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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.