Healthcare Insights

Most Expensive Ambulatory Surgery Center Procedures

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:

  • Cataract removals
  • Botox injections, and
  • Colonoscopies

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.

What is the most expensive surgery center 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.

Top 25 most expensive ASC procedures by average cost

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 HCPCS/CPT CodeDescriptionTotal Number of ProceduresTotal ChargesAvg. Charge per ProcedureExplore This Dataset
1.S2067Breast stacked " diep/gap"109$14,535,855$133,356Explore This Profile
2.C1882AICD, other than sing/dual134$14,899,027$111,187Explore This Profile
3.J7330Cultured chondrocytes implnt555$47,451,368$85,498Explore This Profile
4.J1300Eculizumab injection273$21,136,511$77,423Explore This Profile
5.C1722AICD, single chamber69$5,304,665$76,879Explore This Profile
6.Q2043Sipuleucel-T auto CD54+95$7,264,735$76,471Explore This Profile
7.J0221Lumizyme injection24$1,824,000$76,000Explore This Profile
8.C9733Non-ophthalmic FVA48$3,600,000$75,000Explore This Profile
9.55970Sex Transformation M to F35$2,561,500$73,186Explore This Profile
10.S2068Breast DIEP or SIEA flap641$43,741,013$68,239Explore This Profile
11.J2350Injection, ocrelizumab, 1 mg494$33,618,530$68,054Explore This Profile
12.33264Removal & replacement of defibrillator generator; multiple lead system986$64,874,630$65,796Explore This Profile
13.J0202Injection, alemtuzumab16$948,000$59,250Explore This Profile
14.C1721AICD, dual chamber138$8,155,647$59,099Explore This Profile
15.33263Removal & replacement of defibrillator generator; dual lead670$39,376,798$58,771Explore This Profile
16.33249Insertion/replacement of permanent pacing cardioverter-defibrillator system with transvenous lead(s)2,968$168,067,067$56,626Explore This Profile
17.L8614Cochlear device594$32,521,724$54,750Explore This Profile
18.C9600Percutaneous transcatheter placement of drug-eluting intracoronary stent; single major coronary artery or branch371$19,223,041$51,814Explore This Profile
19.69930Implant cochlear device1,515$76,613,993$50,570Explore This Profile
20.J3385Velaglucerase alfa147$7,419,120$50,470Explore This Profile
21.L8687Implant neurostimulator pulse generator, dual array, rechargeable2,318$116,052,701$50,066Explore This Profile
22.33262Removal & replacement of defibrillator generator; single lead201$9,935,101$49,428Explore This Profile
23.0375TTotal disc arthroplasty anterior approach15$648,868$43,258Explore This Profile
24.L8688Implant neurostimulator pulse generator, dual array, non-rechargeable727$31,365,650$43,144Explore This Profile
25.L5856Elec knee-shin swing/stance16$682,054$42,628Explore 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.

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