Reimbursement up for urology E&M services, down for surgical procedures

November 11, 2004

Reimbursement for urologic evaluation and management services increased by one-half since 1995, while surgical reimbursement rates have decreased by about one-third, according to a study in the November Journal of Urology (2004; 172:1958-62).

Reimbursement for urologic evaluation and management services increased by one-half since 1995, while surgical reimbursement rates have decreased by about one-third, according to a study in the November Journal of Urology (2004; 172:1958-62).

A total of 115 urologists provided University of Texas, Southwestern researchers information regarding physician time and work required before, during, and after three common E&M services, two outpatient procedures, and nine inpatient procedures. For comparison, researchers used mean operative times during the previous year for their institution, and they collected Medicare reimbursement rates for 1995, 1999, and 2004.

The researchers found that reimbursement for seven of nine surgical procedures dropped between 25.5% and 32% from 1995 to 2004. For E&M codes, overall reimbursement rates per hour increased 51% during the same period, with office cystoscopy and transrectal ultrasound biopsy of the prostate yielding the highest reimbursement in 2004.