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Relative Value Units Underestimate Reimbursement for Revision Shoulder Arthroplasty.

Publication ,  Journal Article
Belay, ES; Charalambous, LT; Saltzman, EB; Klifto, CS; Anakwenze, O
Published in: J Am Acad Orthop Surg
May 1, 2022

INTRODUCTION: Relative value units (RVUs) have been fundamental to reimbursement calculations in payment models for arthroplasty surgeons. RVUs are based on various factors, including physician work, and have been higher for increased complexity, such as revision arthroplasty. The purpose of this study was to compare RVUs and estimated reimbursement differences between primary and revision shoulder arthroplasty. METHODS: The National Surgical Quality Improvement Program database was used to collect primary and revision shoulder arthroplasty cases in 2017. Data variables collected included age at the time of surgery, surgical time, and RVU for each shoulder arthroplasty. RESULTS: A total of 4,948 shoulder arthroplasty patients (4,657 primary and 291 revision) were included in this study. The mean age was 69.1 years (9.6 SD) for primary shoulder arthroplasty and 67.8 years (10.4 SD) for revision shoulder arthroplasty, P = 0.02. RVU for primary shoulder arthroplasty was 22.1 (0 SD) compared with 26.4 (1.1 SD) for revision shoulder arthroplasty (P = 0.0001). Surgical time was significantly higher in revision versus primary cases, 131.5 minutes (89.0 SD) versus 109.3 minutes (42.5 SD) (P = 0.0001). RVUs per minute were near equivalent for primary and revision arthroplasty at 0.20 (0.1 SD) and 0.20 (01 SD), respectively. However, owing to the difference in surgical time and cases per day, this translates to an estimated reimbursement difference of $174,554.4 per year more for primary shoulder arthroplasty over revision cases. CONCLUSION: The current RVU model does not adequately factor surgical time for revision shoulder arthroplasty and translates to a notable yearly reimbursement difference that favors primary shoulder arthroplasty.

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Published In

J Am Acad Orthop Surg

DOI

EISSN

1940-5480

Publication Date

May 1, 2022

Volume

30

Issue

9

Start / End Page

416 / 420

Location

United States

Related Subject Headings

  • Surgeons
  • Retrospective Studies
  • Reoperation
  • Orthopedics
  • Operative Time
  • Humans
  • Databases, Factual
  • Arthroplasty, Replacement, Shoulder
  • Aged
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Belay, E. S., Charalambous, L. T., Saltzman, E. B., Klifto, C. S., & Anakwenze, O. (2022). Relative Value Units Underestimate Reimbursement for Revision Shoulder Arthroplasty. J Am Acad Orthop Surg, 30(9), 416–420. https://doi.org/10.5435/JAAOS-D-21-00466
Belay, Elshaday S., Lefko T. Charalambous, Eliana B. Saltzman, Christopher S. Klifto, and Oke Anakwenze. “Relative Value Units Underestimate Reimbursement for Revision Shoulder Arthroplasty.J Am Acad Orthop Surg 30, no. 9 (May 1, 2022): 416–20. https://doi.org/10.5435/JAAOS-D-21-00466.
Belay ES, Charalambous LT, Saltzman EB, Klifto CS, Anakwenze O. Relative Value Units Underestimate Reimbursement for Revision Shoulder Arthroplasty. J Am Acad Orthop Surg. 2022 May 1;30(9):416–20.
Belay, Elshaday S., et al. “Relative Value Units Underestimate Reimbursement for Revision Shoulder Arthroplasty.J Am Acad Orthop Surg, vol. 30, no. 9, May 2022, pp. 416–20. Pubmed, doi:10.5435/JAAOS-D-21-00466.
Belay ES, Charalambous LT, Saltzman EB, Klifto CS, Anakwenze O. Relative Value Units Underestimate Reimbursement for Revision Shoulder Arthroplasty. J Am Acad Orthop Surg. 2022 May 1;30(9):416–420.

Published In

J Am Acad Orthop Surg

DOI

EISSN

1940-5480

Publication Date

May 1, 2022

Volume

30

Issue

9

Start / End Page

416 / 420

Location

United States

Related Subject Headings

  • Surgeons
  • Retrospective Studies
  • Reoperation
  • Orthopedics
  • Operative Time
  • Humans
  • Databases, Factual
  • Arthroplasty, Replacement, Shoulder
  • Aged
  • 3202 Clinical sciences