Trends of Medicare Reimbursement Rates for Common Plastic Surgery Procedures

Charalampos Siotos, M.D.; Michael A. Cheah, M.D.; George Damoulakis, M.S.; Jonathan Kelly, M.B.B.S., B.Ch.D.; Kalliopi Siotou, D.D.S.; Loren S. Schechter, M.D.; Deana S. Shenaq, M.D.; Gordon H. Derman, M.D.; Amir H. Dorafshar, M.D.

Disclosures

Plast Reconstr Surg. 2021;147(5):1220-1225. 

In This Article

Patients and Methods

Procedure Selection

We selected the procedures performed most commonly at our institution by the senior authors (G.H.D. and A.H.D.). Procedures were chosen to represent a broad range, including general reconstruction, hand surgery, peripheral nerve surgery, craniofacial surgery, and breast surgery (Table 1). The CPT code for each procedure was identified. Microsurgery procedures were excluded, as they represent a specific category with unique challenges in plastic surgery and require special equipment. Aesthetic procedures were not analyzed, as they are not covered by Medicare.

Data Extraction

The Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services was accessed, and the CPT codes of each procedure were used to identify information of interest. Average national relative value units, including physician, facility, and malpractice components, along with conversion factors were abstracted for each year.[11] The general consumer price index and general inflation over the studied period were acquired from the U.S. Department of Labor, Bureau of Labor Statistics.[12]

Statistical Analysis

To convert monetary data into U.S. dollars, we used the following formula: [(physician relative value units) + (facility relative value units) + (malpractice relative value units)] × (conversion factor) for each procedure for each fiscal year. Relative differences of relative value units and data in U.S. dollars between 2010 and 2020 were calculated and compared for each procedure. The inflation rate was used to convert monetary data into U.S. dollars (2020), and the information was reanalyzed. In addition, the compound annual growth rate was calculated, as follows: Compound annual growth rate = [(2020 value/2010 value)(1/2020–2010) − 1.Finally, a subgroup analysis was performed for general plastic surgery procedures, hand surgery, peripheral nerve surgery, craniofacial surgery, and nerve surgery to identify changes in the subgroups.

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