Relative Value Units and Operative Time in Plastic and Reconstructive Surgery

Cadwell, Joshua B.; Ahsanuddin, Salma; Patel, Shreya; Luthringer, Margaret; Weisberger, Joseph; Ignatiuk, Ashley

doi:10.1016/j.bjps.2022.02.045

Cited by 2 publications

(6 citation statements)

References 15 publications

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“…Recent NSQIP studies in urology and plastic surgery have similarly found wRVUs per hour to decrease by 1.32 and 0.82 per additional operative hour, respectively. 6,8 Furthermore, when comparing procedures shorter or longer than 1-hour, shorter cases received more wRVUs per hour (10.0 vs. 8.1, P = .005). Therefore, our findings suggest a proportionally lower reimbursement for physician time during longer cases, and this issue has more strength and magnitude in hand surgery when compared to these other fields.…”

Section: Discussionmentioning

confidence: 99%

“…This finding reflects recent work by our group as well as Hayon et al However, these analyses had stronger positive correlations at R 2 = 0.78 and R 2 = 0.82, with an increase of 5.3 and 9.4 wRVUs for each additional procedural hour in plastic and orthopaedic surgery, respectively. 8,18 However, the association between wRVUs per hour and operative time is weakly negative (R 2 = 0.25), such that each additional hour of surgery was associated with 3.28 fewer wRVUs per hour (Figure 2). Recent NSQIP studies in urology and plastic surgery have similarly found wRVUs per hour to decrease by 1.32 and 0.82 per additional operative hour, respectively.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Case selection criteria were based on recent work in urology, otolaryngology, and plastic and reconstructive surgery. [6][7][8]…”

Section: Case and Variable Identificationmentioning

confidence: 99%

“…5 Recent work in the surgical literature has focused on the accuracy of this system in estimating wRVUs and thus physician time and effort. [6][7][8] This is important to understand because RVUs are currently used to calculate Medicare reimbursement directly and are used indirectly by HAND 19 (3) many private payers in their reimbursement schemata. Furthermore, many physicians' pay schedules are linked to their generated wRVUs.…”

Section: Introductionmentioning

confidence: 99%

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Discrepancies in Work Relative Value Unit Assignment Based on Operative Time in Hand Surgery

Cadwell

Weisberger

Gary

et al. 2022

Hand (New York, N,Y.)

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Background: Work relative value units (wRVUs) are an intricate component of physician reimbursement determination in the United States. This paper assesses whether wRVUs appropriately consider operative time in hand surgery. Methods: The 50 most common single Current Procedural Terminology code hand surgery cases were queried from the 2013 to 2018 National Surgical Quality Improvement Program database. The average assigned wRVUs and median operative times were calculated for each CPT. Linear regressions were calculated between operative time, wRVUs, and wRVUs per hour. Cases deviating the most from the expected wRVUs based on operative time were identified. Results: In all, 46 800 cases comprising the top 50 most common hand surgery procedures were identified. Among these cases, the median (range) assigned operative time was 62 minutes (18-110), wRVUs were 7.5 (3.5-18.0), and wRVUs per hour was 8.3 (4.9-14.2). There was a positive linear correlation between operative time and wRVUs ( R2 = 0.60). Each additional operative hour was associated with an additional 6.3 wRVUs ( P < .001). Based on this relationship, the assigned wRVUs for included cases ranged from 59.7% to 172.6% of expected. There was a weak negative relationship between wRVUs per hour and operative time ( R2 = 0.25). Cases shorter than 1 hour had more wRVUs per hour than those longer than 1 hour (10.0 vs. 8.1, P = .003). However, this relationship disappeared when considering case turnover. Conclusion: This study suggests a moderately strong positive correlation between wRVUs and operative time in hand surgery. Yet, numerous outliers from this trend exist, suggesting some discrepancies in reimbursement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Case selection criteria were based on recent work in urology, otolaryngology, and plastic and reconstructive surgery. [6][7][8]…”

Section: Case and Variable Identificationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Discrepancies in Work Relative Value Unit Assignment Based on Operative Time in Hand Surgery

Cadwell

Weisberger

Gary

et al. 2022

Hand (New York, N,Y.)

Self Cite

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Strength in Numbers: A SWOT Analysis of Plastic Surgery

Blum,

Reghunathan,

Bradford

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Plastic surgeons comprise the minority of practicing surgeons, with an even smaller minority practicing in an academic setting. As the practice of medicine and the systems in which we operate continue to evolve, it is essential that plastic surgeons have a say in the changing landscape. This study conducted a strengths, weaknesses, opportunities, and threats (SWOT) analysis of plastic surgery to identify unifying strengths and common threats. Methods: An electronic survey was distributed to American Council of Academic Plastic Surgeons’ Winter Meeting attendees on three separate occasions preceding the meeting. Respondents were asked to provide demographic information and to identify the top three strengths, weaknesses, opportunities, and threats (SWOT analysis) for the specialty. Subgroup analyses were performed based on demographic characteristics. Results: A total of 187 responses were received from meeting attendees, representing an 89.0% response rate. Most respondents were non-Hispanic (78.6%), White (66.8%), women (59.5%), and faculty/independent physicians (65.8%). The most identified strength in plastic surgery was our problem-solving abilities (62.0%). The most identified weakness was poor public perception of plastic surgery (54.0%). The most identified opportunity was demonstration of value to health systems (67.9%), and the most identified threat was scope of practice creep by other specialties (78.1%). The SWOT analysis identified lack of surgeon diversity as a key weakness, improvement of surgeon diversity as a key opportunity, and lack of diversity among plastic surgeons as a key threat to the specialty. Conclusion: Only through a diverse but united front can we effectively use our strengths to face our threats and employ opportunities to overcome our weaknesses.

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Relative Value Units and Operative Time in Plastic and Reconstructive Surgery

Cited by 2 publications

References 15 publications

Discrepancies in Work Relative Value Unit Assignment Based on Operative Time in Hand Surgery

Discrepancies in Work Relative Value Unit Assignment Based on Operative Time in Hand Surgery

Strength in Numbers: A SWOT Analysis of Plastic Surgery

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