Surgical instrument cost and return: how to run the numbers

Published on November 7, 2026 · 7 min read

Why the calculation is hard

What does it cost to lose and reprocess instruments, and how much does that change when each piece is identified? The answer mixes three kinds of data: times and counts measured in studies, financial values calculated by a model and effects nobody has demonstrated.

The Evidence and ROI page always says which kind each figure is.

The four categories of figure

1. Observed. Time, read rate or instrument counts recorded directly in a test or in operation. Example: counting 41 instruments took 64.0 s with RFID and 190.4 s with barcode, with an experienced team. [2]
2. Implemented and measured. A change that actually happened to the kit, the time or the reprocessing volume after rollout. Example: 25 of 62 instruments left a breast surgery kit (40.3%), and none of the 25 was requested in the next 10 surgeries. [7]
3. Estimated. A financial value, payback or avoided cost from a model. It does not prove the money stopped leaving the budget. Example: US$ 69,441 per year in resterilization and US$ 163,800 in avoided purchases, estimated in a plastic surgery study with 183 cases. [11]
4. Proposed. A calculated kit configuration that has not been rolled out or validated over time. Example: a Canadian orthopedics model proposed 47 instruments instead of 88. [13]

What the literature measured and what it only estimated

The studies that used RFID on instruments mostly measured time and kit size. In the Duke program, the average reduction in supply was 50.8% in breast and orthopedic kits, and the assembly of a laparotomy set fell from 20 to 10 minutes. Both results were implemented and measured. [8] [4]

The money values come from another group of papers, on kit rationalization done without RFID. At Brigham and Women's, 29 configurations were cut to 12, and 11,627 instrument reprocessings were avoided in six months. The US$ 153,089 calculated adds operating-room and sterile-processing costs, and the estimated payback of 5.3 months applies to a project without RFID. [16] That payback is not the payback of tags, readers and software.

The two Duke papers belong to the same program and may share cases, so they do not add up as independent samples.

What it costs to reprocess one instrument

Any calculation of reduced reprocessing needs a cost per instrument and per cycle, and there is no proven national value. Six Brazilian costing references range from R$ 0.29 to R$ 8.18, because they measure different things. One is the median of public sterilization contracts, whose unit is not always a single piece. Another allocates only the autoclave and labor.

Two concepts need to stay apart. Full cost is the value of the whole activity of reprocessing, and the suggested value on the Evidence page is R$ 6.34 per instrument per cycle, a 2023 value not adjusted for inflation. Realizable saving is only the part that stops existing when the instrument leaves the kit. If a kit goes from 80 to 60 instruments, the hospital still uses the autoclave and many CME resources, so you cannot count 20 × R$ 6.34 as a saving.

In the Santo André study, 854 consigned boxes were processed and unused after 85 canceled surgeries, with estimated waste of R$ 34,340.18, about R$ 40.21 per box. It is an average, not a cost per instrument nor a price list. [19]

How to use the calculator on the Evidence page

The calculator starts from physical quantities and only then applies the hospital's variable cost. The fields come with example values, which are not market data. The hospital replaces all of them with its own. Your data never leaves your browser.

1. Describe the kits. Enter the kits of the type, the instruments per kit, those withdrawn and validated and the reprocessings per year. The examples use 62 instruments per kit, 25 withdrawn and 50 reprocessings. Only pieces approved by surgeons and the sterile processing team count.
2. Swap in your hospital's cost. The full cost comes with the suggested value of R$ 6.34 and is editable. The share that really stops existing is a separate field, with 30% as a suggestion.
3. Keep hours and money apart. A freed hour is not, by itself, money saved. Only the share that becomes less overtime, avoided hiring or more capacity counts.
4. Enter what the solution costs. The initial investment and the recurring cost come blank, for the hospital to fill in with the values of its proposal: tags, readers, validation, software and integration. The horizon starts at 5 years.

What is still not proven

Published numbers show feasibility and potential, and they do not replace a local assessment.

