OBJECTIVES: To estimate and compare the cost of arthroscopic subacromial decompression (SAD) using VAPR® VUE™ Radiofrequency System with COOLPULSE® 90 Electrode (COOLPULSE) and the ArthroCare® Quantum™ System with Super TurboVac® electrode (Super TurboVac). METHODS: An in-vitro study of 72 bovine tendon specimens was used with COOLPULSE 90 and Super TurboVac. These devices were operated at their default ablation settings (220 and 270 Watts for COOLPULSE and TurboVac, respectively) for multiple trials. The tissue removal rate was determined by measuring the tissue mass before and after ablation. The measure was repeated and averages were calculated. Average length of time needed for tissue removal in SAD procedures and data on the unit cost of operation room (OR) time were obtained from clinical model for arthroscopic procedure and published literature. 2011 IMS data were used to calculate the average selling price for COOLPULSE and Super TurboVac. RESULTS: The in-vitro study showed the average ablation rates for COOLPULSE (no clogs were found with COOLPULSE) and Super TurboVac (excluding data from clogged runs for Super TurboVac) were 1.12+0.22 gram/minute and 0.93+0.21 gram/minute, respectively (p <0.001). Average time for SAD from literature and clinical modeling was 13 minutes and the estimated cost of OR time in the US was $20/minute. The average costs of ablation using COOLPULSE and Super TurboVac were estimated to be $436 and $480, respectively. CONCLUSIONS: Tissue removal rate in arthroscopic procedures is important for surgical efficiency, for procedure duration that directly benefits patients, and for cost. The in-vitro study demonstrated that COOLPULSE achieved significantly higher tissue removal rates compared to Super TurboVac which may result in cost savings to a surgery facility.