Medicare Reimbursement for Arthroscopy Procedures Down Almost a Third Since 2000

Arthroscopy Surgery Medicare

New study analyzes reimbursement trends for minimally invasive arthroscopic surgery, one of the fastest-growing areas of orthopedics

“A Comprehensive Analysis of Medicare Reimbursement to Physicians for Common Arthroscopy Procedures: Adjusted Reimbursement has Fallen Nearly 30% from 2000 to 2019,” printed in the December issue of Arthroscopy, sheds light on what has happened to reimbursement rates in the past 20 years.

“This was the first study to assess and characterize some of the most recent trends in Medicare reimbursement for orthopedic arthroscopic surgery,” said co-author Michael Lane Moore, a medical student at Mayo Clinic Alix School of Medicine in Scottsdale, Ariz.

While previous analyses have identified declines in Medicare reimbursement among common procedures such as neurosurgery and general orthopedics, said Moore, “data regarding reimbursement trends for one of the fastest-growing areas of orthopedics, minimally invasive arthroscopic surgery, was lacking.”

Using the CMS website, the researchers identified the 20 most common arthroscopic procedures using the 2017 Public Use File (PUF) data file. They also utilized the Physician Fee Schedule Look-Up Tool to calculate national reimbursement averages from 2000-2019.

“The primary finding from our analysis was that when adjusted for inflation, the mean Medicare reimbursement for the 20 most utilized arthroscopic procedures has declined by nearly 30% (29.8% exactly) between 2000 and 2019,” said Moore. 

“This analysis will give orthopedic surgeons and hospital administrators a better understanding of the financial trends surrounding one of the fastest-growing techniques in surgery. Additionally, this financial trend data will be increasingly important as the population in the United States continues to age, and new payment models are introduced. As arthroscopic procedures continue to grow at increasing rates, it is essential that the declining Medicare reimbursement rates outlined in this analysis and elsewhere in the literature are addressed by practitioners, administrators, and policymakers.”

SOURCE: OrthoSpineNews

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