Utilization of Arterial and Venous Thrombectomy in the United States: A 6-Year Evaluation of Medicare Claims.

Abstract

The aim of this study was to understand the utilization of arterial thrombectomy (AT) and venous thrombectomy (VT) by provider specialty, region, and diagnosis code in the Medicare population. Common Procedural Terminology (CPT) codes 37184 to 37188 claims for AT and VT between January 2017 and December 2022 were analyzed from the Medicare standard analytic file 5% sample claims database. Data fields included provider specialty, geographic region, place of service, and number of procedures. A secondary analysis was performed of thrombectomy claims by International Classification of Diseases, 10th rev, codes for venous thromboembolism (VTE) or arterial thromboembolism. Thrombectomy claims increased by 38%, with a 137% increase in VT (compound annual growth rate [CAGR] +19%) compared with a 7% increase in AT (CAGR +1%). Dominant VT specialties were radiology (34%), surgery (29%), and cardiology (20%). Dominant AT specialties were surgery (41%), cardiology (35%), and radiology (17%). Cardiology demonstrated a 19% decrease in AT (CAGR -4%), whereas radiology experienced a 47% increase (CAGR +5%). The majority of AT and VT claims were performed in the Southeast and Midwest, accounting for 62% of AT and 57% of VT. Dominant place of service for both AT and VT was outpatient hospital (76% of AT, 78% of VT). International Classification of Diseases, 10th rev, analysis demonstrated a 712% increase in AT claims for pulmonary embolism (CAGR 52%). VT and AT for VTE continue to rise at a higher rate than non-VTE claims, with a 712% increase in AT for pulmonary embolism and 137% increase in VT. Radiology remains the dominant VT specialty and experienced the greatest increase in AT claims as a specialty.