(A306) Economic Impact and Use of Head & Neck Surgeon-Performed Ultrasound in a Tertiary Care Clinic

Introduction: Surgeon-performed ultrasound (US) has enormous potential in the field of otolaryngology-head and neck surgery (H&N); however, a small percentage of otolaryngologists perform US regularly. We aim to assess the use and clinical and economic value of Surgeon-performed US in a tertiary H&N center.

Methods: A retrospective chart review was performed of patient visits to a tertiary H&N center from July 2019 to April 2023 with CPT codes related to US procedures. Descriptive analysis was performed in Microsoft Excel of procedure indications, visit types, and billing.

Results: Of 1776 unique encounters, the most common procedure was diagnostic US of H&N tissues (78.8%), followed by fine needle aspiration (FNA) with US guidance (11.1%). The most common indication was thyroid and parathyroid pathologies (66.2%), followed by H&N mass (12.3%), salivary gland diseases (n=161), and lymph node disorders (n=137). 32.8% of US, 48.0% of FNA, and 18.5% of core needle biopsy procedures were initial patient visits.  The mean net profit per encounter was $294 with a median of $247, ranging from $270 by Hillsborough County Health Care Plan to $311 by Managed Medicaid.

Conclusions: Surgeon-performed US is highly useful in the workup and treatment of a wide array of head and neck pathologies, with endocrine disorders being the most common. Several key benefits include earlier diagnosis and decision-making, economic feasibility, and improving the surgeon’s understanding of the individual patient’s anatomy and disease. A significant portion of US, FNA, and core needle biopsy procedures were performed at the initial patient visit, improving the efficacy of care by preventing recurrent medical visits for the patient, limiting the anxiety associated with a delay of care, and ensuring an earlier treatment plan. There was low variability and overall cost between reimbursement from commercial insurance versus Medicare and Medicaid, making US universally available to our patient population and reducing the burdensome overall costs of head and neck cancer. Thus, all otolaryngologists should be well-trained in performing and reading ultrasounds.