Introduction: Per the Hospital Price Transparency Rule, effective January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) requires hospitals to disclose prices for all services provided. The aim of this study was to evaluate regional price and disclosure variability for two key urologic services, (Prostate Biopsy, CPT 55700; Prostatectomy, CPT 55866) across hospitals providing urologic care in several US census divisions. Findings were then compared to mammography (77066), to determine any differences in reporting within Men’s and Women’s Health domains.
Methods: Self-pay prices for 55700, 55866, and 77066 were selected from chargemasters of urology-providing hospitals listed in the US News and World Reports Rankings (USNWRR). Hospitals in all US census regions were included. Variance in price for these procedures was evaluated, rates of disclosure for each CPT and overall were calculated, and correlation with the USNWR ranking was analyzed.
Results: N=1475 hospitals were included which were found in the following regions: Northeast (NE) 18.37%, Midwest (MW) 23.05%, South (S) 39.12%, and West (W) 19.45% . In NE, MW, S, and W, price disclosure for 77066 is 88.92%, 84.71%, 84.58%, and 79.09%; for 55700 is 74.91%, 69.12%, 75.39%, and 70.03%; and for 55866 is 53.14%, 57.65%, 53.21%, and 60.63%; and compliance with all three procedures is 45.02%, 45.29%, 40.55%, and 39.02, respectively. There is significant variability in price of 55688 (F(8, 812)=9.574, p=1E-12)), 55700 (F(8,1065)=3.234,p=0.001)), but not in 77066 (F(8,1235)=0.660, p=0.727) between regions. Median price of 55688 is $34308.00 (IQR 18,407.61-62277.75); 55700 $6,672.95 (IQR 3403.95-12735.00); and 77066 was $424 (239.00-652.31). MW had the highest prices for 77066 ($484.43. S had highest price for 55700 ($12125.48). W had the highest price for 55866 ($46777.00). Better USNWR scores (out of 100) correlated with higher mammography (R=0.208, p=1.7E-7) and slightly with prostatectomy prices (R=0.08, p=0.046).
Conclusion: Disclosure of prices for urological procedures with CMS requirements is lower than that of mammography. Of the prices that were disclosed, there is significant regional variability, and prices for services tend to increase with hospital ranking on USNWR. Overall compliance with the final rule remains low, and men are faced with additional challenges due to significant variability in the cost of urologic care. Further study of regional practice trends with these services may provide insight into the gender-related health disparities observed.
