Physician Professional Fees Are Declining and Inpatient and Outpatient Facility Fees Are Increasing for Orthopaedic Procedures in the United States

Abstract

The purpose of the study was to examine the trends in physician professional fees and inpatient and outpatient facility fees in orthopedic surgery in the United States. Physician professional fees and inpatient and outpatient facility fees were tracked from 2008-2021 for the most common orthopedic procedures in each orthopedic subspecialty. Utilizing common procedure codes for physician and outpatient procedures and MS-DRG codes for inpatient procedures, the Medicare Physician Fee Schedules were used to obtain the national payment amounts for physician professional fees and inpatient and outpatient facility fees. Trends in fees were tracked over time after adjustment for inflation. From 2008 to 2021, physician professional fees decreased by an average of 20%, while inpatient facility fees increased by 15%, and outpatient facility fees increased by 72%. The orthopedic subspecialty with the largest decrease in physician professional fees was oncology, with an average decrease of 23.5%, followed by general orthopedics (23.1%), and sports medicine (22.8%). The largest increase in outpatient facility fees was seen in the subspecialties of general orthopedics (149.8%), spine (130.1%), and trauma (123.0%). Over the past 13 years, physician professional fees for the most common orthopedic procedures have declined while inpatient and outpatient facility fees have increased. Understanding these changes is important to the practice of orthopedic surgery in the United States. Economic IV.