Inflation-adjusted Medicare reimbursement for primary and revision shoulder arthroplasty: an updated analysis

Physician reimbursement for orthopedic procedures, such as total shoulder arthroplasty (TSA) and related revision surgeries, has been subject to economic pressures over the past 2 decades. Understanding trends in reimbursement, especially when adjusted for inflation, provides insight into health care economics and informs policy decisions.

The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was queried to extract reimbursement data from 2000 to 2025 for various TSA procedures, including primary and revision surgeries. Current Procedural Terminology (CPT) codes 23470; 23472; 23473; 23474; 23334; and 23335 were included. All monetary values were converted to 2025 United States dollars using the Consumer Price Index to adjust for inflation. For each procedure, we calculated the mean annual reimbursement and trends in inflation-adjusted reimbursement through 2025.

Across all procedures, there was a consistent decline in inflation-adjusted reimbursement. For instance, CPT code 23470 (hemiarthroplasty) decreased from $2,419.81 in 2000 to $1,192.43 in 2025. CPT code 23472 (TSA) showed a similar trend, declining from $2,467.96 in 2000 to $1,433.64 in 2025. Revision procedures, such as CPT code 23474 (humeral and glenoid component), experienced notable reductions, with a peak of $2,515.25 in 2015 falling to $1,718.62 in 2025. All linear regression models showed statistically significant downward trends (P < .001), with R² values ranging from 0.885 to 0.915.

Inflation-adjusted physician reimbursement for TSA procedures has declined substantially from 2000 to 2025. These findings highlight a continued decline in reimbursement despite stable or increasing procedural complexity, which may impact provider sustainability and access to care.