Gender disparities in medicine have been well established, with differences in attainment of roles in administration, and differences in physician income. Our objective was to determine Medicare payment differences by gender and specialty training track of FPMRS surgeon. Medicare payments from the Provider Utilization Aggregate Files were used to determine the payments made by Medicare to urogynecologists. This database was merged with the NPI registry with information on subspecialty training and years since graduation, along with the geographic pricing cost index to account for Medicare payment adjustments. Physicians with <90% female patients, and graduated medical school <7 (OBGYN) and <8 years ago (urology) were excluded. Effects of gender, specialty of training, number of services, years of practice, and geographic pricing cost index on physician reimbursement were evaluated using linear mixed modeling. There were 578 surgeons with FPMRS subspecialty training met inclusion criteria. Of those 517 (89%) trained as gynecologists, while 61 (11%) trained as urologists. 265 (51%) of the gynecology trained surgeons were women, and 39 (80%) of urology trained surgeons were women. Among urology trained surgeons the median female surgeon was paid $85,962 while the males were paid $121,531, or a 41% difference in payments, while women urology trained FPMRS surgeons performed a median of 1,135 services, while male surgeons performed a median of 1,793 services or a 57% difference in volume. Among gynecology trained surgeons the median female payments were $59,277 while performing 880 services, and male gynecology trained surgeons received a median of $66,880 and performed 791 services, representing a difference of 12% in payments and 11% in services. Male physicians were paid more than female physicians while controlling for specialty training, number of services, years of practice, and geographic pricing cost index. Despite Medicare payments being based on an equation, differences in reimbursement by physician gender continue to exist in FPMRS. Female surgeons in FPMRS receive lower payments from Medicare. The differences in reimbursement could not be solely explained by differences in patient volume, area of practice, or years of experience, suggesting that similar to other fields in medicine, women in FPMRS are not paid as much as male physicians.View Large Image Figure ViewerDownload Hi-res image Download (PPT)