Economic Evaluation of Tympanostomy Tube Placement

OBJECTIVES: The purpose of this study is to compare the economics of in-office tympanostomy tube placement using single use devices versus standard placement in the operating room (OR). METHODS: A retrospective chart review was completed for all pediatric patients who underwent in-office tympanostomy tube placement (CPT 69433) along with insurance and date matched patients with placement in the OR (CPT 69436) between 12/1/21-3/1/24. Financial data were compared among the public vs. private insurance cohorts using the Wilcoxon rank-sum test with a two-sided significance level of 5%. RESULTS: One hundred and thirty-six in-office patients were identified, 102 private versus 34 public, and compared with 136 insurance and date matched OR patients. The average total payment for both privately insured patients, $647.14 in-office versus $6873.45 in the OR, and publicly insured patients, $312.74 in-office versus $2656.34 in the OR, was statistically significant. The average insurance payment for both privately insured patients, $301.58 in-office versus $5445.73 in the OR, and publicly insured patients, $310.63 in-office versus $2258.65 in the OR, was statistically significant. For the patient payment, public insurance usually has 0 copay and is therefore excluded. The patient payment of the private insurance cohort, $308.30 in-office versus $670.61 in the OR, was not found to be statistically significant. CONCLUSION: As expected, this study demonstrates significant reductions in overall cost with in-office tympanostomy tube placement even with the added cost of single-use devices compared to the standard placement in the OR, particularly for insurance companies, suggesting the potential benefit of providing reimbursement for these devices. LEVEL OF EVIDENCE: N/A.