MP28-09 CONTEMPORARY TRENDS IN UTILIZATION AND MEDICARE REIMBURSEMENT FOR AMBULATORY BPH PROCEDURES (2014-2018)

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (MP28)1 Sep 2021MP28-09 CONTEMPORARY TRENDS IN UTILIZATION AND MEDICARE REIMBURSEMENT FOR AMBULATORY BPH PROCEDURES (2014-2018) Evan Garden, Nir Tomer, Osama Al-Alao, Alexander Small, and Michael Palese Evan GardenEvan Garden More articles by this author , Nir TomerNir Tomer More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , Alexander SmallAlexander Small More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002025.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Historically, patients with symptomatic benign prostatic hyperplasia (BPH) underwent either transurethral resection of the prostate (TURP) or simple prostatectomy. However, novel minimally invasive surgical treatments for BPH have been recently introduced to the marketplace. We sought to describe trends in utilization and reimbursement rates for ambulatory BPH procedures in a contemporary, national cohort. METHODS: Using the CMS Provider Utilization and Payment Database (2014-2018), all cases for the following procedures were isolated (with corresponding CPT codes): TURP (52601), laser vaporization [i.e. Greenlight] (52648), laser enucleation [i.e. HoLEP] (52649), transurethral needle ablation [TUNA] (53852), transurethral microwave therapy [TUMT] (53850), and prostatic urethral lift [UroLift] (52441, 52442);. Providers who performed <10 procedures annually were excluded from the database. Descriptive statistics were calculated for total annual case volume and total annual Medicare spending per procedure. RESULTS: From 2014-2018, TURP was the most commonly utilized ambulatory BPH procedure (2014: 50.63% of procedures, 2018: 43.76%). In 2014-2017, Greenlight was the second most common (2014: 32.13%, 2017: 24.63%), but in 2018, UroLift overtook Greenlight (22.41% vs. 22.38%, respectively). Based on total case volume, TURPs were performed nearly twice as frequently as the next most-commonly utilized BPH procedure (2014: 1.58x greater case volume than Greenlight, 2018: 1.95x greater case volume than UroLift). Over time, cumulative Medicare spending rose for UroLift (2015-18: +2,843.9%), HoLEP (2014-18: +35.6%), and TUNA (2014-18: +4.0%), while spending for TUMT (2014-18: -56.5%), Greenlight (2014-18: -24.1%) and TURP (2014-18: -11.7%) decreased (Figure 1). CONCLUSIONS: TURP remains the most performed surgical option for urologists in managing BPH. UroLift has seen a precipitous increase in utilization and a commensurate rise in Medicare spending that has recently surpassed TURP. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e484-e484 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evan Garden More articles by this author Nir Tomer More articles by this author Osama Al-Alao More articles by this author Alexander Small More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...