Trends in Medicare reimbursement for urological cancer surgeries in male genitourinary malignancies: A 10-year analysis.

Abstract

e23129 Background: Male genitourinary (GU) cancers, including testicular, penile, kidney, and prostate cancers, necessitate surgical interventions critical for disease management. Medicare reimbursement trends for these procedures have implications for healthcare access, provider sustainability, and policy planning. This study evaluates changes in reimbursement rates for urological surgeries over the past decade, focusing on trends from 2015 to projected 2025 rates. Methods: Medicare reimbursement rates for commonly performed surgical procedures in testicular, penile, kidney, and prostate cancers were extracted for 2015 (adjusted for inflation) and projected for 2025. Percent change (% change) and compound annual growth rate (CAGR) were calculated to evaluate trends. Procedures analyzed included orchiectomies, partial and radical penectomies, nephrectomies, ablative procedures for renal tumors, and various forms of prostatectomies. Results: Across all GU cancer types, significant reductions in adjusted Medicare reimbursement rates were observed between 2015 and 2025. Procedures for testicular cancer (e.g., extensive orchiectomy) saw a total % decrease of -27.19% to -27.35% (CAGR: -3.12% to -3.14%). Penile cancer procedures (e.g., partial and radical penectomies) exhibited a decline of -26.94% to -28.94% (CAGR: -3.09% to -3.36%). Reimbursements for kidney cancer surgeries, including open radical nephrectomies and percutaneous ablative procedures, decreased by -28.74% to -34.61% (CAGR: -3.33% to -4.16%). Prostate cancer procedures, particularly radical and extensive prostatectomies, demonstrated a reduction of -28.43% to -34.99% (CAGR: -3.29% to -4.21%). The greatest declines were observed in minimally invasive kidney cancer interventions (e.g., percutaneous cryoablation) and subtotal prostatectomies, reflecting a CAGR exceeding -4%. Conclusions: Medicare reimbursement rates for male GU cancer surgeries have declined significantly over the past decade, with reductions ranging from -26.94% to -34.99%. These trends may challenge provider participation and access to care, particularly for complex or minimally invasive procedures. Policymakers should consider the financial implications of declining reimbursement rates to ensure equitable care for patients with GU malignancies.