Materials & Methods
All CTR surgeries done by three fellowship trained orthopedic hand surgeons in the hospital operating room (OR) and PR at a rural health system from 2019-2020 were reviewed. The operative time of each procedure, number of personnel and supplies required in each clinical location were examined to calculate costs. CTR cost and insurance revenue models were created and total costs, revenue, and net revenue were compared.
Results
Data was collected on 1,416 carpal tunnel surgeries done in our hand practice in the hospital operating room and PR from 2019-2020. 855 CTRs were performed in the OR and 561 procedures in the PR. The average total cost for CTR in the hospital OR was $2,196.10 compared to $549.07 in the PR. Average net revenue of CTR was significantly greater when done in hospital OR vs. PR at $1,011.06 and $85.87, respectively. The average reimbursement rate was greater in the OR at 55% compared to 30% for CTRs done in the PR.
Conclusion
Average net revenue for hospital OR CTR was significantly higher than in-clinic CTR, secondary to higher reimbursement rates in the hospital and the lack of a facility fee for the office procedure room. Future work could seek to better understand the opportunity cost of hospital OR utilization and to determine the true procedure costs. Pre-procedure analysis could optimize CTR revenue based on procedure location and expected insurance reimbursement.
