OBJECTIVES: Legislators, health system administrators, employers and other stakeholders are increasingly concerned about growing health care costs. Technologies must therefore continue to demonstrate safety and effectiveness alongside sound economics. Surgical tools for balloon catheter dilation (BCD) of sinus ostia offer an alternative way for surgeons to treat patients with chronic rhinosinusitis (CRS) in a tissue-sparing fashion. In some instances, these tools are also used alongside rigid instruments during functional endoscopic sinus surgery (FESS). BCD has strong safety and effectiveness evidence and allows migration of site of care from the operating room (OR) to the physician office. However, limited data exist analyzing the economic impact of the technology on CRS cost of care. METHODS: A budget impact analysis (BIA) was developed to determine the potential impact of BCD on healthcare costs. The analysis was performed from the viewpoint of the US payer and actual payments for healthcare services were included in the model, in lieu of costs. Inputs included frequency of service and payments for preoperative care and surgery;  frequency, type of visits and procedures and payments for postoperative care (including debridements and related procedures), and payments and frequency of reoperations and exacerbations. Clinical inputs were based on published literature and analyses of claims databases from Marketscan, using a cohort with at least 2 years of continuous enrollment post-index. Monte Carlo simulations were conducted to determine impact of uncertainty on final estimates. RESULTS: For 1,400 surgical cases (expected surgical volume within a 1 million population), the total cost of care over 2 years assuming current treatments was estimated at US$ 14.23±0.26 million.  Assuming however that  20% patients transition from FESS to BCD and 10% thereof would be treated in the office vs. the OR, total cost would reach US$13.92±0.22 million. CONCLUSIONS: For well selected patients, shifting site of care from the OR to the office, along with the less-invasive BCD technology vs. FESS, shows trends of cost favorability over a 2-year time horizon.