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Related Experiment Video

Updated: Nov 17, 2025

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Cost Analysis of Routine Vitrectomy Surgery.

Sean T Berkowitz1, Paul Sternberg2, Shriji Patel2

  • 1Vanderbilt University School of Medicine, Nashville, Tennessee.

Ophthalmology. Retina
|February 15, 2021
PubMed
Summary

Routine vitrectomy surgery costs significantly exceed Medicare reimbursement, with 68% of cases being unprofitable. Accurate cost analysis using electronic health record data is crucial for academic ophthalmology departments to inform reimbursement policies.

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Area of Science:

  • Ophthalmology
  • Health Economics
  • Health Services Research

Background:

  • Pars plana vitrectomy is a common ophthalmic surgical procedure.
  • Accurate cost assessment is essential for financial sustainability in healthcare.
  • Electronic Health Records (EHR) contain valuable data for cost analysis.

Purpose of the Study:

  • To determine the complete cost profiles of routine pars plana vitrectomy surgery.
  • To compare the actual costs with Medicare reimbursement rates.
  • To identify factors influencing the profitability of vitrectomy procedures.

Main Methods:

  • Utilized electronic health record (EHR) time logs for cost calculation.
  • Employed time-driven activity-based costing (TDABC) methodology.
  • Integrated data from perioperative data warehouse and financial management software.

Main Results:

  • The total cost per patient for vitrectomy was $7169.79, exceeding Medicare reimbursement by $2053.85.
  • 68% of analyzed vitrectomy cases were unprofitable.
  • Break-even requires case durations under 26.81 minutes, a 53.78% overhead reduction, or a 40.15% reimbursement increase.

Conclusions:

  • Routine vitrectomy procedures are significantly underfunded by current Medicare reimbursement rates.
  • Accurate costing using EHR data can aid academic ophthalmology departments in financial planning.
  • Findings support policy discussions for appropriate reimbursement adjustments.