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Information Journal Paper

Title

Medicare Compensation Rates for Hand and Shoulder/ Elbow Surgery by Operative Time: A Comparative Analysis

Pages

  173-183

Abstract

 Background: There is a high demand for shoulder/elbow experience among hand-fellowship trainees due to the perception that this exposure will improve their professional “ marketability” in a subspecialty they perceive as having higher Compensation. Methods: Using Medicare data, we investigated the most common surgeries from these fields and determined which have the highest Compensation [work relative value unit (wRVU), Payment, charge, and Reimbursement (Payment-to-charge percentage] rates per operative time. We then determined whether the overall non-weighted and weighted (by surgical frequency/volume) Compensation rates of Shoulder/elbow surgery are greater than that of Hand surgery. Results: Among 30 shoulder/elbow procedures, arthroplasty and arthroscopic rotator cuff repair had the highest Payment and wRVU assignments. Among 83 hand procedures, upper-extremity flaps, carpal stabilization, distal radius open reduction internal fixation (ORIF), both-bone ORIF, and interposition arthroplasty had the greatest wRVU assignments with correspondingly high Payments. A non-weighted comparison of the two subspecialties showed that Hand surgery has a higher mean Payment/min ($10. 46± 3. 22 vs. $7. 52± 2. 89), charge/min ($51. 02± 17. 11 vs. $41. 96± 11. 32), and Reimbursement (21± 4. 7% vs. 18± 5. 1%) compared with Shoulder/elbow surgery (all, P<0. 01). Non-weighted mean wRVUs/min were similar (0. 12± 0. 03 vs. 0. 13± 0. 03, P = 0. 12). When weighted by procedure frequency, Hand surgery had greater wRVUs/min (0. 15± 0. 036 vs. 0. 13± 0. 032), Payments/min ($14. 17± 4. 50 vs. $6. 97± 2. 26), charges/min ($75. 68± 30. 47 vs. $42. 61± 7. 83), and Reimbursement (20± 5. 0% vs. 17± 6. 0%) (all, P<0. 01). Conclusion: According to Medicare Compensation, and when weighted by procedure frequency, hand procedures are associated with greater overall mean wRVUs/min, Payments/min, charges/min, and Reimbursement compared with shoulder and elbow procedures. Hand-surgery fellowship applicants should be aware that subspecialty Compensation is complex in nature but should seek shoulder/elbow elective experience to acquire an additional surgical skill-set as opposed to primarily monetary reason.

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    Cite

    APA: Copy

    Nayar, Suresh K., Sabharwal, Samir, Aziz, Keith T., Srikumaran, Umasuthan, Giladi, Aviram M., & La Porte, Dawn M.. (2020). Medicare Compensation Rates for Hand and Shoulder/ Elbow Surgery by Operative Time: A Comparative Analysis. THE ARCHIVES OF BONE AND JOINT SURGERY, 8(2), 173-183. SID. https://sid.ir/paper/740283/en

    Vancouver: Copy

    Nayar Suresh K., Sabharwal Samir, Aziz Keith T., Srikumaran Umasuthan, Giladi Aviram M., La Porte Dawn M.. Medicare Compensation Rates for Hand and Shoulder/ Elbow Surgery by Operative Time: A Comparative Analysis. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2020;8(2):173-183. Available from: https://sid.ir/paper/740283/en

    IEEE: Copy

    Suresh K. Nayar, Samir Sabharwal, Keith T. Aziz, Umasuthan Srikumaran, Aviram M. Giladi, and Dawn M. La Porte, “Medicare Compensation Rates for Hand and Shoulder/ Elbow Surgery by Operative Time: A Comparative Analysis,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 8, no. 2, pp. 173–183, 2020, [Online]. Available: https://sid.ir/paper/740283/en

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