Costs for spinal fusion surgery vary—even substantially—depending on the region where it is performed, according to a new study published recently in the journal Spine.

According to a media release from Wolters Kluwer Health: Lippincott Williams and Wilkins, W. Ryan Spiker, MD, and colleagues at the University of Utah in Salt Lake City analyzed 2012 Medicare data on the costs of two common types of spinal fusion surgery: anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF). For comparison, they also assessed the costs of total knee arthroplasty (KA).

Their analysis focused on direct costs, which is defined in the release as the amount of reimbursement to healthcare providers (such as surgeons or hospitals) by Medicare or other payors.

Average national costs were about $14,000 for a single-level ACDF procedure and $26,000 for a single-level PLF. (These total figures reflected combined professional and facility costs.) Average cost for KA was about $13,000, increasing to $22,000 for TKA in patients with accompanying other major medical conditions, the release explains.

“Each procedure had a significant range in cost across the country,” Spiker and coauthors write in their study, per the release.

Costs for ACDF ranged from about $11,000 to $25,000, while PLF costs ranged from $20,000 to $37,000. For TKA patients without major medical conditions, the range was from about $11,000 to $19,000.

All procedures except ACDF also showed significant variations on the regional level—with the lowest costs in the Midwest and highest costs in the Northeast. For PLF, costs ranged from $24,000 in the Midwest to $28,000 in the Northeast. The figures were $12,000 versus $14,000 for primary TKA, and $21,000 versus $25,000 for TKA with major medical conditions, the release continues.

On the state level, total costs for all four procedures were significantly correlated with the state’s cost of living index, but not with state population, per the release.

The study does not show what’s behind the variations in cost, although state cost-of-living index is one related factor, the release notes.

[Source(s): Wolters Kluwer Health: Lippincott Williams and Wilkins, Newswise]