A Decade of Medicare Part B Reimbursement to Plastic Surgeons: Gender Pay Gaps Persist.

Background: Gender-based pay gaps among physicians remain a significant issue, with noticeable disparities continuing despite the increasing presence of women in the medical field. This gap is particularly pronounced in surgical specialties such as plastic and reconstructive surgery, where female surgeons often face a multifactorial system of barriers.

Methods: This investigation used the Centers for Medicare & Medicaid Services data from 2013 to 2022, encompassing more than 42,000 physician entries. Analysis of covariance models estimated the average pay difference between male and female plastic surgeons, controlling for factors such as individual states, rural-urban designation, number of beneficiaries and unique CPT codes, total annual physician services, year of service, and patient morbidity risk scores to isolate the impact of sex on Medicare reimbursement.

Results: Male surgeons performed an average of 541 services per year compared with 363 for female surgeons and billed for a wider range of unique CPT codes (56.2 versus 43.0). Despite controlling for practice volume and style, significant gender-based disparities persisted, with male plastic surgeons earning approximately $9000 more annually-representing a 12% pay gap. Geographic variations were notable, with states such as Iowa and Texas showing larger earnings for men, whereas a few states, such as Nebraska and Oklahoma, were exceptions where female surgeons out-earned their male counterparts.

Conclusions: This investigation underscores the enduring gender-based compensation disparities among plastic surgeons. Our analysis also reveals substantial geographic variations in reimbursement trends, with only a limited number of outlier states exhibiting instances where female surgeons earn more than their male counterparts.