AI Article Synopsis
- The study investigates trends in soft palate surgery for obstructive sleep apnea (OSA) from 2000 to 2021 using Medicare data, focusing on trends in procedure usage and reimbursement.
- Overall surgeries decreased by 65.7%, with traditional uvulopalatopharyngoplasty (UPPP) dropping 87.6%, while pharyngoplasty (PP) rose by 245.4%.
- Total Medicare payments for these procedures fell significantly by 57.2%, with a notable decrease in UPPP reimbursements, highlighting a shift in preferences toward less invasive options like PP.
Article Abstract
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 ( < .001). UVU also fell in popularity, from 568 to 376 (33.8%; < .001). In contrast, the performance of PP rose 245.4% over time, from 185 to 639 ( < .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%; < .001). Total Medicare payments for all 3 procedures fell 57.2% from $1 658 844 to $633 091 ( < .001). Adjusted total UPPP payments fell 88.7% ( < .001). Adjusted total PP payment rose 137.5% to $262 538 in 2021 ( < .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.
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| http://dx.doi.org/10.1177/00034894241288435 | DOI Listing |
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