Current Relative Value Scale Methodology Underestimates Perioperative Workload in Hip Arthroscopy

Purpose

To evaluate the accuracy of the current times and work relative value units (wRVUs) recommended by the Relative Value Scale (RVS) Update Committee (RUC) for the perioperative work associated with hip arthroscopy in a single surgeon’s practice.

Methods

The RUC was contacted to obtain a list of perioperative tasks and times allotted for these tasks for hip arthroscopy procedures (Current Procedural Terminology codes 29914, 29915, and 29916). A board-certified, sports medicine fellowship–trained orthopaedic surgeon recorded the time it took to perform each perioperative task. Recorded times were multiplied by their respective Centers for Medicare & Medicaid Services–assigned intensity coefficients to calculate the wRVUs for preservice and postservice tasks. Calculated and allotted wRVUs were compared for accuracy.

Results

The tasks timed in this study were allotted 83 minutes by the RUC with a wRVU of 1.72. Our study found that these same tasks significantly differed, at 93.4 minutes and total wRVU of 1.95 (P < .001). The overall time it took to perform perioperative tasks for hip arthroscopy was underestimated by 10.4 minutes, resulting in an undervaluation of wRVU by 0.23.

Conclusions

In a single surgeon’s practice, the RUC underestimates the time required to perform perioperative tasks for hip arthroscopy procedures.

Clinical Relevance

It is important to determine whether the amount surgeons are reimbursed for certain procedures, such as hip arthroscopy, is an accurate reflection of actual cost. Discrepancies between reimbursement and actual costs can influence the financial viability of offering such procedures, impacting access to care, procedural volume, and potentially long-term outcomes, particularly as health care systems move toward value-based reimbursement models.