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COVID-19-associated trends in Medicare utilization for plastic and reconstructive surgery
Jason Zhang1, Anitesh Bajaj1, Nikhil Sriram1
1Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, United States.
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|February 28, 2026
Summary
Medicare reimbursements and charges for plastic and reconstructive (PR) surgery have declined significantly since 2020, exacerbated by the COVID-19 pandemic. These trends impact PR surgeons and Medicare patients, potentially creating barriers to care.
Area of Science:
- Plastic and Reconstructive Surgery
- Health Economics
- Healthcare Policy
Background:
- The Medicare population presents unique healthcare needs within plastic surgery.
- Pre-pandemic studies indicated declining reimbursements and rising charges for plastic surgery services.
- The COVID-19 pandemic has potentially altered the financial landscape for healthcare providers.
Purpose of the Study:
- To analyze changes in Medicare reimbursements and charges for plastic and reconstructive (PR) surgery following the onset of the COVID-19 pandemic.
- To characterize trends in service volume, payment, and reimbursement rates for PR surgery among Medicare beneficiaries.
- To assess the financial impact on PR surgeons serving the Medicare population.
Main Methods:
- Utilized the CMS Medicare Physician & Other Practitioners database to analyze procedural codes billed by PR surgeons from 2013 to 2023.
- Conducted subgroup analysis based on organ systems (integumentary, musculoskeletal, nervous, other).
- Employed interrupted time series analysis (ITSA) with a 2020 breakpoint, adjusting all dollar amounts for inflation to 2023.
Main Results:
- Analyzed 4,903,961 services for 2,970,140 beneficiaries billed by 3767 PR surgeons.
- Observed significant decreases from 2013-2023: volume (-31.9%), Medicare payment (-39.9%), non-Medicare payment (-33.7%), percent reimbursed (-10.9%), and charges (-12.8%).
- ITSA revealed a significant volume drop in 2020 (p < 0.001) and significant post-2020 changes in Medicare payments (p = 0.009) and average charges (p = 0.001).
Conclusions:
- The COVID-19 pandemic has intensified pre-existing downward trends in Medicare utilization and reimbursements for PR surgery.
- These financial challenges pose difficulties for surgeons serving Medicare recipients.
- Addressing these trends is crucial to mitigate care barriers and improve health outcomes for Medicare patients receiving PR surgery.
