MIAMI — A retrospective study examined the cost differences between total surgical excision and Mohs surgery to treat skin cancer in the Miami VA Healthcare system.
“Skin cancer risk is elevated in veterans, whites and males older than 50 years, who comprise the majority of patients at the Miami VA healthcare system,” according to the report in the Annals of Plastic Surgery. “Treatments include total surgical excision (TSE) with frozen section or permanent pathology, and Mohs surgery. Our protocol consists of Mohs procedures performed off-site followed by reconstruction at the VA. This retrospective study examines the cost difference between TSE and Mohs surgery.”
A retrospective chart review was performed of 132 VA patients who underwent TSE or Mohs surgery between 2017 and 2019. The participants were subdivided into TSE vs. Mohs, with 82 undergoing TSE and 48 undergoing Mohs with reconstruction.
The researchers determined that cost per operating room minute for inpatient government-owned facilities was $37.94. A flat fee of $1,400 for the Mohs surgery was the contracted rate with the offsite institution. The average cost of Mohs surgery with reconstruction was $3,534.12; the average cost of TSE with pathology was $2,643.85. The study determined that total surgical excision was significantly more cost-efficient than Mohs with reconstruction (P < 0.01).
“At our institution, TSE seems more cost-effective than Mohs with subsequent reconstruction,” the authors concluded. “While these are generalized costs, and data specific to our institution, cost efficiency is an important consideration in improving the value of care for VA patients.”
- Liu S, Mathew P, Al Bayati M, Remer H, Verling S, Spector S, Thaller S. A Cost Analysis of Mohs and Total Surgical Excision: A Retrospective Review of Skin Cancer Treatments. Ann Plast Surg. 2023 Jul 1;91(1):e1-e3. doi: 10.1097/SAP.0000000000003583. PMID: 37450872.
