Healthcare Insights

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

RankHCPCS/CPT CodeDescriptionTotal # of ProceduresTotal ChargesAverage Charge Per ProcedureExplore Dataset”
1S2067 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 134 $16,115,051 $120,262  Explore
2. J7330 Autologous cultured chondrocytes, implant 699 $65,744,708 $94,055  Explore
3. J1300 Injection, eculizumab, 10 mg 249 $22,213,830 $89,212  Explore
4J2350 Injection, ocrelizumab, 1 mg 615 $52,840,922  $85,920  Explore
5S2068 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 749 $57,504,604  $76,775  Explore
6C1824 Generator, cardiac contractility modulation (implantable) 29 $2,213,402  $76,324  Explore
755970 Intersex surgery; male to female 39 $2,963,500  $75,987  Explore
8C9733 Non-ophthalmic fluorescent vascular angiography 97 $7,057,951  $72,762  Explore
964893 Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm 25 $1,635,780  $65,431  Explore
1033264 Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system 1,106 $72,281,126  $65,354  Explore
1127100 Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft) 52$3,391,127  $65,214  Explore
12Q2043 Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion 59 $3,639,414  $61,685  Explore
1322220 Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical 46 $2,762,442  $60,053  Explore
1469930 Cochlear device implantation, with or without mastoidectomy 1,510 $90,505,426  $59,937  Explore
1533249 Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber 2,734 $158,861,667  $58,106  Explore
16J3385 Injection, velaglucerase alfa, 100 units 21 $1,198,256  $57,060  Explore
1733263 Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system 685 $37,349,965  $54,525  Explore
18L8614 Cochlear device, includes all internal and external components 554$30,091,977  $54,318  Explore
190408T 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 31 $1,680,313  $54,204  Explore
20C9604 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 133$7,123,302  $53,559  Explore
21Q4254 Novafix dl, per square centimeter 74 $3,660,488  $49,466  Explore
2232664 Thoracoscopy, surgical; with thoracic sympathectomy 36 $1,753,085  $48,697  Explore
23L8687 Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension 1,813 $86,276,487  $47,588  Explore
24C1882 Cardioverter-defibrillator, other than single or dual chamber (implantable) 229 $10,864,624  $47,444  Explore
2522857 Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar 372 $17,554,621  $47,190  Explore

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. 

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