RVU (relative value unit) is something that CMS (Medicare) assigns to each CPT procedural code / HCPCS code. It is subject change from time to time. For the simplicity of this posting, I will only be talking about work RVU and not get into facility and non-facility RVUs and malpractice RVU. The RVU for each CPT procedural code is the same whether it is for Foot and Ankle Orthopedic Surgeon or Podiatrist. RVU is one of the several factors used in a complicated formula in calculating reimbursement (fee schedule). Even though, the RVU for each procedure is the same between the Orthopedic Surgeon and Podiatrist, but the fee schedule may be different between Orthopedic Surgeon and Podiatrist since the fee schedule is something that the medical provider sometimes negotiates or accepts from the insurance company. Technically (though not always true), the fee schedule for Medicare should be the same between Podiatrist and Orthopedic Surgeon.
As I mentioned earlier, every CPT procedural code (I will ignore the HCPCS code for simplicity at this time) does get assigned RVU. Obviously, the more complex procedures, such as the hindfoot and ankle procedures, in general, will have a higher RVU than the simpler procedures.
RVU is really used to measure productivity and not really determine how much money a physician will earn from the procedures. However, in general, one expects that a physician with a higher RVU productivity would get reimbursed more. RVUs (not reimbursement) are now being used more and more by hospitals / multispecialty groups / large single specialty groups / Kaisers to measure the productivity of the physician. By using RVUs to measure productivity, it avoids having to deal with the different reimbursement for each physican from different insurance companies and also in different regions of the country.
Here are some examples of 2014 work RVU for the common office visits CPT codes used in Podiatry. Remember, Orthopedic Surgeruy can and will bill higher level office visit codes, which Podiatry cannot.
99201 0.48
99202 0.93
99203 1.42
99204 2.43
99211 0.18
99212 0.48
99213 0.97
99214 1.50
Here are some examples of 2014 work RVU for various office base procedures in Podiatry.
11042 (wound debridement skin and subcut 2o sq cm or less) 1.01
11055 (trim 1 skin lesion such as callus) 0.35
11056 (trim 2 - 4 skin lesions) 0.50
11057 (trim over 4 skin lesions) 0.65
11060 (I&D skin abscess) 1.22 - this procedure has 10 day global period
11719 (trimming of non-dystophic nails) 0.17
11720 (debridement of mycotic nails 1 - 5) 0.32
11721 (debridement of mycotic nails 6 or more) 0.54
11730 (1st nail avulsion procedure) 1.10
11732 (2nd, 3rd toes etc... nail avulsion on same day) 0.44
11740 (drainage of subungal hematoma) 0.37
11750 (nail matrixectomy) 2.50 - this procedure has 10 day global period
20550 (plantar fascial injection) 0.75
20600 (injection small joint) 0.66
29540 (low dye strapping or ankle strapping) 0.39
64455 (neuroma injection) 0.75
Here are some examples of 2014 work RVU for various surgical procedures in Podiatry. (Most will have 90 days global period)
27650 (repair of achilles tendon) 9.21
27652 (repair of achilles tendon with graft) 10.78
27698 (modified brostrom gould) 9.61
27702 (initial total ankle replacement) 14.42
27703 (revisional total ankle replacement) 16.94
27814 (orif bimalleolar ankle fracture) 10.62
27822 (orif trimalleolar ankle fracture - med and lat mall fixation only) 11.21
27823 (orif trimalleolar ankle fracture - med, lat, and post mall fixation) 13.16
27870 (open ankle joint fusion) 15.41
28002 (debridement skin and subcut foot infection) 5.34
28003 (debridement skin, subcut, deep, tendons foot infection) 9.06
28285 (hammertoe correction - arthroplasty and arthrodesis) 5.62
28289 (hallux limitus / rigidus correction via cheilectomy or ostectomies only) 8.31
28290 (silver / mcbride bunionectomy) 5.83
28292 (keller bunionectomy) 9.05
28293 (bunionectomy with implant or 1st MPJ implant) 11.48
28296 (bunionectomy via metatarsal osteotomy - head or base) 8.35
28297 (lapidus fusion) 9.43
28300 (sliding calcaneal osteotomy) 9.73
28415 (orif calcaneal fracture) 16.19
28445 (orif talar neck fracture) 15.76
29446 (osteochondral talus autograft) 17.71
28485 (orif metatarsal fracture) 7.44
28505 (orif hallux fracture) 7.44
28705 (pantalar fusion) 20.33
28715 (triple arthrodesis) 13.42
28725 (subtalar joint fusion) 11.22
28750 (1st MPJ fusion) 8.57
28755 (hallux IPJ fusion) 4.88
28760 (hallux IPJ fusion with Jones tenosuspension) 9.14
28800 (chopart or lisfranc amputation) 8.79
28805 (transmetatarsal amputation) 12.71
28810 (partial ray amputation) 6.64
28820 (complete toe amputation) 5.82
28825 (partial toe amputation) 5.37
29891 (ankle arthroscopy with small OCD lesion microfracturing) 9.67
29892 (ankle arthroscopy with large OCD lesion debridement) 10.27
29893 (endoscopic plantar fasciotomy) 6.32
29894 (ankle arthroscopy with loose body removal) 7.35
29895 (ankle arthroscopy with synovectomy) 7.13
29899 (ankle joint fusion via ankle arthroscopy) 15.41
