Extracorporeal photopheresis chargemasters show haphazard billing practices

Brian D. Adkins, Jessica Kneib, W. Dale Plummer, William D. Dupont, Garrett S. Booth

Research output: Contribution to journalArticlepeer-review


Background: United States healthcare spending continues to outpace other developed nations although efforts are being made to increase cost-transparency. Recent legislation requires hospitals to publish a chargemaster, a list of all billable procedure codes together with prices. Chargemaster prices have been shown to be highly variable, if available, and are not typically paid, but contribute to negotiated rates. Extracorporeal photopheresis (ECP) is performed for a limited number of indications and could serve as a marker of this variability. We investigated the availability of chargemaster documentation for ECP procedures and the variability of pricing as assessed by institutional characteristics. Study design and methods: A list of centers with photopheresis systems was obtained from the device manufacturer and the institutional websites were analyzed for chargemaster list prices. Multivariate linear regressions were performed to compare impact of facility variables on chargemaster pricing. Results: There are 139 locations in the US which are listed as referral centers for ECP; and chargemaster prices were available in 66.2% of these centers. The range was $571.48–183,452.00, maximum price 321 times greater than minimum, and the median price, after outlier exclusion, was $8989.06 (SD = $4361.72). ECP cost did not correlate with hospital size, facility type, ownership, number of hospitals in the referral region, hospital care intensity index, academic status, or region (p ≥.05). Conclusions: Chargemaster costs for ECP procedures are highly variable and nonuniform, and the current data available for patients undergoing these specialized apheresis procedures is insufficient to afford patients the ability to compare prices.

Original languageEnglish (US)
Pages (from-to)2844-2848
Number of pages5
Issue number10
StatePublished - Oct 2021
Externally publishedYes


  • cellular therapy
  • chargemaster
  • extracorporeal photopheresis
  • therapeutic apheresis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology


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