Health care resource utilization and costs before and after epilepsy surgery

•Descriptive study of epilepsy surgery in privately-insured patients in the USA in the period 2006–2019.•Only a minority of patients with refractory epilepsy underwent epilepsy surgery and the proportion has barely changed from 2006 to 2019.•StereoEEG has progressively substituted subdural electrodes as the preferred form of long-term intracranial monitoring.•The median healthcare costs per person-year decreased by 59% after resective epilepsy surgery ($7,691 versus $18,750).•The median healthcare costs per person-year decreased by 51% after hemispherectomy ($26,834 versus $54,596).