Surgical Volume of Dermatologists Who Do Not Perform Mohs Micrographic Dermatologic Surgery: A Cross-Sectional Individual-Level Analysis Using Medicare Data.

ABSTRACT

BACKGROUND: Dermatologists overall perform a large number of procedures billed to Medicare, though the proportion of surgical procedures attributable to general dermatologists who do not perform Mohs micrographic dermatologic surgery (MDS) is unknown. OBJECTIVE: To determine the surgical volume of dermatologists who do not perform MDS and compare it to the surgical volume of MDS-performing dermatologists and all non-dermatologists. METHODS: A cross-sectional analytical study was performed using the Medicare public use file for 2014. Data were divided by physician specialty (dermatologists vs all non-dermatologists), and dermatologists were then dichotomized by MDS performance. RESULTS: Non-MDS dermatologists performed 42.19% of the benign excisions, 57.18% of the malignant excisions, and 46.00% of the intermediate repairs billed to Medicare in 2014. Micrographic dermatologic surgery-performing dermatologists were responsible for most of the complex repairs (67.56%), flaps (52.85%), and grafts (59.65%) billed to Medicare. CONCLUSION: Dermatologists who do not perform MDS represent the single largest group billing Medicare for benign excisions, malignant excisions, and intermediate repairs. They also bill for more complex repairs than all non-dermatologists combined. Micrographic dermatologic surgery-performing dermatologists performed most of the complex repairs, flaps, and grafts billed to Medicare.