D90. Investigation into Medicare’s Price Transparency Law: Influence of Hospital Factors on Peripheral Nerve Procedure Costs and Price Variation among these Procedures

PURPOSE: This study aims to elucidate the impact of the 2021 Center for Medicare and Medicaid Services (CMS) Hospital Price Transparency Rule on the price of peripheral nerve procedures in US hospitals. Price data from the Turquoise Health national database will be compared to identify which hospital factors influence price among common peripheral nerve surgeries. METHODS: Current Procedural Terminology (CPT) codes for 13 common peripheral nerve procedures were used to search the Turquoise Health database for price data published by hospitals nationwide. Hospital details were collected, and univariate and multivariate analyses assessed the relationship between these factors and the price for each CPT code. RESULTS: 181,347 rates from approximately 900 unique hospitals were analyzed from the 13 selected peripheral nerve CPT codes. The greatest price variation was seen with CPT 64856, while the smallest price variation was seen with CPT 64837. Multivariate analysis of hospital factors demonstrated that geographic region, private vs government ownership, safety net status, and bed size impacted price, while Medicare's hospital rating, academic status, and compliance to the price transparency law did not consistently impact price. Higher prices were seen in hospitals in the northwest and west regions, those that were privately owned, non-safety net, in urban settings, and having greater than 200 beds. CONCLUSION: Despite CMS efforts to increase price transparency, hospitals continue to charge widely variable rates for certain peripheral nerve procedures. Without price transparency, hospitals prohibit patients from considering cost when making healthcare decisions, particularly when soliciting a physician or hospital system for elective surgeries.