Regional Variation in Reimbursement for Body Contouring Surgery: A Claims-based Analysis across the United States

Recent trends in patient-driven weight loss efforts highlight the need for additional investigation into the utilization and accessibility of subsequent body contouring procedures. Previous insurance claim analyses have largely focused on factors associated with coverage determination. However, regional differences in payer reimbursement are not well understood. Therefore, this study examines regional variation in reimbursement rates for body contouring procedures across the United States.

Insurance claims database PearlDiver Mariner was used to retrieve records of abdominoplasty (current procedural terminology [CPT] 15847) and panniculectomy (CPT 15830) that occurred between 2010 and 2023. A total of 4152 records were disaggregated into 4 separate US census regions (Northeast, Midwest, South, and West) for analysis.

The US South contributed the highest reimbursement value for abdominal body contouring surgery with an average of $3426.6 per record, whereas the West contributed the lowest ($2105.92 per record). The Midwest displayed the most interstate variability with a range of $5102.32 per record between the highest-paying and lowest-paying state. When stratified by payer type, private insurers reimbursed at higher rates compared to public insurers across all regions.

Regional differences exist for insurance coverage for abdominoplasty and panniculectomy within the United States. The South had the highest average reimbursement rate, whereas the West had the lowest. The Midwest had the highest interstate variability in reimbursement within a region. Regional differences in costs and coverage of body contouring surgery have significant implications on patient accessibility to these procedures, health policy development, and physician counseling on the cost of care.