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Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
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Utilization and reimbursements for sinus procedures: A five-year analysis.

Lindsey K Koester1, Parul Goyal2

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

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|March 19, 2019
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Summary

Balloon sinuplasty procedures saw a 450% payment increase in Medicare patients from 2012-2016. This minimally invasive sinus surgery option now generates higher payments than traditional endoscopic sinus surgery.

Keywords:
MedicareSinus surgeryballoon sinuplastycost-effectivenessoutcomesreimbursementrhinologyutilization

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Area of Science:

  • Otolaryngology
  • Health Services Research

Background:

  • Balloon sinuplasty is a growing surgical option for sinusitis.
  • Understanding its utilization and financial impact is crucial.

Purpose of the Study:

  • To analyze the utilization and payment trends of balloon sinuplasty compared to traditional endoscopic sinus surgery in the Medicare population.
  • To assess the growth of these procedures over a five-year period (2012-2016).

Main Methods:

  • Retrospective review of Medicare utilization and billing data from 2012 to 2016.
  • Analysis of claims data for balloon sinuplasty and endoscopic sinus surgery.
  • Comparison of procedure volume, provider numbers, charges, and payments.

Main Results:

  • Balloon sinuplasty procedures increased by over 350% (5,603 to 25,640) from 2012 to 2016.
  • Total Medicare payments for balloon sinuplasty surged by 450%, reaching $40.5 million in 2016.
  • The number of providers performing balloon sinuplasty increased by 277%, significantly outpacing traditional sinus surgery.

Conclusions:

  • Balloon sinuplasty has experienced rapid expansion within the Medicare population.
  • Office-based balloon procedures drive the majority of growth in utilization and payments.
  • Current payments for balloon sinuplasty exceed those for traditional endoscopic sinus surgery.