Trends in Medicare Billing Among Mohs Surgeons in the United States During 2012: A Retrospective Cohort Study.

BACKGROUND: It is important to understand variability in practice patterns of Mohs surgeons.

OBJECTIVE: To examine the practice patterns of physicians performing Mohs micrographic surgery (MMS) in the United States.

METHODS AND MATERIALS: This retrospective cohort study of the 2012 Medicare Physician and Other Supplier Public Use Files includes all physicians who billed Medicare for MMS.

RESULTS: The authors found 2,067 physicians who billed Medicare for MMS in 2012. American College of Mohs Surgery (ACMS) members took a significantly higher average number of head and neck (H&N) and trunk layers compared with American Society for Mohs Surgery (ASMS) members and those with no membership (p < .001). Male surgeons, surgeons with more experience (21+ years out), surgeons in private practice, and those practicing in rural populations closed a significantly greater proportion of cases with flaps or grafts, as compared to females (p < .001), those with less experience (<21 years out) (p < .001), surgeons in academic practice (p = .004), and those practicing in urban or cluster populations (p < .001), respectively.

CONCLUSION: There is significant variability in practices of Mohs surgeons in the United States.