• Sraavya G Anne, Aman M Patel, Hassaam S Choudhry, Hannaan S Choudhry, Ghayoour S Mir, and Andrey Filimonov.
• Rutgers New Jersey Medical School, Newark, New Jersey, USA.
• World Neurosurg. 2025 Jan 23: 123720123720.

ObjectiveIn recent decades, many physicians have chosen to opt out of Medicare, allowing them to set their own pricing models for their patients. Characterization of Medicare opt-outs has not been thoroughly studied in any surgical specialty, including Neurosurgery. Our study characterizes the factors that may influence a neurosurgeon's decision to opt out of Medicare acceptance and contextualizes them both within the field and across various surgical specialties.MethodsRetrospective cross-sectional analysis using Centers for Medicare and Medicaid Services (CMS) data on starting date of physician opting out as well as geographic state of practice for neurosurgeons and other specialty surgeons. Additional parameters were collected from publicly available profiles of neurosurgeons regarding medical school graduation year, subspecialty, and type of practice.Results63 neurosurgeons opted out of Medicare. The rate of Medicare opt-outs was highest for Neurosurgery during 2023, while for most other surgical specialties it was highest between the years 2015 and 2017. 54.0% of opt-out neurosurgeons were exclusively private practice physicians. Most were spine (66.7%) or general neurosurgeons (20.6%). Most Medicare non-participating neurosurgeons chose to opt out in their mid-career compared to early or late career. A higher number of these neurosurgeons were located in Alaska, Iowa, California, Connecticut, Florida, and New Jersey.ConclusionsThe circumstances influencing a neurosurgeon's decision to opt out of Medicare acceptance are multifaceted, and our findings suggest that physician experience, specialty, location, and practice structure may all play roles and should be further investigated.Copyright © 2025. Published by Elsevier Inc.

2 keywords...

hide…