Medicare reimbursement down a third for hip, knee joint procedures, study of CPT codes finds

Average physician reimbursement for all hip and knee joint procedures fell more than 30 percent in the past 20 years, according to a study published in The Journal of Arthroplasty.

For the study, researchers evaluated trends in Medicare reimbursement rates from 2000-19 for hip and knee arthroplasty procedures. The authors queried the American Academy of Orthopedic Surgeons coding reference to uncover which CPT codes were most frequently used to document adult hip and knee reconstruction. They paired the codes with physician payment data from CMS.

On average, physician reimbursement fell by 31.9 percent for all hip joint procedures in the study period and 33.3 percent for all knee joint procedures. The researchers also found primary total hip arthroplasty physician fees fell by 37.1 percent in the study period, with primary total knee arthroplasty fees falling 40.6 percent.

"Throughout the study period, physician reimbursement decreased for all knee and hip arthroplasty procedures. Increased awareness and consideration of these trends will be important for policy-makers, hospitals, and surgeons to assure equitable access to quality hip and knee arthroplasty care in the United States," the authors concluded.

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