Clinical Productivity and Medicare Payments Among Female and Male Oral and Maxillofacial Surgeons

To characterize and compare clinical productivity and payments between female and male oral and maxillofacial surgeons (OMSs) serving Medicare beneficiaries in 2017.

This cross-sectional study was composed of Medicare Provider Utilization and Payment Data from 2017. Providers were included if they were labeled as maxillofacial surgeons. The primary outcome variable was Medicare payment. Secondary outcome variables included clinical productivity (number of charges), unique billing codes, mean payment per charge, and beneficiary hierarchical condition category. Descriptive statistics and pair-wise comparisons were computed at an α level of .05.

The analysis cohort was composed of 737 distinct OMSs, of whom 58 were women. Although female surgeons recorded higher mean clinical productivity, total Medicare payments, and number of unique Healthcare Common Procedure Coding System billing codes relative to male surgeons in both the facility and office settings, the differences were not statistically different. Payment per charge did not differ significantly between genders in the office setting. In the facility setting, women were reimbursed $63.74 per charge whereas men were reimbursed $109.69 per charge (P < .02). Female OMSs treated more medically complex patients relative to male OMSs (P < .02).

Clinical productivity and total Medicare payments were similar between genders in both the facility and office settings, disputing prior surveys that illustrated bias about the productivity and ability of female OMSs. Female OMSs earned, on average, less per submitted charge in facility settings, which may be due to differences in documentation. The reason for this difference warrants further study.