Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients
Background: Total hip (THA) and knee arthroplasty (TKA) are highly successful surgeries, but reimbursement for these procedures has decreased due to relative value unit scale devaluation and Medicare cuts. The shift to outpatient joint replacements has increased workload for orthopaedic surgeons and...
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| Language: | English |
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Elsevier
2025-06-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344125001293 |
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| author | John M. Dundon, MD, FAAOS Nicholas Brown, BS Jennifer Escobar, BS, RN Paul M. Lombardi, MD, FAAOS |
| author_facet | John M. Dundon, MD, FAAOS Nicholas Brown, BS Jennifer Escobar, BS, RN Paul M. Lombardi, MD, FAAOS |
| author_sort | John M. Dundon, MD, FAAOS |
| collection | DOAJ |
| description | Background: Total hip (THA) and knee arthroplasty (TKA) are highly successful surgeries, but reimbursement for these procedures has decreased due to relative value unit scale devaluation and Medicare cuts. The shift to outpatient joint replacements has increased workload for orthopaedic surgeons and office staff while saving Medicare costs. This study evaluates 3 groups of orthopaedic surgeons to determine their hourly rate for Medicare total joints. Methods: We categorized 3 groups of orthopaedic surgeons by operative time and efficiency to assess hourly rates. Group 1 performs 2-3 cases daily, group 2 performs 4-5 cases, and group 3 performs 10+ cases. We evaluated total operative time based on historical data and Centers for Medicare & Medicaid Services guidelines for preoperative and postoperative time. Results: For group 1, average times for THA and TKA were 400 minutes ($188.89/hour) and 408.5 minutes ($184.92/hour). Group 2's times and hourly rates for THA and TKA were 401.5 minutes ($188.18/hour) and 404 minutes ($190.68/hour). Group 3 had total times of 300.5 minutes ($251.50/hour) for THA and 300.25 minutes ($256.57/hour) for TKA. Conclusions: With decreasing actual rates and even further decline in inflation adjusted reimbursement and increasing practice costs, some surgeons may have to consider discontinuation of or minimizing TKA and THA in Medicare patients to maintain financial viability. |
| format | Article |
| id | doaj-art-36601da33a6e4ab0bb8d59cefc56026f |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-36601da33a6e4ab0bb8d59cefc56026f2025-08-20T03:24:07ZengElsevierArthroplasty Today2352-34412025-06-013310174210.1016/j.artd.2025.101742Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare PatientsJohn M. Dundon, MD, FAAOS0Nicholas Brown, BS1Jennifer Escobar, BS, RN2Paul M. Lombardi, MD, FAAOS3Orthopedic Research Institute of New Jersey, Chester, NJ, USA; Morristown Medical Center, Morristown, NJ, USA; Corresponding author. Orthopedic Research Institute of New Jersey, 8 Pond View Rd, Chester, NJ 07930, USA. Tel.:+1 614 288 1393.Orthopedic Research Institute of New Jersey, Chester, NJ, USAAtlantic Health Systems, Morristown, NJ, USAMorristown Medical Center, Morristown, NJ, USA; Tri-County Orthopedics, Cedar Knolls, NJ, USABackground: Total hip (THA) and knee arthroplasty (TKA) are highly successful surgeries, but reimbursement for these procedures has decreased due to relative value unit scale devaluation and Medicare cuts. The shift to outpatient joint replacements has increased workload for orthopaedic surgeons and office staff while saving Medicare costs. This study evaluates 3 groups of orthopaedic surgeons to determine their hourly rate for Medicare total joints. Methods: We categorized 3 groups of orthopaedic surgeons by operative time and efficiency to assess hourly rates. Group 1 performs 2-3 cases daily, group 2 performs 4-5 cases, and group 3 performs 10+ cases. We evaluated total operative time based on historical data and Centers for Medicare & Medicaid Services guidelines for preoperative and postoperative time. Results: For group 1, average times for THA and TKA were 400 minutes ($188.89/hour) and 408.5 minutes ($184.92/hour). Group 2's times and hourly rates for THA and TKA were 401.5 minutes ($188.18/hour) and 404 minutes ($190.68/hour). Group 3 had total times of 300.5 minutes ($251.50/hour) for THA and 300.25 minutes ($256.57/hour) for TKA. Conclusions: With decreasing actual rates and even further decline in inflation adjusted reimbursement and increasing practice costs, some surgeons may have to consider discontinuation of or minimizing TKA and THA in Medicare patients to maintain financial viability.http://www.sciencedirect.com/science/article/pii/S2352344125001293MedicareTotal knee arthroplastyTotal hip arthroplastyEfficiency |
| spellingShingle | John M. Dundon, MD, FAAOS Nicholas Brown, BS Jennifer Escobar, BS, RN Paul M. Lombardi, MD, FAAOS Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients Arthroplasty Today Medicare Total knee arthroplasty Total hip arthroplasty Efficiency |
| title | Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients |
| title_full | Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients |
| title_fullStr | Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients |
| title_full_unstemmed | Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients |
| title_short | Declining Service Labor Rates for Total Hip and Total Knee Arthroplasty in Medicare Patients |
| title_sort | declining service labor rates for total hip and total knee arthroplasty in medicare patients |
| topic | Medicare Total knee arthroplasty Total hip arthroplasty Efficiency |
| url | http://www.sciencedirect.com/science/article/pii/S2352344125001293 |
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