How are RVUs calculated for compensation purposes?

[GI-Scopes]

I'm a 3rd-year fellow here, starting job next summer in a community hospital-employed position. Pay is base + bonus after RVU threshold. I've heard different answers to this question from the various attendings at my institute. For those of you who are RVU based, how are RVUs calculated, and are the calculations uniform across all jobs you've had experience with?

E.g. patient coming in for a double for dyspepsia and chronic diarrhea. You obtain biopsies in the upper, and then remove 2 polyps in the colon one with snare and one EMR, you also take random biopsies.

EGD with biopsy (CPT 43239): RVU 2.39
Colonoscopy with biopsy (CPT 45380): RVU 3.56
Colonoscopy with Snare (CPT 45385): RVU 4.57
Colonoscopy with EMR (CPT 45390): RVU 6.04

How many RVUs does your employer give you in this scenario? These are the variations I've heard from my faculty.

Colonoscopy with EMR 6.04 + difference between diagnostic colonoscopy (CPT 45378 with RVU 3.26) and colonoscopy with snare (4.57 - 3.26 = 1.31) + difference between diagnostic colonoscopy (CPT 45378 with RVU 3.26) and colonoscopy with biopsy (3.56 - 3.26 = 0.3) + 1/2 EGD with biopsy (2.39 / 2 = 1.2) = Total 8.85

Vs

Adding all the CPT codes for each individual procedure i.e. Colonoscopy with EMR 6.04 + Colonoscopy with biopsy 3.56 + Colonoscopy with Snare 4.57 + EGD with biopsy 2.39 = 16.56

Vs

Highest CPT RVU then half for everything else i.e. Colonoscopy with EMR 6.04 + Colonoscopy with biopsy 3.56/2 = 1.78 + Colonoscopy with Snare 4.57/2 = 2.29 + EGD with biopsy 2.39/2 = 1.2 = Total 11.31

I'd appreciate those with actual knowledge about how employers compensate GI docs to comment and provide their insight. Also, does this vary among employers?

Thanks

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[Suprep]

varies by employer. ideally need someone working there to explain their model.

 

[1Cor1557]

I'm a 3rd-year fellow here, starting job next summer in a community hospital-employed position. Pay is base + bonus after RVU threshold. I've heard different answers to this question from the various attendings at my institute. For those of you who are RVU based, how are RVUs calculated, and are the calculations uniform across all jobs you've had experience with?

E.g. patient coming in for a double for dyspepsia and chronic diarrhea. You obtain biopsies in the upper, and then remove 2 polyps in the colon one with snare and one EMR, you also take random biopsies.

EGD with biopsy (CPT 43239): RVU 2.39
Colonoscopy with biopsy (CPT 45380): RVU 3.56
Colonoscopy with Snare (CPT 45385): RVU 4.57
Colonoscopy with EMR (CPT 45390): RVU 6.04

How many RVUs does your employer give you in this scenario? These are the variations I've heard from my faculty.

Colonoscopy with EMR 6.04 + difference between diagnostic colonoscopy (CPT 45378 with RVU 3.26) and colonoscopy with snare (4.57 - 3.26 = 1.31) + difference between diagnostic colonoscopy (CPT 45378 with RVU 3.26) and colonoscopy with biopsy (3.56 - 3.26 = 0.3) + 1/2 EGD with biopsy (2.39 / 2 = 1.2) = Total 8.85

Vs

Adding all the CPT codes for each individual procedure i.e. Colonoscopy with EMR 6.04 + Colonoscopy with biopsy 3.56 + Colonoscopy with Snare 4.57 + EGD with biopsy 2.39 = 16.56

Vs

Highest CPT RVU then half for everything else i.e. Colonoscopy with EMR 6.04 + Colonoscopy with biopsy 3.56/2 = 1.78 + Colonoscopy with Snare 4.57/2 = 2.29 + EGD with biopsy 2.39/2 = 1.2 = Total 11.31

I'd appreciate those with actual knowledge about how employers compensate GI docs to comment and provide their insight. Also, does this vary among employers?

Thanks

The facility gets full value for the most valuable service rendered (snare or EMR in your hypothetical), then 50 percent for each additional 59 modifier applied ( biopsy or tattoo or injection or whatever)

The PROVIDER should get credited full work RVU for each service rendered since they are distinct procedures. If the employee is not willing to do so or has a comp structure where they will not, you are being taken for a ride, kindly speaking. Look elsewhere.

 

[slopes23]

The facility gets full value for the most valuable service rendered (snare or EMR in your hypothetical), then 50 percent for each additional 59 modifier applied ( biopsy or tattoo or injection or whatever)

The PROVIDER should get credited full work RVU for each service rendered since they are distinct procedures. If the employee is not willing to do so or has a comp structure where they will not, you are being taken for a ride, kindly speaking. Look elsewhere.

For clarity - I believe you meant to say *employer*, not employee

 

[1Cor1557]

For clarity - I believe you meant to say *employer*, not employee

Yes