Medicare Surgery Status: The Regulations and the Finances

June 17, 2021

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Watch now

As of 2021, CMS has removed almost 300 surgeries from the inpatient only list – and has proposed to eliminate the list in entirety over the next three years. As a result, hospitals with large orthopedic and spine programs will especially feel the financial impact, experiencing potential revenue loss of up to $30,000 per surgery. But before laying off staff and culling services, the finance department must understand that removing a surgery from the list does not mean it must be done as outpatient. A small investment in the proper process to determine admission status can have a significant positive impact on revenue.

In this webinar, Tom Burton, Director of Operations for Orthopedic and Neuroscience Clinical Institutions at Providence Health, Southern California Region and Dr. Ronald Hirsch, physician advisory industry expert, will explain CMS’s actions and discuss their financial impact. Together, they will present a solution for preserving revenue by ensuring that determinations lead to compliant claim submission, reviewing a case study from Providence St. Joseph Health, a prominent West Coast orthopedic program. Attendees will also have the ability to request a financial impact analysis for their organization after the webinar.


Tom Burton, Director of Operations Orthopedic and Neuroscience Clinical Institutes at Providence Health Southern California Region

Ronald Hirsch, MD, FACP, CHCQM, Vice President of the Regulations and Education Group at R1 RCM


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