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Previous studies have characterized utilization rates and cost of BMP use in spinal fusion, but factors that affect these relationships need further investigation.

To characterize the utilization, cost and payments for BMP use in spinal fusion among Medicare beneficiaries.

Retrospective cohort study.

We identified all adult patients who underwent spinal fusion from 2006-2015 in the 20% Medicare inpatient file (n=316,070).

BMP utilization rates, total cost, and total payments.

Patient age, sex, race, geographical region, Charlson Comorbidity Index (CCI) and length of stay were gathered. Primary outcomes included surgical utilization rates, total cost (calculated via Medicare charges and hospital-specific charge-to-cost ratios), and total Medicare payments for spinal fusion.

BMP was used in 60,249 …