What does one minute of operating room time cost?

“How much does one minute of OR time cost?” is a question often asked in the operating room (OR) suite. We hear this question during cases that seem to be taking longer than they should, or when a missing piece of equipment delays the next step of the surgery. This question also arises if there is a last-minute cancellation that leaves the OR unexpectedly idle until another case can be assigned. The latter issue is specifically addressed in the nice article by Lau et al. in this issue of the Journal of Clinical Anesthesia. In it, the authors analyze the reasons that cases are cancelled after the patient has arrived in the OR [1]. The short answer to “How much does one minute of OR time cost?” is, “It depends.” It depends on many factors including: which country you are in, as resource costs vary from country to country; which surgical procedure is being performed, as, for example, OR time for a coronary artery bypass graft costs more than for an inguinal hernia repair; whether the answer refers to hospital charges as appearing on the hospital bill sent to the insurance company or to hospital costs related to the actual amount of money that the hospital spends in providing the surgery; whether the OR cost includes fixed overhead costs that are constant regardless of the number of surgeries perfomed, or if it only accounts for the variable costs, which vary according to the number of cases performed; or whether professional fees of the physician work in the OR are included. The objective of this article is to review these concepts in more detail.