Ninety-Day Overall Healthcare Reimbursements and Their Drivers for Primary Arthroscopic Bankart Repair

Background: Arthroscopic Bankart repair (ABR) is a widely performed procedure for anterior glenohumeral instability. The aim of this study was to characterize variability and identify drivers of 90-day healthcare reimbursement after primary ABR. Methods: Primary ABR patients were identified in the PearlDiver M170 database (January 2010–April 2023). Patients who were inactive within 90 days preoperatively or postoperatively or who were coded for neoplasm or infection within 90 days preoperatively were excluded. Variables analyzed included patient characteristics (age, sex, Elixhauser Comorbidity Index [ECI]), nonclinical factors (insurance plan, geographic region), postoperative events (any adverse event [AAE], emergency department [ED] visit, hospital readmission), and total 90-day reimbursements. Multivariable linear regression was conducted to identify independent predictors of reimbursement. Results: Overall, 135,144 primary ABR patients were identified, representing $596,112,149 in total reimbursements. The mean ± SD reimbursement was $4450 ± $5268. The median (25th quartile–75th quartile) reimbursement was $3192 ($1751–$5465). Variables independently associated with the greatest 90-day reimbursement were readmission (+$18060), AAE (+$1169), and ED visit ($1044). Weaker associations were observed for geographic region, ECI, and male sex ( P < 0.0001 for all). Compared with commercial insurance, Medicare (–$2072) and Medicaid (–$1371) were associated with lower reimbursement ( P < 0.0001 for both). Notably, over the course of the study period, median overall reimbursement increased from $1930 to $3540 ( P < 0.0001). Conclusion: This longitudinal, national analysis identified cost variability and key drivers related to ABR. Preventing readmissions may yield the largest cost reductions while observed disparities across insurance plans and regions highlight opportunities for standardization and equity in reimbursement.