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.
