Reimbursement Trends Research Articles

Trends in Physician Payments for Hand Surgery Consultations and Clinic Visits

The primary objective of this study was to identify the trends in reimbursement for hand surgeons for new patient visits, outpatient consultations, and inpatient consultations from the years 2010-2018. In addition, we sought to investigate the influence of payer mix and coding level of service on physician reimbursement in these settings. The PearlDiver Patients Records Database was used to identify clinical encounters and their respective physician reimbursements for analysis within this study. This database was queried using Current Procedural Terminology codes to identify relevant clinical encounters for inclusion, filtered for the presence of valid demographic information and byphysician specialty for the presence of a hand surgeon, and tracked by primary diagnoses. Cost data were then calculated and analyzed regarding the payer type and level of care. In total, 156,863 patients were included in this study. The mean reimbursement for inpatient consultations, outpatient consultations, and new patient encounters increased by 92.75% ($134.85 to $259.93), 17.80% ($161.33 to $190.04), and 26.78% ($102.58 to $130.05), respectively. When normalized to 2018 dollars to adjust for inflation, the percent increases were 67.38%, 2.24%, and 10.09%, respectively. Commercial insurance reimbursed hand surgeons to a greater degree than any other payer type. Mean physician reimbursement differed depending on the level of service billed, with the level of service V reimbursing 4.41 times more than the level of service I visits for new outpatient visits, 3.66 times more for new outpatient consultations, and 3.04 times more for new inpatient consultations. This study helps to provide physicians, hospitals, and policymakers with objective information regarding the trends in reimbursement to hand surgeons. Although this study indicates increasing reimbursements for consultations and new patient visits to hand surgeons, the margins shrink when adjusted for inflation. Economic Analysis IV.

Trends in Utilization and Reimbursement of Interspinous Process Devices in the Medicare Population.

aThe Warren Alpert Medical School of Brown University, Providence, RI bDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD Jung Ho Gong and Kelly Jiang: Authors contributed equally The authors report no conflicts of interest. Address correspondence and reprint requests to Tej D. Azad, MD, MS, 600 North Wolfe St., Johns Hopkins Hospital, Department of Neurosurgery, Baltimore, MD 21287; E-mail: [email protected] Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.spinejournal.com.

Are Cervical Disc Arthroplasty Medicare Reimbursement Trends Sustainable?

Cervical disc arthroplasty (CDA) was originally approved by the US Food and Drug Administration (FDA) in 2007 as a motion-sparing procedure to treat cervical degenerative disc disease. Since then, promising results from randomized control trials have led to increasing popularity. However, data discussing monetary trends are limited. The aim of this study was to determine how utilization, hospital charges, and Medicare physician reimbursement for CDA have changed over time. In this retrospective cohort study, International Classification of Diseases procedure codes were used to identify all patients who underwent CDA from 2007 to 2017 in the National Inpatient Sample database. The Physician Fee Schedule Look-up Tool from the Centers for Medicare and Medicaid Services was queried for primary CDA using current procedural terminology codes to determine Medicare physician reimbursement from 2009 to 2021. Nominal monetary values were adjusted for inflation using the Consumer Price Index and inflation-adjusted data reported in 2021 US dollars. A total of 33,079 weighted patients who underwent CDA were included for analysis. CDA utilization increased by 183% from 2007 to 2017, with Medicare beneficiary utilization increasing 149%. Inflation-adjusted total hospital charges for CDA increased by 22.4%. However, inflation-adjusted Medicare physician reimbursement fell by 1.20% per year, demonstrating a total decrease of 12.9%, starting at $1928 in 2009 and declining to $1679 in 2021. While utilization and total hospital charges for CDA continue to rise, Medicare physician reimbursement has not shown the same trend. In fact, inflation-adjusted reimbursement has seen a steady decline since FDA approval in 2007. If this trend persists, it may become unsustainable for physicians to continue offering CDA to Medicare patients. As disproportionate increases in hospital charges incentivize a transition to outpatient CDA, stricter patient selection criteria associated with outpatient procedures may create health care disparities for Medicare patients and those with higher comorbidity burden. This study shows the decreasing reimbursement trends for CDA, which may disproportionately affect Medicare patients and those with increased comorbidities.

