Orthopedic Spine Surgeon Reimbursement: Patient Perception vs. Reality

Thirty-three percent of the patients said their insurance coverage impacted their access to care but 71.8 percent did not believe that insurance coverage influenced the decisions their spine surgeons made. Around 38 percent of the patients thought surgeon compensation should be addressed in healthcare reform and 27 percent of the patients thought it should not.

When asked what they thought spine surgeon reimbursement was for their procedures, 62 percent of the patients undergoing minor procedures thought reimbursement was $5,000 to $10,000 when in actuality Medicare and Blue Cross Blue Shield compensated all of the minor procedures at less than $2,500. The highest reimbursement was for two-level laminectomy with fusion, which received $1,363 from Medicare and $2,038 from BCBS.

Around 84 percent of patients undergoing major fusion procedures thought the reimbursement was greater than $5,000 for spine surgeons and 28 percent of those patients thought the reimbursement was more than $15,000. However, reimbursement to the spine surgeons for these procedures was less than $5,000 for Medicare patients and less than $7,000 for BCBS patients undergoing laminectomies with fusion. The greatest reimbursement was two-level lumbar laminectomy, which received $4,880 from Medicare and $6,611 from BCBS.

The survey also measured where patients thought orthopedic spine surgeon salary fell; 41 percent thought the salary was $250,000 to $500,000 and 22 percent thought it was $500,000 to $750,000 when in actuality 68 percent of orthopedic spine surgeons receive less than $750,000 according to the MGMA Physician Compensation and Production Survey, noted in the report. Around 24 percent of patients thought spine surgeons were under compensated. Most believed that reimbursement should be based on technical difficulty then surgical time, patient satisfaction and risk should be considered.

"The findings from this study highlight the discontinuity between how physicians are reimbursed and how the patient population perceives their healthcare dollars are being spent. If healthcare is seen as a free-market commodity, then it is one of only a few industries in which buyers have no real idea of how much they are paying for the services they receive," the authors wrote in the discussion.

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