Trends in Medicare Reimbursement for Reconstructive Plastic Surgery Procedures: 2000 to 2019

Area of Science:

• Health Economics
• Plastic Surgery
• Reimbursement Policy

Background:

• Understanding financial trends is crucial for developing effective reimbursement models in plastic surgery.
• Medicare reimbursement rates are a key factor influencing the provision of reconstructive plastic surgery services.

Purpose of the Study:

• To analyze Medicare reimbursement trends for the 20 most common reconstructive plastic surgery procedures between 2000 and 2019.
• To identify changes in reimbursement rates after adjusting for inflation.

Main Methods:

• Utilized Centers for Medicare and Medicaid Services (CMS) data to identify the top 20 reconstructive procedures billed by plastic surgeons.
• Extracted reimbursement data from the CMS Physician Fee Schedule Look-Up Tool.
• Adjusted all monetary values for inflation to 2019 U.S. dollars and calculated percentage changes.

Main Results:

• The average inflation-adjusted reimbursement for all studied procedures decreased by 14.0% from 2000 to 2019.
• Complex wound repair saw the largest decrease (-33.2%), while scalp layer closure increased slightly (+6.5%).
• Annually, adjusted reimbursement rates declined by an average of 0.8% over the study period.

Conclusions:

• This study is the first to comprehensively examine Medicare reimbursement trends in plastic surgery.
• Inflation-adjusted Medicare reimbursement for reconstructive procedures has shown a consistent decline from 2000 to 2019.
• These findings necessitate policy adjustments to ensure continued patient access to vital reconstructive plastic surgery care.