Between-hospital variation in prices for robot-assisted surgery: a multilevel analysis of Korea's 2026 non-covered...

Robot-assisted surgery is not reimbursed by Korea's National Health Insurance, and hospitals set their own prices. In April 2026, procedure-specific codes for robot-assisted surgery were introduced into the national non-covered price disclosure system, enabling procedure-level comparisons of hospital-posted prices. We analyzed posted prices retrieved in October 2026 from the Health Insurance Review and Assessment Service: 733 hospital-procedure observations from 115 hospitals across 10 procedure-specific codes, using two-level linear mixed models of log-transformed posted minimum prices. For breast surgery, which has no specific code, we classified 318 hospital-defined items from 40 hospitals. Median posted minimum prices ranged from 7.00 to 10.00 million Korean won; within procedures, the 90th-percentile price was 1.7-2.6 times the 10th-percentile price. After adjustment for procedure type and measured hospital characteristics, the between-hospital share of residual log-price variance (intraclass correlation coefficient) was 0.54 (95% CI 0.38-0.62; 0.48 after excluding one outlying hospital). University-owned hospitals posted 15.2% lower minimum prices than private hospitals; public ownership, hospital type, bed count, and location were not significantly associated with minimum price. Each additional code with a reported price was associated with a 4.2% higher posted maximum price. Among breast surgery items, 20.1% did not specify the procedure, and 22.5% of hospitals posted prices by grade alone. Because these are posted prices, they do not show what patients paid or which price tier applied. Standardized procedure codes and transparent tier definitions could improve comparability.