Reimbursement for Neuroma Surgery Over the Past Decade.

Area of Science:

• Neurosurgery
• Health Economics
• Medical Policy

Background:

• Symptomatic neuromas are a significant cause of chronic pain and disability.
• Peripheral nerve surgeries are crucial for managing these conditions.
• Understanding reimbursement trends is vital for surgical practice sustainability.

Purpose of the Study:

• To analyze Medicare physician reimbursement trends for surgeries treating symptomatic neuromas from 2014 to 2024.
• To quantify the changes in reimbursement rates for key peripheral nerve procedures.
• To assess the impact of these changes on surgical care accessibility.

Main Methods:

• Retrospective analysis of Medicare Physician Fee Schedule data (2014-2024).
• Inclusion of CPT codes for neuroma excision, muscle burying, targeted muscle reinnervation (TMR), and regenerative peripheral nerve interface (RPNI).
• Calculation of gross and inflation-adjusted reimbursement changes and compound annual growth rates.

Main Results:

• All analyzed peripheral nerve procedures showed significant inflation-adjusted reimbursement decreases.
• Reimbursement for TMR (CPT 64905) dropped by 30%; RPNI (CPT 15769) by 21%; neuroma excision (e.g., CPT 64784) by 28%.
• Average annual reimbursement decline was -3.6%, necessitating a substantial increase in procedure volume for equivalent earnings.

Conclusions:

• Consistent Medicare physician reimbursement decreases for neuroma-related surgeries were observed.
• This trend threatens the viability of important treatment modalities for symptomatic neuromas.
• Declining reimbursement may limit surgeons' capacity to provide essential patient care.