In October of 1992, Medicare reimbursement decreased by 50% for a second total hip or knee arthroplasty performed as part of a simultaneous bilateral procedure. The Medicare records of 67726 patients who underwent total hip and knee arthroplasty were reviewed using data from the New York State Department of Health in the period from October 1, 1989, to September 30, 1996. Simultaneous bilateral total hip arthroplasties represented 1.8% of the total number of total hip replacements performed in fiscal year 1991 (60 of 3418) compared with 1.7% (77 of 4547) performed in fiscal year 1994 (P=.902). Similarly, the number of simultaneous bilateral total knee arthroplasties did not change significantly, with simultaneous bilateral procedures representing 5.9% of the total number of total knee replacements performed in fiscal year 1991 (214 of 3620) compared with 6.2% (369 of 5,931) performed in fiscal year 1994 (P=.568).
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