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Inflation-adjusted medicare physician reimbursement for adult spinal deformity surgery substantially declined from 2002 to 2020

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Abstract

Purpose

Physician fees for orthopaedic surgeons by the Centers for Medicare and Medicaid Services (CMS) are increasingly scrutinized. The present retrospective review aims to assess whether adult spinal deformity (ASD) surgeries are properly valued for Medicare reimbursement.

Methods

Current Procedural Terminology (CPT) codes related to posterior fusion of spinal deformity of ≤ 6, 7–12, and ≥ 13 vertebral levels, as well as additional arthrodesis and osteotomy levels, were assessed for (1) Compound annual growth rate (CAGR) from 2002 to 2020, calculated using physician fee data from the CMS Physician Fee Schedule Look-Up Tool; and (2) work relative value units (RVUs) per operative minute, using data from the National Surgical Quality Improvement Program.

Results

From 2002 to 2020, all CPT codes for ASD surgery had negative inflation-adjusted CAGRs (range, − 18.49% to − 27.66%). Mean physician fees for spinal fusion declined by 26.02% (CAGR, − 1.66%) in ≤ 6-level fusion, 27.91% (CAGR, − 1.80%) in 7- to 12-level fusion, and 28.25% (CAGR, − 1.83%) ≥ 13-level fusion. Fees for both 7–12 (P < 0.00001) and ≥ 13 levels (P < 0.00001) declined more than those for fusion of ≤ 6 vertebral levels. RVU per minute was lower for 7- to 12-level and ≥ 13-level (P < 0.00001 for both) ASD surgeries than for ≤ 6-level.

Conclusions

Reimbursement for ASD surgery declined overall. CAGR for fusions of ≥ 7 levels were lower than those for fusions of ≤ 6 levels. For 2012–2018, ≥ 7-level fusions had lower RVU per minute than ≤ 6-level fusions. Revaluation of Medicare reimbursement for longer-level ASD surgeries may be warranted.

Level of evidence

III.

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Data availability

Data used for this study is publicly available.

References

  1. Schwab F, Dubey A, Gamez L, Elfegoun AB, Hwang K, Pagala M, Farcy J-P (2005) Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976) 30:1082–1085. https://doi.org/10.1097/01.brs.0000160842.43482.cd

    Article  PubMed  Google Scholar 

  2. Safaee MM, Ames CP, Smith JS (2020) Epidemiology and socioeconomic trends in adult spinal deformity care. Neurosurgery 87:25–32. https://doi.org/10.1093/neuros/nyz454

    Article  PubMed  Google Scholar 

  3. Cheng JS, Forbes J, Wong C, Perry E (2014) The epidemiology of adult spinal deformity and the aging population. In: Wang MY, Lu Y, Anderson DG, Mummaneni PV (eds) Minimally invasive spinal deformity surgery: an evolution of modern techniques. Springer, Vienna, pp 3–10

    Chapter  Google Scholar 

  4. Drazin D, Shirzadi A, Rosner J, Eboli P, Safee M, Baron EM, Liu JC, Acosta FL (2011) Complications and outcomes after spinal deformity surgery in the elderly: review of the existing literature and future directions. Neurosurg Focus 31:E3. https://doi.org/10.3171/2011.7.FOCUS11145

    Article  PubMed  Google Scholar 

  5. Daubs MD, Lenke LG, Cheh G, Stobbs G, Bridwell KH (2007) Adult spinal deformity surgery: complications and outcomes in patients over age 60. Spine 32:2238–2244. https://doi.org/10.1097/BRS.0b013e31814cf24a

    Article  PubMed  Google Scholar 

  6. Neuman BJ, Harris AB, Klineberg EO, Hostin RA, Protopsaltis TS, Passias PG, Gum JL, Hart RA, Kelly MP, Daniels AH, Ames CP, Shaffrey CI, Kebaish KM (2021) Defining a surgical invasiveness threshold for increased risk of a major complication following adult spinal deformity surgery. Spine (Phila Pa 1976) 46:931–938. https://doi.org/10.1097/BRS.0000000000003949

