The numbers being discussed are the physician fees, not the facilities or supplies charges. This is the cash going directly to the docs to compensate them for their time.
I was just trying to call out that the cost of supplies and facility fees are paid by Medicare separately.
The physician fee is separate from these payments.
For those looking in, ASP is how medicare reimburses outpatient drugs. The physician practice buys the drugs up front, then bills Medicare the "average sales price" + 6%. The issue at hand is that Lucentis runs $2120 per injection. If you have a decent or large sized macular degeneration patient population, you'll be doing a lot of these injections. However, the number the practice collects is $320. Out of that number, you have to pay overhead / office staff / supplies etc.
The other thing to remember is that if it did include ASP reimbursement, ophthalmologists wouldn't be at the top, oncologists would. If a cancer doc saw 200 HER2 positive breast cancer patients in one year (16/month), treating them with Herceptin alone would cost $14,000,000. Most docs I've spoken to see 100-200 cancer patients per month (of course not all get treated with expensive drugs).
Unfortunately, I don't have a good source. The above is merely my speculation.