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Invest Ophthalmol Vis Sci 2004;45: E-Abstract 5265.
© 2004 ARVO


5265—B589

Trends in Retinal Detachment Surgery and Associated Reimbursement in the Medicare Database

D. Paikal, F. Yu and A. Coleman

Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, CA

Commercial Relationships: D. Paikal, None; F. Yu, None; A. Coleman, None.

Grant Identification: none

Abstract

Purpose: To examine trends in retinal detachment surgery and associated reimbursements in the Medicare database

Methods: Patients who underwent retinal detachment surgery were identified from a 5% sample of the Medicare database between 1995 and 1999. Specifically, we determined the number of patients who underwent 3 different retinal detachment procedures with the following CPT codes: 67107 (repair of retinal detachment with scleral buckle), 67108 (repair of retinal detachment with vitrectomy), and 67112 (repair of retinal detachment on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vitrectomy techniques). The mean values for the total allowed reimbursement related to these CPT codes were determined between 1995 and 1999.

Results: The number of Medicare patients who underwent these 3 retinal detachment procedures between 1995 and 1999 are listed in the table below:
CPT 67107 CPT 67108 CPT 67112
1995 535 337 40
1996 468 386 51
1997 384 452 38
1998 319 470 26
1999 324 486 34

Allowed reimbursements decreased for all 3 retinal procedures over the 5 year period. Furthermore, during this period, the number of scleral buckles has trended downward while the number of vitrectomies has trended upward.

Conclusion: The decrease in scleral buckles and the increase in vitrectomies over the study period may reflect the results of studies which have shown certain perceived benefits to vitrectomy. There is no reason to believe that reimbursement rates have guided surgeons choices of procedures to repair retinal detachments. There were not a sufficient number of reoperations for retinal detachment in the Medicare database to make conclusions regarding those trends.

Keywords: retinal detachment • vitreoretinal surgery • retina

 © 2004, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.





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