Opioid Prescribing Among Mohs Surgeons From 2014 Through 2022: An Analysis of Medicare Claims Data

Abstract

BACKGROUND Mohs micrographic surgery causes significant postsurgical pain, particularly when more extensive reconstructions are required. Although opioids are a reasonable choice for pain control in select cases, the risks of dependency and overdose warrant stringent opioid stewardship. OBJECTIVE To determine how the opioid prescribing practices among Mohs surgeons treating Medicare beneficiaries have changed during the opioid epidemic using the available Medicare claims data from 2014 to 2022. METHODS A retrospective analysis of opioid prescribing using Medicare claims data. RESULTS Between 2014 and 2022, the percent of Mohs surgeons prescribing opioids decreased from 48% to 33%. Factors associated with opioid prescribing included medical school graduation in 1990 or after; location in the South, Midwest, or West; higher Mohs case volume; and performing higher complexity repairs. Surgeons prescribing opioids decreased the average days' supply by 19%. The percent of opioid prescriptions for hydrocodone decreased by 28% while those for tramadol increased by 246%. CONCLUSION Mohs surgeons' opioid prescribing practices have continued to improve since 2014 through limiting the frequency and duration of opioid prescriptions, with most surgeons not prescribing opioids in 2022.