Methods
We queried the Medicare Provider Utilization and Payment Data: Physician
and Other Supplier Public Use File (PUF) available through the Centers
for Medicare & Medicaid Services (CMS.gov)[3]. The Physician
Utilization and Other Supplier PUF through CMS.gov was developed as part
of the Obama Administration’s efforts to make the US healthcare system
more transparent, affordable, and accountable. The data file is fully
open to public scrutiny, does not require a fee, and does not require
identification to query the file. Patients (beneficiaries) are not
identifiable; however, providers are listed by their National Provider
Identifier (NPI) number, full name, and facility address.
Billable procedures are listed by Healthcare Common Procedure Coding
System (HCPCS) code and we included the following HCPCS code: 76536 -
Ultrasound, soft tissues of the head and neck (e.g. thyroid,
parathyroid, parotid), real time with image documentation. As 76942 -
Ultrasonic guidance for needle placement (e.g. biopsy, aspiration,
injection, localization device), imaging supervision and interpretation,
and 10022 - Fine needle aspiration, with imaging guidance, are not
specific to the head and neck, these two HCPCS codes were not included.
For each of the years available in the dataset (2012-2015), the files
were filtered to include 4 provider types: Diagnostic Radiology (DR),
Endocrinology (ENDO), General Surgery (GS), and Otolaryngology (OTO).
Statistics were performed using Microsoft Excel 2011 (Microsoft
Corporation, Redmond, WA). Descriptive statistics were used for all 4
years; however, since the same providers are included year after year,
we chose to perform student t-test and one way ANOVA between the years
2012 and 2015 to analyze trends. As this is an analysis of a public
database, institutional review board exemption was obtained.