Changes in Medicare Reimbursement for Top Burn Surgery Procedures by State Between 2011 and 2022.

Abstract

This study analyzed the geographic variation in annual Medicare reimbursement changes for common burn surgery procedures from 2011 to 2022 to clarify trends in reimbursement. The Center for Medicare and Medicaid Services' Physician fee schedule database was analyzed to find state-by-state reimbursement rates for the most common burn surgery procedures. Physician reimbursement was adjusted for inflation utilizing the consumer price index. Procedures were weighted according to frequency, and an inflation-adjusted percent change was identified for each state. Since 2011, the inflation-adjusted Medicare reimbursement for the top burn surgery procedures for all U.S. states decreased by a yearly average of 2.67%. Washington (-2.17%), New York (-2.31%), Oregon (-2.33%), and the District of Columbia (-2.35%) showed the smallest annual percent change. Illinois (-3.34%), Mississippi (-3.04%), Idaho (-2.99%), and Michigan (-2.96%) were the states with the greatest annual decrease. The most common procedures included initial treatment of burns (16000), burn dressing and debridement (16020, 16025, 16030), and burn eschar incision (16035). Medicare reimbursement for burn surgery procedures decreased from 2011 to 2022. The geographic variance in reimbursement patterns may incentivize physicians to pursue other surgical specialties or practice in certain areas which could limit access to care in low reimbursement areas. Further research is needed to examine disparities that may have arisen due to decreasing reimbursement over the last decade. New action is also needed to moderate diminishing burn surgery reimbursement to ensure quality care for Medicare beneficiaries in low-reimbursement states.