Peripheral Nerve Surgeries are Significantly Lower Cost in Ambulatory Surgery Centers Compared to Hospital Outpatient Departments

Introduction: Peripheral nerve surgeries are common procedures that are increasingly being done in outpatient settings, commonly in ambulatory surgery centers (ASCs) or hospital outpatient departments (HOPDs). This study aims to assess differences in costs for peripheral nerve surgeries conducted in ASCs and HOPDs.

Methods: Publicly available data was extracted from the Centers for Medicare and Medicaid Services (CMS) utilizing the Medicare Procedure Price Lookup Tool. Current Procedural Terminology (CPT) codes for neuroplasty, transection/avulsion, excision, and neurorrhaphy were included. For each code, total cost, facility fees, doctor fees, Medicare payments, and patient copayments were extracted. Differences in costs were determined using the Mann-Whitney U test.

Results: Eighty-two individual CPT codes were identified. In the entire cohort, ASCs were associated with lower total cost ($2,719.41 ± $1,555.96 vs $4,425.48 ± $2,432.94, p < 0.001), facility fees ($2,719.41 ± $1,555.96 vs $4,425.48 ± $2,432.94, p < 0.001), Medicare payments ($2,175.67 ± $1,244.68 vs $3,788.02 ± $2,628.12, p < 0.001), and patient copayments ($543.14 ± $311.16 vs $883.91 ± $487.07, p < 0.001), compared to HOPDs. No significant difference was found in doctor fees. Significantly lower total cost, facility fees, Medicare payments, and patient copayments were observed for neuroplasty, transection/avulsion, excision, and neurorrhaphy when analyzed individually.

Conclusion : ASCs show significantly lower costs for neuroplasty, transection/avulsion, excision, and neurorrhaphy when compared to HOPDs. Alongside growing utilization of ASCs, policy efforts to drive cost reductions at HOPDs may promote lower total healthcare expenses for peripheral nerve surgeries and in turn, lower Medicare and patient costs.