National Medicare trends in navigation-assisted spine surgery: A temporal and geographic analysis

Although initially utilized for pedicle screw placement, indications for navigation assistance in spine surgery have expanded over the past several years. While existing studies have evaluated safety, efficacy, and outcomes from navigation assistance, national reimbursement, and utilization patterns remain poorly characterized. This study aims to quantify temporal, geographic, and provider-level trends in navigation-assisted spine surgery among Medicare beneficiaries.

The Medicare Part B National Summary Data Files were queried for national utilization and reimbursements for Current Procedural Terminology (CPT) 61783 (add-on code for navigation-assisted spine surgery) from 2011 to 2024. Additional Medicare databases were queried for geographic- and physician-level trends in navigation assistance utilization from 2013 to 2023. Linear regression was performed on national utilization trends.

From 2011 to 2024, allowed services for navigation-assisted spine surgery grew 917.41%, from 3447 in 2011 to 35,070 in 2024. Adjusting for growth in the number of Medicare Part B beneficiaries, this represents a 637.03% increase. In 2023, most physicians performing navigation-assisted spine surgery were neurosurgeons and practiced in urban metropolitan settings. Between 2013 and 2023, all 50 states observed an increase in utilization rate for navigation-assisted spine surgeries. From 2011 to 2024, reimbursements for this add-on code steadily declined by 31.78%, from $334.88 to $228.45.

As indications have expanded, utilization of the navigation-assisted spine surgery CPT code has increased sixfold from its introduction in 2011 to 2024. Simultaneously, reimbursements have declined by 31.78%, raising important concerns about misalignment between the clinical value and financial support for navigation-assisted spine surgery.