Reoperative Cervical Endocrine Surgery: Appropriate Valuation for the Time and Effort?

J Surg Res. 2021 Jul:263:155-159. doi: 10.1016/j.jss.2021.01.034. Epub 2021 Feb 27.


Background: Controversies currently exist regarding the best way to appropriately quantify complexity and to benchmark reimbursement for surgeons. This study aims to analyze surgeon reimbursement in primary and redo-thyroidectomy and parathyroidectomy using operative time as a surrogate for complexity.

Methods: A retrospective analysis using the National Surgical Quality Improvement Program database was performed to identify patients who underwent primary and redo-thyroidectomy and parathyroidectomy. Calculations of median operative time work relative value units per minute and dollars per minute were compared between primary and redo procedures.

Results: Thyroidectomy cases represented 53.5% (22,521 cases), and the other 46.5% (19,596 cases) were parathyroidectomy cases. The median dollars per minute in primary thyroidectomy was $4.97 and for redo-thyroidectomy was $8.12 (P < 0.0001). By the same token, dollars per minute were higher in the redo cases with $15.40 when compared with primary parathyroidectomy cases with $13.14 dollars per minute (P < 0.0001).

Conclusions: By Current Procedural Terminology codes, surgeons appear to be appropriately reimbursed for redo-thyroid and parathyroid procedures indexed to first time parathyroidectomy based on the compensated operative time of these procedures calculated using a nationally representative sample.

Keywords: Current procedural terminology; Endocrine surgical procedures; General surgery; Reimbursement; Relative value scale; Reoperation.

MeSH terms

  • Humans
  • Operative Time
  • Parathyroidectomy / economics*
  • Parathyroidectomy / standards
  • Relative Value Scales*
  • Reoperation / economics*
  • Retrospective Studies
  • Surgeons / economics*
  • Surgeons / standards
  • Thyroidectomy / economics*
  • Thyroidectomy / standards
  • Time Factors