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Because  the cost of the balloon dilatation systems, the other expenses of setting up for the procedure, the staff and personnel required, the relative savings that Medicare achieved were this to be done in the hospital OR settings, balloon sinuplasty are reimbursed at  a higher rate then other ENT procedures done in the office by Medicare and other insurance company that pays for this procedure.

Since Medicare has allowed for this, the number of traditional functional endoscopic sinus surgery done in the OR with general anesthesia has declined and the number of  balloon sinuplasty cases has increased.  Despite a greater number of people entering  Medicare rolls over the last 3 years, the number of balloon sinuplasty and traditional endoscopic sinus surgery cases nationally has remain stable. Aside from the cost savings, it appears that a large number of these cases done in the office under local anesthesia has prevent the need to go to the OR which entails higher risks for the patient and higher cost for Medicare.

Tricounty ENT charges for balloon sinuplasty is in line with the national reimbursement rates for this procedures.  Medicare covers 80 percent of the charges and 20% of the charges are paid by supplemental medicare insurance company where it applies.

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