Because Congress has been committed to “budget neutrality” for Medicare’s physician payments, this was financed by reducing Medicare’s conversion factor by about 3.5 percent, from $36.09 per RVU to $34.89 per RVU.Jul 8, 2021
|Code||Work RVUs||Total non-facility RVUs|
|99214, Established-patient office visit||1.5||3.02|
|99215, Established-patient office visit||2.11||4.7|
|Transitional care management|
|99495, Moderate complexity TCM||2.11||4.62|
How RVUs Work. RVUs do not represent monetary value. Instead, they signify the relative amount of physician work, resources, and expertise required to service patients. The actual dollar amount of payment for those services only comes when a conversion factor (CF) — dollar per RVU — is applied to the total RVUs accrued Aug 31, 2017
Emergency physician reimbursement is directly derived from RVU generation. RVU per patient will vary by institution, but a report from 79 academic medical centers determined the average RVU to be 2.92 per patient. In 2019, the CMS payment per RVU was approximately $36.May 19, 2021
The Medicare conversion factor is the dollar amount that is multiplied by the total RVU values for each physician service to determine Medicare reimbursement. Medicare's final rule, and the subsequent Consolidated Appropriations Act of 2021, reduced its conversion factor from $36.09 per RVU to $34.89 per RVU.Feb 9, 2021
Top 20 ED Reimbursement Codes
|Service||CPT Code||Total RVUs|
|Spinal Puncture - Lumbar||62270||2.25|
|Dressings and/or Debridement of Partial-Thickness Burns||16020||1.55|
|Single Laceration 2.6 up to 5.0cm (face, ears, eyelids, nose, lips) and/or mucous membranes||12013||1.66|
For example, Whipple procedure (52.8 RVUs) had the highest 30-day overall morbidity and frequency of SAEs (45% and 35%, respectively), while trans-hiatal esophagectomy (44.2 RVUs) had the second highest (32% and 21%, respectively), and partial hepatectomy (39 RVUs) had the third highest (25% and 22% respectively).
1.29 RVUs RVUs and established patient visits Relative Value Scale (RBRVS) Under the Resource-Based used by Medicare and many other third-party payers to determine physician reimbursement, a level-III established patient office visit (i.e., code 99213) has a total of 1.29 RVUs assigned to it.