Medicare Reimbursement for General Surgery Procedures

Abstract

OBJECTIVE: The purpose of this study is to evaluate monetary trends from 2000 to 2018 in Medicare reimbursement rates for the most common general surgery procedures. SUMMARY BACKGROUND DATA: A complete understanding of financial trends in general surgery in the United States is lacking. As such, an evaluation of trends in reimbursement rates in general surgery is important for defining the specialty's current and future financial health. METHODS: The Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services was queried for each of the 20 top codes top in general surgery. The total raw percent change in Medicare reimbursement rate for each procedure from 2000 to 2018 was calculated and averaged. All data was corrected for inflation. Both average annual and total percentage change were calculated based on these adjusted trends. Compound annual growth rate was calculated using the adjusted data. RESULTS: After adjusting all data for inflation, the reimbursement rate for all included procedures decreased by an average of 24.4% throughout the study period. During this time, the adjusted reimbursement rate decreased by an average of 1.4% each year with an average compound annual growth rate of -1.6%. CONCLUSION: After adjusting for inflation, Medicare reimbursement rates in general surgery have steadily decreased from 2000 to 2018. It is important that these trends are understood and considered by surgeons, healthcare administrators, and policy-makers in order to develop and implement agreeable models of reimbursement while ensuring access to quality general surgery care in the United States.

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