Think about it this way. The surgeon gets paid surgeon's fee for the procedure billed to the patient (small fee). The hospital or surgery center bills for the facility fee based on the allowable by insurance based on the procedure code complexity. The anesthesiologist group bills their fee for services. The facility also bills for DME dispensed, meds, and ancillaries/materials. For implants the facility buys the implant from the implant company and bills the patient. So in the end for say a bunionectomy the patient may get billed $1000 and insurance allows/pays $500. Also patient gets billed maybe $6000-$7000 by the facility for these other services. At one of my hospitals they refuse to allow me and a fellow orthopod from another group do TARs because the cost of the implant itself is cost-prohibitive so they feel they don't make enough or lose money on those cases. So I take those cases to another hospital that wants me to do them because it is a good advertisement for their facility.
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