OBJECTIVES: Spinal fusion procedures (SFPs) in adult deformity (AD) result in significant blood loss and bleeding-related complications, blood product transfusions and higher hospital costs. Two approaches (monopolar/bipolar dissection [MBD] and ultrasonic dissection [UD]) are used to remove soft tissue in SFPs. 50% blood loss reduction has been demonstrated in UD versus MBD [Cakir et al.2006]. This study determined the budget impact of MBD versus UD. METHODS: A budget impact model was created using preclinical data, literature review and surveys to clinical and economic stakeholders. The outcomes are reflective of a hospital with 50 AD cases yearly. The model accounts for unit cost, number of units used, and frequency used to determine the cost of bleeding management products (BMPs) and surgical consumables used during the exposure phase of SFPs along with exposure phase operating and anesthesia times and hospital length of stay. Three scenarios were calculated comparing MBD and UD assuming that dissection time with UD is decreased by 25% and 50% blood loss reduction using UD would show 50% reduction in the use of BMPs. RESULTS: The cost savings of UD ranged from $460.69 per case ($23,034.57 yearly; Scenario A: UD used 50.2% of BMPs compared to MBD) to $629.12 per case ($31,456.17 yearly; Scenario C: Scenario A plus UD used 50.2% use of frequency compared to MBD). Higher surgical consumable costs were seen with UD compared to MBD, but the cost of BMPs was lower using UD. CONCLUSIONS: The UD approach for soft tissue removal results in less bleeding and the potential for fewer complications compared to MBD.  Even though UD device costs are higher than MBD, this model provides evidence that UD, which is potentially more effective and clinically better for the patient, does not result in large additional device costs and even provides cost savings versus MBD.