title: A Retrospective Case-Matched Cost Comparison of Surgical Treatment of Melanoma and Nonmelanoma Skin Cancer in the Outpatient Versus Operating Room Setting.
abstract: BACKGROUND
  To date, no study has used authentic billing data in a case-control matched fashion to examine the cost of treating skin cancer in different settings.
  
  
  OBJECTIVE
  To compare the cost of surgical treatment of skin cancer in the outpatient versus operating room setting using matched cases based on patient and skin cancer characteristics.
  
  
  METHODS
  ICD-9 diagnosis codes for skin cancers were used to find patients who had a malignant excision current procedural terminology code in the operating room setting during 2010 to 2014. Patient and skin cancer characteristics were used to match cases to those treated as an outpatient. A total of 36 cases (18 operating room and 18 outpatient) had the required information and characteristics to be matched and analyzed for cost. Health status was determined using the American Society of Anesthesiologists anesthesia grading scale.
  
  
  RESULTS
  No statistically significant differences were found in the age (p > 0.9) or American Society of Anesthesiologists scores (p > 0.6) of the outpatient and operating room cases. The median cost for outpatient cases was $1,745. For operating room cases, the median cost was $11,323. This was a statistically significant difference (p < 0.001).
  
  
  CONCLUSIONS
  The outpatient setting remains a cost-effective location to treat skin cancer compared with the operating room.
authors.affiliation: *Dermatologic Surgery, Dermatology & Skin Surgery Center of Princeton, Plainsboro, New Jersey; †Dermatology, Cooper Hospital, Rowan University, Marlton, New Jersey; ‡Dermatologic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; §Dermatologic Surgery, Cooper Hospital, Rowan University, Marlton, New Jersey.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Johnson
authors.forename: Niraj
authors.initials: N
authors.lastname: Butala
authors.forename: Murad
authors.initials: M
authors.lastname: Alam
authors.forename: Naomi
authors.initials: N
authors.lastname: Lawrence
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008545:Melanoma / Q000191:economics* / Q000601:surgery*; D008875:Middle Aged; D009873:Operating Rooms; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000191:economics* / Q000601:surgery*; D055815:Young Adult