Department of Radiology, University of Pittsburgh Medical Center, Presbyterian University Hospital Suite E204, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.
Abdom Radiol (NY). 2021 Aug;46(8):4056-4061. doi: 10.1007/s00261-021-03054-3. Epub 2021 Mar 27.
The purpose of this study is to analyze trends in Medicare volume and physician reimbursement for percutaneous ablation, surgical ablation, and resection of liver tumors from 2010 to 2018.
Claims from the Medicare Part B PSPSMF for the years 2010 to 2018 were extracted using the CPT codes for percutaneous and surgical ablation of liver tumors and surgical liver resection. Total procedural volume and physician payment were analyzed by procedure and physician specialty.
From 2010 to 2018, the volume of percutaneous ablation of liver tumors increased 94.3% from 1630 to 3168 procedures, and the volume of surgical ablations increased 86.2% from 593 to 1104 procedures. In contrast, there was a 16.8% decrease in liver resections from 10,807 to 8994 procedures. Physician reimbursement for percutaneous ablation decreased from $702.41 to $610.11 (- 13.1%). Conversely, reimbursement for resection increased from $849.18 to $1015.06 (19.5%). Reimbursement for surgical ablation also increased from $722.36 to $744.25 (3.0%). In 2018, physician reimbursement for resection and surgical ablation were 66% and 22% more than that for percutaneous ablation.
An increasing number of patients with liver tumors were treated with percutaneous ablation from 2010 to 2018. Despite higher morbidity, a dwindling set of theoretical advantages over percutaneous ablation, and higher overall costs, the volume of surgical ablation also increased over this time period. The findings of this study suggest that a reevaluation of practice and referral patterns for surgical ablation of liver tumors is warranted in many institutions.
本研究旨在分析 2010 年至 2018 年期间，医疗保险对经皮消融、手术消融和肝肿瘤切除术的数量和医生报销的趋势。
使用 CPT 代码提取 2010 年至 2018 年医疗保险 B 部分 PSPSMF 的索赔数据，用于经皮和手术消融肝肿瘤和手术肝切除术。按手术程序和医生专业分析总手术量和医生支付情况。
从 2010 年到 2018 年，经皮肝肿瘤消融术的数量增加了 94.3%，从 1630 例增加到 3168 例，手术消融术的数量增加了 86.2%，从 593 例增加到 1104 例。相比之下，肝切除术的数量减少了 16.8%，从 10807 例减少到 8994 例。经皮消融术的医生报销从 702.41 美元降至 610.11 美元（-13.1%）。相反，切除术的报销从 849.18 美元增加到 1015.06 美元（19.5%）。手术消融术的报销也从 722.36 美元增加到 744.25 美元（3.0%）。2018 年，切除术和手术消融术的医生报销比经皮消融术分别高出 66%和 22%。
2010 年至 2018 年，越来越多的肝肿瘤患者接受经皮消融治疗。尽管手术消融术的发病率较高，相对于经皮消融术的理论优势逐渐减少，且总体费用较高，但在此期间，手术消融术的数量也有所增加。本研究的结果表明，在许多机构中，有必要重新评估肝肿瘤手术消融的实践和转诊模式。
