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Ambulatory Surgery - General Average Cost - Cataracts, Tonsillectomy, Hernia, etc.

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Ambulatory Surgery Average Charges in U.S. Hospitals, 2007  Editor's Pick

Find average prices (mean charge) for about 80 outpatient ambulatory surgery procedures done in hospitals in 2007 (excluding surgeon's or other physician fees.) Average colonoscopy & biopsy price was $2369; upper GI endoscopy $3131; cataract & lens was $4870; tonsillectomy $5286; knee cartilage $7357; hernia repair $8187; outpatient gallbladder removal (cholecystectomy) $10,838; breast biopsy $3863; lumpectomy $7458; ear tube surgery (myringotomy) $3547; D&C $6366; arthroscopy $8970; incontinence procedures $9929; vericose veins $8459; bunionectomy $7699; wrist fracture $7807; $4770 for circumcision. Consumers will need to adjust the 2007 prices to estimate 2010 facility costs; 2007 prices for many surgeries were up 25% to 41 percent over 2003 prices. Overall average was $6100, compared to nearly $40,000 for inpatient surgery. AHRQ Statistical Brief # 86 is based on 28 states (2/3 of US population) published February 2010

Medicare Ambulatory Outpatient Surgery Average Cost (2010)

Find out the average prices (charges) to Medicare patients in your state and county, and how much Medicare actually pays for 50 common ambulatory surgeries for rotator cuff repair, wrist fracture pinning, hernia repair, shoulder scopes, endoscopy, colonoscopy, bladder scopes and stents, laser coagulation or vaporization of prostate for urine flow, lower back injections and more. Example: Hernia repair CPT 49560 has average charge of $4274, with Medicare allowing $907 and actually paying $711. Over 80% discount! Average payments do NOT show how much your costs for co-pays and deductibles are, nor are physician fees shown. Consumers are expected to know CPT codes and how to use Excel files. Not our favorite, but this is the best of what's out there, and it shows how messed up healthcare pricing is. No longer Editor's Pick, since in four years and the Value-Driven Health Care initiative, we expected improved reports. 2009 data published Aug. 20, 2010

Medicare Ambulatory Surgery Charges - 13 Other Commonly Performed Procedures (2010)

See this second file for 13 more procedure prices and discounts to Medicare. This file covers Ambulatory Surgery Center facility charges and Medicare payments for selected outpatient surgery such as breast biopsy (example: $3660 national average breast biopsy charge, with Medicare allowing $444, and paying $349 - over 90% discount), surgical change of stomach tube, prostate needle biopsy (CPT code 55700 $1599 average charge, $396 allowable; $310 average cost paid), nerve blocks, cataract removal & lens insertion ($3135 charge, $953 allowed), cancer screen colon scope for high risk patients, and more. Does not include physician fees. Confusing file unless you know CPT codes. This is the best of what's out there nationally, with state and county average charges. 2009 data published Aug. 20, 2010

Illinois Hospital and Ambulatory Surgery Center Ratings and Prices (IDPH)

Compare IL hospitals on heart attack, heart failure, pneumonia, surgical infection prevention, knee arthroscopy, cardiac surgery, safety measures, infection rates, some survival information, patient satisfaction, more. See volume and 2015 median charges (closest you'll get to average cost) for selected types of inpatients (e.g. birth, c-section, appendectomy, COPD, gall bladder), and outpatients at ambulatory surgery centers (such as bunionectomy, hernia repair, colonoscopy, lens, lumpectomy, tonsillectomy). May get a full report for one hospital at a time, or one measure at a time for multiple hospitals side-by-side, with state averages. Hospital Report Card by IL Dept. of Public Health (IDPH) for all IL cities incl. Chicago area, Peoria, Rockford, Springfield, Champaign. Updated 2017, using 2015 data

Iowa - Average Price for Ambulatory Surgery 2011

Learn about average price for IA hospital-based ambulatory outpatient surgery, before adding surgeon fee or other professional charges. Upper GI endoscopy $4,358; Colonoscopy averages up to $4440; cataract $5163; Tonsillectomy $6082; laparoscopic gall bladder removal averages $11k to $13,000 in hospital charges. 30 procedures listed (scroll to bottom of report) from Iowa Hospital Association April 2012

Maine Charges for Surgery, x-ray, imaging tests (MHDO)

Maine Health Data Organization's website shows average charges (median prices) for surgery such as hip or knee replacement, shoulder arthroscopy, carpal tunnel, gall bladder removal; lab tests such as strep, blood tests, urine. Imaging tests such as mammogram, x-ray, CT, MRI, ultrasound. Good news is that both physician and hospital charges are shown to give you an idea of total cost (and discounts); CPT codes listed. Bad news: prices date from 2015-2016. From maine.gov

Physician: Average Cost for 25 Common Ambulatory Surgery Center Procedures

Difficult file for consumers to use unless familiar with Excel. Allowed amounts (rather than prices) in the Ambulatory Surgery file for 25 Common high volume outpatient surgical procedures in a Surgery Center, shows what Medicare paid during 2012 for cataract surgery, different types of endoscopy, spinal injections, some hernia repairs, carpal tunnel release, kidney stone crushing, prostate biopsy (avg $530 paid on $670 allowable charge), correction of bunion, and more. Uses CPT codes, and all states are listed. Terribly dated; last updated Sept. 2013

