Utilization Growth and Reimbursement Decline in Spine Surgery: A Retrospective Analysis Using National Medicare Data From 2012 to 2024

Background Spine disorders are among the most common causes of disability, with utilization of spine procedures nearly doubling over the past 2 decades. As costs have continued to escalate, the Centers for Medicare 52.9% were women, with an average Elixhauser Comorbidity Index of 4.9 ± 3.7. Overall utilization increased by 19% (P = 0.04), with cervical and lumbar procedures rising by 30.61% (P = 0.01) and 19.97% (P = 0.04), respectively. Despite increased utilization, inflation-adjusted Medicare reimbursement significantly declined across all procedure types, with lumbar procedures experiencing the greatest reduction (−28.56%, P Conclusion Despite the growing utilization of all included procedures, the present data have demonstrated a decrease in Medicare reimbursement across all subgroups. Clinical Relevance These reimbursement trends shape the field of spine surgery, impacting the sustainability of spine practices, affecting patient access to care, and influencing the adoption of new technologies. Level of Evidence 3.