    Article  PubMed  Google Scholar 

  7. Passias PG, Brown AE, Bortz C, Pierce K, Alas H, Ahmad W, Passfall L, Kummer N, Krol O, Lafage R, Lafage V, Burton D, Hart R, Anand N, Mundis G, Neuman B, Line B, Shaffrey C, Klineberg E, Smith J, Ames C, Schwab FJ, Bess S (2021) A risk-benefit analysis of increasing surgical invasiveness relative to frailty status in adult spinal deformity surgery. Spine (Phila Pa 1976) 46:1087–1096. https://doi.org/10.1097/BRS.0000000000003977

    Article  PubMed  Google Scholar 

  8. Jella TK, Acuña AJ, Samuel LT, Schwarzkopf R, Fehring TK, Kamath AF (2021) Medicare physician fee reimbursement for revision total knee arthroplasty has not kept up with inflation from 2002 to 2019. J Bone Jt Surg Am 103:778–785. https://doi.org/10.2106/JBJS.20.01034

    Article  Google Scholar 

  9. Acuña AJ, Jella TK, Samuel LT, Schwarzkopf R, Fehring TK, Kamath AF (2021) Inflation-adjusted Medicare reimbursement for revision hip arthroplasty: study showing significant decrease from 2002 to 2019. J Bone Jt Surg Am 103:1212–1219. https://doi.org/10.2106/JBJS.20.01643

    Article  Google Scholar 

  10. Simcox T, Becker J, Kreinces J, Islam S, Grossman M, Gould J (2021) Are orthopaedic trauma surgeons adequately compensated for longer procedures? An analysis of relative value units and operative times from the American College of Surgeons National Surgical Quality Improvement Program Database. J Orthop Trauma 35:e458–e462. https://doi.org/10.1097/BOT.0000000000002105

    Article  PubMed  Google Scholar 

  11. Jiang DD, Hayes M, Gillis KA, Korets R, Wagner AA, Hedges JC, Chakiryan NH (2021) Misaligned incentives in benign prostatic enlargement surgery: more complex and efficacious procedures are earning fewer relative value units. J Endourol 35:835–839. https://doi.org/10.1089/end.2020.0941

    Article  PubMed  Google Scholar 

  12. Jiang DD, Gillis KA, Chakiryan NH, Acevedo AM, Austin JC, Seideman CA (2020) Work relative value units do not account for complexity and operative time in hypospadias surgery. J Pediatr Urol 16:459.e1-459.e5. https://doi.org/10.1016/j.jpurol.2020.04.032

    Article  PubMed  Google Scholar 

  13. Nayar SK, Aziz KT, Best MJ, Giladi AM, LaPorte DM, Srikumaran U, Ingari JV (2021) Relative value unit compensation rates for hospital-based shoulder/elbow surgery versus hand surgery. Orthopedics 44:e373–e377. https://doi.org/10.3928/01477447-20201119-08

    Article  PubMed  Google Scholar 

  14. Smith JF, Moore ML, Pollock JR, Haglin JM, LeBlanc MP, Deckey DG, Arthur JR, Chhabra A (2021) National and geographic trends in Medicare reimbursement rates for orthopedic shoulder and upper extremity surgery from 2000 to 2020. J Shoulder Elbow Surg S1058–2746(21):00707–00712. https://doi.org/10.1016/j.jse.2021.09.001

    Article  Google Scholar 

  15. Haglin JM, Edmonds VS, Money SR, Davila VJ, Stone WM, Soh IY, Meltzer AJ (2021) Procedure reimbursement, inflation, and the declining buying power of the vascular surgeon (2011–2021). Ann Vasc Surg 76:80–86. https://doi.org/10.1016/j.avsg.2021.04.001

    Article  PubMed  Google Scholar 

  16. Fang Z, Judelson D, Simons J, Steppacher R, Arous E, Sideman M, Schanzer A, Aiello FA (2021) Vascular surgeons are not adequately valued by traditional productivity metrics. Ann Vasc Surg 73:446–453. https://doi.org/10.1016/j.avsg.2020.11.018

    Article  PubMed  Google Scholar 

  17. Leven DM, Lee NJ, Kothari P, Steinberger J, Guzman J, Skovrlj B, Shin JI, Caridi JM, Cho SK (2016) Frailty index is a significant predictor of complications and mortality after surgery for adult spinal deformity. Spine (Phila Pa 1976) 41:E1394–E1401. https://doi.org/10.1097/BRS.0000000000001886

