In office vs. HOPD vs ASC with ownership

[SpineandWine]

Why do many pain docs want to do kyphos in office? I am trying to figure out whether it’s better to do kypho in office vs. ASC you may be part owner for vs. HOPD where you may collect facility.

Same with other common procedures done by pain docs- TFESI, MBB, SI joint.

Does anyone have good source for reimbursement info comparing different settings that includes both professional component and facility component?

---

Members don't see this ad.

 

[pmrmd]

Simple: kypho pays better in-office than in ASC.

ASIPP puts out the information you’re seeking every year.

 

[SpineandWine]

For Medicare, based on prior threads- it seems to utilize Procedure Price Lookup for Outpatient Services | Medicare.gov
This gives breakdown for ASC vs HOPD

ASIPP fee schedule gives price for in office procedures but unclear if medicare- also since I’m not member, don’t have latest info


Looking up kyphoplasty- it seems it’s about the following If you include facility: ASC (3.4k), HOPD (6.8k), office (7k).
That means HOPD vs. office is similar if one collects facility?

 

[pmrmd]

What doctor gets 100% of the facility fee of an HOPD?

 

[SpineandWine]

Fair point. For office procedures, my understanding is that the overhead is part of that fee so difficult to make full comparisons for other procedures like TFESI, etc.

 

[lobelsteve]

Office takes 20-30 min. No turn around time for next patient or procedure. ASC or OR can be an hour or more until your next case is up. Not always about money. I gotta get home for Matrix R50 and pullups.