Comparison of Medicare Reimbursement for Common Urologic and Gynecologic Procedures: An Economic Analysis of...

To assess physician fees for general urologic procedures compared to gynecologic over the past decade, analyzing trends in reimbursement and the impact of inflation on Medicare compensation due to the need to balance fair wages with decreased financial burden for patients.

Utilizing CPT codes, we assessed procedures via the governmental Physician Fee Schedule Look-Up Tool for Medicare from 2015-2024. Annual physician fee reimbursements were collected as the "nonadjusted values" each year was then adjusted to reflect yearly inflation rates and documented as "inflation adjusted values." Mann-Kendall tests were used to assess both nonadjusted and inflation adjusted trends for each procedure over time; t tests were used to compare urologic compensation trends to gynecologic.

Over the decade, both urology and OBGYN reimbursements decreased significantly at an inflation-adjusted rate of -47.44% and -33.15%, respectively. Nonadjusted rates for both specialties exhibit a 2.00% increase for OBGYN and an -11.03% decrease for urology. Such trends highlight an increasing disparity across both fields, with urology facing significantly steeper declines.

These reductions leave urologists with reduced payments for the same services, diminishing physician compensation across this subspecialty. This trend impacts the financial stability of providers while affecting access to care if physicians are disincentivized to perform these procedures or accept certain insurances due to declining reimbursements. These trends are unsustainable for practice in an overburdened medical system.