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Medicare Reimbursement Rates and Utilization Trends in Sacroiliac Joint Fusion

Vincent P. FedericoCervical Spine Research SocietyAthan G. ZavrasAccepted April 11, 2023; All coauthors have seen and agree with the contents of the manuscript.; An or an immediate family member has received royalties from U&i Corporation and Zimmer Biomet Inc; From the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL; Received August 28, 2022; Received in revised form March 18, 2023; editorial or governing board of ISASS.; has received research or institutional support from the Cervical Spine Research Society and DePuy; has stock or stock options held in Articular Engineering LLC. Colman or an immediate family member has received royalties from Alphatec Spine; has stock or stock options held in Augmedics, the Cervical Spine Research Society, Medtronic, Orthofix Inc, SI Bone, the Society of Minimally Invasive Spine Surgery, Stryker, Theracell, and Vital 5; is a member of a speakers’ bureau or has made paid presentations on behalf of K2M and 2M/Stryker Spine; serves as a board member, owner, officer, or committee member of CSRS; serves as a board member, owner, officer, or committee member of Edge Surgical, Mainstay, Nuvasive, and Spinal Simplicity; serves as a board member, owner, officer, or committee member of the Musculoskeletal Tumor Society, the North American Spine Society, Orthofix. Phillips or an immediate family member serves as a paid consultant to the Spine Journal, the North American Spine Society, SI Bone, and Surgio; serves as a paid consultant to AO Spine North America, Orthofix Inc, Spinal Elements, and Xenix Medical; serves as a paid consultant to Bioventus Inc. and Dio Medical CorpAlexander J. ButlerAccepted April 11, 2023; All coauthors have seen and agree with the contents of the manuscript.; An or an immediate family member has received royalties from U&i Corporation and Zimmer Biomet Inc; From the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL; Received August 28, 2022; Received in revised form March 18, 2023; editorial or governing board of ISASS.; has received research or institutional support from the Cervical Spine Research Society and DePuy; has stock or stock options held in Articular Engineering LLC. Colman or an immediate family member has received royalties from Alphatec Spine; has stock or stock options held in Augmedics, the Cervical Spine Research Society, Medtronic, Orthofix Inc, SI Bone, the Society of Minimally Invasive Spine Surgery, Stryker, Theracell, and Vital 5; is a member of a speakers’ bureau or has made paid presentations on behalf of K2M and 2M/Stryker Spine; serves as a board member, owner, officer, or committee member of CSRS; serves as a board member, owner, officer, or committee member of Edge Surgical, Mainstay, Nuvasive, and Spinal Simplicity; serves as a board member, owner, officer, or committee member of the Musculoskeletal Tumor Society, the North American Spine Society, Orthofix. Phillips or an immediate family member serves as a paid consultant to the Spine Journal, the North American Spine Society, SI Bone, and Surgio; serves as a paid consultant to AO Spine North America, Orthofix Inc, Spinal Elements, and Xenix Medical; serves as a paid consultant to Bioventus Inc. and Dio Medical CorpMichael T. NolteAccepted April 11, 2023; All coauthors have seen and agree with the contents of the manuscript.; An or an immediate family member has received royalties from U&i Corporation and Zimmer Biomet Inc; From the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL; Received August 28, 2022; Received in revised form March 18, 2023; editorial or governing board of ISASS.; has received research or institutional support from the Cervical Spine Research Society and DePuy; has stock or stock options held in Articular Engineering LLC. Colman or an immediate family member has received royalties from Alphatec Spine; has stock or stock options held in Augmedics, the Cervical Spine Research Society, Medtronic, Orthofix Inc, SI Bone, the Society of Minimally Invasive Spine Surgery, Stryker, Theracell, and Vital 5; is a member of a speakers’ bureau or has made paid presentations on behalf of K2M and 2M/Stryker Spine; serves as a board member, owner, officer, or committee member of CSRS; serves as a board member, owner, officer, or committee member of Edge Surgical, Mainstay, Nuvasive, and Spinal Simplicity; serves as a board member, owner, officer, or committee member of the Musculoskeletal Tumor Society, the North American Spine Society, Orthofix. Phillips or an immediate family member serves as a paid consultant to the Spine Journal, the North American Spine Society, SI Bone, and Surgio; serves as a paid consultant to AO Spine North America, Orthofix Inc, Spinal Elements, and Xenix Medical; serves as a paid consultant to Bioventus Inc. and Dio Medical CorpMohammed A. Munimto Dr. Phillips: [email protected]Gregory D. Lopezthe Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, ILC. Dewaldto Dr. Phillips: [email protected]Howard S. AnAll coauthors have seen and agree with the contents of the manuscriptMatthew W. ColmanAll coauthors have seen and agree with the contents of the manuscriptFrank M. PhillipsAll coauthors have seen and agree with the contents of the manuscript

Journal of the American Academy of Orthopaedic Surgeonsjournal2023en

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Annotatsiya

INTRODUCTION: Sacroiliac joint (SIJ) fusion is a surgical treatment option for SIJ pathology in select patients who have failed conservative management. More recently, minimally invasive surgical (MIS) techniques have been developed. This study aimed to determine the trends in procedure volume and reimbursement rates for SIJ fusion. METHODS: Publicly available Medicare databases were assessed using the National Summary Data Files for 2010 to 2020. Files were organized according to current procedural terminology (CPT) codes. CPT codes specific to open and MIS SI joint fusion (27279 and 27280) were identified and tracked. To track surgeon reimbursements, the CMS Medicare Physician Fee Schedule Look-Up Tool was used to extract facility prices. Descriptive statistics and linear regression were used to evaluate trends in procedure volume, utilization, and reimbursement rates. Compound annual growth rates were calculated, and discrepancies in inflation were corrected for using the Consumer Price Index. RESULTS: A total of 33,963 SIJ fusions were conducted in the Medicare population between 2010 and 2020, with an overall increase in procedure volume of 2,350.9% from 318 cases in 2010 to 7,794 in 2020. Since the introduction of the 27279 CPT code in 2015, 8,806 cases (31.5%) have been open and 19,120 (68.5%) have been MIS. Surgeon reimbursement for open fusions increased nominally by 42.8% (inflation-adjusted increase of 20%) from $998 in 2010 to $1,425 in 2020. Meanwhile, reimbursement for MIS fusion experienced a nominal increase of 58.4% (inflation-adjusted increase of 44.9%) from $582 in 2015 to $922 in 2020. CONCLUSION: SIJ fusion volume in the Medicare population has increased substantially in the past 10 years, with MIS SIJ fusion accounting for most of the procedures since the introduction of the 27279 CPT code in 2015. Reimbursement rates for surgeons have also increased for both open and MIS procedures, even after adjusting for inflation.

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Mavzular

Spine and Intervertebral Disc Pathology Scoliosis diagnosis and treatment Cervical and Thoracic Myelopathy

Identifikatorlar

DOI: 10.5435/jaaos-d-22-00800

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