COST OF CARDIAC SURGERY IN THE UNITED STATES: A SCOPING REVIEW khyles@stanford.edu

 

COST OF CARDIAC SURGERY IN THE UNITED STATES: A SCOPING REVIEW

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Yihan Lin yihan.lin@stanford.edu Stanford University Cardiothoracic Surgery - Adult Cardiac Surgery Stanford United States

 

 

 

United States

Oral or Poster

Cardiac surgery is among the most resource-intensive areas of U.S. healthcare, yet cost data are fragmented and inconsistently reported. We mapped U.S. cardiac surgery cost reporting, quantified procedural cost ranges, and identified gaps that limit comparability and decision-making for clinicians, policymakers, and global health stakeholders.

We searched PubMed, Embase, and Web of Science (3,243 titles/abstracts; 511 full texts). 299 studies met inclusion criteria reporting U.S. cardiac surgery costs post- Affordable Care Act (2010). We extracted design, population, procedure, scope, economic evaluation type, and stratification by payer, geography, and hospital characteristics. To avoid mixing non-comparable figures, we re-classified every data point by five buckets: Dollar representation, episode scope, time horizon, construction method and statistical summary.

Adult-focused studies comprised 90.7% of articles, with TAVR/TAVI representing 37.9% of studies and CABG 25.5%, followed by smaller shares for the categories drawn from 12 surgery categories. Results are reported by dollar representation and episode scope. In index admissions, on average, internal costs were far lower than charges: CABG median cost $39,637 vs median charge $78,162; TAVR/TAVI median cost $54,647 vs median charge $203,968, underscoring substantial cost–charge divergence within the same scope. Across procedures, congenital cardiac surgeries were among the highest median hospitalization costs for index admissions.

U.S. cardiac surgery “costs” vary by procedure, scope, perspective, and construction method. Lack of standardization in cost reporting constrains comparability. Standardized cost definitions, consistent inflation adjustment, and richer stratification are needed to inform clinical decision-making, equitable resource allocation, and international benchmarking.