Table 11.
Cost Scores among Episodes with and without Complications
| Episodes∗ | Episode Cost Mean (SD) |
Score Percentile |
Mean-Observed/Expected Cost Ratio | ||||||
|---|---|---|---|---|---|---|---|---|---|
| 1st | 10th | 25th | 50th | 75th | 90th | 99th | |||
| All | $3029 ($1101) | $1604 | $1825 | $2001 | $2807 | $3736 | $4702 | $5569 | 1.00 |
| No complication codes | $2276 ($630) | $1462 | $1750 | $1857 | $2014 | $2651 | $2897 | $5094 | 0.96 |
| Any complication codes | $3738 ($970) | $1873 | $2182 | $3456 | $3716 | $3941 | $5315 | $5701 | 1.04 |
| Broken posterior capsule | $4535 ($869) | $2364 | $3357 | $3987 | $4506 | $5245 | $5511 | $6306 | 1.25 |
| Dropped lens | $4326 ($970) | $2150 | $3118 | $3526 | $4399 | $5248 | $5423 | $6176 | 1.46 |
| IOL repositioning/removal/exchange | $4221 ($903) | $2167 | $3163 | $3579 | $3944 | $5130 | $5410 | $5964 | 1.51 |
| Retinal tear/detachment repair | $3711 ($1098) | $1596 | $2387 | $2647 | $3903 | $4412 | $5167 | $6230 | 1.21 |
| Endophthalmitis | $3487 ($1075) | $1744 | $2197 | $2635 | $3379 | $4104 | $5076 | $6312 | 1.26 |
| Cystoid macular edema† | $2885 ($264) | $2121 | $2682 | $2760 | $2850 | $2974 | $3162 | $3806 | 1.05 |
CPT = Current Procedural Terminology; HCPCS = Healthcare Common Procedure Coding System; IOL = intraocular lens; SD = standard deviation.
∗
Complication categories based on the codes listed in Table S4 (available at www.ophthalmologyscience.org).
†
Cystoid macular edema is identified from diagnosis codes (not CPT/HCPCS), and part D services such as eye drops are not included in cost calculations (not included in initial measure specifications); therefore, the reported episode mean cost may not reflect all complication-related costs.