Otol Neurotol. 2025 Jun 2. doi: 10.1097/MAO.0000000000004524. Online ahead of print.
ABSTRACT
OBJECTIVE: To understand trends in Medicare reimbursement for neurotology procedures from 2000 through 2024.
METHODS: The Physician Fee Schedule (PFS) Look-Up Tool from the Center for Medicare and Medicaid Services was used to assess reimbursement data for relevant otologic/neurotologic Current Procedural Terminology (CPT) codes from 2000 to 2024. All monetary data were adjusted to 2024 U.S. dollars using the U.S. Bureau of Labor Statistics Consumer Price Index. Percent changes in reimbursement were calculated.
RESULTS: The average nominal value of reimbursement for all procedures increased by 11.20% from 2000 to 2024. However, after adjusting for inflation, the average change in Medicare reimbursement was -33.52%. The greatest decrease was in CPT code 69714, which saw a 2024 U.S. dollar -66.43% change. The greatest increase was in CPT code 61798, which saw a 43.43% change. An increase in reimbursement for all CPT codes occurred only in 2024. This increase was associated with the calendar year 2024 PFS final rule, which came into effect on March 9 and increased the PFS conversion factor from $32.7442 to $33.2875. From 2000 to 2024, the PFS conversion factor decreased from $36.6137 to $33.2875.
CONCLUSION: From 2000 to 2023, Medicare reimbursements for otologic and neurotologic procedures decreased after adjusting for inflation. The only year with an increase in reimbursement was 2024, which saw an increase to the PFS conversion factor. These trends highlight the need for greater awareness of, and agreement on, neurotology reimbursement models among surgeons, policy makers, and facility administrators.
PMID:40466113 | DOI:10.1097/MAO.0000000000004524
