(017) Nose to Nose: Competitive Trends Between Otolaryngologists, Plastic Surgeons, and Rhinoplasty Reimbursement Rates

Introduction: Rhinoplasty is a common cosmetic procedure historically performed by plastic surgeons (PS), however in recent years, otolaryngologists (ENT) are increasingly performing these procedures. This study aims to explore the financial trends of these shifting practice patterns and understand how competition might affect compensation.

Methods: Data was collected from the Centers for Medicare Physician and Other Practitioners - by Provider and Service database from the years 2013 to 2023, using current procedural terminology (CPT) codes 30400 to 30500. Data was analyzed at the individual provider level, comparing ENT and/ or PS. Group practices were excluded to ensure clarity in the provider's specialty. Compensation was assessed as average reimbursement per rhinoplasty procedure.

Results: Data was collected for 8,252 rhinoplasty procedures. Rhinoplasty reimbursement trends were flat up until 2020 and increased up to 2023. The number of PS procedures and the number of PS performing these procedures remained stable. ENT rhinoplasty volume increased significantly. ENT billing volume grew by over 436% and the number of ENT surgeons billing rhinoplasties to Medicare increased 315%. At the same time, rhinoplasty reimbursement grew 132% in the last five years.

Conclusions: The rhinoplasty landscape has continued to become more competitive in recent years with more physicians performing the procedure each year. The results from our study indicate that as competition has grown, providers are being compensated more per rhinoplasty procedure performed. These data show that as rhinoplasty volume billed to Medicare has continued to increase, ENT providers have also recently grown their footprint in this market. Further analyses should be done to examine the mechanisms of these shifting practice patterns and any implications they may have on Medicare reimbursement in the future.