Volume 134, Issue 2 pp. 659-665

Original Report

Incidence and Reimbursement Trends for Facial Fracture Repair in the Elderly: A Medicare Analysis

Sina J. Torabi MD,

Sina J. Torabi MD

orcid.org/0000-0002-1964-7109

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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Miranda B. An BA,

Miranda B. An BA

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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Jack L. Birkenbeuel MD,

Jack L. Birkenbeuel MD

Department of Otolaryngology, Ohio State College of Medicine, Columbus, Ohio, USA

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Ashley R. Lonergan MD,

Ashley R. Lonergan MD

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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Parsa P. Salehi MD, MS,

Parsa P. Salehi MD, MS

orcid.org/0000-0001-6716-8914

Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA

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R. Peter Manes MD,

R. Peter Manes MD

Department of Surgery (Division of Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA

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Babak Azizzadeh MD,

Babak Azizzadeh MD

Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA

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Edward C. Kuan MD, MBA,

Corresponding Author

Edward C. Kuan MD, MBA

[email protected]

orcid.org/0000-0003-3475-0718

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

Send correspondence to Edward C. Kuan, MD, MBA, Department of Otolaryngology–Head and Neck Surgery, University of California, 101 The City Drive South, Irvine, CA 92868, USA. Email: [email protected]

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Sina J. Torabi MD,

Sina J. Torabi MD

orcid.org/0000-0002-1964-7109

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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Miranda B. An BA,

Miranda B. An BA

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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Jack L. Birkenbeuel MD,

Jack L. Birkenbeuel MD

Department of Otolaryngology, Ohio State College of Medicine, Columbus, Ohio, USA

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Ashley R. Lonergan MD,

Ashley R. Lonergan MD

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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Parsa P. Salehi MD, MS,

Parsa P. Salehi MD, MS

orcid.org/0000-0001-6716-8914

Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA

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R. Peter Manes MD,

R. Peter Manes MD

Department of Surgery (Division of Otolaryngology), Yale School of Medicine, New Haven, Connecticut, USA

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Babak Azizzadeh MD,

Babak Azizzadeh MD

Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA

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Edward C. Kuan MD, MBA,

Corresponding Author

Edward C. Kuan MD, MBA

[email protected]

orcid.org/0000-0003-3475-0718

Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, USA

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First published: 27 June 2023

https://doi.org/10.1002/lary.30854

Citations: 1

Editor's Note: This Manuscript was accepted for publication on June 11, 2023.

Presentation: This study was presented as a Poster at the 2022 Triological Society Combined Sections Meeting.

The authors have no other funding, or financial relationships to disclose.

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Abstract

Objectives

The aim was to describe incidence and reimbursement trends of surgical repair of facial fractures among the Medicare population.

Methods

The annual procedure data from the Centers for Medicare and Medicaid Service National Part B Data File from 2000 to 2019 were queried.

Results

The total number of surgically corrected facial fractures increased from 10,148 in 2000 to 19,631 in 2019 in a linear pattern (r = 0.924). Specifically, nasal bone/septum fracture repairs increased the most by 200.6% (n = 4682 to n = 14,075), whereas operations for TMJ dislocations, malar/zygoma fractures, and alveolar ridge/mandibular fractures decreased by 27.9%, 12.3%, and 3.2%, respectively, between 2000 and 2019. Correspondingly, the total Medicare reimbursement rose from $2,574,317 in 2000 to $4,129,448 in 2019 (r = 0.895). However, the mean reimbursement for all procedures decreased from $376.63 to $210.35 (44.1% fall) over the same time after adjusting for inflation, with this trend holding for individual fracture types as well.

Conclusions

Given the population's increasing age, there has been a significant increase in the number of surgical repairs of facial fractures in Medicare patients between 2000 and 2019. However, this is largely driven by an increase in nasal bone/septum closed reductions, with stagnant and, in some cases, declining incidence among other fracture repairs. The reason is unclear and may be related to an increase in nonoperative management or poor outcomes. Nevertheless, like other subfields within otolaryngology and medicine at large, payments have lagged far behind, which may play some role.

Level of Evidence

3 Laryngoscope, 134:659–665, 2024

CONFLICT OF INTEREST STATEMENT

EK is a consultant for Stryker. The other authors declare no relevant conflicts of interest.

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Citing Literature

Volume134, Issue2

February 2024

Pages 659-665

Incidence and Reimbursement Trends for Facial Fracture Repair in the Elderly: A Medicare Analysis

Abstract

Objectives

Methods

Results

Conclusions

Level of Evidence

CONFLICT OF INTEREST STATEMENT

BIBLIOGRAPHY

Citing Literature

References

Information

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Incidence and Reimbursement Trends for Facial Fracture Repair in the Elderly: A Medicare Analysis

Abstract

Objectives

Methods

Results

Conclusions

Level of Evidence

CONFLICT OF INTEREST STATEMENT

BIBLIOGRAPHY

Citing Literature

References

Related

Information