The healthcare system in the United States is facing a growing issue of minor interventions being rebranded and billed as surgery, leading to surprise bills for patients. These procedures, which may seem routine and simple, are being classified as surgical procedures, resulting in higher costs for patients.
For example, a simple removal of a splinter or a skin tag is being billed as a surgical procedure, costing patients hundreds of dollars. These interventions, which may only take a few seconds or minutes to perform, are being coded as surgical procedures, leading to inflated bills for patients.
The current payment system, which values procedures over intellectual work, has contributed to this trend. The Resource Based Relative Value Scale (RBRVS), created in the late 1980s to rationalize Medicare payments to doctors, prioritizes invasive services and procedures over other types of medical care.
The American Medical Association committee responsible for updating billing codes is heavily influenced by surgeons, leading to an increase in the valuation of surgical procedures. This incentivizes healthcare providers to classify even minor interventions as surgery in order to charge higher fees.
Experts have long critiqued this system, calling for reform to ensure fair and accurate billing practices. President-elect Donald Trump’s pick for Health and Human Services secretary, Robert F. Kennedy Jr., has expressed interest in reevaluating the current payment calculation process, potentially shifting the responsibility from the AMA committee to a government agency.
Without reform, patients will continue to face surprise bills for minor interventions that are classified as surgery. It is essential to address this issue to ensure transparency and fairness in healthcare billing practices.
