Pay per operation

[NDESTRUKT]

How much does a surgeon get for an operation on average? I'm not looking for accurate numbers, just estimates or anecdotal stuff for b and b cases like appy, lap chole, hernia, lumpectomy, hell why not mention a whipple...

Kind of for the fun of it, but with a slight serious tone as well.

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[Dr JPH]

How much does a surgeon get for an operation on average? I'm not looking for accurate numbers, just estimates or anecdotal stuff for b and b cases like appy, lap chole, hernia, lumpectomy, hell why not mention a whipple...

Kind of for the fun of it, but with a slight serious tone as well.

I think there was a discussion on this recently...take a quick stroll through the last week of posts.

 

[Winged Scapula]

How much does a surgeon get for an operation on average? I'm not looking for accurate numbers, just estimates or anecdotal stuff for b and b cases like appy, lap chole, hernia, lumpectomy, hell why not mention a whipple...

Kind of for the fun of it, but with a slight serious tone as well.

Let's use Medicare reimbursement since most insurance plans are a percentage of Medicare (sometimes slightly more, many times less than Medicare) and your current state of Indiana (there may be different rates depending on location:

inguinal hernia repair, reducible, age 5 and over, CPT Code 49505: $415.51
cholecystectomy, open, CPT 47600: $840.70
chole, lap, CPT 47562: 594.26
appy, open, CPT 44950: 526.05

You should generally figure on getting 65-70% of what you bill for overall (ie, in some cases you will get nothing, some 100%, etc.), so the quotes above aren't necessarily what you will receive in the check.

This link from the AMA is pretty useful: https://catalog.ama-assn.org/Catalog/cpt/cpt_search_result.jsp?_requestid=39470

 

[TxMed]

How much does a surgeon get for an operation on average? I'm not looking for accurate numbers, just estimates or anecdotal stuff for b and b cases like appy, lap chole, hernia, lumpectomy, hell why not mention a whipple...

Kind of for the fun of it, but with a slight serious tone as well.

i had to take alot of the data off of these charts to make them fit. hopefully they still have some of what you are looking for.

-tm

 

[Pilot Doc]

You should generally figure on getting 65-70% of what you bill for overall (ie, in some cases you will get nothing, some 100%, etc.), so the quotes above aren't necessarily what you will receive in the check.

Keep in mind that you bill is a rather fictional number that is generated to ALWAYS be more than the payer will pay. If you bill an insurance company $5 for a lap chole, they'll pay you 100%. If you bill them $5 million, they might only pay you 1%, but you still come out ahead. Medicare is something of a special case in that they have a very transparent fee schedule. You'll receive 100% of the numbers listed above for medicare patients (assuming you bill at least that much.)

 

[Winged Scapula]

Keep in mind that you bill is a rather fictional number that is generated to ALWAYS be more than the payer will pay. If you bill an insurance company $5 for a lap chole, they'll pay you 100%. If you bill them $5 million, they might only pay you 1%, but you still come out ahead. Medicare is something of a special case in that they have a very transparent fee schedule. You'll receive 100% of the numbers listed above for medicare patients (assuming you bill at least that much.)

Thank you for clarifying that. I should have pointed out that yes, those are Medicare schedules and that they will pay you 100% of the code (as long as you code correctly) although insurance companies may not.

Note to self: bill 5 million for lap choles. 😀

 

[NDESTRUKT]

i had to take alot of the data off of these charts to make them fit. hopefully they still have some of what you are looking for.

-tm

Wow thanks...I didn't expect that much work!

So you get paid 70 some bucks to control a nosebleed?! where do i sign up?!?!

 

[cerulean grass]

Forgive my ignorance for a moment, but are these numbers strictly the surgeon's fee for service? That is, are these the dollar amounts that the surgeon sees at the end of the day (before withholdings)?

If so, are there separate codes/fee-schedules for materials, hospital stay, and other labor (nursing, anesthesia), or is that lumped into one big global fee?

 

[Winged Scapula]

Forgive my ignorance for a moment, but are these numbers strictly the surgeon's fee for service? That is, are these the dollar amounts that the surgeon sees at the end of the day (before withholdings)?

If so, are there separate codes/fee-schedules for materials, hospital stay, and other labor (nursing, anesthesia), or is that lumped into one big global fee?

Those are fees for performing the procedure. Assuming a hospital practice, the patient is billed separately for materials used, anesthesia, nursing, etc. If you perform a procedure in your office, you can bill for some materials - ie, a suture tray, for example. The total bill to the patient's insurance company will include all of the above, with the surgeon's fee a small part of the total.

 

[Pilot Doc]

Forgive my ignorance for a moment... these the dollar amounts that the surgeon sees at the end of the day (before withholdings)?
[\QUOTE]

I'm going to pick on you a bit to dispel what I think is a commonly held belief .. don't take it personally.

Most physicians are actually small business owners, not employees. You need to think about revenues and expenses, not withholdings. Yes, you do have to pay social security tax, etc, but you have many, many bigger claims on your revenue. You have to pay rent/mortgage on an office, pay support staff, malpractice, etc.

As a general rule, you will start each month $10,000 or more in the hole and you have to crawl your way out of it. The first $X,000 you collect nets you zip. You just pay your bills. After that you get to take money home (and start paying taxes)

 

[Amgen1]

it is always helpful to see these fee scales. thanks for the post.

 

[Leforte]

What is outrageous is the hospital charges.

We had a resident get tubes for their kid recently, surgeon reimbursement ~$200, hospital charges ~$4,000! Seriously! For a 15 minute block of OR time, a BMTT tray and 2 tubes. Crazy.

Interestingly, for our trachs, surgeon collects ~$350, anesthesia ~$450 (which is often nurse anesthesia) - no wonder people keep choosing the lifestyle residencies....

 

[Skylizard]

...for our trachs, surgeon collects ~$350....

There is a certain quote we have heard often, "two trachs and a PEG equal a whipple".