1. Clinical outcomes. There is no robust study attributing to individual RFID on instruments a reduction in surgical site infection, mortality, retained items or canceled surgeries.
2. Losses and breakage. There is also no demonstration of a causal reduction in asset losses, repairs or breakage. Per-instrument history lets service life be studied, but it does not prove that alerts reduced breakage.
3. Rationalization payback. The payback from trimming trays without RFID is not the payback of tags, readers and software. The two Duke papers also do not add up as independent samples.
4. Different technology, different result. Several studies use high-frequency RFID (13.56 MHz). A UHF architecture, like SureKits, needs its own validation of reading, nearby metal and sterilization.
5. Manual counting stays. AORN treats RFID as an aid to counting. None of the studies justifies dropping the manual count from the protocol without hospital validation and approval. [21]
6. Brazilian regulation. RDC 15/2012 covers traceability of sterilization batches and does not require individual RFID on each instrument. [20]

How to validate it at your hospital

SureKits is the RFID identification and reading layer and integrates with the sterile processing software the hospital already uses. The tags are applied at the hospital itself, without taking instruments out of the institution.

Identhis suggests a pilot with agreed indicators. A well-designed pilot separates three results and never counts the same hour of work twice.

1. Reading performance. Checking time and accuracy, with the same kit types and the same team, including exceptions and rework.
2. Measured operating saving. Instruments withdrawn after clinical approval, requests for withdrawn pieces in later cases and reprocessings avoided, comparing before and after.
3. Net financial benefit. Reconciling variable cost, truly capturable hours, avoided purchases, investment and recurring cost.

Sources

2. Kusuda K, Yamashita K, Morishita E, et al. Comparison of Reading Times of RFID-Tagged and Barcode-Engraved Surgical Instruments. J Surg Res. 2024;304:121-125. doi.org/10.1016/j.jss.2024.09.087
4. Hanada E, Ohira A, Hayashi M, Sawa T. Improving Efficiency through Analysis of Data Obtained from an RFID Tag System for Surgical Instruments. IEEE ICCE-Berlin. 2015. doi.org/10.1109/ICCE-Berlin.2015.7391339
7. Olivere LA, Hill IT, Thomas SM, Codd PJ, Rosenberger LH. Radiofrequency Identification Track for Tray Optimization: An Instrument Utilization Pilot Study in Surgical Oncology. J Surg Res. 2021;264:490-498. doi.org/10.1016/j.jss.2021.02.049
8. Hill I, Olivere L, Helmkamp J, et al. Measuring Intraoperative Surgical Instrument Use with Radio-Frequency Identification. JAMIA Open. 2022;5(1):ooac003. doi.org/10.1093/jamiaopen/ooac003
11. Wood BC, Konchan S, Gay S, Rath S, Deshpande V, Knowles M. Data Analysis of Plastic Surgery Instrument Trays Yields Significant Cost Savings and Efficiency Gains. Ann Plast Surg. 2021;86(6S Suppl 5):S635-S639. doi.org/10.1097/SAP.0000000000002913
13. Toor J, Bhangu A, Wolfstadt J, et al. Optimizing the Surgical Instrument Tray to Immediately Increase Efficiency and Lower Costs in the Operating Room. Can J Surg. 2022;65(2):E275-E281. doi.org/10.1503/cjs.022720
16. Hyland CJ, Etheridge JC, Newell PC, Yates EF, Talbot SG. The Financial and Environmental Impacts of Optimizing Surgical Instrument Trays in Plastic Surgery. Plast Reconstr Surg. 2026;157(4):644e-647e. doi.org/10.1097/PRS.0000000000012444
19. Lopes SG, Poveda VB. Proposta de modelo para cálculo de desperdício associado ao processamento de instrumentais cirúrgicos consignados. Rev Latino-Am Enfermagem. 2023;31. doi.org/10.1590/1518-8345.6716.4062
20. Anvisa. Resolução RDC nº 15, de 15 de março de 2012, arts. 24 a 26. anvisalegis.datalegis.net
21. Cochran K. Guidelines in Practice: Prevention of Unintentionally Retained Surgical Items. AORN J. 2022;116(5):427-440. doi.org/10.1002/aorn.13804