Findings from Jason Zhang and Co-Researchers Advance Knowledge in Managed Care (A Regional Analysis of Medicare Reimbursement Rates for Plastic Surgery From 2012 to 2025): Managed Care

2026 FEB 18 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting out of Chicago, Illinois, by NewsRx editors, research stated, “The purpose of this analysis is to highlight trends in Medicare reimbursement rates in recent years and examine any regional differences in reimbursements that may exist over the past decade. The CMS Physician and Other Practitioners database was used to extract the top 20 plastic surgery HCPCS codes in 2022 by volume.”

Our news journalists obtained a quote from the research, “The Medicare Physician Fee Schedule Database was then used to analyze trends in reimbursements for these procedure codes from 2012 to 2025. Dollar amounts were inflation adjusted to 2025 estimates based on consumer price index (CPI) values. From 2012 to 2025, the mean overall reimbursement rate for plastic surgery procedures fell 34.2% from $373.21 to $245.65, with a 14.9% decrease in MP RVU * GPCI. A majority of codes analyzed were integumentary procedures. Nevada (40.4%, $408.26-$243.40) and Wyoming (39.0%, $396.83-$241.89) had the most dramatic decreases in reimbursement rate, whereas Massachusetts (30.5%, $378.12-$262.86) and New York (30.7%, $392.55-$272.15) had the smallest decreases in reimbursement rate. The West had the largest decrease in reimbursement rate (36.6%, $411.44-$260.66). Medicare reimbursement rates for plastic surgery are decreasing nationally, most drastically in the West region.”

According to the news editors, the research concluded: “These trends may have important indications for shaping practice and fair compensation for services.”

This research has been peer-reviewed.

For more information on this research see: A Regional Analysis of Medicare Reimbursement Rates for Plastic Surgery From 2012 to 2025. Annals of Plastic Surgery, 2026. Annals of Plastic Surgery can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Annals of Plastic Surgery - http://journals.lww.com/annalsplasticsurgery/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting Jason Zhang, the Northwestern University Feinberg School of Medicine, Chicago, IL. Additional authors for this research include May Li, Hannah Soltani, Sophia G. Allison, Puja Jagasia, Christian Arcelona, Kristian Nenchev, Michael A. Howard and Chad M. Teven.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/sap.0000000000004669. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Annals of Plastic Surgery is: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.

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