David Carl Levin MD, Presenter: Nothing to Disclose

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Andrea Joann Maitino MS, Abstract Co-Author: Nothing to Disclose

Jonathan H. Sunshine PhD, Abstract Co-Author: Nothing to Disclose

Radiologists have become concerned about recent encroachment by cardiologists and vascular surgeons upon noncardiac vascular interventions. Our purpose was to document recent trends in procedure volume among different specialties and to ascertain where this turf battle currently stands.

We reviewed the Medicare Part B fee-for-service databases between 1997 and 2002 for the surgical procedure CPT codes for percutaneous transluminal angioplasty of noncardiac peripheral arteries (6 codes) and transcatheter placement of noncardiac intravascular stents (2 codes). Using the Medicare physician specialty codes, procedure volume in each CPT code was determined for radiologists, cardiologists, vascular surgeons, and other physicians.

Between 1997 and 2002, the total Medicare volume in these 8 procedure codes increased from 88,865 to 173,119 (+94.8%). In 2002, radiologists performed 72,657 procedures; cardiologists 62,901; vascular surgeons 17,895; and other physicians 19,666. Over the 5-year interval, procedure volume among radiologists increased 29%, cardiologists 181%, vascular surgeons 398%, and other physicians 195%. Radiologists’ share in the total pool of procedures in 2002 was 42.0% (down from 63.3% in 1997); cardiologists 36.3% (up from 25.2% in 1997); vascular surgeons 10.3% (up from 4.0% in 1997); and other physicians 11.4% (up from 7.5% in 1997).

Between 1997 and 2002, procedure volume in percutaneous peripheral vascular interventions grew at much faster rates among cardiologists, vascular surgeons, and other physicians than they did among radiologists. As a result, radiologists’ share of this market declined from substantially between 1997 and 2002. However, the more encouraging news for radiologists is that over the 5 years their procedure volume continued to grow substantially and that in 2002 they still had the largest share of any physician specialty. Thus, despite the erosion, interventional radiologists still maintain a strong position in this rapidly growing field.

Levin, D, Rao, V, Parker, L, Maitino, A, Sunshine, J, The Changing Roles of Radiologists, Cardiologists, and Vascular Surgeons in Percutaneous Peripheral Vascular Interventions: Recent 5-year Trends.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406441.html