Trends in inflation-adjusted costs and reimbursements for breast cancer procedures: A decade of decline.

Abstract

e23131 Background: As healthcare costs continue to rise, understanding trends in reimbursement for breast cancer surgical procedures is crucial for both providers and policymakers. This study evaluates the changes in inflation-adjusted reimbursements for breast mastectomy, breast reconstruction, and lymph node (LN) resection between 2015 and 2025, highlighting critical financial trends impacting breast cancer care delivery. Methods: We analyzed reimbursement trends using inflation-adjusted 2015 prices and 2025 reimbursement values for key breast cancer procedures, categorized as mastectomy, reconstruction, and lymph node (LN) resection. Total percentage change and compound annual growth rate (CAGR) were calculated to quantify financial trends over the study period. Results: For mastectomy procedures, inflation-adjusted reimbursements decreased significantly, ranging from a -23.61% change for mastectomy (CAGR: -2.66%) to a -31.54% change for simple complete mastectomy (CAGR: -3.72%). Reconstruction procedures exhibited even sharper declines, with immediate same-day implant reconstructions experiencing a -45.07% change (CAGR: -5.82%) and free-flap reconstructions decreasing by -29.29% (CAGR: -3.41%). LN procedures showed moderate declines, with biopsy of axillary LNs seeing a -28.00% change (CAGR: -3.23%) and regional lymphadenectomy declining by -27.20% (CAGR: -3.12%). Across all categories, reductions in reimbursement exceeded 25%, reflecting a substantial financial contraction. Conclusions: Over the past decade, reimbursements for breast cancer-related surgical procedures have declined significantly, with the steepest decreases observed in breast reconstruction surgeries. These trends raise concerns about potential challenges in maintaining access to advanced surgical care for breast cancer patients. Further investigation is warranted to explore the implications for healthcare providers, disparities in care access, and the financial sustainability of surgical oncology practices. Figure- Inflation-adjusted reimbursements for breast cancer procedures. Breast CancerProcedure CPT code Subtype of Procedure Adjusted inflation prices 2015 ($) Reimbursement in 2025 ($) Adjusted total %change Adjusted CAGR Breast Mastectomy 19300 Mastectomy 559.73 427.6 -23.61 -2.66 19307 Modified radical mastectomy 1627.13 1155.09 -29.01 -3.37 Reconstruction of breast 19340 Immediate same day implant 1359.81 746.88 -45.07 -5.82 19342 Delayed insertion of implant 1250.04 748.82 -40.10 -5.00 19364 Reconstruction with free flap 3744.92 2648.21 -29.29 -3.41 LN procedures 38500 Biopsy of axillary lymph node 347.28 250.04 -28.00 -3.23 38525 Lymph node biopsy, excisional 595.21 434.41 -27.02 -3.10 38740 Lymphadenectomy, regional, of axillary lymph nodes, including axillary contents (dissection of lymph nodes) 947.71 689.95 -27.20 -3.12