- 1Capital Costs - Buildings and Fixtures
- 2Capital Costs - Movable Equipment
- 3Employee Benefits
- 4Administrative and General
- 5Operation and Maintenance of Plant
- 6Housekeeping
- 7Medical Supplies
- 8Other Overhead (Specify)
- 9Procurement Coordinators
- 10Professional Education
- 11Public Education
- 12Other Acquisition (Specify)
- 13Kidney Acquisition
- 14Tissue Typing Laboratory
- 15Liver Acquisitions
- 16Heart Acquisitions
- 17Pancreas Acquisitions
- 18Lung Acquisitions
- 19Other Acquisitions
- 20Other Acquisitions
- 21Research
- 22Blood Bank
- 23Laboratory - Non-Tissue Typing
- 24Dialysis Units
- 25Other Non-Reimbursable (Specify)
- 26Total Expenses (sum of lines 1-25)$3.80BSource: OPO cost report, fiscal 2024
Atlas
BetaHow money moves in donation and transplant
What came in, on the two lines that record it
The first two sit on different pages of the cost report, so the site never adds them. They are not the whole of what an organization takes in, and the third is a part of the second rather than an addition to it.
Cost reports: how organ donation is paid for
Every independent organ procurement organization (OPO) files a cost report with Medicare each year, the CMS-216-94. Hospital-based ones report inside the hospital's own cost report. It lists what the OPO spent to recover organs and what it received for them, organ by organ. Transplant hospitals file their own, the CMS-2552-10, and most OPOs file an IRS Form 990. This site reads all three and traces every figure to a cell or to a stated formula.
These totals cover the OPOs that file their own cost report with Medicare. 7 more OPOs are run inside a hospital and report within that hospital's cost report, so they are not included here. 28 histocompatibility laboratories file the same form and are excluded from every figure here.
Organ recovery in America is paid for at cost, and every organ procurement organization files the account of it with Medicare each year. Those filings are public, they are hard to read, and almost nobody reads them. This site reads them and shows the cell behind every figure.
All payments to providers of services must be based on the reasonable cost of services covered under Medicare and related to the care of beneficiaries."
42 CFR 413.9(a), Principle
Organ acquisition is paid at cost, outside the payment system used for everything else
Almost everything Medicare pays a hospital for is set by diagnosis. Organ acquisition is reimbursed at cost. The OPO reports what it spent to recover organs, and the cost report reconciles that against what it received. The result is a filing that carries costs, line by line, and settles them against receipts.
Line 1 Capital Costs - Buildings and Fixtures Line 4 Administrative and General Line 8 Other Overhead (Specify) Line 9 Procurement Coordinators Line 14 Tissue Typing Laboratory Line 20 Other Acquisitions Line 26 Total Expenses (sum of lines 1-25)
The unit of account is the organ
The cost report has one line for each organ and tissue: how many were recovered, and how many dollars came in for them. Kidneys are the exception and are reported on a separate page. Every figure on this site comes from one of those lines and names it.
Line 1 Total number of kidneys retrieved (viable and nonviable) Line 2 Total number of kidneys included in line 1 that were nonviable. Line 3 Net number of kidneys for which payment should have been received (line 1 minus line 2). Line 8 Cornea Line 9 Total
Two federal filings count the same organs
The OPO reports how many organs it found usable. The transplant hospital reports, on its own cost report, how many organs it recorded as acquired from OPOs. The two counts can be compared. The ratio runs from 0.7876Source: calculated from the OPO cost report, 2022 to 1.4680Source: calculated from the OPO cost report, 2019 by organ and year. The dollars cannot be compared, because the hospital side carries a cost pool with no line for the amount reimbursed to the OPO. The comparison is national only, because organs cross service-area boundaries.
S-1 Part I, organ line, column 1 recovered, total S-1 Part I, organ line, column 2 of which not usable usable is column 1 less column 2 D-4, line 73, column 2 organs acquired from OPOs, as the hospital counted them D-4, line 61, column 1 total organ acquisition cost pool
Every filing, stage by stage
Explore the filingsThe flow
One money path, four parties: who pays, the transplant hospital, the organ procurement organization, and who is paid. One party lit at a time, with the filing each figure comes from.
Open the lensBy organ
Kidney, liver, heart, lung and pancreas. What OPOs received for each, and why kidneys are reported on a different page.
Open the lensOrgan procurement organizations
Every OPO that filed, listed by name. Choose one to read its own figures on both sides of the flow.
Open the lensTransplant centers
The hospital side of the same organs, from each transplant hospital's own filing, one card per hospital and organ program for the chosen year.
Open the lensWhat the filings do not show
OPOs with no report whose period ends in the year, the choices filers can make, related organizations as the filer wrote them, and the figures no form asks for.
Open the lens