Declining Medicare reimbursement in abdominal transplantation from 2000 to 2021

BackgroundThe Centers for Medicare and Medicaid Services is a major payer for abdominal transplant services. Reimbursement reductions could have a major impact on the transplant surgical workforce and hospitals. Yet government reimbursement trends in abdominal transplantation have not been fully characterized. MethodsWe performed an economic analysis to characterize changes in inflation-adjusted trends in Medicare surgical reimbursement for abdominal transplant procedures. Using the Medicare Fee Schedule Look-Up Tool, we performed a procedure code–based surgical reimbursement rate analysis. Reimbursement rates were adjusted for inflation to calculate overall changes in reimbursement, overall year-over-year, 5-year year-over-year, and compound annual growth rate from 2000 to 2021. ResultsWe observed declines in adjusted reimbursement of common abdominal transplant procedures, including liver (-32.4%), kidney with and without nephrectomy (-24.2% and -24.1%, respectively), and pancreas transplant (-15.2%) (all, P < .05). Overall, the yearly average change for liver, kidney with and without nephrectomy, and pancreas transplant were -1.54%, -1.15%, -1.15%, and -0.72%. Five-year annual change averaged -2.69%, -2.35%, -2.64%, and -2.43%, respectively. The overall average compound annual growth rate was -1.27%. ConclusionThis analysis depicts a worrisome reimbursement pattern for abdominal transplant procedures. Transplant surgeons, centers, and professional organizations should note these trends to advocate sustainable reimbursement policy and to preserve continued access to transplant services.

Charting Trends in Medicare Reimbursement for Lower Extremity Imaging.

Medicare reimbursement is rapidly declining in many specialties. An in-depth analysis of Medicare reimbursement for routinely performed diagnostic imaging procedures in the United States is warranted. The purpose of this study was to evaluate Medicare reimbursement trends for the 20 most common lower extremity imaging procedures performed between 2005 and 2020, including radiographs, computed tomography (CT), and magnetic resonance imaging (MRI). We hypothesized that Medicare reimbursement for imaging procedures would decline substantially over the studied period. Cohort study. The Physician Fee Schedule Look-up Tool from the Centers for Medicare and Medicaid Services was analyzed for reimbursement rates and relative value units associated with the top 20 most utilized Current Procedural Terminology (CPT) codes in lower extremity imaging from 2005 to 2020. Reimbursement rates were adjusted for inflation and listed in 2020 US dollars using the US Consumer Price Index. To compare year-to-year changes, the percentage change per year and compound annual growth rate were calculated. A 2-tailed t test was used to compare the unadjusted and adjusted percentage change over the 15-year period. After adjusting for inflation, mean reimbursement for all procedures decreased by 32.41% (P = .013). The mean adjusted percentage change per year was -2.82%, and the mean compound annual growth rate was -1.03%. Compensation for the professional and technical components for all CPT codes decreased by 33.02% and 85.78%, respectively. Mean compensation for the professional component decreased by 36.46% for radiography, 37.02% for CT, and 24.73% for MRI. Mean compensation for the technical component decreased by 7.76% for radiography, 127.66% for CT, and 207.88% for MRI. Mean total relative value units decreased by 38.7%. The commonly billed imaging procedure CPT 73720 (MRI lower extremity, other than joint, with and without contrast) had the greatest adjusted decrease of 69.89%. Medicare reimbursement for the most billed lower extremity imaging studies decreased by 32.41% between 2005 and 2020. The greatest decreases were noted in the technical component. Of the modalities, MRI had the largest decrease, followed by CT and then radiography.

National Utilization, Reimbursement, and Urban Versus Rural Trends of Extracorporeal Shockwave Lithotripsy and Ureteroscopic Laser Lithotripsy

