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An Analysis of Procedural Medicare Reimbursement Rates in Hand Surgery: 2000 to 2019
Danielle A Thornburg1, Nikita Gupta2, Nathan Chow2
1Mayo Clinic, Phoenix, AZ, USA.
Insights
Medicare reimbursement for hand surgery procedures has declined significantly over the past two decades when adjusted for inflation. This trend impacts healthcare policy and patient access to specialized hand care.
Area of Science:
- Orthopedics
- Health Economics
- Surgical Reimbursement Analysis
Background:
- Limited data exists on long-term Medicare reimbursement trends specifically for hand surgery.
- Previous analyses have focused on broader surgical subspecialties.
Purpose of the Study:
- To analyze Medicare reimbursement trends for common hand surgery procedures from 2000 to 2019.
- To compare these trends against inflation rates.
Main Methods:
- Identified 20 common hand surgery procedure codes from Medicare data (2016).
- Collected and analyzed reimbursement rates using the Physician Fee Schedule Look-Up Tool (2000-2019).
- Adjusted reimbursement data for inflation using the Consumer Price Index (CPI).
Main Results:
- Average reimbursement increased 13.9%, while CPI rose 46.7% (P < .0001).
- Inflation-adjusted reimbursement decreased by 22.6% from 2000-2019.
- The most significant decline occurred between 2000-2009 (21.92% decrease).
Conclusions:
- Medicare reimbursement for hand surgery has steadily decreased when adjusted for inflation over 20 years.
- Healthcare policy must consider these trends and their effect on access to hand surgery.
Background:
Medicare reimbursement trends across multiple surgical subspecialties have been analyzed; however, little has been reported regarding the long-term trends in reimbursement of hand surgery procedures. The aim of this study is to analyze trends in Medicare reimbursement for commonly performed hand surgeries.
Methods:
Using the Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File, we determined the 20 hand surgery procedure codes most commonly billed to Medicare in 2016. Reimbursement rates were collected and analyzed for each code from The Physician Fee Schedule Look-Up Tool for years 2000 to 2019. We compared the change in reimbursement rate for each procedure to the rate of inflation in US dollars, using the Consumer Price Index (CPI) over the same time period.
Results:
The reimbursement rate for each procedure increased on average by 13.9% during the study period while the United States CPI increased significantly more by 46.7% (P < .0001). When all reimbursement data were adjusted for inflation to 2019 dollars, the average reimbursement for all included procedures in this study decreased by 22.6% from 2000 to 2019. The average adjusted reimbursement rate for all procedures decreased by 21.92% from 2000 to 2009 and decreased by 0.86% on average from 2009 to 2019 (P < .0001).
Conclusion:
When adjusted for inflation, Medicare reimbursement for hand surgery has steadily decreased over the past 20 years. It will be important to consider the implications of these trends when evaluating healthcare policies and the impact this has on access to hand surgery.
