The article authors analyzed the 90-day episode for primary lumbar discectomy, including the commercial payer rates, Medicare and Medicare Advantage rates for a seven or eight year period between 2005 and 2015. Study authors found:
1. The average cost breakdown for each aspect of the total bill was:
• Facility fee: 59.7 percent to 73.6 percent
• Surgeon fees: 13.7 percent to 18.5 percent
• Postacute services: 8.8 percent to 15 percent
2. Inpatient surgeries were significantly more expensive than the outpatient surgeries.
3. The 90-day bundles were established at $11,091 for commercial payers, $6,571 for Medicare Advantage and $6,239 for Medicare patients.
4. Reimbursement was lowest for spine surgeries performed in the Southern region of the country among commercial and Medicare payers when compared with other regions.
5. Study authors determined postacute services weren’t major drivers of increased cost for discectomy procedures, as they are for total joint replacements.
More articles on spine surgery:
50 things to know about the spine industry | 2018
Biggest spine industry change? Reimbursement—Dr. John Peloza explains spine trends, challenges & opportunities
The best practices for cost-effective spine care
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