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. 2018 May 3;18(4):1–141.

Table 27:

Average Surgical Procedure Costs

Resource Item MRgFUS Neurosurgery, $ Deep Brain Stimulation, $ Radiofrequency Thalamotomy, $ Data Source and Comments
Pre-procedure
Neurology consultation 176 176 176 Schedule of Benefits (A185)91
Neurosurgery consultation 121 121 121 Schedule of Benefits (A045)91
MRI scan
   Professional fee 73 73 73 Schedule of Benefits (X421)91
   Procedure cost 972 972 972 OCC 2015 (CCI code 3.AN.40), ambulatory92
CT scan
   Professional fee 65 NA NA Schedule of Benefits (X401)91
   Procedure cost 513 NA NA OCC 2015 (CCI code 3.AN.20), ambulatory92
Total pre-procedure costs 1,921 1,343 1,343  
Peri-procedure
Inpatient procedure cost 14,095a 17,221b 6,822c MRgFUS thalamotomy (clinical expert, email communication, June 21, 2017); deep brain stimulation (OCC 201592); radiofrequency thalamotomy (OCC 201692)
Device cost NA 14,355 NA Medtronic 2011; 90% unilateral DBS based on expert opinion (email communication, July 13, 2017)
Physician fees 1,551 1,551 1,551 Schedule of Benefits (N124)91
Surgical assistant 445 590 373 Schedule of Benefits (N124)91 (see Appendix 6, Table A8)
Anesthesiologist 585 766 495 Schedule of Benefits (N124)91 (see Appendix 6, Table A9)
Total peri-procedure costs 16,677 34,483 9,242  
Post-procedure
MRI scan
   Professional fee 73 73 73 Schedule of Benefits (X421)91
   Procedure cost 972 972 972 OCC 2015 (CCI code 3.AN.40.), ambulatory92
Neurology, repeat consultation 85 85 85 Schedule of Benefits (A186)91
Neurosurgeon, repeat consultation 58 58 58 Schedule of Benefits (A046)91
Initial DBS programming NA 363 NA Schedule of Benefits (G547, G549)91; 1.8 visits for initial programming based on Ondo et al, 2005,97 and Picillo et al, 201698
Total post-procedure costs 1,189 1,551 1,189  
Total cost per procedure 19,786 37,377 11,774  

Abbreviations: CCI, Canadian Classification of Health Interventions; CT, computerized tomography; MRgFUS, magnetic resonance-guided focused ultrasound; MRI, magnetic resonance imaging; NA, not applicable; OCC, Ontario Case Costing database.

Note: All costs are presented in 2017 Canadian dollars.

a

This is the operational cost only; capital costs (i.e., those related to equipment, installation, and maintenance) are excluded in the reference case analysis.

b

CCI procedure code 1AE53SEJA (implantation, thalamus and basal ganglia, of electrodes [e.g., recording, stimulating] using burr hole approach) for essential tremor (G250); inflated from 2015 to 2017.

c

CCI procedure code 1AE59SEAW (destruction, thalamus and basal ganglia, using burr hole approach and radiofrequency probe) for all diagnoses; inflated from 2016 to 2017.