Table 2.

The average and total charges of low-value procedures claimed to the insurance funds and Medicare in 2014 and from 2010 to 2014

Low-value procedure	Charges (cost to private payers)					Medicare payment only
	Average hospital charge ($A)	Average medical charge ($A)	Average prosthesis charge ($A)	Total 2014 ($A million)	Total 2010–2014 ($A million)	Average Medicare benefit ($A)	Total 2014 Medicare benefit ($A million)	Total 2010–2014 Medicare benefit ($A million)
Knee arthroscopy	1793.20	1776.30	–	5.81–10.73	24.49–45.73	718.1	1.17–2.16	5.11–9.53
Percutaneous coronary interventions	10 220.13	2919.43	5064.66	1.98–2.03	6.03–6.25	1631.14	0.18	0.53–0.55
Intravitreal injections	565.3	469.74	–	2.66	7.06	–	–	–
Spinal fusion	12 325.48	8904.38	14 259.14	0.26–4.93	1.39–16.69	3467.79	0.00–0.05	0.03–0.18
Colonoscopy	745.33	866.4	–	0.2	0.98	453.36	0.06	0.28
Endoscopy	674.67	776.29	–	0.72	3.07	407.43	0.2	0.88
Renal angioplasty/stenting	6482.18	3227.21	3995.92	0.13–0.15	0.62–0.67	1884.55	0.02	0.09–0.10
Epidural steroid injections	926.7	853.12	–	0.05	0.11	371.7	0.01	0.02
Nasolacrimal duct procedures	821	499.1	–	0.01	0.06	271	0	0.01
Carotid endarterectomy	9306.71	5418.95	363.73	0.24–0.35	0.95–1.33	2719.91	0.09–0.12	0.17–0.24
Endovascular aortic aneurysm repair	12 019.75	7681.17	15 872.82	0.18–0.46	1.86–3.16	4219.51	0.02–0.05	0.22–0.37
Inferior vena cava filter	8063.43	4574.60	2348.00	0.18–0.4	0.73–1.5	2735.18	0.03–0.07	0.11–0.22
Laparoscopic uterine nerve ablation	1598.81	1749.61	–	0.01–0.05	0.03–0.26	856.28	0.00–0.01	0.01–0.06
Total all				12.43–22.74	47.38–86.87		1.78–2.93	7.46–12.44

Admissions were included if the identified low-value procedure was the principal reason for the admission. Medicare payment is 75% of the MBS fee for inpatient procedures for private patients. Ranges of costs are provided where broad and narrow indicators were used to identify low-value procedures based on differing recommendation/s.

MBS, Medical Benefits Schedule.