Sheppard. Per-case costs are essentially a nonfactor because there are
few, if any, consumables needed and there are no per-click fees to
worry about. Plus, laser platforms take up very little real estate in
your facility.
• Demand is high. Mr. Sheppard says 10% to 30% of cataract patients
require YAG capsulotomy after having IOLs implanted. More patients
are undergoing glaucoma laser procedures, in line with the growing
number of people with diabetes, which has been associated with
increases in intraocular pressure.
"Many surgeons are opting to use laser treatments as a first-line
treatment before resorting to more invasive procedures or even a
multi-drop daily regimen of eye drops," adds Mr. Dawes.
Do the math
OK, now for the numbers.
• YAG capsulotomy (CPT code 66821). Cell growth that occurs in
the eye after cataract surgery can cloud the posterior capsule, giving
patients the sensation that their cataract is growing back. Surgeons
use a YAG laser to ablate the tissue in the posterior capsule, behind
the intraocular lens, in order to reopen up the visual pathway.
The average Medicare facility reimbursement for the procedure is
$250, according to Mr. Sheppard. That means your facility would have
to perform between 90 and 100 cases to pay off a YAG laser.
"If 20% of patients in a facility that performs 1,000 cataract cases a
year undergo laser capsulotomy, the facility would pay for the YAG
in about 6 months," he explains. "The payback period is fairly
short."
• Selective laser trabeculoplasty (CPT code 65855). Surgeons per-
form selective laser trabeculoplasty (SLT) on glaucoma patients to
open up the trabecular meshwork in order to increase fluid outflow.
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