V59: Trends in Reimbursement for Index Surgical Oncology Procedures in Contemporary Practicedeclining Reimbursement for Surgical Oncology Procedures – How Low Do We Go?

Comprehensive trends in Medicare reimbursement, increasingly relevant to current and future surgical oncology practice, have not been well studied. The objective of this study is to analyze Medicare reimbursement for index surgical oncology procedures between 2007–2021. 


Methods:

Using the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services, reimbursement data from 2007–2021 was obtained for 23 index surgical oncology procedures. Total raw change in Medicare reimbursement, yearly rates of change, and compound annual growth rate were then calculated. All data was corrected for inflation using the consumer price index. Subset analysis was performed to look at most recent 5 year trends.


Results:

Overall reimbursement for the index surgical oncology procedures increased by an average of 21.6% from 2007 to 2021. The greatest increase was for partial mastectomy (85.3%) and the least for thyroidectomy and radical neck dissection (8.5%).  After correcting for inflation, the average reimbursement rate actually decreased to -8.6%, with the greatest decline seen for thyroid surgery (-16.9%). Breast surgery was the only category to experience an increase in adjusted reimbursement (9.0%). The average compound annual growth rate for all procedures was -0.68% from 2007-2021. In the most recent 5 year subanalysis, the average yearly decrease in inflation adjusted medicare reimbursement was -2.47% per year, in comparison to the -0.60% overall rate of yearly decline (p < 0.05).


Conclusions:

Adjusted Medicare reimbursement for surgical oncology procedures decreased steadily from 2007–2021, with an accelerating trend over the last 5 years. As the Medicare population increases, surgical oncologists need to understand these trends so they may consider practice implications, advocate for proper reimbursement models, and preserve access to surgical oncology services.