Global Spine J. 2026 Jan 10:21925682251412809. doi: 10.1177/21925682251412809. Online ahead of print.
ABSTRACT
Study DesignRetrospective Database Study.ObjectivesAnterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are common procedures performed for cervical spondylosis. Sparse data exists comparing the utilization and reimbursement rates associated with these procedures. This study seeks to compare Medicare utilization of single- and multilevel ACDF to CDA between 2011 and 2021. Additionally, this study evaluates Medicare reimbursement rate changes for ACDF with structural allograft, ACDF with cage, and CDA between the years 2016 and 2021.MethodsThis study used the publicly available Medicare National Summary Data Files to aggregate annual utilization and reimbursement rates for ACDF procedures as well as CDA procedures based on Current Procedural Terminology codes. Reimbursement rates were adjusted for inflation through use of the U.S. Bureau of Labor Statistics’ 2021 Consumer Price Index. Changes in reimbursement rates and utilization were calculated and compared between procedures.ResultsIn 2011, 27 974 single-level ACDF procedures were performed on Medicare Part B patients compared to 34 683 performed in 2021. This represents a growth in procedure utilization of 24% over the study period. Over the course of the same study period CDA procedures grew by 1087.3%, from 118 in 2011 to 1401 in 2021. Throughout the reimbursement study period, Medicare reimbursements per case for single-level CDAs had an average annual percent change of 9.96%, rising from $1636 in 2016 to $2779 in 2021. Reimbursement per case for single-level ACDF with allograft had an average annual change of -1.25%, falling from $3408 in 2016 to $3206 in 2021. Medicare reimbursement per case for single-level ACDF with cage had an average annual change of 1.19%, from $3379 in 2017 to $3547 in 2021.ConclusionAll procedures saw an increase in utilization throughout the study period, with CDAs showing significant growth within the Medicare population. While the reimbursement for ACDFs remained relatively constant, the reimbursement for CDAs demonstrated a moderate increase.
PMID:41520188 | DOI:10.1177/21925682251412809
