A Decade of Change: Trends in Medicare Part B Utilization and Reimbursement for Nerve Transfer Surgery

Nerve transfers have emerged as a versatile and effective repair method for peripheral nerve injuries. The aim of this study was to compare the trends in Medicare Part B utilization and reimbursement for nerve transfer surgeries with other peripheral nerve repair techniques over a 10-year period.

We queried the Medicare Part B National Summary Data Files for retrospective utilization and reimbursement data related to peripheral nerve surgery from 2013 to 2022. Data were extracted for the following Current Procedural Terminology® (CPT) codes: nerve transfer (CPT 64905), short single-nerve segment autografts (CPT 64885, 64890, 64892), long single-nerve segment autografts (CPT 64886, 64893), and synthetic nerve grafts (CPT 64910). Reimbursement values were adjusted for inflation using the Consumer Price Index. Trends in utilization and reimbursement were analyzed.

Between 2013 and 2022, a total of 4633 nerve transfer procedures were performed and reimbursed under Medicare Part B. During this period, the rate of nerve transfer surgeries increased by 2030%. By contrast, synthetic nerve graft repairs rose by 55%, long single-nerve autografts increased by 34%, whereas short single-nerve autografts decreased by 15%. For the first time in 2022, the number of nerve transfer surgeries (1193) surpassed synthetic nerve graft repair (1016). However, over the same period, the average reimbursement for nerve transfer surgeries declined by 23.3%. Similarly, long single-nerve autografts reimbursement declined 12.6%. By contrast, average reimbursements for synthetic nerve grafts and short single-nerve autografts have not meaningfully changed since 2013 (3.3% and 0.6%, respectively).

Over the last decade, nerve transfer surgery has gained popularity among Medicare Part B patients, overtaking synthetic nerve grafts in terms of utilization. Despite this increase in utilization, reimbursements for nerve transfers have declined compared with other nerve repair procedures.