Which spine surgeries belong in the ambulatory surgical center? Determining economic viability using time-driven activity-based costing - PubMed
5 hours ago
- #ambulatory surgical center
- #cost analysis
- #spine surgery
- Study uses time-driven activity-based costing (TDABC) to determine true costs of spine surgeries in outpatient hospital settings.
- Compares costs with Medicare ASC reimbursement to identify economically viable procedures for ambulatory surgical centers (ASCs).
- Analyzed 2148 procedures (1274 lumbar, 874 cervical) from 2020-2024, with costs varying significantly by procedure type.
- Cervical: ACDF (anterior cervical discectomy and fusion) more often cost less than reimbursement (71.8% vs. 40% for disc arthroplasty).
- Lumbar: Microdiscectomy and laminectomy/decompression had highest proportion of cases below reimbursement (95.3% and 94.5%).
- Lumbar fusion had highest total cost, making it less suitable for ASCs under current reimbursement structures.
- Multivariable analysis shows ACDF, laminectomy/decompression, and microdiscectomy are most economically viable for ASC transition.
- Suggests reimbursement reform is needed to expand feasible ASC procedures beyond those currently identified.