Can Reducing Implant Costs Increase Revenue for Surgically Treated Ankle Fractures: Time-Driven Activity-Based Costing for 1-Year Episode of Care.

This study investigates how intraoperative decision-making, specifically implant selection, influences reimbursement margins in the surgical fixation of ankle fractures. Using Time-Driven Activity-Based Costing (TDABC) to analyze costs from a single-insurer database of 249 patients treated between 2010 and 2017, implant costs were found to constitute approximately one-third of the total cost of care, second only to surgical costs. The study demonstrated that reducing implant costs significantly increases net revenue, particularly in outpatient settings, highlighting implant choice as a key driver of both cost and profitability. These findings suggest that cost-conscious implant selection can support institutional cost containment and enhance healthcare value in ankle fracture management.