--- title: "iOR Office-Based Surgery: Reimbursements" description: When surgery is performed in an office-based surgerical suite, 100% of surgical revenue is retained by the practice. --- [Skip to content](https://iorpartners.com/office-based-surgery-reimbursements#main-content) [![iOR Partners](https://iorpartners.com/hubfs/iOR%20Partners%20Logo%20Stacked_Full%20Color.svg)](https://iorpartners.com/?hsLang=en) - [Office-Based Surgery](https://iorpartners.com/office-based-surgery) Show submenu for Office-Based Surgery - [Accreditation](https://iorpartners.com/office-based-surgery-accreditation) - [Reimbursements](https://iorpartners.com/office-based-surgery-reimbursements) - [Safety & Efficacy](https://iorpartners.com/office-based-surgery-safety-efficacy) - [Anesthesia](https://iorpartners.com/office-based-surgery-anesthesia) - OBS Resources Show submenu for OBS Resources - [White Papers & Webinars](https://iorpartners.com/office-based-surgery-white-papers-webinars) - [FAQs](https://iorpartners.com/faq) - [Blog](https://iorpartners.com/blog) - [iOR Suites](https://iorpartners.com/office-based-surgery-suite-implementation/) Show submenu for iOR Suites - iOR Services Show submenu for iOR Services - [Planning & Development](https://iorpartners.com/office-based-surgery-suite-implementation/planning-development) - [Accreditation & Compliance](https://iorpartners.com/office-based-surgery-suite-implementation/accreditation) - [iSupply Materials Management](https://iorpartners.com/office-based-surgery-suite-implementation/isupply) - [iBenefits Billing](https://iorpartners.com/office-based-surgery-suite-implementation/ibenefits) - [Operational Expertise](https://iorpartners.com/office-based-surgery-suite-implementation/operations) - [iOR Suite Gallery](https://iorpartners.com/ior-surgery-suites-portfolio) Show submenu for iOR Suite Gallery - [Portfolio](https://iorpartners.com/ior-surgery-suites-portfolio) - [Virtual Tour](https://iorpartners.com/ior-surgery-suite-interactive-tour) - [iOR Video Library](https://iorpartners.com/ior-surgery-suite-videos) - [About Us](https://iorpartners.com/about) Show submenu for About Us - [Careers](https://iorpartners.com/careers) Open main navigation Close main navigation - [Office-Based Surgery](https://iorpartners.com/office-based-surgery) Show submenu for Office-Based Surgery - [Accreditation](https://iorpartners.com/office-based-surgery-accreditation) - [Reimbursements](https://iorpartners.com/office-based-surgery-reimbursements) - [Safety & Efficacy](https://iorpartners.com/office-based-surgery-safety-efficacy) - [Anesthesia](https://iorpartners.com/office-based-surgery-anesthesia) - OBS Resources Show submenu for OBS Resources - [White Papers & Webinars](https://iorpartners.com/office-based-surgery-white-papers-webinars) - [FAQs](https://iorpartners.com/faq) - [Blog](https://iorpartners.com/blog) - [iOR Suites](https://iorpartners.com/office-based-surgery-suite-implementation/) Show submenu for iOR Suites - iOR Services Show submenu for iOR Services - [Planning & Development](https://iorpartners.com/office-based-surgery-suite-implementation/planning-development) - [Accreditation & Compliance](https://iorpartners.com/office-based-surgery-suite-implementation/accreditation) - [iSupply Materials Management](https://iorpartners.com/office-based-surgery-suite-implementation/isupply) - [iBenefits Billing](https://iorpartners.com/office-based-surgery-suite-implementation/ibenefits) - [Operational Expertise](https://iorpartners.com/office-based-surgery-suite-implementation/operations) - [iOR Suite Gallery](https://iorpartners.com/ior-surgery-suites-portfolio) Show submenu for iOR Suite Gallery - [Portfolio](https://iorpartners.com/ior-surgery-suites-portfolio) - [Virtual Tour](https://iorpartners.com/ior-surgery-suite-interactive-tour) - [iOR Video Library](https://iorpartners.com/ior-surgery-suite-videos) - [About Us](https://iorpartners.com/about) Show submenu for About Us - [Careers](https://iorpartners.com/careers) - [FREE Analysis](https://iorpartners.com/free-analysis) [FREE Analysis](https://iorpartners.com/free-analysis?hsLang=en) ## Office-Based Surgery: # Reimbursements At iOR Partners, we are redefining the surgery suite and redefining how we traditionally think about reimbursements.  When surgery is performed in an office-based surgical suite, 100% of surgical revenue is retained by the practice. ## 270,000+ Claims Paid ![Reimbursement-Mix-2](https://iorpartners.com/hs-fs/hubfs/Reimbursement-Mix-2.png?width=300&height=300&name=Reimbursement-Mix-2.png "Reimbursement-Mix-2") #### iOR Reimbursement Mix Office-based surgery (OBS) billing is more complex than ASC billing and requires highly specialized expertise. At iOR Partners, we understand the regulatory and billing requirements for OBS reimbursement. We have a well-established compliant model working with local payers to help you receive the reimbursement you deserve. iOR Partners has successfully collected reimbursements from all major payors nationwide, including Medicare, with zero refunds or deficiencies.   ## Medicare Reimbursement for Office-Based Surgery You can receive Medicare reimbursement for OBS. You’re simply paid in a different way. Instead of a Traditional Primary-National reimbursement of the facility fee, OBS surgeons receive a Secondary-Local reimbursement of their professional fee based on local Medicare Administrative Contractor (MAC) codes in all 12 local jurisdictions. ![local-MAC-jurisdictions](https://iorpartners.com/hs-fs/hubfs/local-MAC-jurisdictions.png?width=1000&height=683&name=local-MAC-jurisdictions.png "local-MAC-jurisdictions") #### Local MAC Jurisdictions ## Reimbursement Comparison: OBS vs. ASC The reimbursement received for OBS is similar to what you receive in an ASC. They are just reimbursed differently. With OBS, the practice retains 100% of the surgical reimbursement.   |   | #### OBS | #### ASC | | --- | --- | --- | | Surgeon Professional Fee Standard fee paid to surgeon for services | | | | Traditional Primary-National Fee Facility fee paid to ASC for overhead expenses | | | | Secondary-Local Fee Professional fee paid to surgeon for overhead expenses | | | | Surgical Fees Retained by Surgeon | 100% | 34% |   ## Get a Local Reimbursement Analysis We provide a feasibility analysis with a local reimbursement estimate and financial pro forma.  [Start Here](https://iorpartners.com/free-analysis?hsLang=en) ## Reimbursement FAQs Why are there naysayers claiming that Medicare does not reimburse for OBS? Office-based surgery billing is more complex than the ASC or hospital setting and requires highly specialized expertise.  You can receive Medicare reimbursement for OBS. You’re simply paid in a different way. Instead of a Traditional Primary-National reimbursement of the facility fee, OBS surgeons receive a Secondary-Local reimbursement of their professional fee based on local Medicare Administrative Contractor (MAC) codes.   Is OBS billing Medicare compliant? iOR Partners employs a robust and compliant billing method known as 'Code-Set Billing'. This method involves negotiating with local Medicare Administrative Contractors (MACs) using Local Coverage Determination (LCD). On a case-by-case basis, we seek permission from the local MACs to bill the primary code along with secondary codes, modified for use on cataracts and other ophthalmic surgical procedures in the office setting. If permission is not granted, we do not seek reimbursement for the claim. This process has been audited multiple times in several jurisdictions, with over 55,420 Medicare claims paid to date, and zero refunds or deficiencies. Will I receive a professional and facility fee? You’re always paid a standard professional fee regardless of where you perform surgery. Instead of a facility fee, you will receive a Secondary-Local professional fee reimbursement. Can I get reimbursed for ophthalmic office-based surgery? Yes, iOR has been successful in collecting reimbursements from all major payers, including Medicare. #### iOR Reimbursement Mix: **![Reimbursement-Mix-2](https://iorpartners.com/hs-fs/hubfs/Reimbursement-Mix-2.png?width=318&height=318&name=Reimbursement-Mix-2.png)**   How does the reimbursement amount compare to an ASC? The money received for OBS is similar to that for ASC, but they are reimbursed differently. OBS payments can be slightly higher on average because they are not standardized yet.  Will CMS standardize OBS reimbursement? Next opportunity for revaluation is 2027 and earliest it could go into effect is 2028. Will OBS lower the professional reimbursement? OBS saves Medicare dollars by eliminating an anesthesia provider and physician medical clearance. It does not impact the professional reimbursement. Should I wait for CMS to establish primary-national Medicare reimbursement? The evolution of OBS closely mirrors the transition from hospital-based surgery to ASC surgery. More and more surgeons are choosing to make the transition now because OBS is beneficial for their practices. Being at the forefront of evolution provides you with an excellent opportunity to contribute to the revaluation process. ### Related Articles ![patient-care-stock-image-1253x835](https://iorpartners.com/hs-fs/hubfs/patient-care-stock-image-1253x835.jpg?width=1253&height=835&name=patient-care-stock-image-1253x835.jpg "patient-care-stock-image-1253x835") ##### Safety & Efficacy A growing body of research indicates OBS outcomes match or exceed those in other facilities. With 938,000+ successful outcomes, OBS is the epitome of safe and effective surgery. [Learn more](https://iorpartners.com/office-based-surgery-safety-efficacy?hsLang=en) ![accreditation-stock-1080x720](https://iorpartners.com/hs-fs/hubfs/accreditation-stock-1080x720.jpg?width=1080&height=720&name=accreditation-stock-1080x720.jpg "accreditation-stock-1080x720") ##### Accreditation OBS accreditation standards for ophthalmic procedures are equally as rigorous as any other licensed surgical facility for the same procedures. [Learn more](https://iorpartners.com/office-based-surgery-accreditation?hsLang=en) ![ophthalmic-topical-anesthesia](https://iorpartners.com/hs-fs/hubfs/ophthalmic-topical-anesthesia.jpg?width=1408&height=939&name=ophthalmic-topical-anesthesia.jpg "ophthalmic-topical-anesthesia") ##### Anesthesia OBS suites utilize either Class A (oral) or Class B (IV) sedation.  The main difference is that the type of anesthesia used is the surgeon’s choice vs. facility protocols. 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