Reconstructive Costs of Non-Melanoma Skin Cancer Treated By Mohs Surgery or Surgical Excision

Abstract:

 Introduction:

Non-melanoma skin cancer (NMSC) is commonly treated with either Mohs surgery or surgical excision with narrow margins.  Both can be safely performed by experienced physicians and result in a similar high quality of care with low recurrence.¹  However, with an increasing focus on economic considerations, the question arose as to which modality was the most cost-effective. 

 Hypothesis:

In our tertiary care setting, we hypothesized that minor procedures to treat NMSC by surgical excision and reconstruction would be less costly than Mohs surgery and reconstruction. 

Methods:

Using ICD-9 codes for NMSC and relevant CPT codes for Mohs surgery and reconstruction versus surgical excision and reconstruction, financial information was collected on all outpatient cases from 2010 to 2012.

Results:

There were 977 Mohs procedures and 2016 surgical excisions in the two-year period.  The average charge was $2994.00 for Mohs surgery and $2167.78 for surgical excision. Average total cost was $339.70 for Mohs and $250.54 for surgical excision. Average payment for Mohs was $1001.62 and $723.97 for surgical excision.  Average profit for Mohs was $661.92 and $473.43 for excision and reconstruction.

Conclusion: 

For outpatient treatment of NMSC at our tertiary care institution, Mohs surgery and reconstruction had a higher cost, payment and net income when compared to surgical excision and reconstruction.