Trends in in-office rhinology: Analysis of patients using the Medicare database

Introduction: Devices for in-office posterior nasal nerve ablation and nasal airway remodeling have become available recently and are becoming increasingly popular for rhinitis and nasal airway obstruction. This study analyzes the utilization and growth of these procedures over a 5-year period.

Methods: Retrospective review of Medicare utilization and billing data. The relevant information was obtained from Medicare claims data using Centers for Medicare and Medicaid Services datasets. All Medicare claims were analyzed from 2017 to 2022. Data were extracted for Current Procedural Terminology (CPT) code 30117, destruction of intranasal lesion maxillary sinus balloon dilation (CPT 31295), and endoscopic inferior turbinate submucous resection (CPT 30140). Location was set to in-office. Total services, beneficiaries, and payments were compared. Linear regression was used to evaluate the yearly change in total services

Results: From 2017 to 2022, the number of services for CPT 30117 increased from 1009 to 7795. On linear regression, the number of procedures increased by 1404.1 per year, (p = .005, 95% CI: 693.6-2114.7). Utilization for maxillary balloon dilation and inferior turbinate submucous resection did not vary significantly by year. Aggregate Medicare payments over the period have increased 875.8% to $3.96 million. Total payments for maxillary balloon have increased modestly by 18% over the same period to $14.6 million. Similarly, total payments for inferior turbinate submucous resection increased 6.56% to 0.94 million. The number of unique providers performing 30117 increased 693.18% over the same period, while turbinate resection decreased by 2.79% and maxillary balloon dilation decreased by 29.26%.

Conclusions: There has been rapid growth of in-office utilization of CPT 30117, secondary to new devices available for posterior nasal nerve ablation and nasal airway remodeling. This growth is significantly greater to other in-office procedures. Further trends will be clarified with the recent release of device and procedure specific codes for nasal airway remodeling and posterior nasal nerve ablation.