Torabi Sina J, Nguyen Theodore V, Bitner Benjamin F, Du Amy T, Warn Michael, Chernyak Michelle, Hsu Frank Pk, Kuan Edward C
Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, USA.
University of California, Riverside School of Medicine, Riverside, California, USA.
World Neurosurg. 2024 Dec;192:e243-e251. doi: 10.1016/j.wneu.2024.09.077. Epub 2024 Oct 9.
Medicare reimbursements for otolaryngology and neurosurgery procedures have generally declined since 2000. We explore Medicare reimbursement trends for anterior cranial fossa, middle cranial fossa, posterior cranial fossa, pituitary surgery, and skull base reconstruction surgery from 2000-2022.
Cross-sectional analysis of the Centers for Medicare and Medicaid Services Physician Fee Schedule was performed from 2000-2022 on approach, resection, and repair of the skull base (Current Procedural Terminology codes 31290-31291, 61546, 61548, 61575-61619, and 62165). Reimbursement data were adjusted for inflation to 2022 U.S. dollars, and annual and total changes calculated. The Centers for Medicare and Medicaid Services Part B National Summary Data File was analyzed for trends in Medicare procedure volume and total payment.
Adjusted for inflation since 2000, reimbursements for anterior cranial fossa, middle cranial fossa, posterior cranial fossa, pituitary surgery, and skull base reconstruction codes had an overall decrease of 22.85%, 32.43%, 28.09%, 44.22%, and 38.65%, respectively. Simultaneously, procedure volume increased at an average annual rate of 63.99%, 128.57%, 19.75%, 36.11%, and 12.79%, respectively.
While nominal per-service Medicare reimbursement has increased for skull base surgery codes, there has been a downward trend in inflation-adjusted procedural reimbursement. This parallels findings in other otolaryngology and neurosurgery procedures. Despite this, surgical volume in all skull base surgery subfields has increased, indicating increased utility and adoption of these techniques.
自2000年以来，医疗保险对耳鼻喉科和神经外科手术的报销费用总体呈下降趋势。我们探讨了2000年至2022年医疗保险对前颅窝、中颅窝、后颅窝、垂体手术和颅底重建手术的报销趋势。
对医疗保险和医疗补助服务中心2000年至2022年的医师费率表进行横断面分析，涉及颅底的入路、切除和修复（现行程序编码31290 - 31291、61546、61548、61575 - 61619和62165）。报销数据经通货膨胀调整为2022年美元，并计算年度和总变化。分析医疗保险和医疗补助服务中心B部分国家汇总数据文件，以了解医疗保险手术量和总支付的趋势。
自2000年经通货膨胀调整后，前颅窝、中颅窝、后颅窝、垂体手术和颅底重建编码的报销费用分别总体下降了22.85%、32.43%、28.09%、44.22%和38.65%。同时，手术量分别以年均63.99%、128.57%、19.75%、36.11%和12.79%的速度增长。
虽然医疗保险对颅底手术编码的名义每项服务报销费用有所增加，但经通货膨胀调整后的手术报销费用呈下降趋势。这与其他耳鼻喉科和神经外科手术的情况相似。尽管如此，所有颅底手术亚领域的手术量都有所增加，表明这些技术的实用性和采用率有所提高。
