Declining Medicare reimbursement and income in primary total shoulder arthroplasty: a comparison of osteopathic and allopathic orthopedic surgeons, 2013-2023

By 2023, MD physicians experienced a 13% decline in API compared with 2013 despite averaging 15% more services, highlighting a concerning trend of providers working more for less. Both MD and DO physicians had significant declines in procedural reimbursement over this period (24% and 23%, respectively) despite a 31% rise in inflation. Although procedural reimbursement did not differ between degree types in either year, DO physicians consistently billed 7 fewer services and earned $11,493 less in API in 2013 and $8,422 less in 2023.