Cost of shoulder surgery.

A cost analysis of four common shoulder procedures was performed to better advise patients and payers of the expected costs and to provide a foundation for future cost/benefit analysis. Four groups of 50 patients each were evaluated. Group 1 underwent primary, open rotator cuff repair. Group 2 underwent open, anterior instability repair. Group 3 underwent arthroscopic subacromial decompression. Group 4 underwent hemiarthroplasty or total shoulder arthroplasty. The surgical and anesthetic fees, hospital bills, and perioperotive consultation charges were obtained and tabulated for all patients. The average ages for groups 1 to 4 were 56, 32, 50 and 63 years, respectively. In group 1 37% of the patients had worker's compensation, 35% had private insurance, and 28% had Medicare. In group 2 64% of the patients had worker's compensation, and 36% had private insurance. In group 3 39% of the patients had worker's compensation, 48% had private insurance, and 13% had Medicare. In group 4 4% of the patients had worker's compensation, 43% had private insurance, and 53% had Medicare. For group 1 the average length of stay was 3 days, and the average total cost was $9444. For group 2 the average stay was 1.7 days, and the average cost was $8675. For group 3 the average stay was 0 days, and the average cost was $7246. For group 4 the average stay was 5 days, and the average cost was $16,323. We believe that these figures represent the direct costs of four common types of shoulder surgery in a private setting and that such data are important to decision-making in a changing health care environment.