ObjectiveTo evaluate the healthcare costs associated with unresolved slipping rib syndrome (SRS). MethodsData pertaining to patients who underwent operative repair for SRS at our academic institution were retrospectively analyzed. Duration of symptoms, previous management efforts, number of healthcare provider consultations, imaging studies, adjunctive surgical and pain management procedures performed to treat the symptoms, and prior unsuccessful SRS operations were cataloged. US Medicare billing standards were used to average costs for provider visits and overall cost of surgical and interventional pain management procedures. Analgesic medication costs were determined using generic pricing. ResultsFrom February, 2019 to January, 2024 a total of 435 consecutive patients spent a median of 36 months searching for a diagnosis and symptom relief prior to evaluation at our institution. The median number of physicians consulted was 6 (range 0-75). Cost of physician visits totaled $2,990,434 USD. Median number of imaging studies was 5 (range 0-55), totaling $965,949. Cholecystectomy was performed in 47 patients (11%) totaling $716,750. Previous SRS surgery had been attempted 150 times at various institutions and accounted for $4,500,000 (estimated $30,000/operation in billing). Intercostal nerve blocks, ablations, and spinal cord stimulator placement had been performed in 30%, 15%, and 5%, respectively, totaling $963,821. Median analgesic medications used per patient was 1 (mean 1.3, range 0-5). Total medication cost was $1,111,860. Total preoperative healthcare cost in our series was $12,445,173. Averaged per patient, cost totaled $28,610. ConclusionsSlipping rib syndrome remains poorly understood. Symptoms can be severe and debilitating and patients frequently consume significant healthcare resources. With recognition and definitive surgical management, SRS may be addressed successfully. Prompt treatment has the potential for significant healthcare savings.