Musculoskeletal Global Surgery Fees Often Did Not Reflect the Number of Evaluation and Management Services Provided.

摘要

The American Medical Association Current Procedural Terminology (CPT) identifies codes that physicians use to report medical services and procedures and claim reimbursement through the physician fee schedule. The CPT includes 1,355 codes for major musculoskeletal global surgeries. CMS reimbursed physicians approximately $1.5 billion for 1,331 of these CPT codes for surgeries performed during calendar year (CY) 2007. CMS requested this review. Our objective was to determine whether musculoskeletal global surgery fees reflected the actual number of E&M services that physicians provided to beneficiaries during the global surgery periods.