CMS launches new consumer tool to compare surgery prices

Medicare beneficiaries can use the Procedure Price Lookup tool to look up the national average that Medicare pays hospitals or ambulatory surgical centers for certain surgeries. The website also can reveal the national average co-payment that a beneficiary with no Medicare supplemental insurance would pay the provider.

The new tool, which the CMS was required to create under the 21st Century Cures Act, will help Medicare patients consider procedure costs at different types of providers, Verma said.

A Medicare beneficiary who needs knee surgery can use the website to find out-of-pocket cost estimates for a local hospital's outpatient department and an independent surgery center.

The CMS is pushing hospitals to be more transparent about patient charges, not just for surgeries. The agency has updated its previous price transparency guideline, drawn from the Affordable Care Act, and will require hospitals to publish a list of standard charges in an online, machine-readable format starting Jan. 1. They must update that charge information, drawn from their retail chargemaster list, at least annually.

The American Hospital Association and other hospital industry stakeholders have pushed back against the price transparency efforts. They argue that payers should be the primary source of information for patients about prices and out-of-pocket costs.

They also said data on charges and payments from providers are proprietary, and that such information would not be useful to consumers interested in what they will have to pay out of pocket.