Trends in Medicare Reimbursement for Adult Cardiothoracic Surgery Procedures: 2007 to 2020

Abstract

Background. Cardiovascular disease has been the leading cause of death in the US for decades. Over half a million cardiothoracic surgery procedures are performed per year, with an increasingly aging population and rising healthcare costs. The purpose of this study was to evaluate trends in Medicare reimbursement rates from 2007 to 2020 for various cardiothoracic surgery procedures. Methods. The Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool was queried for common procedural terminology codes for 119 common cardiothoracic surgery procedures to obtain reimbursement data by year. Procedures were organized into cardiac, CABG, and thoracic subgroups. All monetary data were adjusted for inflation to 2020 US dollars. Adjusted data were analyzed to calculate compound annual growth rates (CAGR), average annual change, and total percent change for each procedure. Results. After adjusting for inflation, the reimbursement rates for cardiothoracic surgery procedures decreased by 10.20% on average. Reimbursement rates for cardiac, CABG, and thoracic surgical procedures decreased by 8.74%, 14.46%, and 10.94%, respectively. The mean annual change overall was −$14.47, and the CAGR was 0.82%. CABG procedures had the greatest decrease in CAGR (−1.11%), annual change (−$30.30), and total percent change (−14.46%). Conclusions. Medicare reimbursements for cardiothoracic surgery procedures steadily decreased from 2007 to 2020, with CABG procedures experiencing the highest percentage of decline. Dissemination of these findings is crucial to raising awareness for healthcare administrators, surgeons, insurance companies, and policymakers to ensure the accessibility of these procedures for high-quality cardiothoracic surgery care in the United States.