Top 25 most expensive ASC procedures by average charge
Ambulatory surgery centers (ASCs) represent one of the fastest-growing areas of the outpatient care market. Below we’ve compiled a list of the top 25 most expensive ambulatory surgery center procedures by the average charge per procedure.
What is an ambulatory surgery center (ASC)?
Created in 1970, ASCs are modern healthcare facilities that provide outpatient surgical care for procedures that do not require hospital admission. ASCs are highly regulated by states and by CMS to ensure high-quality care. The combination of high-quality care and lower costs makes them an attractive alternative for both patients and hospital systems.
What is the most expensive ambulatory surgery center procedure?
Three types of procedures dominate the top five most expensive surgical center procedures: breast reconstruction, implantable therapies and injectable treatments.
In 2021, breast reconstruction appeared twice in the top five most expensive procedures. Breast reconstruction of a single breast with “stacked” deep inferior epigastric perforator flap(s) and/or gluteal artery perforator flap(s)—HCPCS code S2067 —took the top spot with a reported average charge of $120,262 per procedure. Meanwhile, breast reconstruction with deep inferior epigastric perforator (DIEP) flap or superficial inferior epigastric artery (SIEA) flap (HCPCS code S2068) was the fifth most expensive procedure. Breast reconstruction surgeries with flap repairs of this kind are among the most complex breast procedures, explaining the high average cost.
The second most expensive surgery center procedure is autologous chondrocyte implantation (HCPCS code J7330), used to treat cartilage defects of the knee. Chondrocytes, the cartilage-producing cells of the body, are taken from the patient, multiplied in number over a few weeks and implanted back in the joint to replace the damaged cartilage with living, healthy cartilage. Multiple implantable treatments, from cardiac contractility modulation devices to defibrillator pulse generators to cochlear implants, appear on the list.
Injections of specific treatments also appear multiple times on the list and in the top five most expensive procedures. Injections of eculizumab (HCPCS code J1300), a monoclonal antibody treatment used most frequently in the treatment of blood disorders, came in as the third most expensive procedure, and injections of ocrelizumab (HCPCS code J2350), a monoclonal antibody treatment used for multiple sclerosis, took the fourth spot.
Most expensive ambulatory surgery center procedures
||Total # of Procedures
||Average Charge Per Procedure
||Breast reconstruction of a single breast with "stacked" deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascular transfer, closure of donor site(s) and shaping the flap into a breast, unilateral
||Autologous cultured chondrocytes, implant
||Injection, eculizumab, 10 mg
||Injection, ocrelizumab, 1 mg
||Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral
||Generator, cardiac contractility modulation (implantable)
||Intersex surgery; male to female
||Non-ophthalmic fluorescent vascular angiography
||Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm
||Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system
||Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)
||Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion
||Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical
||Cochlear device implantation, with or without mastoidectomy
||Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber
||Injection, velaglucerase alfa, 100 units
||Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system
||Cochlear device, includes all internal and external components
||Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator with transvenous electrodes
||Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
||Novafix dl, per square centimeter
||Thoracoscopy, surgical; with thoracic sympathectomy
||Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension
||Cardioverter-defibrillator, other than single or dual chamber (implantable)
||Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar
Fig. 1 – Data from Definitive Healthcare’s ClaimsMx product representing claims from January – November 2021. Procedures with fewer than a total of 20 procedures were excluded. Commercial claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accessed January 7, 2022.