70 - The US IR Workforce: An Analysis of Temporal Trends of IR Physicians Serving the Medicare Fee for Service Population 2013-2023

Purpose: To evaluate trends in the interventional radiology (IR) workforce serving the Medicare fee-for-service (FFS) population from 2013–2023 using a work relative value unit (wRVU)-based classification of radiologists, and to compare findings with self-identified IR physicians

Materials and Methods: This retrospective study analyzed data from the Centers for Medicare & Medicaid Services (CMS) Physician and Other Supplier Public Use Files (POPSUF) from 2013–2023. Radiologists were categorized by the proportion of total billed work relative value units (wRVUs) attributable to interventional radiology (IR): ≥50% IR. These groups were compared with physicians who self-identified as IRs. Radiologists who did not perform any IR procedures were excluded. For the remaining, total, diagnostic, and IR workloads were evaluated. To ensure accurate year-to-year comparisons, wRVUs were adjusted for the number of radiologists in each work category and the annual Medicare fee-for-service beneficiary population. Descriptive and longitudinal statistical analyses were conducted using Stata 18.5.

Results: The number of radiologists billing any IR procedure fell from 14,490 in 2013 to 13,035 in 2023 ,while self-identified interventional radiologists rose from 925 to 1,978 (+114%). Total IR work RVUs declined among radiologists and self-identified IR physicians performing ≥50% IR, but increased among those billing < 50% IR. Among the ≥50% IR group, annual IR work RVUs per radiologist per 100,000 beneficiaries decreased from 48 to 35 (–27%). For radiologists performing ≥50% IR, diagnostic work RVUs dropped from 9 to 4 per radiologist per 100,000 beneficiaries (–56%), while E/M contributions rose from 2 to 5 (+150%). IR-based facility work declined from 35 to 20 (–43%), whereas IR-based non-facility work increased from 13 to 15 (+15%).

Conclusion: The proportion of radiologists dedicating the majority of their practice to IR has declined in the Medicare FFS population over the past decade, with a growing concentration of radiolgoists performing < 10 % IR work. Self-identified specialty designations underestimate the true number of practicing IRs, as only 52% of radiologists billing >90% IR work RVUs self-identified as interventional radiologists .