Background: Successful microsurgical autologous breast reconstruction (MABR) requires significant resources. The co-surgery model, involving 2 experienced surgeons, aims to improve outcomes. This study evaluated the financial and patient benefits of implementing a co-surgery model in MABR at an academic center. Methods: A retrospective study was conducted on MABR procedures (2021–2023) at an academic cancer center. Encounters were categorized by the co-surgery modifier (-62) or single-surgeon. Financial data (expected versus actual payments, time to payment) and patient outcomes (complications, flap compromise) were collected. Statistical analysis used the Pearson χ 2 test and independent samples t test. Results: Of 393 encounters, 193 were single-surgeon, and 200 were co-surgery. Single-surgeon cases had more accurate payments (88. 5% versus 76. 4%, P < 0. 001) and faster payment times (82. 5 versus 103. 9 d, P = 0. 02). Co-surgery cases were underpaid by 86, 748 during 3 years, with single-surgeon cases receiving 1200 more per patient. First-pass payment rates were higher for single surgeons (48. 2% versus 39. 5%, P = 0. 04). Patient outcomes showed no significant differences in overall complications, donor-site complications, flap compromise, or flap loss, though the co-surgery group had higher infection rates (9. 3% versus 0%, P < 0. 01) and breast wounds (14% versus 1. 3%, P < 0. 01). Operative time and length of stay were comparable. Conclusions: The co-surgery model in MABR enhances surgical efficiency but complicates billing, resulting in underpayment and delayed reimbursement. Streamlining reimbursement could foster co-surgery adoption, benefiting patient outcomes and efficiency.
Haddock et al. (Thu,) studied this question.