Surgeries account for almost half of hospital costs


Hospital stays with surgeries made up just under 29% of all admissions in 2014 but accounted for over 48% of all hospital costs, according to the Agency for Healthcare Research and Quality (AHRQ).

Of the 35.4 million inpatient stays in 2014 – the last full year of ICD-9-CM coding – 10.1 million (28.6%) involved at least one any-listed surgical procedure, and 25.2 million (71.4%) did not. The total cost of all admissions was $386.2 billion, of which $187.1 billion (48.4%) went for stays with surgeries and $199.1 billion (51.6%) went for nonsurgical stays, the AHRQ reported in a statistical brief.

Most costly inpatient stays by surgical procedure, 2014
The most expensive operating room procedure that year was spinal fusion, with an aggregate cost of $12 billion – that’s 413,200 stays with a spinal fusion performed at a mean cost per stay of $28,900. That also works out to be 7.3% of the total cost of $163.8 billion for the 9.2 million stays with a first-listed surgery in the ICD-9 coding.

There were five other musculoskeletal procedures among the 20 most costly surgery-related admissions: knee arthroplasty was second at $11.8 billion, hip replacement was third at $8.3 billion, treatment of hip and femur fracture/dislocation was ninth at $4.3 billion, amputation of lower extremity was 13th at $2.5 billion, and treatment of lower extremity (other than hip or femur) fracture/dislocation was 14th at $2.4 billion. Those six procedures combined were $41.2 billion in hospital costs, which was a quarter of the total for all stays with a first-listed OR procedure, the AHRQ said.

The nonmusculoskeletal procedures in the top five were percutaneous coronary angioplasty in fourth, with an aggregate cost of $8.1 billion, and cesarean section in fifth at an even $7 billion. Coronary artery bypass graft, the most expensive procedure per stay ($52,000) among the top 20 procedures, was sixth in aggregate cost at $6.7 billion, according to the AHRQ researchers.

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