Medicare uses a formula for arthroscopic procedure discounting that is becoming more widespread among other payors. According to the report, the highest valued arthroscopic procedure is reimbursed at 100 percent, but additional procedures could be reduced by more than 50 percent.
For example, an orthopedic surgeon performing arthroscopic hip acetabuloplasty and arthroscopic treatment for a cam lesion in the same procedure and operative session must use the multiple procedure reduction rule. The acetabuloplasty is reimbursed at 100 percent and the cam lesion reimbursement would be reduced by 64 percent.
The percent of reduction varies between different procedures based on the joint and value of the additional arthroscopic procedure, according to the report.
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