A Regional Analysis of Medicare Reimbursement Rates for Plastic Surgery From 2012 to 2025.

[PURPOSE] The purpose of this analysis is to highlight trends in Medicare reimbursement rates in recent years and examine any regional differences in reimbursements that may exist over the past decade.

[METHODS] The CMS Physician and Other Practitioners database was used to extract the top 20 plastic surgery HCPCS codes in 2022 by volume. The Medicare Physician Fee Schedule Database was then used to analyze trends in reimbursements for these procedure codes from 2012 to 2025. Dollar amounts were inflation adjusted to 2025 estimates based on consumer price index (CPI) values.

[RESULTS] From 2012 to 2025, the mean overall reimbursement rate for plastic surgery procedures fell 34.2% from $373.21 to $245.65, with a 14.9% decrease in MP RVU * GPCI. A majority of codes analyzed were integumentary procedures. Nevada (40.4%, $408.26-$243.40) and Wyoming (39.0%, $396.83-$241.89) had the most dramatic decreases in reimbursement rate, whereas Massachusetts (30.5%, $378.12-$262.86) and New York (30.7%, $392.55-$272.15) had the smallest decreases in reimbursement rate. The West had the largest decrease in reimbursement rate (36.6%, $411.44-$260.66).

[CONCLUSION] Medicare reimbursement rates for plastic surgery are decreasing nationally, most drastically in the West region. These trends may have important indications for shaping practice and fair compensation for services.