    Article  PubMed  Google Scholar 

  18. Yagi M, Michikawa T, Hosogane N, Fujita N, Okada E, Suzuki S, Tsuji O, Nagoshi N, Asazuma T, Tsuji T, Nakamura M, Matsumoto M, Watanabe K (2019) The 5-item modified frailty index is predictive of severe adverse events in patients undergoing surgery for adult spinal deformity. Spine (Phila Pa 1976) 44:E1083–E1091. https://doi.org/10.1097/BRS.0000000000003063

    Article  PubMed  Google Scholar 

  19. Daniels AH, Reid DBC, Tran SN, Hart RA, Klineberg EO, Bess S, Burton D, Smith JS, Shaffrey C, Gupta M, Ames CP, Hamilton DK, LaFage V, Schwab F, Eastlack R, Akbarnia B, Kim HJ, Kelly M, Passias PG, Protopsaltis T, Mundis GM (2019) Evolution in surgical approach, complications, and outcomes in an adult spinal deformity surgery multicenter study group patient population. Spine Deform 7:481–488. https://doi.org/10.1016/j.jspd.2018.09.013

    Article  PubMed  Google Scholar 

  20. Smith JS, Shaffrey CI, Berven S, Glassman S, Hamill C, Horton W, Ondra S, Schwab F, Shainline M, Fu K-M, Bridwell K, Spinal Deformity Study Group (2009) Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery 65:86–93. https://doi.org/10.1227/01.NEU.0000347005.35282.6C. (discussion 93-94)

    Article  PubMed  Google Scholar 

  21. Smith JS, Lafage V, Shaffrey CI, Schwab F, Lafage R, Hostin R, Obrien M, Boachie-Adjei O, Akbarnia BA, Mundis GM, Errico T, Kim HJ, Protopsaltis TS, Hamilton DK, Scheer JK, Sciubba D, Ailon T, Fu K-MG, Kelly MP, Zebala L, Line B, Klineberg E, Gupta M, Deviren V, Hart R, Burton D, Bess S, Ames CP, International Spine Study Group (2016) Outcomes of operative and nonoperative treatment for adult spinal deformity: a prospective, multicenter, propensity-matched cohort assessment with minimum 2-year follow-up. Neurosurgery 78:851–861. https://doi.org/10.1227/NEU.0000000000001116

    Article  PubMed  Google Scholar 

  22. Kelly MP, Lurie JD, Yanik EL, Shaffrey CI, Baldus CR, Boachie-Adjei O, Buchowski JM, Carreon LY, Crawford CH, Edwards C, Errico TJ, Glassman SD, Gupta MC, Lenke LG, Lewis SJ, Kim HJ, Koski T, Parent S, Schwab FJ, Smith JS, Zebala LP, Bridwell KH (2019) Operative versus nonoperative treatment for adult symptomatic lumbar scoliosis. J Bone Jt Surg Am 101:338–352. https://doi.org/10.2106/JBJS.18.00483

    Article  Google Scholar 

  23. Bridwell KH, Glassman S, Horton W, Shaffrey C, Schwab F, Zebala LP, Lenke LG, Hilton JF, Shainline M, Baldus C, Wootten D (2009) Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine (Phila Pa 1976) 34:2171–2178. https://doi.org/10.1097/BRS.0b013e3181a8fdc8

    Article  PubMed  Google Scholar 

  24. Lau D, Clark AJ, Scheer JK, Daubs MD, Coe JD, Paonessa KJ, LaGrone MO, Kasten MD, Amaral RA, Trobisch PD, Lee J-H, Fabris-Monterumici D, Anand N, Cree AK, Hart RA, Hey LA, Ames CP, SRS Adult Spinal Deformity Committee (2014) Proximal junctional kyphosis and failure after spinal deformity surgery: a systematic review of the literature as a background to classification development. Spine (Phila Pa 1976) 39:2093–2102. https://doi.org/10.1097/BRS.0000000000000627

    Article  PubMed  Google Scholar 

  25. Cho SK, Shin JI, Kim YJ (2014) Proximal junctional kyphosis following adult spinal deformity surgery. Eur Spine J 23:2726–2736. https://doi.org/10.1007/s00586-014-3531-4

    Article  PubMed  Google Scholar 

  26. Bridwell KH, Sedgewick TA, O’Brien MF, Lenke LG, Baldus C (1993) The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis. J Spinal Disord 6:461–472. https://doi.org/10.1097/00002517-199306060-00001

