Objective: To investigate the economics of lung volume reduction surge
ry. Design: Medical center and physician charges obtained from billing
records. Setting: Academic health center. Patients: Twenty-three cons
ecutive patients undergoing lung volume reduction surgery at a single
institution who were discharged from the hospital prior to November 1,
1995. Outcome measures: Length of hospital stay, mortality, medical c
enter charges and professional fees, and sponsor reimbursement. Result
s: Median hospital stay was 8.0 days and there were no deaths. The med
ian charge was $26,669 (range, $20,032 to $75,561) of which 73% was fo
r medical center services and 27% was for physician services. Fees for
medical center rooms and operating suite time accounted for 71% of me
dicals. Total charges were directly related to length of stay (r(2) =
0.95). Median reimbursement for medical center services was $22,264 (1
14%; range, $13,333 to $123,362) and for physician services was $2,783
(34%; range, $2,597 to $11,265), resulting in a median total reimburs
ement that represented 94% of total charges. The median reimbursement-
to-cost ratio was 1.22, compared with 1.05 for all medical services in
fiscal year 1995. Conclusions: These data must now be assessed relati
ve to outcomes such as quality of life, patient function, and long-ter
m survival to determine cost-effectiveness of lung volume reduction su
rgery.