Cervical disc replacement reimbursement sees 'steady decline'


After adjusting for inflation, reimbursements for cervical disc replacement have fallen 12.9 percent between 2009 and 2021, according to an analysis in the International Journal of Spine Surgery.

Researchers evaluated 33,079 weighted patients who had cervical disc arthroplasty from 2007 to 2017. They also looked at reimbursement for the procedure from 2009 to 2021. 

Cervical disc replacements jumped 183 percent from 2007 to 2017, and Medicare beneficiary utilization increasing 149 percent. Inflation-adjusted hospital charges for cervical disc replacement grew 22.4 percent, and inflation-adjusted Medicare reimbursement fell 1.2 percent per year.

In 2009 reimbursement for the procedure was $1,928, and in 2021 it was $1,679.

The study concluded, "While utilization and total hospital charges for CDA continue to rise, Medicare physician reimbursement has not shown the same trend. In fact, inflation-adjusted reimbursement has seen a steady decline since FDA approval in 2007. If this trend persists, it may become unsustainable for physicians to continue offering CDA to Medicare patients. As disproportionate increases in hospital charges incentivize a transition to outpatient CDA, stricter patient selection criteria associated with outpatient procedures may create health care disparities for Medicare patients and those with higher comorbidity burden."

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