CMS's lowest vs. highest-paid physicians: 5 key points

Written by Laura Dyrda | March 18, 2016 | Print  |

The highest-paid surgeons by CMS bill five times higher than the lowest paid surgeons, according to a study published in Surgery.

The study authors investigated provider and regional payment variation to surgeons from CMS with data released for 2012. The data included Medicare B participants in the fee-for-service program. The researchers found:

 

1. The services-per-beneficiary ratios were:

 

• 20th percentile: 1.6
• 40th percentile: 2.2
• 60th percentile: 3.1
• 80th percentile: 5.0

 

2. The surgeons who earned more offered more services per beneficiary. There is a precipitous increase from the lowest docile to the highest docile.

 

3. The charges between the physicians were consistently greater than payments by a factor of three.

 

4. The female providers had lower ratios on a multivariate analysis of services per beneficiary ratio.

 

5. There was a regional variation in the ratio of services per beneficiary.

 

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