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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Trends in Medicare Utilization and Reimbursement for Intertrochanteric Femur Fractures: A 21-Year Review.

Evan H Richman, Joseph C Brinkman, Benjamin R Paul, Nicole Griffin, Nicholas Alfonso

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Evan H RichmanDepartment of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Evan.richman@cuanschutz.edu.ORCID http://orcid.org/0000-0002-6313-7616
Joseph C BrinkmanDepartment of Orthopedics, Mayo Clinic Arizona, Phoenix, AZ, USA.
Benjamin R PaulCreighton School of Medicine - Phoenix Campus, Phoenix, AZ, USA.
Nicole GriffinDepartment of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Nicholas AlfonsoDepartment of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSliding hip screw (SHS) and intramedullary (IMN) constructs are commonly utilized treatments for intertrochanteric (IT) femur fractures. The aim of this study was to assess the economic and utilization trends in the management of IT fractures among the Medicare population over the last 21 years.

methodsA review of the publicly available Medicare Part B National Summary Data File for years 2000-2021 was performed. Collected data included true physician reimbursement and utilization numbers for all CPT codes pertaining to fixation of IT fractures with either SHS or IMN.

resultsA total of 1,361,112 IMN implants and 739,032 SHS implants were billed to Medicare for intertrochanteric femur fractures during the studied timeline. In this 21-year span, utilization of IMN increased 695% (9648-76,667), while utilization of SHS decreased by 96% (94,223-4224). After adjusting for inflation, the average physician reimbursement for SHS decreased by 34%, while IMN decreased by 41%. Absolute physician reimbursement was found to be $943.36 for SHS and $999.88 for IMN constructs.

conclusionIntramedullary implants are being increasingly utilized while sliding hip screw, and intramedullary construct reimbursement continues to decrease for intertrochanteric femur fracture fixation. These trends suggest that opting for a sliding hip screw may be more cost-effective when the fracture pattern allows for either construct.

Indexed as

Bone ScrewsFracture Fixation, IntramedullaryHip FracturesMedicareFracture Fixation, InternalHumansInsurance, Health, ReimbursementUnited StatesGeriatric fractureHip fractureIntertrochanteric fractureIntramedullary nailMedicareReimbursementRVUSliding hip screw

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.