Anesthesia subsidy benchmarks: what’s normal per location

Your anesthesia group says the market rate is a certain number per location, and your board wants to know if that is true. Or you are building next year's budget and want to know whether your subsidy is in line with what other hospitals pay. You search for a benchmark and find several, each with a different number.

That is not a reason to give up on benchmarking. It is a reason to know exactly what each published figure measures, how it was built, and what it leaves out, before you hold it up against your own contract.

What the published benchmarks actually measure

A handful of figures get cited over and over in anesthesia subsidy discussions. They are not interchangeable. Each comes from a different sample, a different year, and a different definition of what is being counted.

Source	What it measures	Sample	Period	Figure
Enhance Healthcare Consulting	Subsidy per anesthetizing location, by contract signing date	Proprietary database of more than 120 hospitals	Contracts signed in the three years before publication vs. the three years before that	$185,000 average for recent contracts, up from $132,0001
HFMA (Nathan Kaufman)	Subsidy per licensed bed	Not disclosed	January 2026	$10,000 to $30,000 per bed2
Healthcare Performance Strategies, cited by the American Association of Nurse Anesthetists	Subsidy per anesthetizing location, nationally and by CRNA employment model	National survey; sample size not disclosed in the secondary source	2012	$160,096 national average; $180,992 in the southern United States; $154,552 where CRNAs are group-employed; $320,755 where CRNAs are hospital-employed and anesthesiologists are separately contracted3
MD Ranger, reported by ECG Management Consultants	Year-over-year change in total anesthesia payments per contract, not per location	More than 51,000 physician contracts nationwide	Trend since 2020, published May 2024	Median payment up more than 50% since 2020; 75th percentile reached $3.9 million a year4

Each of these has a real limit. Enhance's figure is a proprietary consulting database, not a public survey, so you cannot see the underlying contracts or how "anesthetizing location" was defined for each one. The HFMA per-bed range comes from one author's practice, without a published sample or methodology. The Healthcare Performance Strategies survey is more than a decade old, and it only reaches you secondhand, through a nursing association publication that has its own point of view on staffing models.³ MD Ranger's benchmark is useful for the direction of travel, a fast and broad rise, but it reports total contract payments, not a per-location figure, so it cannot tell you what a location should cost.

A 2026 industry analysis put the underlying problem plainly: there is no dedicated network for exchanging anesthesia economic data, and no consensus-driven, specialty-specific benchmark for compensation, subsidy levels or productivity. The same piece described subsidy requests that had gone from an average of $2 million to $4 million a year to $12 million or more in some markets, in under two years, negotiated, in the author's words, "based on anecdote rather than evidence."⁵ Treat every published number, including the ones in the table above, as a reference point, not a verdict.

Why a single average misleads

Even a well-built benchmark hides more than it shows once you try to apply it to one hospital. A few reasons a single average is the wrong tool:

• Location type. A main OR anesthetizing location, staffed for eight or ten hours of scheduled surgery, is not the same cost or revenue unit as a GI suite location, a cath lab location or an obstetrics location. Blending them into one "per location" figure erases the difference.
• Hours staffed versus hours used. A location scheduled from 7 a.m. to 5 p.m. costs the same in staffing whether it runs a full day or finishes at noon. Benchmarks built on scheduled locations do not capture how well those hours are actually used.
• Care team model. A physician-only room, a medically directed team and a non-medically directed CRNA room carry different staffing costs for the same Medicare payment, because Medicare splits the medically directed fee between the anesthesiologist and the anesthetist rather than paying each in full. Our care team ratios explainer covers how that math works. A subsidy benchmark that does not control for care team model is comparing different cost structures as if they were one.
• Payer mix. A hospital with a heavier Medicare population will need a larger subsidy than one with the same volume and a richer commercial mix, for reasons that have nothing to do with how efficiently the group or the hospital runs the schedule. Our look at why subsidies keep rising goes into the Medicare and commercial rate trends behind this.
• Call, obstetrics and trauma obligations. Coverage that must be available around the clock, regardless of volume, costs money whether or not it is used. Two hospitals with identical daytime schedules can have very different subsidies once you add a labor floor or a trauma program.
• Rural versus urban. A lower-volume rural site needs the same anesthesia coverage per scheduled hour as a busy urban one, spread across fewer cases. National averages are pulled toward the more common, higher-volume setting.
• How the contract defines "anesthetizing location." CMS guidance, drawing on the fire and life safety code, defines an anesthetizing location as any area designated for administering anesthetic agents during examination or treatment, which in practice can include operating rooms and certain procedure rooms.⁶ Contracts do not always use that definition. Some count every room capable of anesthesia; others count only rooms staffed on a given day, or exclude block or overflow rooms. A benchmark and your contract can both say "per anesthetizing location" and be counting different things.

None of this means the published numbers are wrong. It means they answer a narrower question than "is our subsidy normal," and you have to normalize your figures before a comparison means anything.

How to build your own benchmark

The most reliable benchmark is the one built from your own data, tracked the same way every year. Four pieces make it useful.

Define "location" once, in writing, and hold everyone to it. List every site that counts, by name, whether it is staffed daily or only on certain days, and whether call-only sites count as a fraction of a location or a full one. Put that definition in the contract itself, not only in a side spreadsheet, so a renewal cannot quietly redefine it.

