Abstract
Purpose :
Surgical authority is a continually expanding landscape for optometrists nationwide. This national retrospective cohort analysis is focused on characterizing rates of lid lesion removal by optometrists over the past 5 years.
Methods :
The Centers for Medicare and Medicaid Services (CMS) Public Use File (PUF) was executed for lid lesion removals performed by optometrists using Current Procedural Terminology (CPT) code 15823 (removal of excessive skin and fat of upper eyelid) and 67840 (removal of eyelid growth) between 2016 and 2020. Provider type was determined via National Provider Identification (NPI). Provider count, service count, unique beneficiary count, total Medicare allowed payments, RUCA code, and US state of practice were extracted and analyzed. Providers performing less than 11 lid lesion removals for any given year were excluded from our analysis. All statistical analyses were performed with IBM SPSS Version 29.
Results :
Lid lesion removal service count totaled 184 across 4 US states (FL, LA, NV, and OK) between 2016 and 2020. A total of 7 optometrists performed at least 11 lid lesion removals across the same time frame. Optometrists practiced in OK (N=3, 42%), FL (N=2, 28%), LA (N=1, 14%), and NV (N=1, 14%). 50% of all lid lesion removals were performed in OK (N=92), while N=54 (29%), N=24 (13%), and N=14 (7%) were performed in FL, LA, and NV, respectively. Considering all states, regression outcomes highlighted a decrease of 8.8 lid lesion removals per year between 2016 and 2020. By RUCA, optometrists practiced mostly in metropolitan areas (N=5, 71%) with fewer in micropolitan areas (N=2, 28%). Average Medicare-allowed payments were lowest in Florida ($168 in 2016) and highest in Nevada ($276 in 2019).
Conclusions :
Recently, optometric surgical authority faced challenges in expansion in several US states. Lid lesion removal by optometrists has not experienced significant growth profiles and remains limited to few US states. Similar to prior studies, the CMS Medicare PUF may continue to serve as a surrogate dataset to monitor optometric-based services.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.