Sina J Torabi, Theodore V Nguyen, Benjamin F Bitner, Amy T Du, Michael Warn, Michelle Chernyak, Frank P K Hsu, Edward C Kuan
{"title":"Medicare Reimbursement and Utilization Trends Within Skull Base Surgery.","authors":"Sina J Torabi, Theodore V Nguyen, Benjamin F Bitner, Amy T Du, Michael Warn, Michelle Chernyak, Frank P K Hsu, Edward C Kuan","doi":"10.1016/j.wneu.2024.09.077","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Medicare reimbursements for otolaryngology and neurosurgery procedures have generally declined since 2000. We explore Medicare reimbursement trends for anterior (ACF), middle (MCF), posterior cranial fossa (PCF), pituitary surgery (PS), and skull base reconstruction (SBR) surgery from 2000-2022.</p><p><strong>Methods: </strong>Cross-sectional analysis of the Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule was performed from 2000-2022 on approach, resection, and repair of the skull base (CPTs 31290-31291, 61546, 61548, 61575-61619, 62165). Reimbursement data was adjusted for inflation to 2022 US dollars, and annual and total changes calculated. The CMS Part B National Summary Data File was analyzed for trends in Medicare procedure volume and total payment.</p><p><strong>Results: </strong>Adjusted for inflation since 2000, reimbursements for ACF, MCF, PCF, PS, and SBR codes had an overall decrease of 22.85%, 32.43%, 28.09%, 44.22%, and 38.65%, respectively. Simultaneously, procedure volume increased at an average annual rate of 63.99%, 128.57%, 19.75%, 36.11%, and 12.79%, respectively.</p><p><strong>Conclusions: </strong>While nominal per-service Medicare reimbursement has increased for skull base surgery codes, there has been a downward trend in inflation-adjusted procedural reimbursement. This parallels findings in other otolaryngology and neurosurgery procedures. Despite this, surgical volume in all skull base surgery subfields has increased, indicating increased utility and adoption of these techniques.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.09.077","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Medicare reimbursements for otolaryngology and neurosurgery procedures have generally declined since 2000. We explore Medicare reimbursement trends for anterior (ACF), middle (MCF), posterior cranial fossa (PCF), pituitary surgery (PS), and skull base reconstruction (SBR) surgery from 2000-2022.
Methods: Cross-sectional analysis of the Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule was performed from 2000-2022 on approach, resection, and repair of the skull base (CPTs 31290-31291, 61546, 61548, 61575-61619, 62165). Reimbursement data was adjusted for inflation to 2022 US dollars, and annual and total changes calculated. The CMS Part B National Summary Data File was analyzed for trends in Medicare procedure volume and total payment.
Results: Adjusted for inflation since 2000, reimbursements for ACF, MCF, PCF, PS, and SBR codes had an overall decrease of 22.85%, 32.43%, 28.09%, 44.22%, and 38.65%, respectively. Simultaneously, procedure volume increased at an average annual rate of 63.99%, 128.57%, 19.75%, 36.11%, and 12.79%, respectively.
Conclusions: While nominal per-service Medicare reimbursement has increased for skull base surgery codes, there has been a downward trend in inflation-adjusted procedural reimbursement. This parallels findings in other otolaryngology and neurosurgery procedures. Despite this, surgical volume in all skull base surgery subfields has increased, indicating increased utility and adoption of these techniques.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS