Study on Surgical Procedure Efficiency Contradicts CMS Misperception

Childers CP, Foe LM, Mujumdar V, et al. Longitudinal Trends in Efficiency & Complexity of Surgical Procedures. J Coll. Surg. 2025; in press. 

In its Medicare Physician Fee Schedule (MPFS) proposed rule for 2026, the US Centers for Medicare & Medicaid Services (CMS) created a -2.5% “efficiency adjustment” based on the assumption that surgeons are faster today in completing procedures than they were 5 years ago. 

After learning about this negative efficiency adjustment, Christopher Childers, from the University of Washington in Seattle, and colleagues from several other institutions and the ACS analyzed National Surgical Quality Improvement Program (NSQIP) data from 2019 and 2023. The sample included more than 1.7 million operations across 249 CPT codes and 11 surgical specialties.

They found that overall operative times increased by 3.1% in 2023, compared to 2019, and at the procedure level, 90% of CPT codes had similar or longer operative times in 2023 compared to 2019. In addition, they found that patient complexity correspondingly increased.

Read more about the MPFS and the ACS response in the August 14 Advocacy Brief and an ACS press release.