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Medicare Trends in Auricular Cartilage and Composite Graft Utilization Among Mohs Surgeons and Other Specialists From
Samantha S Sattler1, Andrea Tan2, Jordan B Slutsky1
1Department of Dermatology, Stony Brook University Hospital, Stony Brook, New York.
Background:
Cartilage and composite grafts are technically challenging yet remain valuable reconstruction methods in Mohs surgery. The frequency of utilization by Mohs surgeons is currently unknown.
Objective:
To determine the frequency of auricular cartilage and composite graft utilization by Mohs surgeons compared with other specialists treating the Medicare population and to quantify total Mohs surgeons using these grafts.
Materials And Methods:
A cross-sectional analysis was performed using the Medicare Public Use Files from 2013 through 2022.
Results:
Of all Mohs surgeons billing Medicare from 2013 through 2022, a total of 7.95% (278/3498) used auricular cartilage grafts and 0.09% (3/3498) used composite grafts. Mohs surgeons performed their highest number of auricular cartilage grafts in 2015 (419/1563, 26.8%) and their lowest in 2020 (249/1160, 21.5%). Mohs surgeons performed 100% of all Medicare composite grafts in 2018 (17/17) and 2022 (19/19) and none in 2017, 2019, or 2021. Mohs surgeons performed the most composite grafts (125/343, 36.4%) across all specialties. The only specialty surpassing Mohs surgery (3345/14303, 23.4%) in auricular cartilage graft usage was otolaryngology (6371/14303, 44.5%).
Conclusion:
Auricular cartilage grafts are used more often than composite grafts. Mohs surgeons comprise a large subset of specialists using both, underscoring their utility in Mohs reconstruction.
