Mohs micrographic surgery utilization in the Medicare population, 2009.
BACKGROUND
Mohs micrographic surgery (MMS) is the criterion standard treatment for high-risk skin cancers. Few data on current MMS Utilization are available.


OBJECTIVE
To better understand current trends in MMS use in the Medicare population.


METHODS
The 2009 Medicare Limited Data Set Standard Analytic File (LDSSAF), carrier claims, 5% sample and the Physician Supplier Procedure Master File (PSPMF) 100% summary were analyzed.


RESULTS
In 2009, 558,447 Medicare MMS cases were performed, with an average of 1.75 stages per case. In the 5% claims sample, 0.3% and 1.3% of MMS cases were performed for melanoma and carcinoma in situ, respectively. Total annual volume predictions for 1,777 providers showed a left-shifted curve. 65.8% of LDSSAF cases had same-day MMS repairs: 48.7% of repairs were complex, 9.8% intermediate, 32.4% flaps, and 7.4% full-thickness skin grafts.


CONCLUSIONS
The 5% LDSSAF is highly predictive of total claim volumes and is useful for modeling practice trends. There is wide variation in MMS provider annual case volume. These data reflect only Medicare Part B enrollees in 2009; 5% LDDSAF extrapolations are predictions based on sampling.
Mountain West Dermatology, Grand Junction, CO, USA. mrdonaldson@medscape.com
Matthew R
MR
Donaldson
Brett M
BM
Coldiron
D002278:Carcinoma in Situ / Q000601:surgery*; D004428:Ear Neoplasms / Q000601:surgery; D005142:Eyelid Neoplasms / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008048:Lip Neoplasms / Q000601:surgery; D035002:Lower Extremity; D006278:Medicare / Q000706:statistics & numerical data*; D008545:Melanoma / Q000601:surgery*; D015580:Mohs Surgery / Q000706:statistics & numerical data* / Q000639:trends; D009333:Neck; D012535:Scalp; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation / Q000706:statistics & numerical data; D013524:Surgical Flaps / Q000706:statistics & numerical data; D060726:Torso; D014481:United States; D034941:Upper Extremity