Abstract No. 537 Trends in Volume, Reimbursement, and Patient Out-of-Pocket Costs for Port Placements, Revisions, and Removals from 2009-2021 by Provider Specialty : A Market Scan Data Analysis

The purpose of our study is to provide an update on trends in volume, reimbursement, and out-of-pocket costs for port placements, revisions, and removals by provider specialty from 2009-2021 using the Market Scan IBM data set. Claims from the Market Scan IBM data set for the years 2009-2021 were extracted using CPT codes for central port placement, port revisions, and complete port removal. Procedural utilization rates (number of procedures per 100, 000 beneficiaries), out-of-pocket patient costs, provider specialty, and place of service were analyzed. During this time period, utilization rate of new port placements decreased from 111. 1 to 71. 1 (-36. 0%), removals decreased from 54. 5 to 32. 6 (-40. 1%), and port revisions decreased from 0. 02 to 0. 01 (-50%). Radiologists saw an increase in both new port placements from 12. 0% to 19. 9% and port removals from 9. 9% to 16. 9%. Surgeons, on the other hand, had a significant decrease in both of these procedures from 25. 6% to 15. 2% and 29. 4% to 16. 9%, respectively. The majority of new port placements (90. 2%) and port removals (80. 5%) were performed in the outpatient hospital setting. Physician assistants saw a 5-6-fold increase in new port placements (0. 1 to 1. 8%) and removals (0. 2% to 2. 9%). After adjusting for inflation using the annual average consumer price index (CPI), the average reimbursement for new port placements and removals increased from 1217. 7 to 1869. 6 and 628. 6 to 805. 0, respectively. Average coinsurance, copay, and deductible for patients undergoing new port placement increased from 40. 4 to 81. 4, 4. 7 to 5. 2, and 11. 1 to 41. 6, respectively. Although prior studies showed a steady increase in the volume of port procedures performed by interventional radiology in the early 2000s for Medicare beneficiaries, this study shows declining volumes of these procedures over the past decade for non-Medicare beneficiaries. Within this patient population, radiologists have now surpassed surgeons as the primary providers of new ports and subsequent port care. Although unclear, overall declining volumes may be related to a combination of an increasingly aging population and recent Medicaid expansions as well as other governmental insurance programs.