Variability in Excess Lobectomy Billing Among US Thoracic Surgeons

Area of Science:

• Health Services Research
• Medical Economics
• Surgical Billing

Background:

• Physician billing practices in the U.S. lack transparency, leading to significant charge variations.
• Patients may incur excess charges due to inconsistent provider billing.
• This study examines Medicare billing for minimally invasive lobectomy to understand national practices and identify cost predictors.

Purpose of the Study:

• To evaluate Medicare charges and payments for Video-Assisted Thoracoscopic Lobectomy.
• To identify predictors of higher billing practices among surgeons.

Main Methods:

• Utilized 2018 Medicare Provider Utilization Data to identify surgeons performing Video-Assisted Thoracoscopic Lobectomy.
• Collected demographic variables: geographic region, years in practice, practice setting.
• Employed multivariate gamma regression to analyze predictors of high billing.

Main Results:

• 307 providers submitted charges from $1,104 to $25,128 (median $4,265).
• Medicare payments ranged from $163 to $1,409 (median $1,056).
• Male surgeons, academic settings, and Northeast practice locations were associated with higher charges (p < 0.01).

Conclusions:

• Significant variation exists in physician billing practices across the U.S.
• Medicare charges may reflect overall provider billing across all payers.
• Understanding true healthcare costs is crucial for patients, and providers should consider appropriate charges.