What complex surgery really costs - and why it matters

When complex surgeries lose money… and no one notices

At a leading academic eye center, we asked a simple question: How much does surgery really cost? Not based on guesswork, RVUs, or reimbursements – but on real-time staff involvement, room usage, and material costs. This was harder to do than you might think. Most health systems do not have a great way of calculating costs, even from a resource as expensive and important as the operating room (OR).

In order to answer the question, we pioneered a string of studies using Time-Driven Activity-Based Costing (TDABC). In these studies, we uncovered a consistent pattern – one that many surgeons understand but had yet to quantify: the more complex the surgery, the greater the hidden financial loss.