This document compares the cost of employing surgical assistants at a facility versus contracting the services out. Employing one surgical assistant would cost the facility around $123,992 per year in salary and benefits. Contracting the assistant services out for a flat fee of $100,000 per year would save the facility 19.35% compared to employing one assistant. Employing two assistants would cost around $247,985 per year, while contracting would save 59.67%. For three employed assistants the cost would be around $371,978, with contracting saving 73.12% per year.

1. Surgical Assistant – Cost-Benefit Analysis
Surgical Assistant Staffed Employee
An estimated cost of providing service for facility (contractor) is based upon
standardized employee salaries to include normal operating costs and payroll
expenditures. A cost/benefit analysis has been benchmarked with a Level II trauma
center that currently provides Surgical Assistant services to medical staff. Analysis has
been rounded to the nearest tenth, and amounts correspond to one (1) full year of
Surgical Assistant services.
SALARY- 25.25/hr.
A Salary was taken from a Surgical Assistant with minimum four (4) years of Operating
Room experience in surgical assisting. This includes credentialing as a Certified
Surgical Assistant, RNFA or PA.
Hourly Rate Salary: 25.25 x 80 hr/pay period = $2,020.00 (biweekly)
Call: Avg Two (2) Week Call per pay period @ 2.50/hr; 256 hr x 2.50/hr = $640.00
Overtime: Rate includes 1.5 x hourly base salary;
26 hours x 37.88/hr = $984.75 (low end)
Benefits: Amount taken from the department of workforce development estimates for
employee costs for pension, insurance, taxes, etc.
Bi-Weekly Estimated gross pay $3,644.75 x 30% = $1,093.43
Training/Certification Bonuses: Certification yearly pay: $300.00, CEU yearly
Estimated Cost: $500.00, Yearly Estimated Cost for training, liability
insurance + bonuses: $800.00 (Yearly)
YEARLY COSTS: $123,992.68 per Surgical Assistant on Staff
Non-physician first assistant (NP, PA, CSA, SA-C, CRNFA) fees are built into
hospital billing codes for specific procedures deemed appropriate by federal
regulations modeled into federal payors (Medicare, Medicaid) which are then
taken by most third-party insurers and utilized. These fees are paid to the
hospital or facility for reimbursement for non-physician first assistant services.
Direct Surgical Assistant hospital costs are offset by this reimbursement, which
disables the hospital from billing directly and separately for these services.
Independent practices of non-physician first assistants are not held to this billing
practice and are able to secure reimbursement through third party billing.
In most hospitals, unfortunately the majority of high reimbursable procedures are off
limits as these providers employ their own Physician Assistants and/or are assisted by
their own partners, what is left for third party reimbursement are low reimbursable
procedures (General Surgery, OB-Gyn) which would require a very high volume to be
able to recoup salaries and benefits. However, we would offer a probationary period of 3
months for us to be able to determine the specific needs of your facility and if it is
something that would work our for us as well. We might even offer an option that could
utilize your existing staff sub-contracted by us.
Prepared by American Surgical Assistants, Inc. – © Copyright 2012 – All Rights Reserved

2. Surgical Assistant Contracted Services
An estimated cost of providing service to facility (contractor) is based upon current
contractual agreement services in the immediate area. A cost/benefit analysis has been
benchmarked with a nationwide health insurance provider for service reimbursement.
Analysis has been estimated from current standards and trends for insured, insurance
types, and payment schedules for Surgical Assistant services provided to those
population bases. Figures are taken from the Standard Surgical First Assistant Services
Agreement; in addition, the figures below reflect an assumption of a facility where
coverage is needed in ALL specialties including general, ob-gyn, orthopedics and
neurosurgery (except cardiovascular surgery) and a Public Aid (Medicare and Medicaid)
maximum overall percentage of 40%;
a. $100,000.00 to include one (1) year full coverage of Surgical Assistant services
regardless of payor, previously noted in Service Agreement.
(The yearly fee is variable upon reviewing variables stated above)
Primary Analysis:
Yearly rate: $100,000.00
RSA/RNFA Bonus N/A
Benefits N/A
Training/Certification Bonuses N/A
1 Assistant employed by facility analysis:
HOSPITAL COST: $123,992.68 per 1 employed SA 19.35% Savings
2 Assistants employed by facility analysis:
HOSPITAL COST: $247,985.36 per 2 employed SA 59.67% Savings
3 Assistants employed by facility analysis:
HOSPITAL COST: $371,978.04 per 3 employed SA 73.12% Savings
Thousands
400
350
300
250
200
150
100
50
0
1 Assistant 2 Assistants 3 Assistants
Facility Employed Contracted
Prepared by American Surgical Assistants, Inc. – © Copyright 2012 – All Rights Reserved