A Contemporary Analysis of Changing Payments for Surgical and Transcatheter Valve Procedures

ABSTRACT: We aimed to quantify contemporary changes in physician Medicare reimbursement for surgical and transcatheter valvular procedures. Publicly available 2015–2023 data from the Centers for Medicare & Medicaid Services were used to identify annual physician reimbursement fees for four procedures: surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), mitral valve repair (MVr), and MitraClip. Physician reimbursement fees were adjusted for inflation into 2023 U.S. dollars. Changes over time were analyzed using linear regression to account for differences in average annual U.S. dollar decline, average annual percent change, and total percent change over the study period. Reimbursement for surgical and transcatheter valve procedures declined by a combined total of 28.5%: 25.8% SAVR, 34.2% TAVR, 25.8% MVr, and 28.3% MitraClip. They corresponded to average annual percent changes of −3.7% (SAVR), −5.1% (TAVR), −3.7% (MVr), and −4.1% (MitraClip)—representing a collective decline in reimbursement fee per patient of $784.96 (SAVR), $624.73 (TAVR), $823.54 (MVr), and $706.12 (MitraClip) over the nine-year study span. Over the last decade, physician reimbursement for surgical and transcatheter valve procedures has significantly decreased, potentially threatening access to quality cardiac care within the heart team approach.