Perioperative Work in Hip Arthroscopy is Undervalued by Relative Value Scale Update Committee Methodology: Quantifying Hip Arthroscopy Workload in a Single Hospital System

Perioperative Work in Hip Arthroscopy is Undervalued by Relative Value Scale Update Committee Methodology: Quantifying Hip Arthroscopy Workload in a Single Hospital System

Aaron J. Casp, MD, UNITED STATES Shelby Cate Hodges , BS, UNITED STATES Juan J Gordillo, BS, UNITED STATES Clay Rahaman, BA, UNITED STATES Maxwell Harrell, BS, UNITED STATES Dev Dayal, BS, UNITED STATES Mathew Hargreaves, BS, UNITED STATES Eugene W. Brabston III, MD, UNITED STATES Thomas Evely , DO, UNITED STATES Amit Momaya, MD, UNITED STATES

University of Alabama at Birmingham, Birmingham, Alabama, UNITED STATES


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Anatomic Location

Treatment / Technique


Summary: Perioperative tasks for hip arthroscopy are undervalued by the Relative Value Scale Update Committee.


Background/Purpose: No literature to date has investigated whether work relative value units are underestimated for hip arthroscopy perioperative work. The purpose of this study was to determine the accuracy of the Relative Value Update Committee and Center for Medicare and Medicaid Services current times and work relative value units for the perioperative work involved in hip arthroscopy by directly timing perioperative tasks as they occur in real time.

Methods

The Relative Value Update Committee was contacted to obtain a list of perioperative tasks and times allotted for these tasks for hip arthroscopy procedures (CPT codes 29914, 29915, 29916). A single, fellowship-trained physician recorded the time to perform each perioperative task. Recorded times were multiplied by their respective Center for Medicare and Medicaid Services-assigned intensity coefficient to calculate the work relative value units for preservice and post service tasks. Calculated and allotted work relative value units were compared for accuracy.

Results

The tasks timed in this study were allotted 83 minutes by the Relative Value Update Committee and a work relative value unit of 1.72. Our study found that these same tasks significantly differed at 93.4 minutes and total work relative value units of 1.95 (p<0.0001). The overall time it takes to perform perioperative tasks for hip arthroscopy is underestimated by 10.4 minutes, resulting in an undervaluation of the work relative value units by 0.23.

Conclusion

The Relative Value Update Committee underestimates the amount of time it takes to perform perioperative tasks for hip arthroscopy procedures and thus undervalues procedure reimbursement.