Average charges for three types of hysterectomy procedures: United States, 1998

The average charges associated with three forms of hysterectomies (abdominal-laparotomy) vaginal and laparoscopically-assisted vaginal hysterectomy (LAVH) in 1998 were investigated by geographic area and individual states. Considerable variation in the rates of and charges for these three procedures was reported. Based on data from more than 400,000 women insured under group health contracts, the average charges for these three gynecological surgeries were calculated for the study group of 14,184. The majority of the surgeries were laparotomies (64 percent) with LAVH accounting for only 10 percent; the largest proportion of the procedures were performed in the West South Central and South Atlantic regions of the country and the highest average charge was associated with the LAVH procedures. In 1998, the average charge for an abdominal hysterectomy in the United States was $12,500: that for a vaginal hysterectomy was $10,380; and that for a laparoscopically-assisted vaginal hysterectomy was $14,500. The Pacific area registered the highest average charges for all three (between 19 and 21 percent higher than the U.S. norm) while the lowest geographic area charges were reported in West North Central states (between 18 and 21 percent lower than the U.S. average). The charges in California were the highest of all study states for each of the surgeries, ranging from 38 to 43 percent higher than the average, whereas the charges in Iowa were the lowest for the laparotomies and vaginal hysterectomies (42 and 36 percent, respectively below the norm) and in Kansas for the LAVHs (34 percent lower than the U.S. average). Physicians fees were the highest in New York for each procedure ranging from 33 percent higher than the norm for a vaginal hysterectomy, 50 percent higher for an LAVH and 72 percent higher for a laparotomy. The lowest physician charges were reported in Iowa for the vaginal and abdominal surgeries and in Minnesota for the LAVHs. The average length of stay was 3.10 days for the laparotomy procedures, 2.20 days for the vaginal hysterectomies and 1.99 days for the LAVH patients, with substantial variation between states for each procedure.