PROSPECTIVE EVALUATION OF COSTS OF DISPOSABLE ACCESSORIES IN DIAGNOSTIC AND THERAPEUTIC ERCP

Procedural (room fee) reimbursement from insurance payers is usually f ixed for individual endoscopic procedures and may not include the cost s of disposable equipment. This study estimated costs of disposable it ems used in ERCP procedures and calculated the percentage of total rei mbursement spent on such equipment. A total of 248 ERCPs were performe d in a 5-month study period, 192 (77%) of which were therapeutic. Tota l reimbursement was estimated to be $112,262 ($452 per procedure) and total disposable equipment costs were $47,195 ($190 per procedure), or 42% of total reimbursement. Disposable instrument costs in diagnostic ERCP approximated 13% of those associated with therapeutic ERCP, and the latter costs in turn utilized more than 60% of Medicare/Medicaid r oom fee reimbursement. This reimbursement may be inadequate to cover b oth disposable instrument costs and other procedural expenses, such as admit-recovery costs, nursing assistance, expenses related to endosco pe purchase and capitalization, and equipment cleaning or sterilizatio n. Our data suggest the need for either re-usable endoscopic accessori es or adequate compensation to cover disposable instrument costs.