Abstract
Background
Medicare, via its fee schedule, determines amount of payment to physicians for services for its beneficiaries. Because many private insurance companies base their payment schedule on Medicare rates, it is important for physicians to know the rates of commonly performed procedures. In addition, it seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient, student, resident, and surgeon knowledge and opinion of Medicare reimbursements for laparoscopic cholecystectomy.
Methods
Patients, students, residents, and surgeons filled out an IRB-exempted survey. The survey included a written description of a laparoscopic cholecystectomy. All participants were asked to give their thoughts of what Medicare currently reimburses for a laparoscopic cholecystectomy ($622) and what they thought Medicare should reimburse for a laparoscopic cholecystectomy for our geographic area.
Results
There were 105 participants (47 patients, 17 medical students, 33 surgical residents, and 8 attending surgeons) in the investigation. The reported mean reimbursements of what each group thought Medicare pays were patients, $9,396; students, $3,077; residents, $800; and surgeons, $711. The reported mean reimbursements of what each group thought Medicare should pay were patients, $8,067; students, $3,971; residents, $1,444; and surgeons, $1,600. The mean reimbursements were statistically different between all groups in both the amount Medicare currently pays and the amount Medicare should pay.
Conclusion
Most of our participants overestimated what Medicare currently pays for laparoscopic cholecystectomy. Even the mean amount reported in the attending surgeon group was greater than the actual payment. All groups felt Medicare should pay more than the current rate; however, only patients thought Medicare should pay less than they currently pay (probably because of the incorrect perception of the current fee schedule).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dorman T (2006) Unsustainable growth rate: physician perspective. Crit Care Med 34(3 Suppl): S78–S81
Geiger WJ, Krol RA (1991) Physician attitudes and behavior in response to changes in Medicare reimbursement policies. J Fam Pract 33(3): 244–248
Little DC, St Peter SD, Calkins CM, Shah SR, Murphy JP, Gatti JM, Gittes GK, Sharp RJ, Andrews WS, Holcomb GW III, Ostlie DJ, Snyder CL (2006) Relative value units correlate with pediatric surgeons’ operating time: when perceived myth becomes reality. J Pediatr Surg 41(1): 234–238
Morehouse DL, Elmore JR, Franklin DP, Youkey JR (1997) Physician work effort and reimbursement for ruptured abdominal aortic aneurysms. Am J Surg 174(2): 136-139
Adiga K, Buss M, Beasley BW (2006) Perceived, actual, and desired knowlege regarding Medicare billing and reimbursement. A national needs assessment survey of internal medicine residents. J Gen Intern Med 21(5): 466-470
Lemen PM (2005) Development and assessment of a Web-based evaluation and management coding curriculum for residents. Am J Obstet Gynecol 193(5): 1785-1789
Fisher MB, Bianco FJ Jr, Triest JA (2006) Patient opinion of urologists’ reimbursement. Urology 67(2): 250-253
Acknowledgments
The authors acknowledge the technical assistance of Mrs. Courtney Bishop in the preparation of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Madan, A.K., Tichansky, D.S., Barton, G.E. et al. Knowledge and opinions regarding Medicare reimbursement for laparoscopic cholecystectomy. Surg Endosc 21, 2091–2093 (2007). https://doi.org/10.1007/s00464-007-9313-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-007-9313-x