they'll get a share of the facility's reimbursements and pocket the
physicians' fees, points out Ralph Paylor, MD, managing partner at
Florida Eye Associates/ASC of Brevard.
Physician fees are also slightly lower for laser procedures per-
formed in surgery centers instead of offices. The per-case decreases
might not seem like a lot — surgeons earn about $19 less per YAG
capsulotomy, for example — but they add up with these high-volume
procedures. If surgeons don't have ownership shares in an oph-
thalmic-only surgery center or have only a minority share in a multi-
specialty center, it probably makes more financial sense for them to
collect higher physician fees in their offices.
• It's convenient. Surgeons are more likely to bring laser cases to
your facility if their clinic is physically attached or very close by, says
James Dawes, MHA, CMPE, COE, president and founder of the J.
Dawes Group, a consulting firm based in Sarasota, Fla.
That's why YAG capsulotomies might be the easiest to add — high-
volume cataract surgeons are already in your facility and can take
care of laser patients before or after performing surgery. Dr. Paylor
performs YAG capsulotomies on the same day he performs cataract
surgeries. "The procedures take about 2 minutes to perform," he says.
"Patients are in and out of the facility in 2 hours."
Mr. Sheppard says investing in laser platforms might also attract sur-
geons from a practice with offices in several locations who prefer to
bring cases to a facility in a centralized location or surgeons from low-
volume practices who don't have the budget or interest to invest in
their own unit.
• Start-up costs aren't significant. YAG lasers cost between $20,000
and $25,000, a combination YAG-SLT platform can be had for about
$50,000 and a refurbished 523nm laser needed to perform retina pro-
cedures costs between $12,000 and $20,000, according to Mr.
6 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 8
