Bladder cancer is a costly cancer to manage with high post-operative morbidity and readmission frequencies. Clinical benefits of robotic-assisted radical cystectomy (RARC) suggest that it may be a reasonable and appealing alternative to traditional open radical cystectomy (ORC). However, limited data exist regarding complication, readmission, and cost comparisons between the two approaches. Our two research questions for this study were: (1) During the 30-day perioperative period, does robotic-assisted radical cystectomy demonstrate cost-to-patient savings, reduced complications, and reduced readmissions compared to the open approach? (2) What predicts complication, readmission, or total cost-to-patient following robotic or open cystectomy?