Trends in Soft Palate Surgery and Reimbursements for Obstructive Sleep Apnea Among the Medicare Population.
| Autor: | Torabi SJ; Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA., Frank MI; School of Medicine, University of California, Irvine, Orange, CA, USA., Patel RA; Frank H. Netter M.D. School of Medicine at Quinnipiac University, North Haven, CT, USA., Manes RP; Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA., Kuan EC; Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA., Trask DK; Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2025 Jan; Vol. 134 (1), pp. 49-57. Date of Electronic Publication: 2024 Oct 24. |
| DOI: | 10.1177/00034894241288435 |
| Abstrakt: | Objectives: This study aims to analyze trends in utilization and reimbursement of soft palate surgery for OSA using the Medicare national database. Methods: A retrospective analysis of the 2000 to 2021 Part B National Summery datafiles using current Procedural Terminology (CPT) codes 42145 (uvulopalatopharyngoplasty [UPPP]), 42950 (pharyngoplasty [PP]), and 42140 (uvulectomy [UVU]) was performed. Results: Between 2000 and 2021, the number of OSA surgeries fell 65.7% from 4208 to 1443. UPPP fell 87.6% from 3455 in 2000 to 428 in 2021 ( P < .001). UVU also fell in popularity, from 568 to 376 (33.8%; P < .001). In contrast, the performance of PP rose 245.4% over time, from 185 to 639 ( P < .001). When comparing 2000 to 2009, both PP and UVU rose in relative use (from 4.4% to 12.3% and from 13.5% to 20.4% of all soft palate OSA surgeries, respectively), while UPPP fell (82.1% to 67.3%; P < .001). Total Medicare payments for all 3 procedures fell 57.2% from $1 658 844 to $633 091 ( P < .001). Adjusted total UPPP payments fell 88.7% ( P < .001). Adjusted total PP payment rose 137.5% to $262 538 in 2021 ( P < .001). Conclusion: Soft palate surgery for OSA has declined amongst the Medicare population over 21 years (2000-2021). The more individualized and tissue sparing PP has risen in popularity but did not overcome the large decline of the traditional UPPP. Accordingly, there was a 75.7% fall in inflation-adjusted reimbursements. Overall, our data indicates a decline in soft palate surgery in the management of geriatric OSA, with modest relative increase in pharyngoplasty procedures. Competing Interests: Author’s NoteMadelyn I. Frank is now affiliated to Department of Otolaryngology—Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA. Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: EK is a consultant for Stryker. The other authors declare no relevant |
| Databáze: | MEDLINE |
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