Ambulatory surgery centers (ASCs) represent one of the fastest-growing areas of the outpatient care market. According to a 2019 Bain & Company report, surgery center procedure volumes are expected to grow between 6 and 7 percent per year through 2021.
Outpatient surgical procedures tend to be lower in cost than inpatient procedures, and do not require an overnight hospital stay. Because of this, ASCs offer a convenient, cost-effective alternative for patients undergoing some of the most common outpatient procedures, including:
Although these three procedures are among the most performed at surgery centers, they are far from being the costliest. Below, we’ve compiled a list of the top 25 most expensive ambulatory surgery center procedures by average cost per procedure.
In 2019, breast reconstruction of a single breast with “stacked” deep inferior epigastric perforator flap(s) and/or gluteal artery perforator flap(s)—HCPCS code S2067—was the most expensive procedure at ambulatory surgery centers, with a reported average cost of $133,356 per procedure. Breast reconstruction surgeries with flap repair of this kind are among the most complex breast procedures, which could explain the high average cost.
The second and third most expensive surgery center procedures are automated implantable cardioverter-defibrillators (AICD) other than single or dual chamber (HCPCS code C1882) and autologous chondrocyte implantation (HCPCS code J7330), with average costs of $111,187 and $85,498 per procedure, respectively.
There appears to be little to no correlation between total number of procedures and average charge per procedure. For instance, CPT code 33249—insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s)—has the highest reported total number of procedures on the list below. Despite this, it ranks as only the 16th most expensive surgery center procedure by average cost. In fact, some of the most expensive ASC procedures on this list reported only 15 total procedures in 2019.
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|HCPCS/CPT Code||Description||Total Number of Procedures||Total Charges||Avg. Charge per Procedure||Explore This Dataset|
|1.||S2067||Breast stacked " diep/gap"||109||$14,535,855||$133,356||Explore This Profile|
|2.||C1882||AICD, other than sing/dual||134||$14,899,027||$111,187||Explore This Profile|
|3.||J7330||Cultured chondrocytes implnt||555||$47,451,368||$85,498||Explore This Profile|
|4.||J1300||Eculizumab injection||273||$21,136,511||$77,423||Explore This Profile|
|5.||C1722||AICD, single chamber||69||$5,304,665||$76,879||Explore This Profile|
|6.||Q2043||Sipuleucel-T auto CD54+||95||$7,264,735||$76,471||Explore This Profile|
|7.||J0221||Lumizyme injection||24||$1,824,000||$76,000||Explore This Profile|
|8.||C9733||Non-ophthalmic FVA||48||$3,600,000||$75,000||Explore This Profile|
|9.||55970||Sex Transformation M to F||35||$2,561,500||$73,186||Explore This Profile|
|10.||S2068||Breast DIEP or SIEA flap||641||$43,741,013||$68,239||Explore This Profile|
|11.||J2350||Injection, ocrelizumab, 1 mg||494||$33,618,530||$68,054||Explore This Profile|
|12.||33264||Removal & replacement of defibrillator generator; multiple lead system||986||$64,874,630||$65,796||Explore This Profile|
|13.||J0202||Injection, alemtuzumab||16||$948,000||$59,250||Explore This Profile|
|14.||C1721||AICD, dual chamber||138||$8,155,647||$59,099||Explore This Profile|
|15.||33263||Removal & replacement of defibrillator generator; dual lead||670||$39,376,798||$58,771||Explore This Profile|
|16.||33249||Insertion/replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s)||2,968||$168,067,067||$56,626||Explore This Profile|
|17.||L8614||Cochlear device||594||$32,521,724||$54,750||Explore This Profile|
|18.||C9600||Percutaneous transcatheter placement of drug-eluting intracoronary stent; single major coronary artery or branch||371||$19,223,041||$51,814||Explore This Profile|
|19.||69930||Implant cochlear device||1,515||$76,613,993||$50,570||Explore This Profile|
|20.||J3385||Velaglucerase alfa||147||$7,419,120||$50,470||Explore This Profile|
|21.||L8687||Implant neurostimulator pulse generator, dual array, rechargeable||2,318||$116,052,701||$50,066||Explore This Profile|
|22.||33262||Removal & replacement of defibrillator generator; single lead||201||$9,935,101||$49,428||Explore This Profile|
|23.||0375T||Total disc arthroplasty anterior approach||15||$648,868||$43,258||Explore This Profile|
|24.||L8688||Implant neurostimulator pulse generator, dual array, non-rechargeable||727||$31,365,650||$43,144||Explore This Profile|
|25.||L5856||Elec knee-shin swing/stance||16||$682,054||$42,628||Explore This Profile|
Fig. 1 Surgery center procedure analytics are from Definitive Healthcare’s Medical Claims database. Data represents all-payer medical claims through the end of the 2019 claims year, the most recent full-year data available. All-payer medical claims data is sourced from multiple medical claims clearinghouses in the United States and is updated monthly. Accessed August 2020.