Comparison of Procedure Costs of Various Percutaneous Tumor Ablation Modalities
Materials and Methods
Four cost models were developed, one
for each ablation modality, estimating
the cost of treating a hypothetical 3 cm
kidney lesion. For the purpose of devel-
oping the cost models and based on our
institution’s protocol, the following are
fixed or assumed to be similar in every
• All procedures are performed under
general anesthesia (institutional pro-
• Every patient has a 23 hour observation stay in the hospital after the tumor
• The computed tomography (CT) scanner and procedure room personnel are
booked for 4 hour blocks for each procedure (institutional protocol).
• The CT scan procedure room is not
used for other procedures even if the
ablation procedure takes less than
The interventional radiologist is
booked for 5 hours for every procedure.
In our institution, the interventional
radiologists are employees of the health
system (integrated group practice).
The operation process of each ablation procedure was mapped out from
presentation to our institution to discharge from the hospital following 23
hour observation. A list of materials
and equipment required was compiled.
Personnel time and contribution were
also documented. The operation process
map and the lists of materials, equipment, and personnel contributions were
verified with the interventional radiology physicians, interventional radiology
technologists, and sales representatives
from the ablation companies. Costs were
calculated with the assistance from the
institution’s finance department, which
calculated direct fixed, indirect fixed, and
variable costs. Follow-up and clinic visits
were excluded from the analysis because
they were the same across modalities.
The cost models were built with flexibility of changing the number of probes
to calculate the cost of treating various
lesions. Different size lesions will mainly
differ based on the number of ablation
probes required for treatment. As previously explained, anesthesia, CT scanner time, and other factors are similar
regardless of the lesion. Therefore, when
the number of required probes is determined in advance, it can be inputted into
the model and the cost will be estimated.
Independently, 69 cases of various
percutaneous ablations that were performed by the division of interventional
radiology for the treatment of a variety of lesions from July 2010 to March
2012 were identified retrospectively ( 26
microwave ablation, 11 radiofrequency
ablation, 27 cryoablation, and 5 irreversible electroporation). The cost of each
procedure was determined by the hospital’s finance department. This number
was later compared with the estimated
cost based on the modules developed.
taBLE 3. Common Costs for Percutaneous Microwave Ablation, Radiofrequency Ablation, Cryoablation, and Irreversible Electroporation
Procedures for Treating Any Lesion.
Equipment, supply, and personnel cost
Preoperative & postoperative nursing $231
Anesthesia supplies $890
CT scan technologists $458
CT scanner equipment $680
Interventional radiologist (MD) $1385
IR small procedure tray $32
IV contrast, injector, syringe $30
23-hour post procedure observation (room and board only) $610
Miscellaneous supplies (syringe, gown, etc.) $100
CRNA, Certified Registered Nurse Anesthetist; C T, computed tomography; IR, interventional radiology; IV, intravenous; MDA, anesthesiology physician.