Doctor and Clinician Utilization (Procedure Volume) Data Now Available on Medicare.gov Compare Tool

The Centers for Medicare & Medicaid Services (CMS) added utilization data, specifically procedure volume, for the first time on the Medicare.gov compare tool’s profile pages for doctors and clinicians. The procedures initially added to profile pages were performed by doctors and clinicians for Original Medicare and Medicare Advantage patients in the last 12 months, after allowing a three-month claim processing period (for example, claims for dates of service occurring between June 1, 2022 through June 30, 2023 that were processed by September 30, 2023).

Utilization data was first published only in a downloadable format in late 2017. This information is a subset of the “Medicare Physician & Other Practitioners – by Provider and Service” dataset, and is currently published in the Provider Data Catalog (PDC). A procedure volume data file is now available and includes the procedure category information currently publicly reported on the compare tool on Medicare.gov profile pages for doctors and clinicians.

The initial release of procedure volume data on doctor and clinician profile pages includes 12 procedures (additional procedures will be added periodically, as feasible):

  1. Hip replacement
  2. Knee replacement
  3. Spinal fusion
  4. Cataract surgery
  5. Colonoscopy
  6. Hernia repair – groin (open)
  7. Hernia repair (minimally invasive)
  8. Mastectomy
  9. Coronary artery bypass graft (CABG)
  10. Pacemaker insertion or repair
  11. Coronary angioplasty and stenting
  12. Prostate resection

For more information, access the “Utilization (Procedure Volume) Data Published on the Compare Tool on Medicare.gov” fact sheet (PDF, 195 KB) on the Care Compare: Doctors and Clinicians Initiative page.

If you have any questions about public reporting for doctors and clinicians on the Medicare.gov compare tool, contact the Quality Payment Program (QPP) Service Center by email at [email protected], by creating a QPP Service Center ticket, or by phone at 1-866-288-8292 (Monday-Friday, 8 a.m. - 8 p.m. ET).

To receive assistance more quickly, especially during busier periods such as the submission window, please consider calling during non-peak hours — before 10 a.m. and after 2 p.m. ET.

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