ObjectiveTo describe temporal utilization and reimbursement trends of extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) with laser lithotripsy. MethodsThe Medicare Provider Utilization and Payment Database was queried for all ESWL and URS performed between 2013 and 2020 using Current Procedural Terminology codes: ESWL – 50590; URS - 52352, 52353, 52356. Cases that lacked rural or urban identification codes were excluded. A total of 347,174 ESWL and 401,899 URS cases were identified. Linear regression was performed with statistical significance set to 95% confidence intervals. ResultsThere was a significant upward trend for URS utilization over the study period (R2 = 0.91, P <.001), but there was not a significant trend for ESWL utilization. In 2013, ESWL was used more frequently than URS, but by 2016, URS was used more frequently than ESWL. From 2013 to 2019, URS utilization increased by 241% and 168% by urban and rural urologists, respectively. URS was also associated with a slight increase in physician reimbursement over time (R2 = 0.87, P <.001), whereas there was no association between ESWL and physician reimbursement. For URS, rural and urban urologists were reimbursed an average of $312.07 (standard deviation [SD] $14.03) and $404.86 (SD $21.96), respectively. For ESWL, rural and urban urologists were reimbursed an average of $456.22 (SD $5.74) and $562.66 (SD $16.68), respectively. ConclusionAccording to the Medicare database, URS has surpassed ESWL in utilization, especially by urban urologists. Physician reimbursement for ESWL remained higher than URS reimbursement, though URS reimbursement increased slightly in recent years.

HPR5 Reimbursement of Pharmaceuticals in Turkey: Comparison With Approvals of the FDA Between 2010-2021

Turkey has a highly regulated pharmaceutical market with profound challenges for market approval, pricing and reimbursement decisions. The external and internal reference pricing procedures, low value of exchange rate used in pricing, high statutory discounts required from companies during reimbursement applications, the complex system with imported drugs and alternative reimbursement mechanisms have contributed to the decreased willingness of companies to launch new molecules or new indications for already available ones. This study’s main aim is to have a picture of the new molecule and indication reimbursement trends of Turkey in comparison to FDA approvals between 2010-2021.

Trends in utilization, reimbursement, and price for DOACs and warfarin in the US Medicaid population from 2000 to 2020.

The use of direct oral anticoagulants (DOACs) is widely increasing in the United States (US). Warfarin has been the conventional anticoagulant used in the past few decades, but it has been gradually replaced by DOACs. The objective of the study was to analyze trends in utilization, reimbursement, and price for those anticoagulants in the US Medicaid population. Retrospective data analysis was conducted using the National Summary Files for the Medicaid State Drug Utilization Data. Study drugs included dabigatran, rivaroxaban, apixaban, edoxaban and warfarin. The study assessed secular trends of utilization, reimbursement, and per-prescription price. The data was collected from the first quarter of 2000 through to the second quarter of 2020 restricted for outpatient prescriptions only. During the 21-year study period, a substantial rise in total expenditures on warfarin and DOACs was observed from $144 million in 2000 to $694 million in 2020. Moreover, the utilization of DOACs has increased significantly since the first approval of Xarelto in 2010 from 1079 in 2011 to 1.5 million in 2019. The per-prescription price of DOACs increased from an average of $200 in 2011 to $407 in 2020. Conversely, the total number of prescriptions of Warfarin and branded Coumadin decreased from 2.4 million to 1.4 million and from 3.9 million to less than a million, respectively. The present study demonstrated a change in the trends of US expenditure and utilization for warfarin and DOACs with DOACs representing the majority of market share of both spending per prescription and reimbursement.

Trends in Reimbursement and Approach Selection for Lumbar Arthrodesis.

Changes in reimbursement policies have been demonstrated to correlate with clinical practice. To investigate trends in physician reimbursement for anterior, posterior, and combined anterior/posterior (AP) lumbar arthrodesis and relative utilization of AP. We queried the American College of Surgeons National Surgical Quality Improvement Project registry for anterior, posterior, and AP lumbar arthrodeses during 2010 and 2020. Work relative value units per operative hour (wRVUs/h) were calculated for each procedure. Trends in reimbursement and utilization of the AP approach were assessed with linear regression. Subgroup analyses of age and underlying pathology of AP arthrodesis were also performed. During 2010 and 2020, AP arthrodesis was associated with significantly higher average wRVUs/h compared with anterior and posterior arthrodesis (AP = 17.4, anterior = 12.4, posterior = 14.5). The AP approach had a significant yearly increase in wRVUs/h (coefficient = 0.48, P = .042), contrary to anterior (coefficient = -0.01, P = .308) and posterior (coefficient = -0.13, P = .006) approaches. Utilization of AP approaches over all arthrodeses increased from 7.5% in 2010 to 15.3% in 2020 (yearly average increase 0.79%, P < .001). AP fusions increased significantly among both degenerative and deformity cases (coefficients 0.88 and 1.43, respectively). The mean age of patients undergoing AP arthrodesis increased by almost 10 years from 2010 to 2020. Rates of major 30-day complications were 2.7%, 3.1%, and 3.5% for AP, anterior, and posterior arthrodesis, respectively. AP lumbar arthrodesis was associated with higher and increasing reimbursement (wRVUs/h) during the period 2010 to 2020. Reimbursement for anterior arthrodesis was relatively stable, while reimbursement for posterior arthrodesis decreased. The utilization of the combined AP approach relative to the other approaches increased significantly during the period of interest.

