Inflation-adjusted 25-year trend analysis of foot and ankle surgery reimbursement (2000-2024)

With an aging U.S. population, demand for foot and ankle surgical services continues to increase. The purpose of this study was to evaluate 25-year trends in Medicare reimbursement for foot and ankle surgical procedures. We hypothesized that inflation-adjusted reimbursement has declined.

Medicare reimbursement data (facility pricing, locality 0431200 Oklahoma) for 81 commonly performed foot and ankle surgical CPT codes was extracted from the CMS Physician Fee Schedule Look-Up Tool for 2000-2024. Reimbursement was adjusted to 2000 dollars using both the Consumer Price Index (CPI) and Medicare Economic Index (MEI). Compound annual growth rates (CAGR) were calculated.

From 2000 to 2024, inflation-adjusted reimbursement for foot and ankle surgical procedures declined 45.9% (CPI-adjusted) and 36.9% (MEI-adjusted), corresponding to CAGR values of -2.5% and -1.9%, respectively. This represents an average decline of $221 per procedure (CPI-adjusted) or $178 per procedure (MEI-adjusted) in 2000 dollars.

Medicare reimbursement for foot and ankle surgical procedures has declined substantially over the past 25 years when adjusted for inflation. These findings should alert surgeons, hospital administrators, and policymakers to the widening gap between operative costs and reimbursement, with potential downstream effects on access to care.