Track staffed hours against billed or used hours, by location. A room staffed for ten hours that produces eight hours of billable anesthesia time is a very different location than one that produces four. This gap, sometimes described as location-days when hours are converted into staffed-day units, is the clearest way to see where a schedule is inefficient, not simply uncovered.⁷

Track collections per location, not just total collections. Divide net anesthesia collections by your defined location count for the period. Watch it over time and against payer mix, so a drop tells you whether the problem is volume, rate or bad debt.

Track subsidy per location over time, by site type. Keep the main OR, GI, cath lab, obstetrics and any off-site locations in separate columns. A rising subsidy that is flat per location across most sites, but climbing sharply in one, points you to where to look.

Worked example: building a location-day benchmark

The hospital and numbers here are invented solely to walk through the method.

Say a hospital defines 10 anesthetizing locations in its contract: 7 main OR, 2 GI and 1 obstetrics. Over a year:

• Staffed location-days: 10 locations x 250 scheduled days = 2,500
• Net anesthesia collections: $4,500,000
• Collections per location-day: $4,500,000 / 2,500 = $1,800
• Total staffing and coverage cost, as quoted by the group: $6,300,000
• Subsidy: $6,300,000 minus $4,500,000 = $1,800,000
• Subsidy per anesthetizing location: $1,800,000 / 10 = $180,000
• Subsidy per location-day: $1,800,000 / 2,500 = $720

That $180,000 figure sits inside the range the table above shows, which tells you only that it is not obviously an outlier. It does not tell you whether this hospital's care team model, payer mix or call burden justifies that number. The next step is comparing this year's $180,000 to last year's, and to the same figure calculated the same way at renewal, not to a national average built on a different mix of locations.

Using benchmarks in a negotiation without letting them become a floor

A group's negotiator may tell you "the market is $200,000 per location" and treat that as the starting point for your renewal. Benchmarks are useful in that conversation, but only if you use them the way they were built: as a range drawn from a specific sample, not a single number that applies to your hospital by default.

Ask which survey the figure comes from, what year, what sample, and how it defines a location. If the answer is "everyone knows," you have no way to test the claim. If the group's own historical subsidy has moved in this pattern, from a lower dollar figure to a higher one, tie the discussion to your own trend line first and the external benchmark second. A number a group calls the market rate is more persuasive when it is checked against your own staffed hours, collections and care team model than when it stands alone. Our guide to questions to ask before renewing an anesthesia contract lists the data to request before that conversation starts, and our piece on reviewing a subsidy increase request covers what to do when the number arrives with a leave-or-else deadline attached.

A benchmark also should not become a ceiling you refuse to move past. If your own numbers show real cost pressure, from Medicare rates, call coverage or a genuine staffing shortage, a benchmark that happens to sit below your need is not a reason to hold the line. Use the outside number to sanity-check both directions, not only to argue one.

Before your next renewal

Start now, before a request or a renewal date forces the timeline. Pull your own location, hours and collections data, write down how your contract defines an anesthetizing location, and confirm that definition matches how you count locations internally. Separate your subsidy by site type instead of looking at one total, and track staffed hours against used hours by location so you can see where coverage and demand do not match. When a group cites a market benchmark, ask for its source, year, sample and definition of a location, and check whether your care team model and payer mix are comparable. Compare your subsidy per location to your own history first, and to outside benchmarks second.

Sources

1. Enhance Healthcare Consulting, "Anesthesia Subsidies: Putting It All On the Table," Enhance Healthcare Consulting EHC Insights, September 2022 (updated July 2025). https://enhancehc.com/ehc-insights/anesthesia-subsidies-putting-it-all-on-the-table/ ↩

2. Nathan Kaufman, "Nathan Kaufman: Hospital-based anesthesia and radiology operate in a broken financial model," HFMA, January 2026. https://www.hfma.org/finance-and-business-strategy/physician-compensation/hospital-based-anesthesia-and-radiology-a-broken-financial-model/ ↩

3. American Association of Nurse Anesthetists, "Anesthesia Subsidies – Restraining Hospitals' Economic Viability," AANA, undated. https://www.masscrna.com/assets/Anesthesia_Subsidies.pdf ↩ ↩²

4. ECG Management Consultants, "Key Findings from MD Ranger's 2024 Benchmarks," ECG Management Consultants, May 2024. https://www.ecgmc.com/about/press/3229/key-findings-from-md-rangers-2024-benchmarks ↩

5. Coronis Health, "Isn't It Time? A Call for an Anesthesia Industry Network Dedicated to Objective Standards, Benchmarks and a Common Business Framework," Coronis Health, April 2026. https://www.coronishealth.com/blog/anesthesia-workforce-crisis-benchmarks ↩

6. Centers for Medicare & Medicaid Services, "Relative Humidity (RH): Waiver of Life Safety Code (LSC) Anesthetizing Location Requirements; Discussion of Ambulatory Surgical Center (ASC) Operating Room Requirements," CMS Survey and Certification Group Memorandum (Ref: S&C: 13-25-LSC & ASC), April 2013. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-13-25.pdf ↩

7. Anesthesia Business Consultants, "What is Your Cost Per Anesthetizing Location?," Anesthesia Business Consultants Communique, Spring 2008. https://www.anesthesiallc.com/publications/51-communique/past-issues/spring-2008/239-what-is-your-cost-per-anesthetizing-location ↩