Majmundar V, Deo R, Mishra AK, Li PY, Byer M, Sancassani R. Transcatheter atrial septal defects and patent foramen ovale closure: Medicare utilization and reimbursements. World J Methodol 2025; 15(4): 103146 [DOI: 10.5662/wjm.v15.i4.103146]
Corresponding Author of This Article
Ajay Kumar Mishra, MD, Assistant Professor, Department of Cardiology, Concord Hospital, 250 Pleasant St, Concord, NH 03301, United States. ajaybalasore@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Vidit Majmundar, Rohan Deo, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Ajay Kumar Mishra, Department of Cardiology, Concord Hospital, NH 03301, United States
Peng-Yang Li, Department of Cardiology, Virginia Commonwealth University, Virginia, Richmond, VA 23284, United States
Marina Byer, Rhea Sancassani, Department of Cardiology, University of Miami-Miller School of Medicine, Miami, FL 33136, United States
Author contributions: Majmundar V, Deo R, and Mishra A contributed to manuscript writing and analysis of data; Majmundar V and Mishra A contributed to design; Deo R contributed to manuscript writing, editing; Li PY, Byer M, and Sancassani R contributed to manuscript review.
Institutional review board statement: No Institutional Review Board approval was necessary for this study. All data was deidentified and available from the website of Centre of Medicare Services.
Informed consent statement: No Humans were directly involved in this research project. Signed consent was not necessary as all data was deidentified and available from the website of Centre of Medicare Services.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest related to this work. No financial, personal, or professional affiliations influenced the research, analysis, or conclusions presented in this manuscript.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request. No proprietary or confidential data were used in this research.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ajay Kumar Mishra, MD, Assistant Professor, Department of Cardiology, Concord Hospital, 250 Pleasant St, Concord, NH 03301, United States. ajaybalasore@gmail.com
Received: November 11, 2024 Revised: March 31, 2025 Accepted: April 11, 2025 Published online: December 20, 2025 Processing time: 267 Days and 19.1 Hours
Abstract
BACKGROUND
The Food and Drug Administration has approved percutaneous atrial septal defect (ASD) and patent foramen ovale (PFO) closure devices for hemodynamically significant interatrial shunts, paradoxical emboli including stroke, and decompression sickness. We aimed to study the trends in utilization and reimbursements of transcatheter ASD/PFO closure devices.
AIM
To analyze trends in utilization and Medicare reimbursements for transcatheter ASD/PFO closure procedures from 2013 to 2022.
METHODS
A query of administrative data on United States Medicare beneficiaries undergoing transcatheter ASD/PFO was conducted from 2013 to 2022 using the Centers for Medicare and Medicaid Services Part B National Summary Data File. Inflation adjustments were made using the 2023 Consumer Price Index. Trend analysis was quantified using growth rate and simple linear regression calculations. All analyses were performed using Microsoft Excel 16.77.1 (2023).
RESULTS
The annual number of transcatheter ASD/PFO closure procedures increased by 81% since 2013, with an average yearly growth rate of 44% cases per year (P < 0.001). Annual Medicare reimbursements for transcatheter ASD/PFO therapies mirrored the annual procedure trends. The per-case reimbursements decreased by 18%, i.e., $1128.80 in 2013 and $ 770.21 in 2022 (P < 0.001). There was a significant drop in the number of procedures in the year 2020, which correlates to the onset of the coronavirus disease 2019 pandemic, followed by a sharp uptick in the number of cases in 2021 and 2022.
CONCLUSION
Medicare utilization of transcatheter ASD/PFO closure therapies has grown significantly in procedural volume from 2013 to 2022. However, this has been accompanied by a decrease in per-case reimbursements.
Core Tip: From 2013 to 2022, the volume of transcatheter atrial septal defect (ASD)/patent foramen ovale (PFO) closure procedures in Medicare beneficiaries rose by 81%, with an average annual growth rate of 44%. While annual Medicare reimbursements paralleled this trend, per-case reimbursements decreased by 18%, from $1128.80 in 2013 to $770.21 in 2022. A significant decline in procedures was observed in 2020, coinciding with the coronavirus disease 2019 pandemic, followed by a sharp increase in 2021 and 2022. These results underscore a growing demand for ASD/PFO therapies, despite a reduction in reimbursement rates.
