Summary

This analysis found that both the procedural utilization and physician reimbursement billed to Medicare has been increased for hip arthroscopy from 2011-2019; this data can be used to inform policies and healthcare decisions in the growing field of hip arthroscopy.

Abstract

Background

Several studies have investigated reimbursement and procedural volume for numerous specialties, including orthopedic surgery. However, hip arthroscopy procedural volume and reimbursement trends have not been formally evaluated in the current literature. Such an analysis can inform public policy and reimbursement changes in relation to hip arthroscopic surgery. As such, the purpose of this study was to evaluate trends in Medicare reimbursement and procedural volume for 7 common arthroscopic hip procedural codes between 2011-2019.

Methods

The Medicare Part B National Summary Data Files from the Centers for Medicare and Medicaid Services (CMS) was accessed to collect data regarding the reimbursement and procedural volume rates for hip arthroscopic procedures. The files from 2011 to 2019 were accessed and descriptive statistic were employed to analyze for trends in procedural volume and reimbursement between the study timeline.

Results

In the study period between 2011-2019, there were 31,890 total hip arthroscopic procedures billed to Medicare. There was a 62.6% increase in annual procedural volume of hip arthroscopy from year 2011 to 2019. In the same interval, the total physician payment, adjusted for inflation, for hip arthroscopy procedures billed to Medicare Part B was $24,776,277 with an average adjusted Medicare Reimbursement (AAMR) for hip arthroscopy increasing 19.6%.

Conclusion

This analysis found that both the procedural utilization and physician reimbursement billed to Medicare has been increased for hip arthroscopy from 2011-2019. This data can be used to inform policies and healthcare decisions in the growing field of hip arthroscopy.