Out-of-Pocket Expense for Surgical Chalazion Removal.

Abstract

Purpose: To provide an improved accounting of the economic burden of chalazion removal for patients.

Methods: A retrospective study approved by the institutional review board of patients who underwent surgical incision and drainage of a chalazion at a tertiary academic center from January 2011 to December 2020 was conducted. Patients were younger than 18 years with a diagnosis of chalazion requiring excision. Out-of-pocket expenses were defined as sum of procedure cost, facility fees, and anesthesia. Center for Medicare and Medicaid Services (CMS) physician fee schedule data and the study hospital's cost estimator were used. Out-of-pocket expenses were calculated and adjusted to 2020 dollars. The cumulative cost was calculated by factoring in the average rate of surgical re-intervention for a chalazion recurrence. Cost trends were tabulated and visualized.

Results: The unadjusted, average total incision and drainage cost for chalazion from 2011 to 2020 was $543.42, increasing from $513.89 to $563.48 (+9.7%). Using costs adjusted to 2020 dollars, cost declines from $591.27 (2011) to $563.48 (2020, -4.93%) were uncovered. Using an averaged recurrence rate of 24.3%, the cumulative adjusted total cost of incision and drainage decreased from $734.95 (2011) to $700.41 (2020, -4.70%).

Conclusions: Chalazion treatment costs declined from 2011 to 2020, suggesting potentially greater affordability for families. However, families should be counseled up front on potential future expenses with surgical intervention for a recurring chalazion. Understanding total costs for recurring chalazion by accounting for potential surgical re-intervention will help pediatric ophthalmologists provide more informed counseling regarding the total cost of treatment with an appreciation for potential future costs if surgical re-intervention is required. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].