Are Trends in Revision Total Joint Arthroplasty Sustainable? Declining Inflation-Adjusted Medicare Reimbursement for Hospitalizations

BackgroundWhile the burden of revision total joint arthroplasty (TJA) procedures increases within the United States, it is unclear whether health care resource allocation for these complex cases has kept pace. This study examined the trends in hospital-level reimbursements for revision TJA hospitalizations. MethodsThe Centers for Medicare and Medicaid Services (CMS) inpatient utilization and payment public use files from 2014 to 2019 were queried for diagnostic-related groups (DRGs) for revision TJA: DRG 467 (revision of hip or knee arthroplasty with complication or comorbidity [CC]) and DRG 468 (revision of hip or knee arthroplasty without CC or major CC). From 2014 to 2019, 170,808 revision TJA hospitalizations were billed to Medicare, and revision TJA procedures increased by 3,121 (10.7%). After adjusting to 2019 US dollars with the consumer price index, a multiple linear mixed-model regression analysis was performed. Analysis of covariance compared regressions from 2014 to 2019 for mean-adjusted Medicare payment and mean- adjusted charge were submitted for these DRGs. ResultsMean-adjusted average Medicare payment for DRG 467 decreased by $804.37 (−3.5%) from 2014 to 2019, whereas, that for DRG 468 decreased by $647.33 (−3.6%). The average inflation-adjusted Medicare payment for DRG 467 decreased at a greater rate during the study period, compared to that for DRG 468 (P = .02). ConclusionThe decline in reimbursement for DRGs 467 and 468 reveals decreasing incentives for revision TJA hospitalizations. Further research should assess the efficacy of current Medicare payment algorithms and identify modifications which may provide for fair hospital level reimbursements.

Trends in Metabolic and Bariatric Surgery Reimbursement in the USA.

Trends in Metabolic and Bariatric Surgery Reimbursement in the USA.

Trends in Reimbursement for Index Surgical Oncology Procedures in Contemporary Practice: Declining Reimbursement for Surgical Oncology Procedures-How Low Do We Go?

BackgroundComprehensive trends in Medicare reimbursement, increasingly relevant to current and future surgical oncology practice, have not been well studied.ObjectiveThe aim of this study was to analyze Medicare reimbursement for index surgical oncology procedures between 2007 and 2021.MethodsUsing the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services, reimbursement data from 2007 to 2021 were obtained for 23 index surgical oncology procedures. Total change in Medicare reimbursement, yearly rates of change, and compound annual growth rate were then calculated. All data were corrected for inflation using the consumer price index. Subset analysis was performed to assess the most recent 5-year trends.ResultsOverall reimbursement for the index surgical oncology procedures increased by an average of 21.6% from 2007 to 2021. After correcting for inflation, average reimbursement decreased to − 8.6%, with the greatest decline seen for thyroid surgery (− 16.9%). Breast surgery was the only category to experience an increase in adjusted reimbursement (9.0%). The average compound annual growth rate for all procedures was − 0.68% from 2007 to 2021. In the most recent 5-year subanalysis, the yearly decrease in inflation-adjusted Medicare reimbursement averaged − 2.47% per year, in comparison with the − 0.60% overall rate of yearly decline (p < 0.005).ConclusionAdjusted Medicare reimbursement for surgical oncology procedures decreased steadily from 2007 to 2021, with an accelerating trend over the last 5 years. As the Medicare population increases, surgical oncologists need to understand these trends so they may consider practice implications, advocate for proper reimbursement models, and preserve access to surgical oncology services.

Changes in Medicare Reimbursement for Common Gastroenterology Services Over 15 Years: 2007-2022.

