For ambulatory surgery centers (ASCs), the No. 1 focus is typically outcomes and delivering high-quality care. Following closely behind that: profitability.
A recently released report from ASC software company HST Pathways offers new insights into that secondary focus, with exclusive data on key financial and performance trends such as average net revenue per case and operating room (OR) turnover time per speciality.
“Before proceeding with any case, surgery center administrators must understand how much the center will profit (or lose) from the procedure,” HST Pathways wrote in its report. “Surgeries are complex events – payer contracts are complicated, overhead needs to be accounted for, and costs vary significantly by procedure, especially when implants are involved.”
HST Pathways’ “State of the Industry Report” included information from 590 surgery centers across 47 states. Nearly one-third of participants were from independent ASCs, with the remainder of responses coming from surgery centers that were part of ownership groups or health systems.
Overall, the data from the 2024 report came from 3 million unique ASC patient visits.
“These surgery centers are HST clients who have granted permission for their data to be used in this analysis, offering a comprehensive look into the trends and dynamics shaping the industry,” noted the report.
In terms of average revenue per case, orthopedics continues to generate the largest numbers, according to HST’s data. Year over year, average revenue per case for orthopedics increased from $6,141 in 2023 to $6,419 in 2024.
“This growth reflects strong demand for orthopedic procedures and potentially higher reimbursement rates or a greater mix of complex cases,” the report pointed out.
To some extent, orthopedics is in a league of its own for average revenue per case. No other specialty had an average revenue per case above $5,000, the report found.
In 2024, for example, the average revenue per case for cardiovascular and plastic surgeries was $4,611 and $4,594, respectively. For pain and podiatry procedures, figures dropped down to $3,722 and $3,256, respectively.
General surgery, otolaryngology, dental/perio and gynecology procedures had average revenue per case figures ranging from $2,835 to $2,365. Meanwhile, urology, ophthalmology and gastroenterology all had average revenue per case numbers below the $2,000 mark.
Orthopedics didn’t just have the highest revenue per case in 2024; it also had one of the largest year-over-year increases, according to HST.
“The consistent rise in revenue underscores orthopedics as a key specialty for surgery centers, contributing significantly to overall financial performance and profitability while highlighting the value of investing in orthopedic services,” the report highlighted.
Other specialties that had year-over-year increases in average revenue per case included pain, otolaryngology, dental/perio, gynecology, ophthalmology and gastroenterology. Pain, in particular, saw a big year-over-year jump, with average revenue per case rising by more than $500.
Image from the 2024 HST Pathways State of the Industry Report
Turnover times and efficiencies
Efficiently getting an operating room ready is critical to ASC operations running smoothly. The same holds true for getting patients in and out of ORs for their procedures.
Similar to how average revenue per case varies dramatically by speciality, so too does average OR turnover time and average OR duration per speciality, according to HST’s State of the Industry Report.
On the high end, the average turnover time for plastic surgery was 22.6 minutes. On the low end, the average turnover time for ophthalmology procedures was just 11.9 minutes.
For all ASC specialities, plastic surgery also had the highest average OR duration at 156 minutes. For comparison, the specialty with the second-highest average OR duration was dental/perio at 69.8 minutes, closely followed by orthopedics and podiatry at 66.5 minutes and 65 minutes, respectively.
Interestingly, looking at average OR duration from 2023 to 2024, there was a dramatic drop for the cardiovascular speciality, according to HST.
Related to average OR duration, HST in its report compared expected times vs. actual times to flag which specialities often experienced delays. The specialties that experienced the most delays included gynecology, cardiovascular, gastroenterology and dental/perio.
