Trends in Utilization and Cost of Endoscopic Lumbar Decompression in Ambulatory Surgical Centers: A Nationwide Database Analysis From 2018 Through 2022.

Study DesignRetrospective cohort study.ObjectivesThis study aimed to examine national trends in utilization, charges, and patient characteristics associated with endoscopic spine surgery (ESS) in ambulatory surgery centers (ASCs) from 2018 to 2022.MethodsThe Nationwide Ambulatory Surgery Sample (NASS) was queried for adult encounters identified by Current Procedural Terminology code 62380. Cases with valid weights and complete charge, payer, region (defined as HCUP U.S. Census regions), and month data were retained. Facility charges were inflation-adjusted to 2022 USD and winsorized at the 1st and 99th percentiles. Survey-weighted models estimated differences in charges and temporal trends, with pairwise comparisons from estimated marginal means. Significance was set at the P P P P P < 0.001).ConclusionsESS in ASCs exhibited rapid procedural growth, particularly in the Western U.S., alongside substantial payer and region-specific variation in cost. These findings highlight the need for continued evaluation of access and reimbursement equity as ESS expands nationally.