Retrospective analysis shows the cost of Mohs surgery decreases when adjusted for medical inflation

Background: Mohs surgery (MS) is the gold standard for treating nonmelanoma skin cancers in cosmetically sensitive areas.

Objective: To investigate MS costs over time when adjusting for medical inflation while considering the perspective of patients, payers, and health care systems.

Methods: A retrospective claim analysis using data from the International Business Machines MarketScan Commercial Claims and Encounters Database from 2007 through 2019 was performed. A query of the database for any instance of a MS-specific Current Procedural Terminology (CPT) code in adults (17311, 17312, 17313, 17314, and 17315) was conducted. Aggregate data per claim regarding coinsurance, total cost, deductible, copay, and insurance payout were provided for each CPT code annually.

Results: The total adjusted cost per claim decreased significantly (P < .001) for 4 of the 5 MS-specific CPT codes between 2007 and 2019: 17311 (−25%), 17312 (−15%), 17313 (−25%), and 17314 (−18%). The patient's adjusted out-of-pocket expense increased significantly (P < .0001) for 4 of the 5 MS-specific CPT codes: 17311 (33%), 17312 (45%), 17313 (34%), and 17314 (43%).

Conclusion: Among the 4 most used MS-specific CPT codes (17311, 17312, 17313, and 17314), the total cost per claim decreased and the patient's out-of-pocket expense increased from 2007 to 2019.

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Work Title Retrospective analysis shows the cost of Mohs surgery decreases when adjusted for medical inflation
Access
Open Access
Creators
  1. Ashwath J. Sampath
  2. Karina Paci
  3. Osward Y. Carrasquillo
  4. Steven Maczuga
  5. Melissa Butt
  6. Bradley Merritt
  7. Mathew Helm
  8. Galen T. Foulke
Keyword
  1. Cost
  2. Cost analysis
  3. Micrographic surgery
  4. Mohs
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Journal of the American Academy of Dermatology
Publication Date July 6, 2023
Publisher Identifier (DOI)
  1. https://doi.org/10.1016/j.jaad.2023.06.041
Deposited March 25, 2024

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Version 1
published

  • Created
  • Added Mohs_inflation.pdf
  • Added Creator Ashwath J. Sampath
  • Added Creator Karina Paci
  • Added Creator Osward Y. Carrasquillo
  • Added Creator Steven Maczuga
  • Added Creator Melissa Butt
  • Added Creator Bradley Merritt
  • Added Creator Mathew Helm
  • Added Creator Galen T. Foulke
  • Published
  • Updated
  • Updated Keyword, Description, Publication Date Show Changes
    Keyword
    • Cost, Cost analysis, Micrographic surgery, Mohs
    Description
    • <p>Background: Mohs surgery (MS) is the gold standard for treating nonmelanoma skin cancers in cosmetically sensitive areas. Objective: To investigate MS costs over time when adjusting for medical inflation while considering the perspective of patients, payers, and health care systems. Methods: A retrospective claim analysis using data from the International Business Machines MarketScan Commercial Claims and Encounters Database from 2007 through 2019 was performed. A query of the database for any instance of a MS-specific Current Procedural Terminology (CPT) code in adults (17311, 17312, 17313, 17314, and 17315) was conducted. Aggregate data per claim regarding coinsurance, total cost, deductible, copay, and insurance payout were provided for each CPT code annually. Results: The total adjusted cost per claim decreased significantly (P &lt; .001) for 4 of the 5 MS-specific CPT codes between 2007 and 2019: 17311 (−25%), 17312 (−15%), 17313 (−25%), and 17314 (−18%). The patient's adjusted out-of-pocket expense increased significantly (P &lt; .0001) for 4 of the 5 MS-specific CPT codes: 17311 (33%), 17312 (45%), 17313 (34%), and 17314 (43%). Conclusion: Among the 4 most used MS-specific CPT codes (17311, 17312, 17313, and 17314), the total cost per claim decreased and the patient's out-of-pocket expense increased from 2007 to 2019.</p>
    • <p>Background: Mohs surgery (MS) is the gold standard for treating nonmelanoma skin cancers in cosmetically sensitive areas.
    • Objective: To investigate MS costs over time when adjusting for medical inflation while considering the perspective of patients, payers, and health care systems.
    • Methods: A retrospective claim analysis using data from the International Business Machines MarketScan Commercial Claims and Encounters Database from 2007 through 2019 was performed. A query of the database for any instance of a MS-specific Current Procedural Terminology (CPT) code in adults (17311, 17312, 17313, 17314, and 17315) was conducted. Aggregate data per claim regarding coinsurance, total cost, deductible, copay, and insurance payout were provided for each CPT code annually.
    • Results: The total adjusted cost per claim decreased significantly (P &lt; .001) for 4 of the 5 MS-specific CPT codes between 2007 and 2019: 17311 (−25%), 17312 (−15%), 17313 (−25%), and 17314 (−18%). The patient's adjusted out-of-pocket expense increased significantly (P &lt; .0001) for 4 of the 5 MS-specific CPT codes: 17311 (33%), 17312 (45%), 17313 (34%), and 17314 (43%).
    • Conclusion: Among the 4 most used MS-specific CPT codes (17311, 17312, 17313, and 17314), the total cost per claim decreased and the patient's out-of-pocket expense increased from 2007 to 2019.</p>
    Publication Date
    • 2023-11-01
    • 2023-07-06