Utah Outpatient Ambulatory Surgery Charges, 2009 - by facility (pdf)

Average 2009 charges for outpatient procedures & ambulatory surgery at Utah's 21 freestanding ambulatory surgery centers and 45 hospitals. At 632 pages and full of CPT code abbreviations, the format is extremely cumbersome for consumers. Hospitals and surgical facilities listed alphabetically starting on page 38. Average prices for reportable procedures such as colonoscopy, upper or lower GI endoscopy, EGD, polpectomy, knee arthroscopy, cataract and laser eye procedures, myringotomy (ear tubes), tonsillectomy, cardiac cath, pacemaker, spinal injection, cochlear implants ($50,592), carpal tunnel release, complex laparoscopic procedures (e.g. lap choley gall bladder removal), septoplasty and many more start of page 29. Statewide average charges in Table 5 labeled TOTAL, but do not include physician fees. Report by UT Health Data Committee 2011

Vermont - Hospital Outpatient Surgery Prices, 2013 (pdf)

Table 2A lets you compare average gross charge (the closest you will get to average cost) for most common outpatient surgical procedures at 14 general hospitals in VT. Prices for procedures such as carpal tunnel ($4241), cataract surgery (average $5720), endoscopy ($2671), bladder endoscopy $1419, knee cartilage surgery ($6609 average), shoulder surgery (18,580), gall bladder removal (average $11,631, range $8404 to $25,707 for laparoscopy), breast biopsy (avg. $4038), other biopsies, ear tubes (average $3044), tonsillectomy (about $5900), nerve block ($1717), bunion removal (range $6276 to $17,348), nonsurgical skin treatments (avg $2356), hernia repair $9191, and many more procedures; 12-month avg. charges ending Sept. 30, 2013, DO NOT include the surgeon or other physician fees. As with all of Vermont's reports, the font size is about as small as you can get. More than two years old. Table 2B shows how many of those procedures the hospital did

Virginia Healthcare Prices (2015)

Find average price ALLOWED in 2015 for 30 common healthcare services, including hospitalizations (maternity), outpatient xray/imaging, CT and MRI tests; colonoscopy, mammogram; inpatient or ambulatory surgery (e.g. hernia, gall bladder, knee replacement, tonsillectomy, kidney stones); and ER or office visits. Shows costs but doesn't identify if it's facility cost only or INCLUDES the surgeon or other physician fees. Each service shows the average allowed amount that you or your insurance plan paid in 2015. More relevant than most pricing information, but confusing because of the doctor fee questions. From Virginia Health Information (VHI), updated Dec. 2016

Wisconsin - Ambulatory Surgery Facility Charges, 2014

Average 2014 charges in WI for 20 common ambulatory surgery procedures, such as Colonoscopy (6 codes), Endoscopy, Biopsy, Spinal Injection, Cataract & Lens ($7455 hospital average), outpatient Knee surgery/arthroscopy ($12,191), Carpal Tunnel ($6279), Ear Tubes, and more. Volumes for each hospital and surgical center are shown for top 20 only. Go to Chapter VI, Table 28 for a longer list of procedures including gall bladder removal (cholecystectomy). Prices do NOT include surgeon and physician fees, which may cost thousands of dollars and could double prices shown. Consumers should add inflation to estimate 2016 facility prices. Scroll to bottom of page for Chapters VI and VII Ambulatory Surgery, published by WHA Information Center 2015

Wisconsin PricePoint - Outpatient & Ambulatory Surgery Cost

Compare outpatient and ambulatory surgery volume and charges for colonoscopy, cataracts, eardrum surgery, shoulder or knee surgery, carpal tunnel surgery, removal of tonsils & adenoids, appendectomy, breast biopsy, endoscopy, gallbladder (cholecystectomy), upper GI, heart catheterization and more. Compare hospitals and surgical centers. Typical (median) price in county and statewide Wisconsin median prices shown for 2016-2017. Prices exclude surgeon and other doctors' fees which may double the numbers you see here

Other Helpful Listings

Ambulatory Surgery in U.S. Hospitals, 2003: HCUP Fact Book No. 9

Facts and figures on hospital outpatient surgery in 2003 - volumes, average prices, gender, comparisons to inpatient surgery, more. Read sections online. Published January 2007. Amazingly, the federal government never updated this publication, despite the public's desire to know more about ambulatory surgery costs!

Average Medicare Payments for Hospital Outpatient Services

Average 2014 Medicare costs for certain outpatient procedures commonly performed in hospitals, listed by county and state, as well as US overall average Medicare payment. Files are detailed and complicated, not user-friendly.

Vermont - Outpatient Surgery Market Share & Average 2013 Prices (pdf)

Find out how many outpatient surgeries are done at each Vermont hospital, and the average price statewide (average gross charge) for period of Oct 2012 to Sept. 2013. Prices do not include physician charges. Average price for cataract surgery $5720, large intestine endoscopy (colonoscopy) $2671, ear tubes $3044, tonsillectomy without removing adenoids $5904, removal of a bunion $11,084 for most common procedure code. Part of the State Act 53 Hospital Community Report series

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