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AAOS Now

Published 1/1/2007

The down side of CAS

The technology to implement computer-assisted surgery is not cheap. Systems can range from $150,000 to $220,000, depending on the type and vendor. List prices for disposables, per case, range from $206 to $850.

Another down side is time. All the panelists agreed that CAS TKAs take an average of 15 minutes longer than conventional TKAs.

“Set-up takes about 5 minutes,” noted Dr. Wixson, “with an additional 9 minutes during the surgery to verify cuts and check trial reduction.”

Dr. Robb has similar experience. “I was averaging about 105 minutes before using CAS, and that went up to 130 minutes during the learning curve. But now I’m back at about 110 minutes per surgery.”

According to Dr. Stiehl, part of the extra time is due to setting up the system, and part is due to the interactions between the surgeon and the system. “You can quickly learn the system, and then you focus on using the data swiftly and efficiently,” he said.

The final drawback is reimbursement. Although all the panelists reported using CPT code 0056T, the amount of reimbursement ranged from nothing to $700. Even when cases brought before an administrative law panel were settled in the physician’s favor, reimbursement was slow.

The panelists agreed, however, that it is important for surgeons using CAS for TKA to turn in the T-codes because this provides significant data on usage for the future.

References for this article can be found online on the AAOS Now Web site, www.aaos.org/now