Cost Minimization Analysis of Ganglion Cyst Excision

Abstract

Purpose: Cost minimization analysis can be employed to determine the least costly option when multiple treatments lead to equivalent outcomes. We present a cost minimization analysis from the payers' perspective, of the direct per patient cost of arthroscopic versus open ganglion cyst excision. We tested the null hypothesis that there is no difference in cost between the 2 procedures from the payer perspective.

Methods: We utilized data from a private payer administrative claims database comprising 16 million individuals from 2007 to 2015. Using Current Procedural Terminology codes to identify open and arthroscopic ganglion excisions, we extracted demographic data and fees paid to providers and facilities for the procedure.

Results: We identified 5,119 patients undergoing open ganglion cyst excision and 20 patients undergoing arthroscopic ganglion excision. The average cost of an open excision was significantly lower than an arthroscopic excision ($1,821 vs $3,668).

Conclusions: Surgical costs from arthroscopic ganglion excision are significantly more than open excision. This data can inform health systems participating in value-based models.

Type of study/level of evidence: Economic and Decision Analysis IV.

Keywords: Wrist arthroscopy; cost; ganglion cyst; quality; value.