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61% each year. The largest decrease was seen for laceration repairs up to 7.5 cm, with reimbursement rates for all 4 relevant CPT codes decreasing by more than 60%. When adjusted for inflation, Medicare reimbursement declined by an average of 29% over the last 20 years for the 20most common emergency medicine services. Knowledge of these trends is essential to address current controversies in emergency medicine billing adequately and advocate for sustainable payment system reform. When adjusted for inflation, Medicar