We evaluated trends in Medicare reimbursement for common gastrointestinal (GI) services from 2007 to 2022. Top GI procedures and office/inpatient visits were identified. The Physician Fee Schedule Look-Up Tool from Centers for Medicare & Medicaid Services was queried to extract reimbursement data. Reimbursement trends were analyzed, accounting for inflation. GI procedures exhibited an average decrease in unadjusted and adjusted reimbursement of 7.0% and 33.0%, respectively. Reimbursement for patient visits exhibited an inflation-adjusted decrease of 4.9%. The analysis revealed a steady decline in adjusted reimbursement for both GI procedures and patient visits in the past 15 years.

Practice patterns of dermatologists who have opted out of Medicare

Practice patterns of dermatologists who have opted out of Medicare

Over 20 years of declining Medicare reimbursement for spine surgeons: a temporal and geographic analysis from 2000 to 2021.

Procedural reimbursement for spine surgery has changed drastically over the past 20 years. A comprehensive understanding of these trends is important as major changes in reimbursement models of spine surgery continue to evolve within various spine specialties as well as broader national healthcare policy. In this study the authors evaluated the monetary trends in Medicare reimbursement rates for the 15 most common spinal surgery procedures from 2000 to 2021. The National Surgery Quality Improvement Project database (2019) was queried to determine the 15 most commonly performed spine surgery procedures. The Current Procedural Terminology (CPT) codes for each of these procedures were obtained from the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services, and comprehensive reimbursement data for each code were extracted. Changes in Medicare reimbursement rates were calculated and averaged for each procedure as both raw percent changes and percent changes adjusted for inflation to 2021 US dollars (USD) based on the consumer price index (CPI). The adjusted R2 value, the compound annual growth rate (CAGR), and both the average annual and the total percent change in reimbursement were calculated based on these adjusted trends for all included procedures. After adjustment for inflation, average reimbursement for all procedures decreased by 33.8% from 2000 to 2021. The greatest mean decrease was seen in anterior cervical arthrodesis (-38.7%), while the smallest mean decrease was in vertebral body excision (-17.1%). From 2000 to 2021, the adjusted reimbursement rate for all included procedures decreased by an average of 1.9% each year, with an average R2 value of 0.69. This is the first study to evaluate monetary trends in Medicare reimbursement for spine surgery procedures. After adjusting for inflation, Medicare reimbursement for the 15 most commonly performed spine procedures has steadily decreased from 2000 to 2021. Increased awareness of these trends and the forces driving them will be critical in the coming years as negotiations regarding reimbursement models continue to unfold. Greater understanding of spine surgery reimbursement among policy makers, hospitals, and surgeons will be important to ensure continued access to quality surgical spine care in the United States.

Getting paid less for more: shoulder arthroplasty incidence and reimbursement within Medicare from 2000 to 2019.

Shoulder arthroplasty has grown in popularity in the past 2 decades, especially following US Food and Drug Administration approval of reverse total shoulder arthroplasty (TSA) in 2003. Studies have shown that Medicare reimbursement for a variety of orthopedic procedures has decreased significantly over the past 2 decades. No study has evaluated this trend in the setting of shoulder arthroplasty, however. The purpose of this study was to assess true reimbursement trends in primary and revision shoulder arthroplasty since2000. Information was collected from the publicly available Medicare Part B National Summary Data Files for the period of 2000 to 2019. Data from Current Procedural Terminology codes 23470 (shoulder hemiarthroplasty), 23472 (TSA), 23473 (single-component revision shoulder arthroplasty), and 23474 (both-component revision shoulder arthroplasty) were analyzed. Reimbursement amounts were adjusted for inflation to May 2021 dollars. From 2000 to 2019, the number of shoulder hemiarthroplasty procedures billed to Medicare decreased 70% (from 5847 to 1750) whereas the number of TSA procedures increased 1527% (from 4044 to 65,477). During the same period, per-procedure Medicare reimbursement for hemiarthroplasty decreased 35% (from $1545.71 to $1003.43) after adjustment for inflation to 2021 dollars. Similarly, TSA reimbursement decreased 22% (from $1600.98 to $1248.76) after adjustment for inflation. For revision procedures, the number of single- and both-component revisions billed to Medicare increased 381% (from 344 to 1655) and 1331% (from 220 to 3147), respectively. Adjusted reimbursement per procedure decreased 36% (from $1931.62 to $1244.49) and 37% (from $2293.08 to $1449.43), respectively. This study shows an increase in the annual volume of primary and revision shoulder arthroplasty procedures from 2000 to 2019. During the same period (2000-2019), true Medicare reimbursement to physicians for TSA decreased when adjusted for inflation. This study provides data that may be useful for surgeons, hospitals, and policy makers to maintain access to quality shoulder arthroplasty care moving forward.

