The impact of disposable equipment on room fee reimbursement for endoscopic retrograde cholangiopancreatography.

Disposable equipment is widely used in many gastroenterologic procedures. Such equipment decreases risks of cross contamination, is convenient, and decreases the processing, storage, and cost of reusable equipment. However, disposable equipment has a far-reaching environmental impact. Most disposable equipment must be handled as infectious waste. Moreover, cumulative costs associated with disposable equipment may be quite high. In this study, the authors attempted to delineate the percentage of room fee reimbursement spent on disposable equipment. The procedure selected for the study was Endoscopic Retrograde Cholangiopancreatography (ERCP). Two hundred forty-eight procedures were surveyed over a 6-month period between September 1992 and February 1993, and the total cost of each procedure was calculated. Reimbursement figures for diagnostic and therapeutic ERCPs were obtained for Medicare, contracted providers, and private payors. The percentage of room fee reimbursement monies used for disposable equipment for diagnostic ERCPs ranged from 5.8 to 12.8%. For disposable equipment in therapeutic ERCPs the percentage of room fee reimbursement monies ranged from 40.5 to 59.7%. Combining both diagnostic and therapeutic ERCPs, the percentage of room fee reimbursement to defray the cost of disposable equipment was 42.4%. Disposable equipment costs are a large portion of the room fee reimbursement. leaving potentially inadequate revenues for salaries, general upkeep of equipment, and capital to buy new or replace aging equipment.