National and Location-Specific Medicare Physician Fee Reimbursement Trends in Urologic Oncology from 2002-2024.

Abstract

Introduction: In recent years, Medicare physician reimbursement has been a target for national healthcare spending adjustments, but detailed national and location-specific trends in urologic oncology are lacking. This study investigated reimbursement trends over the past two decades.

Methods: The Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool was used to extract physician reimbursement data for urologic oncology procedures from 2002 to 2024. We analyzed 20 common or relevant urologic oncology CPT codes. Reimbursement data were recorded biennially and inflation-adjusted to 2024 United States Dollars. The compound annual growth rate (CAGR) over the study period was calculated for each procedure. Location-specific reimbursement trends were analyzed for robot-assisted radical prostatectomy (RARP, CPT 55866) in all available Medicare localities (n=89).

Results: Reimbursement data for the 20 procedures were retrieved with an average inflation-adjusted percent change of -41.08% from 2002-2024. For all procedures, the 2014-2024 CAGR indicated a faster rate of decline compared to the 2002-2014 CAGR. RARP showed the most significant inflation-adjusted decline. Kidney procedures experienced an average inflation-adjusted CAGR of -2.15%, bladder -2.49%, prostate -2.53%, and testicular -2.34%. Open surgeries averaged a CAGR of -2.32%, endoscopic -2.60% and laparoscopic/robotic -2.73%. Reimbursement for RARP declined across all 89 Medicare localities from 2014-2024, with slight variability in magnitude.

Conclusion: Inflation-adjusted Medicare physician reimbursement has been declining for all urologic oncology procedures over the past two decades, with more substantial declines noted in recent years. As key stakeholders, urologists must remain active in policy decisions pertaining to physician reimbursement.