DATA & INSIGHTS: ORTHOPEDICS

Leveraging data in every aspect of operations is now essential for long-term success.

Orthopedics remains the top revenue-generating specialty in ASCs, with net revenue per case rising from $6,141 in 2023 to $6,419 in 2024. As patient demand surges and payer reimbursement strengthens, ASCs must optimize key metrics to capture growth opportunities while maintaining efficiency and profitability. Explore the latest orthopedic surgery center trends below.

This data represents 437,971 unique cases across 338 centers.

OR Block Utilization

Slight decline—OR block utilization decreased from 38% to 37%.

Seamless communication between a doctor’s office and the ASC is key to driving case volume. Avoid phone and fax delays—use technology to broadcast OR availability, enable electronic scheduling, and automate block time management to improve efficiency and achieve at least 70% utilization.

Pre-Authorization Rates

Strong improvement—pre-auth approvals rose from 43% to 49%.

Obtaining prior authorization prevents denials and reimbursement delays. ASCs should verify authorizations secured by the doctor’s office to avoid performing procedures without approval. Leveraging integrated payer technology streamlines the process, reducing administrative burden and ensuring compliance.

Insurance Verification Rate

No change—insurance verification rate held steady at 86%.

Verifying insurance eligibility prevents financial issues and last-minute cancellations. ASCs should re-verify coverage twice—upon case acceptance and the morning of surgery—and re-run checks monthly to catch lapses. Automating this process minimizes manual work and ensures seamless patient care.

Case Cancellation Rates

Slight increase—cancellation rate rose from 15.6% to 16.0%.

Maintaining communication with patients, physicians, and vendors keeps cases on track and prevents last-minute cancellations. A centralized system allows the care team to coordinate seamlessly, share updates, and address issues early. Proactive patient communication also reduces the risk of patient-initiated cancellations.

Case Cancellation Reasons

“Patient Decision” accounted for 35% of case cancellations, followed by provider cancellations at 18%.

Some case cancellations are unavoidable, but many can be reduced with better processes. Issues like missing labs, scheduling errors, and surgery center inefficiencies are within your control. Analyzing cancellation reasons helps identify areas for improvement, keeping your schedule optimized and reducing lost revenue.

Patient Deposit Collection Rate

Collection rate dropped from 78% to 71%, impacting upfront payments.

Surgery costs can be overwhelming for patients. Providing accurate estimates 1-2 weeks before their procedure builds trust, reduces cancellations, and improves satisfaction. Using technology, ASCs can generate clear, easy-to-read estimates, send them via text or email, and enable upfront payments.

6 Patient Deposit Collection Rate_Orthopedic

Days to Bill

Billing turnaround improved—average days to bill dropped from 11 to 9.

Accurate coding and charge entry are essential for reimbursement and compliance. Integrating EHR and billing systems reduces errors and streamlines the process. Using well-trained coders and tracking denials helps prevent mistakes, improving financial health and operational efficiency.

Claim Denial Rate

No change—denial rate remains steady at 13%.

Efficient claim management is essential for maintaining cash flow and compliance. Using EHR, practice management, and electronic claims systems streamlines submissions and reduces errors. Regularly monitoring claims helps address denials quickly, ensuring timely reimbursement and sustaining operational efficiency.

Net Revenue Per Case

Net revenue per case grew 11%—up from $4,678 to $5,193.

Beyond patient outcomes, profitability is a top priority for ASCs. Monthly financial reviews help identify trends and address issues quickly. Using analytics tools and standardized reporting ensures data-driven decisions, improving revenue, controlling expenses, and maintaining long-term financial stability.

Case Volume

Case volume increased by 5.5%, signaling growth in orthopedic procedures.

Tracking average case volume is essential for forecasting profitability, resource allocation, and expansion planning. Monitoring trends helps ASCs identify growth opportunities, adjust staffing, and optimize OR utilization to maintain efficiency and financial stability in a rapidly evolving healthcare landscape.

State of the Industry Report: Best Practices & Industry Benchmarks for Optimizing ASC Operations

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Benchmarks & data from 3 million cases

130+ KPIs to track

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*Disclaimer: HST Pathways released an updated version of our State of the Industry Report in September 2024, highlighting best practices, key process steps, and KPIs for every step of the patient journey and for nearly every recurring administrative duty. Most importantly, using our own unique dataset from our clients, we were able to extract data points so that anyone in the industry could compare themselves to their peers. We only pulled data from clients who gave us permission, and we omitted any extreme outliers. Data on this page may differ from the full 2024 State of the ASC Industry report. The full report (published September 2024) included data through Q2 2024, while this page (published March 2025) includes data through Q4 2024. Differences are due to the extended timeframe and new data from clients who have since granted permission.

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