A Contemporary Analysis of Changing Payments for Surgical and Transcatheter Valve Procedures

Abstract

We aimed to quantify contemporary changes in physician Medicare reimbursement for surgical and transcatheter valvular procedures. Publicly available 2015–2023 data from the Centers for Medicare & Medicaid Services were used to identify annual physician reimbursement fees for four procedures: surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), mitral valve repair (MVr), and MitraClip. Physician reimbursement fees were adjusted for inflation into 2023 U.S. dollars. Changes over time were analyzed using linear regression to account for differences in average annual U.S. dollar decline, average annual percent change, and total percent change over the study period. Reimbursement for surgical and transcatheter valve procedures declined by a combined total of 28.5%: 25.8% SAVR, 34.2% TAVR, 25.8% MVr, and 28.3% MitraClip. They corresponded to average annual percent changes of −3.7% (SAVR), −5.1% (TAVR), −3.7% (MVr), and −4.1% (MitraClip)—representing a collective decline in reimbursement fee per patient of \$784.96 (SAVR), \$624.73 (TAVR), \$823.54 (MVr), and \$706.12 (MitraClip) over the nine-year study span. Over the last decade, physician reimbursement for surgical and transcatheter valve procedures has significantly decreased, potentially threatening access to quality cardiac care within the heart team approach.

Keywords

Surgical / Transcatheter / Valve / Reimbursement

Author Contributions

Conceptualization, J.A.T., S.A.H. and C.K.Z.; Methodology, J.A.T. and C.K.Z.; Formal Analysis, J.A.T. and C.K.Z.; Writing—Original Draft Preparation, J.A.T.; Writing—Review & Editing, J.A.T., S.A.H., C.K.Z., D.A.-R., T.K. and K.d.l.C.; Supervision, S.A.H., T.K. and K.d.l.C.

Ethics Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Data is publically available through the Centers for Medicare & Medicaid Physician Fee Schedule Look-Up Tool.

Funding

This research received no specific grant from public, commercial, or not-for-profit funding agencies. The work described in this manuscript was presented at the 60th Annual Meeting of the Society of Thoracic Surgeons on 28 January 2024.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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