Menendez ME, Mahendraraj KA, Grubhofer F, et al. - The present study was conducted to examine patient-level variation in the value of total shoulder arthroplasty (TSA) and characterized factors that contribute to this variation. Researchers distinguished a total of 239 patients undergoing elective primary TSA (anatomic or reverse) between 2016-2017 with a minimum 2-year follow-up applying the institutional registry. They computed value as 2-year postoperative American Shoulder and Elbow Surgeons (ASES) scores classified by hospitalization time-driven activity-based costs. They conducted multivariable linear regression modeling to define factors underlying variation in value. The data exhibited that the wide variation was found in the value of shoulder arthroplasty that was most strongly correlated with procedure type and certain preoperative characteristics (e.g. prior shoulder surgery, number of self-reported allergies, diabetes, ASES score). Awareness of these relationships is important for the implementation of targeted strategies to effectively decrease change and redirect resources towards higher-value, cost-conscious care.