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Healthcare Insights

Top 25 most common ASC procedures by percent of total charges

Ambulatory surgery centers (ASCs) are among the fastest-growing segments of the outpatient care market, driven by their ability to offer surgical services at lower costs compared to hospitals. This cost-effectiveness is appealing to insurers, patients, and healthcare providers aiming to manage healthcare expenditures more efficiently. Advances in medical technology have also broadened the scope of procedures that can be safely performed in ASCs.

Using SurgeryCenterView, we compiled a list of the top 25 most common ambulatory surgery center procedures performed in 2023 and ranked them by percent of charges for all services made for that year. Understanding these procedure trends is crucial for companies navigating the dynamic landscape of outpatient healthcare, facilitating informed decision-making and strategic planning.

Most common ASC procedures by percent of total charges

RankHCPCS/CPT codeHCPCS/CPT description% total chargesAverage charge per procedureExplore dataset
166984Excision of cataract with removal of lens, without ECP8.5%$3,867 Explore
245385Colonoscopy, with removal of lesion(s)4.3%$2,009 Explore
345380Colonoscopy, with biopsy, single/multiple4.3%$2,073 Explore
443239Esophagogastroduodenoscopy, biopsy, single/multiple3.9%$1,806 Explore
545378Diagnostic colonoscopy2.3%$1,949 Explore
664483Injection(s), anesthetic agent and/or steroid, lumbar/sacral1.3%$2,473 Explore
7812Anesthesia for lower intestine scope, colonoscopy0.9%$974 Explore
864493Injection(s), anesthetic agent and/or steroid, lumbar/sacral0.9%$2,517 Explore
964635Destruction of lumbar/sacral facet joint(s) by neurolytic0.9%$3,973 Explore
1069436Incision of eardrum to create opening0.8%$3,366 Explore
11142Anesthesia for lens surgery0.7%$772 Explore
12811Anesthesia for lower intestine endoscopy, not otherwise spec.0.6%$1,013 Explore
13G0121Screening colonoscopy, not high risk individual0.6%$1,750 Explore
1462323Injection, interlaminar lumbar/sacral spine, epidural0.6%$2,003 Explore
15731Anesthesia for upper gastrointestinal endoscopy, not otherw.0.5%$1,129 Explore
16813Anesthesia for upper and lower GI endoscopy, not otherwise sp.0.5%$1,294 Explore
17C1713Anchor/screw, bone/bone, tissue/bone0.5%$1,519 Explore
18G0105Colorectal cancer screening, high risk individual0.5%$1,539 Explore
1964494Injection(s), anesthetic agent and/or steroid, lumbar/sacral0.5%$1,900 Explore
2066821Posterior chamber lens surgery after cataract removal0.4%$1,054 Explore
2199214Office or other outpatient visit, established patient, 30 min0.2%$277 Explore
2299213Office or other outpatient visit, established patient, 20 min0.1%$191 Explore
23G8907Patient had no events on discharge0.0%$0 Explore
24G8918Patient without preoperative ordered intravenous antibiotics0.0%$0 Explore
2536415Routine venipuncture0.0%$11 Explore

Fig. 1 – Data is from the Definitive Healthcare Atlas All Payor Claims Dataset for the calendar year 2023. Claims data is sourced from multiple medical claims clearinghouses in the United States and is updated monthly. Data accessed June 2024.

Which ASC procedures have the most charges?

The procedure with the highest percentage of total charges in 2023 is extracapsular cataract removal without endoscopic cyclophotocoagulation (CPT code 66984), which accounted for 8.5% of charges at ambulatory surgery centers in the U.S. This procedure involves the removal of a cataract and implantation of an artificial intraocular lens (IOL), often using advanced techniques or specialized devices not typical in routine cataract surgery.

Following closely is CPT code 45385, describing a colonoscopy with removal of lesion(s), which represented 4.3% of ASC charges. This procedure involves using a flexible tube with a camera to examine and remove lesions from the colon, aiding in the diagnosis and treatment of various gastrointestinal conditions such as colorectal cancer, polyps, and inflammation. 

Next is CPT code 45380, describing a colonoscopy with biopsy, single or multiple, which also accounted for 4.3% of ASC charges. This procedure uses a flexible tube with a camera to examine the colon's inner lining and take tissue samples for biopsy, aiding in diagnosing various gastrointestinal conditions. 

What surgeries are performed in an ASC?

ASCs can perform a wide range of surgical procedures that do not involve complex interventions or prolonged recovery times. Some surgeries performed in ASCs include:

  • Orthopedics: Arthroscopic procedures for the knee, shoulder, or other joints, and carpal tunnel release
  • Ophthalmology: Cataract surgery, corneal procedures, and other eye surgeries
  • Gastroenterology: Colonoscopy, endoscopy, and certain types of hernia repairs
  • Ear, nose, and throat (ENT): Tonsillectomy, adenoidectomy, and sinus surgery
  • Cosmetic surgeries: Rhinoplasty, blepharoplasty, and abdominoplasty
  • Urology: Prostate biopsies, kidney stone removal, and cystoscopy 
  • Gynecology: Tubal ligation, endometrial ablation, and cervical biopsy
  • Podiatry: Bunion surgery, ingrown toenail removal, and other foot and ankle procedures

Who can own an ambulatory surgery center?

Ownership of ambulatory surgery centers varies based on state regulations and federal laws. Generally, the following entities or individuals can own ASCs:

  • Physicians: Many ASCs are owned wholly or in part by physicians, including surgeons and specialists who perform procedures at the center. 
  • Hospitals: Hospitals may own ASCs either independently or through joint ventures with physicians or other entities. Hospital-owned ASCs can benefit from economies of scale, shared resources, and integrated care models.
  • Health systems and IDNs: Larger healthcare systems and IDNs often own ASCs as part of their broader network of healthcare facilities. This ownership structure allows for coordinated care and seamless patient referrals between ASCs and other healthcare services within the system.
  • Corporate entities: Some ASCs are owned by corporate entities that specialize in healthcare management or outpatient surgery services. These entities may operate multiple ASCs across different regions or specialties.
  • Joint ventures: ASC ownership can also be structured as joint ventures between physicians, hospitals, health systems, or corporate entities. Joint ventures allow for shared investment, risk, and governance among the participating parties.
  • Management companies: Management companies specializing in ASC operations may manage and operate ASCs on behalf of physician groups, hospitals, or corporate owners. These companies provide expertise in regulatory compliance, operational efficiency, and financial management.

Ownership rules and regulations can vary significantly by state, and compliance with federal laws, such as the federal Stark Law and Anti-Kickback Statute, is crucial for structuring ownership arrangements involving referrals and financial relationships between physicians and ASCs. As such, ownership of ASCs is typically structured to comply with these regulatory frameworks while promoting quality care and efficiency in outpatient surgical services. 

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