Medicare Utilization and Reimbursement Trends for Free Flaps in Otolaryngology, Plastic Surgery, and Maxillofacial Surgery

Free flap procedures are important components of reconstructive surgery in otolaryngology, plastic surgery, and maxillofacial surgery. This research investigates trends in utilization, charges, and Medicare reimbursements for free flap procedures performed across these specialties. CMS Medicare Physician & Other Practitioners Data (2013-2022) were analyzed using CPT codes 15757 and 20969 for free skin flaps and osteocutaneous flaps, respectively. Trends in procedure utilization, average charges, average reimbursements, and charge-to-reimbursement ratios (CRRs) were assessed across these specialties. A total of 4920 free flap procedures were reported between 2013 to 2022. Otolaryngology utilization increased by 73.6% while plastic and maxillofacial surgery volumes remained stable. Otolaryngology reimbursements and charges showed significant declines while the CRR remained stable around 7.65 (0.58). Plastic and maxillofacial surgery exhibited the greatest CRRs in 2022 at 9.54 and 8.87, respectively. These data demonstrate the evolving finances of free flap procedures, laying the groundwork for further investigation and discussion.