    Article  CAS  PubMed  Google Scholar 

  27. Overview of the Medicare physician fee schedule search. Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare/physician-fee-schedule/search/overview. Accessed 4 Dec 2021

  28. Hsiao WC, Braun P, Yntema D, Becker ER (1988) Estimating physicians’ work for a resource-based relative-value scale. N Engl J Med 319:835–841. https://doi.org/10.1056/NEJM198809293191305

    Article  CAS  PubMed  Google Scholar 

  29. Hsiao WC, Braun P, Dunn DL, Becker ER, Yntema D, Verrilli DK, Stamenovic E, Chen SP (1992) An overview of the development and refinement of the resource-based relative value scale. The foundation for reform of U.S. physician payment. Med Care 30:NS1-12. https://doi.org/10.1097/00005650-199211001-00001

    Article  CAS  PubMed  Google Scholar 

  30. Goodson JD (2007) Unintended consequences of resource-based relative value scale reimbursement. JAMA 298:2308–2310. https://doi.org/10.1001/jama.298.19.2308

    Article  CAS  PubMed  Google Scholar 

  31. RBRVS Overview. American Medical Association. https://www.ama-assn.org/about/rvs-update-committee-ruc/rbrvs-overview. Accessed 4 Dec 2021

  32. HCPCS—general information. Centers for Medicare & Medicaid Services. https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo. Accessed 4 Dec 2021

  33. Coding & reimbursement: common coding scenarios. Scoliosis Research Society. https://www.srs.org/professionals/online-education-and-resources/coding-corner/common-scenarios. Accessed 5 Dec 2021

  34. Neustadt J, Blasier D (2011) Update on coding for correction of spinal deformity. Scoliosis Research Society News. https://www.srs.org/enews/2011/03/articles.php?content=2. Accessed 5 Dec 2021

  35. Consumer Price Index. U.S. Bureau of Labor Statistics. https://www.bls.gov/cpi/. Accessed 4 Dec 2021

  36. Moses H, Matheson DHM, Dorsey ER, George BP, Sadoff D, Yoshimura S (2013) The anatomy of health care in the United States. JAMA 310:1947–1963. https://doi.org/10.1001/jama.2013.281425

    Article  CAS  PubMed  Google Scholar 

  37. Dorsey ER, de Roulet J, Thompson JP, Reminick JI, Thai A, White-Stellato Z, Beck CA, George BP, Moses H (2010) Funding of US biomedical research, 2003–2008. JAMA 303:137–143. https://doi.org/10.1001/jama.2009.1987

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Glazer AM, Winkelmann RR, Farberg AS, Rigel DS (2017) Analysis of trends in US melanoma incidence and mortality. JAMA Dermatol 153:225–226. https://doi.org/10.1001/jamadermatol.2016.4512

    Article  PubMed  Google Scholar 

  39. Fernando J Compound annual growth rate (CAGR). Investopedia. https://www.investopedia.com/terms/c/cagr.asp. Accessed 5 Dec 2021

  40. Li Z, Li M, Patton GC, Lu C (2018) Global development assistance for adolescent health from 2003 to 2015. JAMA Netw Open 1:e181072. https://doi.org/10.1001/jamanetworkopen.2018.1072

    Article  PubMed  PubMed Central  Google Scholar 

  41. ACS National Surgical Quality Improvement Program. American College of Surgeons. http://www.facs.org/quality-programs/acs-nsqip. Accessed 4 Dec 2021

  42. Hue JJ, Paukovits JL, Bingmer K, Sugumar K, Onders RP, Hardacre JM (2021) Medicare reimbursement for common general surgery procedures has declined over the last decade. Am J Surg. https://doi.org/10.1016/j.amjsurg.2021.10.040

    Article  PubMed  Google Scholar 

  43. Coric D, Guyer RD, Nunley PD, Musante D, Carmody C, Gordon C, Lauryssen C, Boltes MO, Ohnmeiss DD (2018) Prospective, randomized multicenter study of cervical arthroplasty versus anterior cervical discectomy and fusion: 5-year results with a metal-on-metal artificial disc. J Neurosurg Spine 28:252–261. https://doi.org/10.3171/2017.5.SPINE16824

