Publication date: Jan 28, 2025

Declining reimbursement rates can lead to decreased access and utilization of common orthopaedic surgeries for patients on Medicare, which is a particularly vulnerable population for musculoskeletal injuries. Using the Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool from 2016 to 2024 and utilization data for Medicare and part B beneficiaries from 2016 to 2022, we analyzed reimbursement and utilization trends. Simple linear regressions were executed to measure the annual trends, and Wilcoxon matched-pairs signed rank test were used to analyze the statistical significance of price and utilization changes. Between 2016 and 2024, mean reimbursements for all evaluated orthopaedic surgeries decreased 26. 2% with a -3. 34% compound annual growth rate, from $1,558 to $1,150 (P < 0. 0001). Comparatively, reimbursement rates for evaluation and management (E/M) services fell by 15. 82% or a -1. 91% compound annual growth rate, from $102. 3 to $86. 12 (P < 0. 0021). The federal utilization of all orthopaedic surgeries fell from 2016 to 2022 (P < 0. 0001), although no significant changes were seen for E/M services (P = 0. 9102). We observe that Medicare reimbursement rates for orthopaedic surgeries from 2016 to 2024 have fallen consistently with a large drop in utilization, especially during the Covid-19 pandemic. Reimbursements for E/M services have fallen at attenuated rates with minimal changes in utilization. This demonstrates the supportive role that declining reimbursement rates may play in utilization and accessibility of orthopaedic surgery.

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