Reconciling the Literature on Sex-Based Disparities in Reimbursement

Significant disparities in surgical reimbursement by patient sex have been documented for decades, although debate exists regarding their cause, and studies have approached the issue with different methodologies, arriving at seemingly divergent conclusions. In our analysis, we have found that the preponderance of the literature, including the most comprehensive studies, supports a conclusion that there are real payment disparities at the work relative value unit (RVU) level for gynecologic care. Disparities in funding and reimbursement result in differing health care resource allocation and access and ultimately systemic and persistent devaluation of female bodies. We advocate for robust interventions to promote equity rather than a limited approach focused on revising a handful of Current Procedural Terminology codes. Reforms should include broader RVU reassessment, specialty compensation parity, and rigorous yet inclusive comparisons of sex-specific procedures.