    Article  PubMed  Google Scholar 

  44. Shah AM, Siddiqui E, Cuenca C, Drotar P, Okoh AK, Salemi A, Waxman S, Sambol J (2021) Trends in the utilization and reimbursement of coronary revascularization in the United States Medicare population from 2010 to 2018. Catheter Cardiovasc Interv 98:E205–E212. https://doi.org/10.1002/ccd.29649

    Article  PubMed  Google Scholar 

  45. Kufta AY, Maldonado DR, Go CC, Curley AJ, Padilla P, Domb BG (2023) Inflation-adjusted Medicare reimbursement for hip arthroscopy fell by 21.1% on average between 2011 and 2022. Arthrosc Sports Med Rehabil 5:e67–e73. https://doi.org/10.1016/j.asmr.2022.10.009

    Article  PubMed  Google Scholar 

  46. Blackburn CW, Du JY, Marcus RE (2023) Medicare payments to hospitals and physicians for total hip and knee arthroplasty declined from 2009 to 2019. J Arthroplast 38:419–423. https://doi.org/10.1016/j.arth.2022.10.002

    Article  Google Scholar 

  47. Wang KY, Margalit A, Thakkar SC, Hsu NN, Srikumaran U, Ficke JR, Jain A (2021) Reimbursement for orthopaedic surgeries in commercial and public payors: a race to the bottom. J Am Acad Orthop Surg 29:e1232–e1238. https://doi.org/10.5435/JAAOS-D-20-01397

    Article  PubMed  Google Scholar 

  48. (2020) American College of Surgeons strongly opposes proposed Medicare physician fee schedule. American College of Surgeons. http://www.facs.org/media/press-releases/2020/cms-rule-080420. Accessed 4 Dec 2021

  49. Mather M, Scommegna P, Kilduff L (2019) Fact sheet: aging in the United States. PRB. https://www.prb.org/resources/fact-sheet-aging-in-the-united-states/. Accessed 4 Dec 2021

  50. Martin AB, Hartman M, Lassman D, Catlin A, National Health Expenditure Accounts Team (2021) National health care spending in 2019: steady growth for the fourth consecutive year. Health Aff (Millwood) 40:14–24. https://doi.org/10.1377/hlthaff.2020.02022

    Article  PubMed  Google Scholar 

  51. Orr RD, Sodhi N, Dalton SE, Khlopas A, Sultan AA, Chughtai M, Newman JM, Savage J, Mroz TE, Mont MA (2018) What provides a better value for your time? The use of relative value units to compare posterior segmental instrumentation of vertebral segments. Spine J 18:1727–1732. https://doi.org/10.1016/j.spinee.2018.01.026

    Article  PubMed  Google Scholar 

  52. Peterson J, Sodhi N, Khlopas A, Piuzzi NS, Newman JM, Sultan AA, Stearns KL, Mont MA (2018) A comparison of relative value units in primary versus revision total knee arthroplasty. J Arthroplast 33:S39–S42. https://doi.org/10.1016/j.arth.2017.11.070

    Article  Google Scholar 

  53. Jiang DD, Chakiryan NH, Gillis KA, Acevedo AM, Chen Y, Austin JC, Seideman CA (2021) Relative value units do not adequately account for operative time in pediatric urology. J Pediatr Surg 56:883–887. https://doi.org/10.1016/j.jpedsurg.2020.06.043

    Article  PubMed  Google Scholar 

  54. Nayar SK, Skolasky RL, LaPorte DM, Zimmerman RM, Giladi AM, Srikumaran U (2021) Reassessment of relative value in shoulder and elbow surgery: do payment and relative value units reflect reality? Clin Orthop Surg 13:76–82. https://doi.org/10.4055/cios20052

    Article  PubMed  PubMed Central  Google Scholar 

  55. Samuel LT, Grits D, Acuña AJ, Piuzzi NS, Higuera-Rueda CA, Kamath AF (2020) Work relative value units do not adequately support the burden of infection management in revision knee arthroplasty. J Bone Jt Surg Am 102:230–236. https://doi.org/10.2106/JBJS.19.00776

    Article  Google Scholar 

  56. Teisberg E, Wallace S, O’Hara S (2020) Defining and implementing value-based health care: a strategic framework. Acad Med 95:682–685. https://doi.org/10.1097/ACM.0000000000003122

