Affiliation:
1. From the Hansjorg Weiss Department of Plastic Surgery, New York University Grossman School of Medicine.
Abstract
Background:
Relative value units (RVUs) are broadly used for billing and physician compensation; however, the accuracy of RVU assignments has not been scientifically evaluated for craniofacial surgery. The authors hypothesize that unbalanced RVU allocation creates inappropriate disparities in value among procedures performed by cleft and craniofacial surgeons.
Methods:
The National Surgical Quality Improvement Program Pediatric database was queried to identify all cleft and craniofacial surgery cases performed by plastic surgeons from 2012 to 2019 based on CPT code. Microsurgical cases and CPT codes with a case count of fewer than 10 were excluded. Efficiency was defined as total RVUs divided by total operative time (ie, RVUs/hour). Mean efficiency per CPT code was ranked and compared by quartile using t tests.
Results:
The sample consisted of 69 CPT codes with 50,450 cases. In the top quartile, most CPT codes were craniofacial procedures including frontofacial procedures (23.53%) and craniectomies for craniosynostosis or bony lesions (35.29%) (mean, 15.65 ± 4.22 RVUs/hour). The lowest quartile was composed mainly of CPT codes for cleft procedures including operations for velopharyngeal insufficiency (17.65%), cleft palate repair (23.53%), and cleft septoplasty (5.88%) (mean, 7.39 ± 0.98 RVUs/hour; P < 0.001). It was 2.5 times more efficient for a cleft and craniofacial surgeon to perform a local skin flap (15.18 RVUs/hour) than a secondary palatal lengthening for cleft palate (6.09 RVUs/hour).
Conclusions:
The current RVU allocation to cleft and craniofacial procedures creates arbitrary disparities in physician efficiency, with cleft procedures disproportionately negatively affected. RVU assignments should be reevaluated to avoid disincentivizing cleft surgical care.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference18 articles.
1. Toward developing a relative value scale for medical and surgical services.;Hsiao;Health Care Financ Rev,1979
2. Estimating physicians’ work for a resource-based relative-value scale.;Hsiao;N Engl J Med,1988
3. Is the relative value of surgeon effort equal across surgical specialties?;Hayon;Surgery,2020
4. Physician coding and reimbursement.;Beck;Ochsner J,2007
5. The relative value unit: history, current use, and controversies.;Baadh;Curr Probl Diagn Radiol,2016
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