOPD Total cost: $13,560 Medicare pays: $11,820 Patient pays: $1,740 5. Arthrodesis, anterior interbody, includ- ing disc space preparation, discectomy, os- teophytectomy and decompression of spi- nal cord and/or nerve roots; cervical below C2 (22551) ASC Total cost: $10,201 Medicare pays: $8,160 Patient pays: $2,309 HOPD Total cost: $13,682 Medicare pays: $11,917 Patient pays: $1,764 6. Arthrodesis, anterior interbody tech- nique, including minimal discectomy to prepare interspace (other than for decom- pression); cervical below C2 (22554) ASC Total cost: $9,738 Medicare pays: $7,789 Patient pays: $1,947 HOPD Total cost: $13,211 Medicare pays: $11,540 Patient pays: $1,670 7. Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed (63663) ASC Total cost: $4,882 Medicare pays: $3,905 Patient pays: $975 HOPD Total cost: $6,656 Medicare pays: $5,324 Patient pays: $1,330 8. Partial removal of upper spine bone with release of spinal cord and/or nerves (63045) ASC Total cost: $4,145 Medicare pays: $3,315 Patient pays: $828 HOPD Total cost: $7,323 Medicare pays: $5,858 Patient pays: $1,464 9. Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar (63047) ASC Total cost: $3,954 Medicare pays: $3,163 Patient pays: $790 HOPD Total cost: $7,132 Medicare pays: $5,706 Patient pays: $1,426 10. Partial removal of bone with release of spinal cord or spinal nerves of one inter- space in lower spine (63030) ASC Total cost: $3,817 Medicare pays: $3,053 Patient pays: $762 HOPD Total cost: $6,995 Medicare pays: $5,596 Patient pays: $1,398 n

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