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As medical technology advances and guidelines for routine inpatient surgeries are relaxed, physicians are able to perform a greater number of procedures in an outpatient setting.
This is generally beneficial for patients, as costs at an ambulatory surgery center (ASC) are lower on average than at a hospital or other inpatient facility. While most hospitals offer outpatient surgery, ASCs have been praised as a superior choice for certain procedures. This preference is due to facility efficiencies and greater regulatory controls for reimbursements under the outpatient prospective payment system.
Definitive Healthcare tracks nearly 3,000 procedure types performed at over 9,000 ASCs. The following lists rank the top 25 procedures performed at surgery centers by total charges as well as procedure volume.
Topping the list is Extracapsular cataract removal, CPT code 66984, followed by an injection of onabotulinumtoxinA, HCPCSs code J0585, with nearly 900,000 procedures. OnabotulinumtoxinA is an injectable neurotoxin, better known under brand names such as Botox and Botox Cosmetics.
Both lists of procedures are dominated by diagnostic procedures such as colonoscopies and esophagogastroduodenoscopies with biopsies. Cataracts surgeries also topped both lists, with more than 1.2 million procedures reported in 2018 (most recent data available). Spinal injections were also common, including joint denervations.
Top 25 Most Performed Procedures at Ambulatory Surgery Centers
| Rank | HCPCS/CPT Code | HCPCS Description | Number of Procedures | Total Charges |
|---|---|---|---|---|
|
1. |
66984 | EXTRACAPSULAR CATARACT REMOVAL W/ INSERTION OF IO LENS PROSTHESIS W/O ENDOSCOPIC CYCLOPHOTOCOAGULATION | 1,251,164 | $1,203,836,786 |
|
2. |
J0585 |
INJECTION, ONABOTULINUMTOXINA |
894,793 | $5,462,609 |
|
3. |
43239 | EGD BIOPSY SINGLE/MULTIPLE | 527,817 | $166,052,761 |
|
4. |
45380 | COLONOSCOPY AND BIOPSY | 459,209 | $187,755,470 |
|
5. |
45385 | COLONOSCOPY W/LESION REMOVAL | 409,019 | $196,440,448 |
|
6. |
64483 | INJ FORAMEN EPIDURAL L/S | 315,173 | $98,275,396 |
|
7. |
66821 | AFTER CATARACT LASER SURGERY | 279,440 | $67,857,702 |
|
8. |
64493 | INJ PARAVERT F JNT L/S 1 LEV | 226,368 | $64,234,232 |
|
9. |
62323 | NJX INTERLAMINAR LMBR/SAC | 184,148 | $50,642,428 |
|
10. |
G0105 |
COLORECTAL SCRN; HI RISK IND |
138,269 | $47,348,253 |
|
11. |
45378 | DIAGNOSTIC COLONOSCOPY | 115,168 | $36,627,045 |
|
12. |
64635 | DESTROY LUMB/SAC FACET JNT | 112,369 | $79,517,957 |
|
13. |
G0121 | COLON CA SCRN NOT HI RSK IND | 111,684 | $38,509,195 |
|
14. |
J3300 | TRIAMCINOLONE A INJ PRS-FREE | 109,465 | $419,165 |
|
15. |
G0260 | INJ FOR SACROILIAC JT ANESTH | 95,144 | $22,245,165 |
|
16. |
66982 | COMPLEX REMOVAL OF CATARACT WITH INSERTION OF LENS | 91,686 | $88,594,583 |
|
17. |
52000 | CYSTOSCOPY | 82,909 | $23,479,992 |
|
18. |
64490 | INJ PARAVERT F JNT C/T 1 LEV | 75,257 | $21,967,363 |
|
19. |
62321 | NJX INTERLAMINAR CRV/THRC | 65,815 | $18,197,660 |
|
20. |
15823 | REVISION OF UPPER EYELID | 59,700 | $36,619,604 |
|
21. |
43235 | EGD DIAGNOSTIC BRUSH WASH | 59,512 | $19,254,754 |
|
22. |
43248 | EGD GUIDE WIRE INSERTION | 50,542 | $17,342,958 |
|
23. |
64721 | CARPAL TUNNEL SURGERY | 48,889 | $36,582,656 |
|
24. |
26055 | INCISE FINGER TENDON SHEATH | 43,294 | $24,982,443 |
|
25. |
J7328 |
GELSYN-3 INJECTION 0.1 MG |
42,349 | $91,989 |
Fig 1. Data from Surgery Centers database based on 2018 Medicare Ambulatory Surgery Center Limited Data Set. Calendar year data is projected to be released each January by the CMS. The most recent data is from calendar year 2018; 2019 data is scheduled to be released in January 2021. Accessed May 2020.
