VA PUGET SOUND HEALTH CARE SYSTEM

VA Community Care Vascular Surgery Costs Surge as PAD Referrals Nearly Triple Over Five Years

- VA Community Care referrals for vascular surgery nearly tripled from 21,407 in FY2020 to 62,487 in FY2025, a 192% increase driven largely by peripheral artery disease interventions. - Infrainguinal endovascular procedure payments more than quadrupled from $8.8 million to $40.2 million, with femoral-popliteal atherectomy as the highest-paid procedure code across nearly all years analyzed. - Distance from a VA facility accounted for 88% of community care referrals, and no open bypass or groin-level reconstruction procedures appeared among the top 30 paid codes. - Researchers emphasize the need for comparative effectiveness research to guide evidence-based treatment decisions as endovascular spending dominates VA Community Care vascular surgery costs.