    Article  PubMed  Google Scholar 

  57. Boughey JC, Hieken TJ, Jakub JW, Degnim AC, Grant CS, Farley DR, Thomsen KM, Osborn JB, Keeney GL, Habermann EB (2014) Impact of analysis of frozen-section margin on reoperation rates in women undergoing lumpectomy for breast cancer: evaluation of the National Surgical Quality Improvement Program data. Surgery 156:190–197. https://doi.org/10.1016/j.surg.2014.03.025

    Article  PubMed  Google Scholar 

  58. Kaiser LS, Lee TH (2015) Turning value-based health care into a real business model. Harvard Business Review. https://hbr.org/2015/10/turning-value-based-health-care-into-a-real-business-model

  59. Passias PG, Brown AE, Bortz C, Alas H, Pierce K, Ahmad W, Naessig S, Lafage R, Lafage V, Hassanzadeh H, Labaran LA, Ames C, Burton DC, Gum J, Hart R, Hostin R, Kebaish KM, Neuman BJ, Bess S, Line B, Shaffrey C, Smith J, Schwab F, Klineberg E, International Spine Study Group (2022) Increasing cost efficiency in adult spinal deformity surgery: identifying predictors of lower total costs. Spine (Phila Pa 1976) 47:21–26. https://doi.org/10.1097/BRS.0000000000004201

    Article  PubMed  Google Scholar 

  60. Li G, Passias P, Kozanek M, Fu E, Wang S, Xia Q, Li G, Rand FE, Wood KB (2009) Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up. Spine (Phila Pa 1976) 34:2165–2170. https://doi.org/10.1097/BRS.0b013e3181b3ff0c

    Article  PubMed  Google Scholar 

  61. Grosso MJ, Courtney PM, Kerr JM, Della Valle CJ, Huddleston JI (2020) Surgeons’ preoperative work burden has increased before total joint arthroplasty: a survey of AAHKS members. J Arthroplast 35:1453–1457. https://doi.org/10.1016/j.arth.2020.01.079

    Article  Google Scholar 

  62. Krueger CA, Austin MS, Levicoff EA, Saxena A, Nazarian DG, Courtney PM (2020) Substantial preoperative work is unaccounted for in total hip and knee arthroplasty. J Arthroplast 35:2318–2322. https://doi.org/10.1016/j.arth.2020.04.066

    Article  Google Scholar 

  63. Hayon S, Deal A, Tan H-J, Namboodri B, Gan Z, Wood C, Pruthi R (2020) Is the relative value of surgeon effort equal across surgical specialties? Surgery 168:365–370. https://doi.org/10.1016/j.surg.2020.04.018

    Article  PubMed  Google Scholar 

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Acknowledgements

For their editorial assistance, we thank Denise Di Salvo, MS, and Rachel Box, MS, in the Editorial Services group of The Johns Hopkins Department of Orthopaedic Surgery.

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  1. Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA

    Kevin C. Mo, Carlos Ortiz-Babilonia, Farah N. Musharbash, Micheal Raad, Juan Silva Aponte, Brian J. Neuman, Amit Jain & Khaled M. Kebaish

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Contributions

KM, COB, FNM, MR, JSA, BJN, AJ, KK: Made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. KM, COB, FNM, MR, JSA, BJN, AJ, KK: Drafted the work or revised it critically for important intellectual content. KM, COB, FNM, MR, JSA, BJN, AJ, KK: Approved the final version to be published. KM, COB, FNM, MR, JSA, BJN, AJ, KK: Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Khaled M. Kebaish.

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Conflict of interest

Dr. Neuman reports grants/research support from DePuy Synthes and is on the speaker’s bureau for Medtronic. Dr. Amit Jain receives consulting fees from DePuy Spine and Stryker Spine. Dr. Kebaish reports personal or other fees from DePuy Synthes, Stryker Corp., Ethicon Inc., SpineCraft LLC, OrthoFix. All other authors have no competing interests to declare that are relevant to the content of this article.

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Mo, K.C., Ortiz-Babilonia, C., Musharbash, F.N. et al. Inflation-adjusted medicare physician reimbursement for adult spinal deformity surgery substantially declined from 2002 to 2020. Spine Deform 12, 263–270 (2024). https://doi.org/10.1007/s43390-023-00779-7

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