METHODS: Annual retrospective data on lingual and hyoid OSA surgeries was obtained from the 2000-2021 Medicare Part B National Summary Datafiles. Current Procedural Terminology (CPT) codes utilized included 21,685 (hyoid myotomy and suspension [HMS]), 41,512 (tongue base suspension [TBS]), 41,530 (radiofrequency ablation of the tongue [RFT]) and 42,870 (lingual tonsillectomy [LT]).
RESULTS: The number of lingual and hyoid OSA surgeries rose 2777 % from 121 in 2000 to 3481 in 2015, before falling 82.9 % to 594 in 2021. Accordingly, Medicare payments rose 17,899 % from an inflation-adjusted $46,958 in 2000 to $8.45 million in 2015, before falling drastically to $341,011 in 2021. As the number of HMSs (2000: 91; 2015: 84; 2021: 165), TBS (2009: 48; 2015: 31; 2021: 16), and LTs (2000: 121; 2015: 261; 2021: 234) only experienced modest changes in utilization, this change was largely driven by RFT (2009: 340; 2015: 3105; 2021: 179). Average Medicare payments for RFT rose from $1110 in 2009 to $2994 in 2015, before falling drastically to $737 in 2021.
CONCLUSIONS: Lingual and hyoid surgery for OSA has overall fallen in utilization among the Medicare population from 2000 to 2021. However, there was a brief spike in usage, peaking in 2015, driven by the adoption (and then quick dismissal) of RFT. The rise and fall in RFT use coincide with the rise and fall in reimbursement.
方法:舌骨OSA手术的年度回顾性数据来自2000-2021年MedicareB部分国家摘要数据文件。当前使用的程序术语(CPT)代码包括21,685(舌骨肌切开术和悬吊术[HMS]),41,512(舌根悬吊[TBS]),41,530(舌部射频消融[RFT])和42,870(舌部扁桃体切除术[LT])。
结果:舌骨OSA手术的数量从2000年的121例增加到2015年的3481例,增长了2777%,然后在2021年下降了82.9%至594例。因此,医疗保险支付从2000年的通货膨胀调整后的46,958美元增加到2015年的845万美元,增长了17,899%,然后在2021年大幅下降至341,011美元。作为HMS的数量(2000:91;2015:84;2021:165),TBS(2009:48;2015:31;2021:16),和LTs(2000:121;2015:261;2021:234)的利用率只有适度的变化,这一变化主要是由RFT(2009:340;2015:3105;2021:179)推动的。RFT的平均医疗保险费用从2009年的1110美元上升到2015年的2994美元,然后在2021年大幅下降到737美元。
结论:从2000年到2021年,OSA的舌骨和舌骨手术在医疗保险人群中的使用率总体下降。然而,使用量出现了短暂的飙升,在采用(然后快速解雇)RFT的推动下,2015年达到顶峰。RFT使用的上升和下降与报销的上升和下降是一致的。