Regulatory and Reimbursement Aspects of Radiosurgery

  • Rebecca Emerick


When neurosurgeon Lars Leksell and radiobiologist Börje Larsson first collaborated to use the proton beam at the University of Uppsala in Sweden, one would doubt that they were concerned whether the procedure would be reimbursed by the health care system. The development of radiosurgery throughout the 1950s to 1970s was largely funded by private and public research monies. According to Professor Erik-Olof Backlund, MD, PhD, during the early era of radiosurgery, procedures by Lawrence’s group (using heavy particles at Berkeley), Kjellberg (using the cyclotron at Harvard University), and Leksell (who traveled from Stockholm to Uppsala to use the proton beam to treat patients) were either free to patients or the physician accepted what the patient was able to pay (E.O. Backlund, personal conversations, 1996–1999).


Gamma Knife Stereotactic Radiosurgery Medicare Patient Nuclear Regulatory Commission Diagnostic Related Grouping 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Backlung EO. The history and development of radiosurgery. In: Lunsford LD, ed. Stereotactic Radiosurgery Update. New York: Elsevier, 1992:3–9.Google Scholar
  2. 2.
    Lunsford LD, Flickinger J, Lindner G, et al. The stereotactic radiosurgery of the brain using the first United States 201 cobalt-60 source Gamma Knife. Neurosurgery 1989; 24(2):151–159.CrossRefPubMedGoogle Scholar
  3. 3.
    Code of Federal Regulations, Title 21—Food and Drugs. Subchapter H—Medical Devices. Volume 8. 21 CFR 8. U.S. Government Printing Office, 2005. Available at [all dates].Google Scholar
  4. 4.
    The Food and Drug Administration. Information on Premarket Approval Applications. FDA, 2007. Available at Scholar
  5. 5.
    The Food and Drug Administration. 510K Premarket Notification Searchable Database. (510K numbers K984563, K923522, and K913174). FDA, 2007. Available at Scholar
  6. 6.
    Code of Federal Regulations, Title 10—Nuclear Regulatory Commission. Part 35—Medical Use of Byproduct Materials. 10 CFR 35. U.S. Government Printing Office, 2007. Available at [all dates].Google Scholar
  7. 7.
    United States Nuclear Regulatory Commission. Office of Nuclear Material Safety and Safeguards Communications. RIS 2005-23, October 7, 2005.Google Scholar
  8. 8.
    Getzen TE. Management and regulations of hospital costs. In: Health Economics, Fundamentals and Flow of Funds, 2nd ed. New York: John Wiley & Sons, 2004:175–196.Google Scholar
  9. 9.
    University Hospital Consortium Services Corporation, Clinical Practice Advancement Center. Stereotactic Radiosurgery. Oak Brook, IL: UHCSC, 1995.Google Scholar
  10. 10.
    Ott K. A comparison of craniotomy and Gamma Knife charges in a community-based Gamma Knife center. Stereotact Funct Neurosurg 1996; 66(Suppl 1):357–364.CrossRefPubMedGoogle Scholar
  11. 11.
    Healthcare Cost and Utilization Project. 2007. Available at Scholar
  12. 12.
    Pearman WA, Starr P. Medicare: A Handbook on the History and Issues of Health Care Services for the Elderly. New York: Garland, 1988.Google Scholar
  13. 13.
    Centers for Medicare and Medicaid Services. Medicare & You Handbook. Washington, DC: U.S. Government Printing Office, 2007.Google Scholar
  14. 14.
    Berger SH. Fundamentals of Health Care Financial Management, 2nd ed. San Francisco: Jossey-Bass, 2002.Google Scholar
  15. 15.
    Code of Federal Regulations, Parts 419 and 485. Nov. 10, 2005: Vol. 70. No. 217. 42 68515–69040. Washington, DC: U.S. Government Printing Office.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Rebecca Emerick
    • 1
  1. 1.International RadioSurgery Association (IRSA)HarrisburgUSA

Personalised recommendations