On July 15, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 Medicare Outpatient Prospective Payment System (OPPS) proposed rule including the Ambulatory Surgical Center (ASC) Payment System. Included in the proposed rule is an increase to overall OPPS payment rates by approximately 2.7%. This update is based on the projected hospital market basket percentage increase of 3.1%, reduced by 0.4% productivity adjustment. THA and TKA payment is projected to increase approximately 5.4% in 2023, attributable to a 2.2% increase in the relative weight assigned to the procedures.

OPPS
CPT 2021 2022 2023 (proposed) % change from 2022
27130 $12,314.76 $12,593.29 $13,274.06 +5.4%
27447 $12,314.76 $12,593.29 $13,274.06 +5.4%

CMS also proposes to increase overall payment rates under the ASC payment system by 2.7%.  This update is based on a hospital market basket percentage increase of 3.1% reduced by a productivity adjustment of 0.4%.

ASC
CPT 2021 2022 2023 (proposed) % change from 2022
27130 $8,833.04 $9,027.63 $9,553.84 +5.4%
27447 $8,774.20 $8,967.37 $9,351.90 +4.5%

 

Read our summary here. AAHKS will submit comments on the proposed rule before the September 13 deadline.

 

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