INTRODUCTION Racial disparities are known to affect healthcare utilization and outcomes of cancer patients. However, there is limited data on the impact of these disparities in metastatic spinal tumor surgery (MSTS). METHODS The United States National Inpatient Sample database (2012-2014) was queried to identify adult patients who underwent MSTS. Total hospital charges (in 2020 US dollars and adjusted for inflation) were compared based on patient's race (Caucasian, African-American, Hispanic, and Asian/other). A multivariate logistic regression analysis was conducted with high charges (>75th percentile) as the main outcome measure; results are reported as odds ratios (OR) with 95% confidence intervals (CI). RESULTS A total of 10,695 admissions were analyzed. The median adjusted hospital charges were $160,205 dollars (interquartile range: $97,282-$256,623) per patient - this totaled $2.1 billion dollars for all patients. Adjusted charges were significantly different based on race (Kruskal-Wallis test, P < .001). After adjustment for baseline/oncological characteristics, average household income, hospital characteristics, hospital region, and performance of spinal fusion, African Americans (OR 1.98; 95% CI 1.40-2.80; P < .001) Hispanics (OR 1.87; 95% CI, 1.25-2.80; P = .002) and Asian/others (OR 1.82; 95% CI, 1.18-2.78; P = .006) were significantly more likely to incur in higher charges when compared to Caucasians. Other independent predictors of high charges included higher Charlson Comorbidity Index score (OR 1.09), pathological fracture (OR 1.33), visceral metastasis (OR 1.74), hospitals located in the western United States (OR 2.19), medium-sized hospitals (OR 1.67), large-sized hospitals (OR 1.95), and spinal fusion procedures (OR 5.30). CONCLUSION Significant disparities in healthcare utilization exist for patients undergoing MSTS based on race. All minority groups compared to Caucasians were significantly more likely to incur in high hospital charges independent of baseline comorbid conditions, oncological characteristics, hospital characteristics, and type of procedure performed. This cost variation based on race warrants further investigation.