The following list details the top 25 procedures performed at ASCs by total charges. Extracapsular cataract removal, CPT code 66984, had the highest total charges, followed by the insertion or replacement of spinal neurostimulator pulse generator, CPT code 63685, with $259.3 million in total charges.
Top 25 Procedures Performed at Surgery Centers by Total Charges
| Rank | HCPCS/CPT Code | HCPCS Description | Number of Procedures | Total Charges |
|---|---|---|---|---|
|
1. |
66984 | EXTRACAPSULAR CATARACT REMOVAL W/ INSERTION OF IO LENS PROSTHESIS W/O ENDOSCOPIC CYCLOPHOTOCOAGULATION | 1,251,164 | $1,203,836,786 |
|
2. |
63685 | INSRT/REDO SPINE N GENERATOR | 11,325 | $259,397,185 |
|
3. |
45385 | COLONOSCOPY W/LESION REMOVAL | 409,019 | $196,440,448 |
|
4. |
45380 | COLONOSCOPY AND BIOPSY | 459,209 | $187,755,470 |
|
5. |
63650 | IMPLANT NEUROELECTRODES | 40,151 | $185,590,750 |
|
6. |
43239 | EGD BIOPSY SINGLE/MULTIPLE | 527,817 | $166,052,761 |
|
7. |
64483 | INJ FORAMEN EPIDURAL L/S | 315,173 | $98,275,396 |
|
8. |
0191T | INSERT ANT SEGMENT DRAIN INT | 36,510 | $94,373,543 |
|
9. |
66982 | COMPLEX REMOVAL OF CATARACT WITH INSERTION OF LENS | 91,686 | $88,594,583 |
|
10. |
64635 | DESTROY LUMB/SAC FACET JNT | 112,369 | $79,517,957 |
|
11. |
66821 | AFTER CATARACT LASER SURGERY | 279,440 | $67,857,702 |
|
12. |
64493 | INJ PARAVERT F JNT L/S 1 LEV | 226,368 | $64,234,232 |
|
13. |
29827 | ARTHROSCOP ROTATOR CUFF REPR | 25,897 | $63,564,800 |
|
14. |
64590 | INSRT/REDO PN/GASTR STIMUL | 3,246 | $51,779,518 |
|
15. |
62323 | NJX INTERLAMINAR LMBR/SAC | 184,148 | $50,642,428 |
|
16. |
36902 | INTRO CATH DIALYSIS CIRCUIT | 18,446 | $47,501,204 |
|
17. |
G0105 | COLORECTAL SCRN; HI RISK IND | 138,269 | $47,348,253 |
|
18. |
C9740 |
CYSTO IMPL 4 OR MORE |
6,628 | $41,130,006 |
|
19. |
G0121 |
COLON CA SCRN NOT HI RSK IND |
111,684 | $38,509,195 |
|
20. |
V2785 | CORNEAL TISSUE PROCESSING | 9,630 | $37,718,222 |
|
21. |
45378 | DIAGNOSTIC COLONOSCOPY | 115,168 | $36,627,045 |
|
22. |
15823 | REVISION OF UPPER EYELID | 59,700 | $36,619,604 |
|
23. |
64721 | CARPAL TUNNEL SURGERY | 48,889 | $36,582,656 |
|
24. |
22869 |
INSJ STABLJ DEV W/O DCMPRN |
2,649 | $32,414,982 |
|
25. |
29881 | KNEE ARTHROSCOPY/SURGERY | 23,628 | $29,793,651 |
Fig 2. Data from Surgery Centers database based on 2018 Medicare Ambulatory Surgery Center Limited Data Set. Calendar year data is projected to be released each January by the CMS. The most recent data is from calendar year 2018; 2019 data is scheduled to be released in January 2021. Accessed May 2020.