Investigation of Hospital Pricing Information for Plastic Surgery Procedures Reveals Widespread Violation of the CMS Price Transparency Act.

ABSTRACT

BACKGROUND: Price transparency allows patients to estimate surgical procedure costs, which can affect where they elect to receive care and should theoretically result in hospitals setting lower and more uniform prices. To elucidate the traditionally opaque nature of health care pricing, the U.S. Centers for Medicare & Medicaid Services has mandated that hospitals publicly release their pricing information. The authors sought to investigate the utility of price transparency for plastic surgery patients, who are uniquely situated to benefit because of the dominance of elective procedures. METHODS: This study included 54 randomly chosen public and private hospitals. Pricing information for 15 common plastic surgery-related procedures was compiled from their websites. RESULTS: One year after the ruling went into effect, only 13% of hospitals were fully compliant with Centers for Medicare & Medicaid Services requirements for reporting standard charges. The most commonly reported plastic surgery procedures were adjacent tissue transfers (CPT codes 14000, 14001, 14301, and 14302), with an average of 32.4% of hospitals listing pricing data. The 25.9% of hospitals reporting the immediate insertion of breast implants (CPT code 19340) pricing presented a wide range of gross prices, from $2346.09 to $29,969.35. Free and pedicled flaps (CPT codes 19364, 19361, 19367, 19368, and 19369) were less commonly reported than autologous tissue transfer or nonflap breast procedures ( P = 0.00). CONCLUSIONS: A comparative analysis of published prices provides a starting point for surgeons to recommend facilities to patients based on price. However, significant variability was observed in data presentation, reported procedures, and listed prices. These inconsistencies in reporting and unrealistic ranges in price render the comparison of plastic surgery prices among hospitals impractical.