Prostate surgeries: average charges throughout the United States, 1997

During 1997 hospital claims for 2,149 radical (open) prostatectomies among selected group policy insureds averaged $16,990 and for 2,192 transurethral resections of the prostate (TURPs), $6,620. There was marked geographic variation in both the distribution and charges for these two procedures. The Pacific region reported the highest average total charges for both procedures, driven by the high charges in California. The California average total charges were 39 percent above the norm for an open procedure and 54 percent above for a TURP. Illinois and Florida each reported open prostatectomy charges over $20,000, 20 and 18 percent, respectively, above the norm. For a TURP, however, Minnesota and Arizona reported the second and third highest charges, each over $8,000, and around 30 percent above the average. Washington state reported the lowest average charge for an open procedure ($12,020, 29 percent below the norm and about half that in California); Pennsylvania had the lowest TURP total charge ($3,860, 42 percent below the norm and 62 percent lower than the California charge). Among study states, charges 15 percent or more below average for an open procedure were also recorded in Pennsylvania, Indiana, Maryland and North Carolina. Similarly low charges for a TURP were recorded in Ohio. Michigan and North Carolina (each more than 15 percent below the norm). The hospital charges comprised 63 percent of the total for an open procedure and 68 percent for a TURP. The California average was the highest for both surgeries. 58 and 69 percent, respectively, above the norm and 129 percent above the low charge in Maryland for an open procedure and 193 percent above the low charge in Pennsylvania for a TURP. Physicians' charges averaged $6,370 for an open prostatectomy and $2,130 for a TURP. For both surgeries, these charges were the highest in New Jersey and New York (between 20 and 30 percent above the norm) and the lowest in Pennsylvania where they averaged 28 percent lower than the norm for an open procedure and 40 percent lower for a TURP. The length of stay averaged 3.75 days for a radical prostatectomy and 2.80 days for a TURP. These days ranged from 4.20 days in New Jersey to 3.11 days in Minnesota for an open procedure and 3.51 days in New Jersey to 2.14 days in Minnesota for a TURP.