Which spine surgeries belong in the ambulatory surgical center? Determining economic viability using time-driven activity-based costing

Q: What does this research mean for the field?

Under existing payment structures, microdiscectomy, lumbar laminectomy/decompression, and anterior cervical discectomy and fusion (ACDF) are the most economically viable spine surgeries for transition to ambulatory surgical centers, though broader transition requires reimbursement reform. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Advith Sarikonda; Danyal Quraishi; Shaan Patel; Matthews Lan; Arbaz Momin; D. Mitchell Self; Ashmal Sami Kabani; Srinivas Prasad; Jack Jallo; Joshua Heller; Ashwini Sharan; Alexander R. Vaccaro; James Harrop; Ahilan Sivaganesan

doi:10.3171/2026.1.focus251061

April 1, 2026Neurosurgical FOCUSOpen Access

Which spine surgeries belong in the ambulatory surgical center? Determining economic viability using time-driven activity-based costing

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Key Points

The research aims to assess which spine surgeries can be effectively performed in ambulatory surgical centers (ASCs) based on economic viability.
Evaluated existing spine surgery procedures for suitability in ASCs
Utilized time-driven activity-based costing to analyze costs
Focused on microdiscectomy, lumbar laminectomy/decompression, and ACDF
Identified microdiscectomy, lumbar laminectomy/decompression, and ACDF as the most feasible for ASCs
Highlighted the necessity for reimbursement reforms to support expanded ASC procedures

Implication

Analysis identifies spine surgeries suitable for Ambulatory Surgical Centers, suggesting reimbursement reform is necessary.

Abstract

In existing payment structures, microdiscectomy, lumbar laminectomy/decompression, and ACDF might be most suitable for transitioning from the hospital to the ASC. However, to broaden the scope of procedures that can be feasibly performed in the ASC, there is a need for reimbursement reform.

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Cite This Study

Sarikonda et al. (2026) studied this question.

synapsesocial.com/papers/69d0ae68659487ece0fa4548 https://doi.org/10.3171/2026.1.focus251061

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Which spine surgeries belong in the ambulatory surgical center? Determining economic viability using time-driven activity-based costing

Key Points

Implication

Abstract

Discussion

Cite This Study

Which spine surgeries belong in the ambulatory surgical center? Determining economic viability using time-driven activity-based costing

Key Points

Implication

Abstract

Discussion

Cite This Study

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