Issue link: https://beckershealthcare.uberflip.com/i/1425344
12 SPINE SURGEONS CMS pay for 15 spine procedures at ASCs vs. HOPDs By Alan Condon C MS' procedure price look-up tool allows 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 15 spine procedures cost at ASCs and hospital outpatient departments: 1. Insertion or replacement of spinal neu- rostimulator pulse generator or receiver, direct or inductive coupling (63685) ASC Total cost: $24,266 Medicare pays: $19,413 Patient pays: $4,852 HOPD Total cost: $29,816 Medicare pays: $28,258 Patient pays: $1,558 2. 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 3. 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 4. 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 5. 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 6. 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 7. Revision including replacement, when performed, of spinal neurostimulator elec- trode plate/paddle(s) placed via laminoto- my or laminectomy, including fluoroscopy, when performed (63664) ASC Total cost: $9,966 Medicare pays: $7,973 Patient pays: $1,992 HOPD Total cost: $12,143 Medicare pays: $10,478 Patient pays: $1,665 8. 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 9. Revision including replacement, when performed, of spinal neurostimulator elec- trode percutaneous array(s), including flu- oroscopy, 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 10. Discectomy, anterior, with decompres- sion of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace (63075) ASC Total cost: $4,336 Medicare pays: $3,461 Patient pays: $864 HOPD Total cost: $7,661 Medicare pays: $6,129 Patient pays: $1,532 11. Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminoto- my or discectomy (eg, spinal stenosis), one or two vertebral segments; thoracic (63003) ASC Total cost: $4,200 Medicare pays: $3,360 Patient pays: $839 HOPD Total cost: $7,535 Medicare pays: $6,028 Patient pays: $1,507 12. 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