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Related Experiment Video

Updated: May 19, 2026

Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report
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Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report

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Comparative Cost Analysis of Pediatric and Adult Retinal Detachment Repairs Using Time-Driven Activity-Based Costing.

Warren W Pan1, Salma Fleifil2, David S Portney1

  • 1Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.

Journal of Vitreoretinal Diseases
|May 18, 2026
PubMed
Summary

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Pediatric retinal detachment (RD) repair surgeries, particularly standard vitrectomy, incur significantly higher costs than adult procedures. Medicare reimbursement often fails to cover these increased costs, leading to net margin losses for pediatric RD repairs.

Area of Science:

  • Ophthalmology
  • Health Economics
  • Surgical Cost Analysis

Background:

  • Retinal detachment (RD) repair is a critical surgical intervention.
  • Understanding the economic disparities in pediatric versus adult RD repair is essential for healthcare resource allocation and patient access.
  • Previous studies have not comprehensively compared the costs and reimbursement of RD repair across different age groups and surgical complexities.

Purpose of the Study:

  • To conduct a comparative analysis of the costs and Medicare reimbursement rates for pediatric versus adult retinal detachment repair surgeries.
  • To evaluate the financial implications of different RD repair techniques (scleral buckle, standard pars plana vitrectomy, complex pars plana vitrectomy) in pediatric and adult populations.

Main Methods:

  • Utilized Current Procedural Terminology (CPT) codes (67107, 67108, 67113) for scleral buckle, standard RD repair, and complex RD repair.
Keywords:
PPVhealth policypars plana vitrectomypediatricreimbursementretinascleral buckletime-driven activity-based costing

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  • Analyzed data from 103 pediatric and 549 adult cases between January 2017 and May 2024.
  • Employed time-driven activity-based costing methodology for a detailed cost analysis.

    • Main Results:

    • Scleral buckle repair costs were comparable between pediatric and adult patients.
    • Pediatric standard RD repair exhibited significantly higher material, grand total, and day-of-surgery time costs compared to adults.
    • Net margin losses were observed for pediatric standard vitrectomy and both pediatric and adult complex RD repairs under Medicare reimbursement.

    Conclusions:

    • Pediatric standard vitrectomy procedures are substantially more costly (60.8% higher) than those for adults.
    • Medicare reimbursement inadequately covers the costs of pediatric standard vitrectomy and complex RD repairs in both age groups, resulting in financial losses.
    • Surgical complexity and patient age significantly impact the cost-effectiveness and reimbursement adequacy of RD repair.