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A Cost Analysis of Enucleation and Evisceration Surgeries for Treatment of Blind, Painful Eyes. | LitMetric

A Cost Analysis of Enucleation and Evisceration Surgeries for Treatment of Blind, Painful Eyes.

Ophthalmic Plast Reconstr Surg

Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A.

Published: December 2024

AI Article Synopsis

  • The study evaluates the surgical costs and reimbursement rates of enucleation and evisceration surgeries for blind, painful eyes using time-driven activity-based costing.
  • Analyzing data from 110 enucleations and 52 eviscerations over five years, the research found that enucleations took longer and were more expensive than eviscerations, with both surgeries consistently resulting in negative financial margins.
  • Overall, the findings suggest that costs for these surgeries often exceed what is reimbursed by Medicare and Medicaid, with evisceration being slightly more efficient in terms of time and cost.

Article Abstract

Purpose: The purpose of this study is to assess the surgical costs of enucleations and eviscerations and their relation to current reimbursement rates using time-driven activity-based costing.

Methods: This is a retrospective study of patients undergoing enucleation and evisceration surgeries with attachment of muscles (Current Procedural Terminology 65105 and 65093) for a diagnosis of blind, painful eye, from January 1, 2019, to December 31, 2023, at a single, tertiary level, teaching hospital. A time-driven activity-based cost analysis for day of surgery was performed. Operative reports, perioperative times, and supply costs were extracted from the electronic medical record, and average reimbursement fees were taken from Center for Medicare and Medicaid Services data.

Results: In the 5-year study span, 110 patients underwent enucleation and 52 underwent evisceration for a primary indication of blind, painful eye by 10 different surgeons. The average operating room time and surgical time for enucleation was approximately 9 minutes longer compared with evisceration (p < 0.01). Both surgeries on average resulted in a negative margin with enucleations costing on average $624 more than eviscerations. The breakeven total operating room time for enucleation and evisceration surgery was approximately 86.3 and 83.1 minutes, respectively. From the sample, approximately 79% of enucleation and 60% of evisceration surgeries resulted in a net negative margin.

Conclusions: On average, the cost of enucleation and evisceration surgeries exceeded the reimbursement amount set by the Center for Medicare and Medicaid Services. Compared with enucleation, evisceration was more time and cost-effective by only a modest margin.

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Source
http://dx.doi.org/10.1097/IOP.0000000000002836DOI Listing

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