Procedural, workforce, and reimbursement trends in neuroendovascular procedures

BackgroundThis study aims to define the proportion of Medicare neuroendovascular procedures performed by different specialists from 2013 to 2019, map the geographic distribution of these specialists, and trend reimbursement for...

United States Medicare Reimbursement Trends for Glaucoma Procedures: 2000-2020.

The purpose of this study is to investigate US Medicare reimbursement trends for common glaucoma procedures from 2000 to 2020. Current Procedural Terminology codes for Glaucoma procedures in the US centers for Medicare and Medicaid Services database were used to conduct this economic analysis. Reimbursement data from the Physician Fee Schedule look-up tool from the Centers for Medicare and Medicaid Services were compiled for the selected procedures and compensation trends were investigated after adjusting for inflation in 2020 US dollars from the unadjusted data between 2000 and 2020. The average adjusted reimbursement for the analyzed procedures decreased by 20.5% [95% confidence interval (CI), -15.4% to -25.6%] over the 20-year period. On average, there was a 1.03% decrease in reimbursement rates per year (95% CI, -0.74% to -1.33%), with an adjusted compound annual growth rate of -1.35% (95% CI, -1.07% to -1.64%). The results show an overall declining rate in reimbursement for the glaucoma procedures analyzed in this study. The US Medicare reimbursement for glaucoma procedures in the United States showed a significant decline between 2000 and 2020. These findings may be relevant to understanding changing practice patterns for glaucoma care.

An analysis of medicaid reimbursement trends in pediatric ophthalmology in Arizona: 2015 to 2021

A paucity of data exists regarding reimbursement trends in pediatric ophthalmology, especially regarding the consequences of national policy enacted to minimize the COVID-19 pandemic's effect on access to healthcare. The purpose of this study was to evaluate monetary trends for common pediatric ophthalmology procedures among the Arizona Medicaid population, compared to Medicare data.

Trends in Medicare Reimbursement for the Top 20 Surgical Procedures in Craniofacial Trauma.

Research regarding financial trends in craniofacial trauma surgery is limited. Understanding these trends is important to the evolvement of suitable reimbursement models in craniofacial plastic surgery. The purpose of this study was to evaluate the trends in Medicare reimbursement rates for the top 20 most utilized surgical procedures for facial trauma. The 20 most commonly utilized Current Procedural Terminology (CPT) codes for facial trauma repairs in 2018 were queried from The National Summary Data File from the Centers for Medicare & Medicaid Services (CMS). Reimbursement data for each procedure was then extracted from The Physician Fee Schedule Lookup Tool. Changes to the United States consumer price index (CPI) were used to adjust all gathered data for inflation to 2021 US dollars (USD). The average annual and the total percent change in reimbursement were calculated for the included procedures based on the adjusted trends from the years 2000 to 2021. From 2000 to 2021, the average reimbursement for all procedures decreased by 16.6% after adjusting for inflation. Closed treatment of temporomandibular joint dislocation and closed treatment of nasal bone fractures without manipulation demonstrated the greatest decrease in mean adjusted reimbursement at -48.7% and -48.3%, respectively, while closed treatment of nasal bone fractures without stabilization demonstrated the smallest mean decrease at -1.4% during the study period. Open treatment of nasal septal fractures with or without stabilization demonstrated the greatest increase in mean adjusted reimbursement at 18.9%, while closed treatment of nasal septal fractures with or without stabilization demonstrated the smallest increase at 1.2%. The average reimbursement for all closed procedures in the top 20 decreased by 19.3%, while that for all open procedures decreased by 15.5%. The adjusted reimbursement rate for all top 20 procedures decreased by an average of 0.8% each year. To the best of our knowledge, this is the first study to comprehensively evaluate trends in Medicare reimbursement for facial trauma surgical repairs. Adjusting for inflation, Medicare reimbursement for the top 20 most commonly utilized procedures has largely decreased from 2000 to 2021. Consideration of these trends by surgeons, hospital systems, and policymakers will be important to assure continued access to meaningful surgical facial trauma care in the United States.