Medicare Paid Less for Female-Specific Surgeries
Research indicates surgical procedures for women consistently received lower compensation than male counterparts.
Updated on Oct. 9, 2026 in Men’s Health
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Should Medicare reimbursement rates for surgeries be adjusted to eliminate gender-based payment disparities?
A 2023 analysis revealed that Medicare reimbursement rates for female-specific surgeries remained significantly lower than for comparable male procedures. These findings highlight a long-standing trend in healthcare compensation that impacts how hospitals prioritize and resource various surgical services.
Why it matters
Disparities in reimbursement can influence hospital resource allocation, as facilities often prioritize operating room time and staff for procedures that generate higher revenue. This systemic issue affects the accessibility and delivery of gynecologic care compared to urologic and other male-specific surgical specialties.
A 2023 study of 55 procedure pairs found that male-specific surgeries carried RVUs averaging 30 percent higher than female equivalents. This followed earlier findings from 1997 that identified a 44 percent pay disparity, with no statistically significant improvement observed between 2003 and 2023.
The players
American Medical Association
A national organization that maintains the Current Procedural Terminology coding system used to determine healthcare billing and reimbursement values.
Centers for Medicare & Medicaid Services
A federal agency that administers Medicare and sets reimbursement rates based largely on industry-recommended valuations.
The details
The valuation of surgical procedures is largely determined by the American Medical Association committee, which relies on physician surveys to report the time and skill required for specific surgeries. Because surgeons often overestimate time and effort in these surveys, specialties with higher representation on the committee—which currently lacks gynecologic subspecialists—can secure higher valuations. Consequently, Medicare, which accepts nearly 90 percent of these recommendations, pays higher rates for procedures like a penile biopsy at $121.32 compared to a vaginal biopsy at $65.74.
Timeline
1997: Researchers first documented pay disparities for sex-specific procedures.
2003-2023: Studies found no statistically significant improvement in payment disparity.
2023: Researchers evaluated 55 pairs of sex-specific surgical procedures.
2027: New CPT codes for maternity care are scheduled to take effect.
Health Landscape
The valuation process overseen by the Current Procedural Terminology system has historically favored certain surgical specialties over others, creating systemic gaps in compensation. As the healthcare industry moves toward 2027, the implementation of new maternity care billing codes signals a potential shift in how gynecologic services are valued.
While these figures reflect institutional reimbursement rather than direct patient costs, the allocation of operating room resources can affect wait times for elective procedures. Patients should feel empowered to discuss their care timelines and scheduling concerns with their surgeons and primary care physicians.
The takeaway
The valuation of medical procedures often depends on self-reported data that may not reflect actual clinical time, leading to significant financial disparities between specialties. Patients facing surgical decisions can ask their providers about typical wait times and whether resource allocation might impact their treatment plan.
What happens next
New CPT codes for maternity care billing are scheduled to take effect in 2027.
Further reading
For broader context on how clinical care and surgical practices are evolving, visit Men’s Health.
Source note: This article includes information reported by Becker's Hospital Review | Healthcare News & Analysis.
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Should Medicare reimbursement rates for surgeries be adjusted to eliminate gender-based payment disparities?
