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桡骨远端固定器械(CPT 25607、25608 和 25609)之间的植入物计费差异。

Implant Charge Differences Between Distal Radius Fixation Constructs (CPT 25607, 25608, and 25609).

机构信息

Brown University, Providence, RI, USA.

Loma Linda University Health, CA, USA.

出版信息

Hand (N Y). 2022 Sep;17(5):946-951. doi: 10.1177/1558944720963927. Epub 2020 Oct 19.

Abstract

BACKGROUND

Implants are a significant contributor to health care costs. We hypothesized that extra-articular fracture patterns would have a lower implant charge than intra-articular fractures and aimed to determine risk factors for increased cost.

METHODS

In total, 163 patients undergoing outpatient distal radius fracture fixation at 2 hospitals were retrospectively reviewed stratified by Current Procedural Terminology codes. Implants and associated charges were noted, as were sex, age, insurance status, surgeon specialty, and location. Bivariate and multivariable regression were used to determine associations.

RESULTS

Total implant charges were significantly lower for 25607 (extraarticular, $3,348) than 25608 (2-part intraarticular, $3,859) and 25609 (3+ part intraarticular, $3,991). In addition, intra-articular fractures had higher charges for distal screws/pegs and bone graft. Charge was lower when surgery was performed at a trauma center. There was no charge difference associated with insurance status, age, sex, hand surgery specialty, or fellow status. Substantial intersurgeon variation existed in all fracture types.

CONCLUSION

Distal radius fractures may represent a good model for examining implant costs. Extra-articular fractures had lower implant charges than intra-articular fractures. These data may be used to help construct pricing for distal radius fracture bundles and potential cost savings.

摘要

背景

植入物是医疗保健费用的重要组成部分。我们假设关节外骨折模式的植入物费用会低于关节内骨折,并旨在确定增加成本的风险因素。

方法

在 2 家医院对接受门诊桡骨远端骨折固定的 163 名患者进行了回顾性分层分析,根据当前程序术语 (Current Procedural Terminology, CPT) 代码进行分层。记录了植入物和相关费用,以及性别、年龄、保险状况、外科医生专业和位置。使用双变量和多变量回归来确定关联。

结果

25607(关节外,$3,348)的总植入物费用明显低于 25608(2 部分关节内,$3,859)和 25609(3+部分关节内,$3,991)。此外,关节内骨折的远端螺钉/销钉和骨移植的费用更高。在创伤中心进行手术时,费用更低。保险状况、年龄、性别、手外科专业或研究员身份与费用无关。在所有骨折类型中,外科医生之间的差异很大。

结论

桡骨远端骨折可能是检查植入物成本的一个很好的模型。关节外骨折的植入物费用低于关节内骨折。这些数据可用于帮助构建桡骨远端骨折捆绑的定价和潜在的成本节约。

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