OBJECTIVES: Medical device utilization and price are often cited as major cost drivers of hospital care.  Few sources quantify the specific % medical device spend (utilization x price) of hospital care.  The purpose of this study was to assess the contribution of medical device spending in the hospital setting, as well as the impact of hospital facility type on medical device spending.  METHODS: A third party vendor, MOSS Adams (Seattle, WA) compiled data from the 2009 U.S. Healthcare Cost Report Information system (HCRIS).  HCRIS data is reported by providers through Medicare Administrative Contractors. The cost report contains information such as facility characteristics, utilization data, cost and charges by cost center (all payers).  5,452 hospitals reported medical device spending costs with total expenditures of approximately $681 billion dollars. Costs were divided into implant costs, billable supply costs, labor, capital, and all other costs including infrastructure.  Total medical device costs were estimated from implant and billable supply costs.  Stratification included teaching/non-teaching, sole-community/ non-sole, and urban/rural hospitals. RESULTS: Labor and other costs represented the largest expenditure, whereas total medical device costs represented 3.6% (median) of costs.  Urban hospitals spent more than rural hospitals on medical devices (5.5% vs. 2.3%, p<0.0001).  Teaching hospitals also spent more than non-teaching hospitals on medical devices (6.2% vs. 3.1%, p<0.0001). There were no differences in medical device spend for sole community/non-sole community hospitals (3.6% each).  When reviewing a subset of hospitals (n=644) reporting on implantable medical device use, median total medical device spend was 7.1% including 3.5% on medical device implants. CONCLUSIONS: These data suggest that total spending on medical devices, including implantables in the hospital setting represents a small spend of overall hospital expenditures.   Future studies should examine the role of medical device utilization in overall hospital expenditures.