Medicare rates in HOPDs exceed ASC rates by what percentage?

• A. 81%
• B. 71%
• C. 91%
• D. 61%

Answer: (A)

Medicare reimbursement differs between Hospital Outpatient Departments (HOPDs) and Ambulatory Surgery Centers (ASCs) because they are paid under different programs, with HOPDs receiving a facility-based payment that covers overhead, staffing, and equipment, while ASCs are paid under a lower-rate facility fee under the ASC payment system. For the same outpatient procedure, this produces a substantial gap: the HOPD payment is much higher than the ASC payment—essentially close to doubling what an ASC would receive in many cases. That is why the option indicating a large percentage gap best fits the typical Medicare payment difference between these two settings. The other options describe smaller gaps that do not align with the commonly cited magnitude of the HOPD-ASC gap.