Impact of Medicare reimbursement cuts on glaucoma procedures discussed at AAO 2023

Recent CMS Medicare reimbursement cuts to minimally invasive glaucoma surgery (MIGS) have led to significant shifts in surgical practices within the field of ophthalmology, according to a paper presented at AAO 2023. The study found that procedures involving Hydrus and iStent experienced a notable decrease, while goniotomy and canaloplasty procedures saw significant increases.

The research, conducted using a 5% sample of national Medicare claims data, compared procedure volumes in the first quarters of 2021 and 2022.

The findings indicate that between 2021 and 2022, procedures involving Hydrus and iStent experienced a decrease of 28.6%. Conversely, goniotomy procedures saw a substantial increase of 66.97%, while canaloplasty procedures rose by 47.43%. Additionally, Xen and Ex-PRESS procedures demonstrated an 11.61% increase in volume.

In contrast, traditional glaucoma procedures such as trabeculectomy experienced a decrease of 24.04%, and drainage devices saw a reduction of 16.17%. Overall, glaucoma surgeries saw a decline of 4.25%. Cataract surgeries experienced a contrasting trend, with an increase of 15.63% during the same period.

ReferencePaauw M, et al. Glaucoma Surgery Shifts Among Medicare Beneficiaries After 2022 Reimbursement Changes. Presented at: AAO 2023.