Is microsurgical head and neck reconstruction profitable?: analysis at an academic medical center

The complexity of modern head and neck reconstruction is paralleled by consumption of large amounts of resources provided by both treating physicians as well as the institution, that is, hospital. In times of increasing economic constraints, analysis of the financial value of providing these services seems prudent. A retrospective analysis of medical and billing records of patients who underwent immediate microsurgical reconstruction of postablative head and neck defects from 2007 to 2010 at Stanford University Medical Center was performed. Financial data related to the treatment of 60 patients were analyzed. Total reimbursement for plastic surgery services was $319,609, representing a collection rate of 18.4%. Total hospital charges were $31,038,846.10. Actual reimbursement was $9,109,776.55, which represents a collection rate of 29.3%. Analysis of hospital revenue revealed a net profit of $1,512,136.46, which represents a mean net revenue of $25,202.27 per case. Microsurgical reconstruction secures substantial revenue for the institution. Innovative reimbursement models need to be implemented to attract skilled microsurgeons, who represent the backbone of these services.