Kopechek Kyle J, Satariano Matthew, Posid Tasha, Dason Shawn
Department of Urology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio.
Urol Pract. 2025 Jul;12(4):380-390. doi: 10.1097/UPJ.0000000000000795. Epub 2025 Mar 5.
In recent years, Medicare physician reimbursement has been a target for national health care spending adjustments, but detailed national and location-specific trends in urologic oncology are lacking. This study investigated reimbursement trends over the past 2 decades.
The Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool was used to extract physician reimbursement data for urologic oncology procedures from 2002 to 2024. We analyzed 20 common or relevant urologic oncology Current Procedural Terminology codes. Reimbursement data were recorded biennially and inflation adjusted to 2024 US dollars. The compound annual growth rate (CAGR) over the study period was calculated for each procedure. Location-specific reimbursement trends were analyzed for robot-assisted radical prostatectomy (RARP, Current Procedural Terminology 55866) in all available Medicare localities (n = 89).
Reimbursement data for the 20 procedures were retrieved with an average inflation-adjusted percentage change of -41.08% from 2002 to 2024. For all procedures, the 2014 to 2024 CAGR indicated a faster rate of decline compared with the 2002 to 2014 CAGR. RARP showed the most significant inflation-adjusted decline. Kidney procedures experienced an average inflation-adjusted CAGR of -2.15%, bladder -2.49%, prostate -2.53%, and testicular -2.34%. Open surgeries averaged a CAGR of -2.32%, endoscopic -2.60%, and laparoscopic/robotic -2.73%. Reimbursement for RARP declined across all 89 Medicare localities from 2014 to 2024, with slight variability in magnitude.
Inflation-adjusted Medicare physician reimbursement has been declining for all urologic oncology procedures over the past 2 decades, with more substantial declines noted in recent years. As key stakeholders, urologists must remain active in policy decisions pertaining to physician reimbursement.
近年来，医疗保险医师报销一直是国家医疗保健支出调整的目标，但缺乏详细的全国性和特定地区的泌尿肿瘤学趋势。本研究调查了过去20年的报销趋势。
使用医疗保险和医疗补助服务中心医师费率表查询工具，提取2002年至2024年泌尿肿瘤学手术的医师报销数据。我们分析了20个常见或相关的泌尿肿瘤学现行程序术语代码。报销数据每两年记录一次，并根据通货膨胀率调整为2024年美元。计算了研究期间每个手术的复合年增长率（CAGR）。分析了所有可用医疗保险地区（n = 89）机器人辅助根治性前列腺切除术（RARP，现行程序术语55866）的特定地区报销趋势。
检索到了20个手术的报销数据，从2002年到2024年，经通货膨胀调整后的平均百分比变化为-41.08%。对于所有手术，2014年至2024年的复合年增长率表明下降速度比2002年至2014年的复合年增长率更快。RARP显示经通货膨胀调整后的下降最为显著。肾脏手术的经通货膨胀调整后的平均复合年增长率为-2.15%，膀胱手术为-2.49%，前列腺手术为-2.53%，睾丸手术为-2.34%。开放手术的平均复合年增长率为-2.32%，内镜手术为-2.60%，腹腔镜/机器人手术为-2.73%。从2014年到2024年，所有89个医疗保险地区的RARP报销均下降，幅度略有差异。
在过去20年中，经通货膨胀调整后的医疗保险医师报销对所有泌尿肿瘤学手术都在下降，近年来下降幅度更大。作为关键利益相关者，泌尿外科医生必须积极参与与医师报销相关的政策决策。
