我们的目的是描述美国细胞减灭术和腹腔热腹腔化疗 (CRS/HIPEC) 的财务影响。我们对 100 例 CRS/HIPEC 手术进行了回顾性成本分析，以检查患者和手术因素对医院费用和报销的影响。对 CRS/HIPEC 与复杂肿瘤外科手术的代表性样本之间的外科医生工作相对价值单位 (wRVU) 进行比较，以评估医生的补偿率。使用单变量和多变量后向逻辑回归分析围手术期变量与高直接成本 (HDC) 之间的关联。每次 CRS/HIPEC 手术的中位直接成本为 44,770 美元。医院报销中位数为 43,066 美元，而专业报销为 8608 美元，导致每次手术的正贡献边际为 7493 美元。然而，边际贡献率随付款人组合的不同而显着变化。私人保险患者的正贡献边际中位数为 23,033 美元，而医疗保险患者的负贡献边际为 13,034 美元。住院时间 (LOS) 与 HDC 的关联最显着，主要并发症与 LOS 的关联最显着。最后，CRS/HIPEC 手术产生的中位数为 13 wRVU/h，显着低于开放性胰十二指肠切除术、开放性胃切除术和肝切除术产生的 wRVU/h。然而，较高的手术复杂性和多次内脏切除有助于弥补相对较低的wRVU/h。CRS/HIPEC是一项昂贵的手术，而延长的LOS对手术的总成本影响最为显着。高质量的护理对于改善患者治疗效果和维持手术的经济可持续性至关重要。© 2023。外科肿瘤学会。

We aimed to describe the financial implications of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in the USA.We conducted a retrospective cost analysis of 100 CRS/HIPEC procedures to examine the impact of patient and procedural factors on hospital costs and reimbursement. A comparison of surgeons' work relative value units (wRVUs) between CRS/HIPEC and a representative sample of complex surgical oncology procedures was made to assess the physicians' compensation rate. Univariable and multivariable backward logistic regression was used to analyze the association between perioperative variables and high direct cost (HDCs).The median direct cost per CRS/HIPEC procedure was US $44,770. The median hospital reimbursement was US $43,066, while professional reimbursement was US $8608, resulting in a positive contribution margin of US $7493/procedure. However, the contribution margin significantly varied with the payer mix. Privately insured patients had a positive median contribution margin of US $23,033, whereas Medicare-insured patients had a negative contribution margin of US $13,034. Length of stay (LOS) had the most significant association with HDC, and major complications had the most significant association with LOS. Finally, CRS/HIPEC procedures generated a median of 13 wRVU/h, which is significantly lower than the wRVU/h generated by open pancreatoduodenectomies, open gastrectomies, and hepatectomies. However, higher operation complexity and multiple visceral resections help compensate for the relatively low wRVU/h.CRS/HIPEC is an expensive operation, and prolonged LOS has the most significant impact on the total cost of the procedure. High-quality care is essential to improve patient outcomes and maintain the economic sustainability of the procedure.© 2023. Society of Surgical Oncology.