Trends in medicare procedure utilization and physician fee reimbursement for foot and ankle arthrodesis and arthroplasty procedures.

BACKGROUND

Total ankle arthroplasty and arthrodesis utilization has significantly increased in recent years with limited current studies examining physician reimbursement rates.

PURPOSE: This study provides an analysis of physician fee reimbursement from 2007 to 2025 and utilization trends from 2007 to 2022 for foot and ankle arthrodesis and arthroplasty procedures.

STUDY

DESIGN

Retrospective analysis

METHODS

Physician reimbursement data were extracted from the CMS Physician Fee Schedule Look-Up Tool using CPT codes between 2007 and 2025. National payment amounts were inflation-adjusted using the Consumer Price Index (January 2025 values) and reported in 2025 USD. For each CPT code, nominal and inflation-adjusted reimbursement trends were analyzed. Medicare Part B Summary Data File was used to collect utilization trends per CPT code from 2007 to 2022.

RESULTS

From 2007 to 2025, nominal reimbursement rates changed for most CPT codes: 27702 (-1.21 %), 27815 (- 0.38 %), 27870 (- 0.44 %), 28725 (- 1.52 %), and 29899 (-1.71 %). The procedures that showed nominal increases were 27871 (+3.41 %) and 28740 (+1.46 %). When adjusted for inflation, all procedures experienced declines: 27702 (-37.05 %), 27815 (-36.52 %), 27870 (-36.56 %), 27871 (-34.11 %), 28725 (-37.25 %), 28740 (-35.35 %), and 29899 (-37.37 %). The total percentage change from 2007 to 2022 showed increased utilization for CPT codes 27702 (+502.54 %), 27870 (+8.06 %), 28725 (+69.78 %), and 28740 (+156.98 %) and reductions for CPT codes 27871 (-32.88 %), 28715 (-9.52 %), and 29899 (-17.35 %).

CONCLUSION

Between 2007 and 2025, inflation-adjusted reimbursement reductions ranged from 34.11 % to 37.25 %, while utilization rates varied for foot and ankle arthroplasty and arthrodesis procedures.