Medicare Compensation Rates for Hand and Shoulder/ Elbow Surgery by Operative Time: A Comparative Analysis
- سال انتشار: 1399
- محل انتشار: مجله استخوان و جراحی عمومی، دوره: 8، شماره: 2
- کد COI اختصاصی: JR_TABO-8-2_008
- زبان مقاله: انگلیسی
- تعداد مشاهده: 251
نویسندگان
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
چکیده
Background: There is a high demand for shoulder/elbow experience among hand-fellowship trainees due to theperception that this exposure will improve their professional marketability in a subspecialty they perceive as havinghigher compensation.Methods: Using Medicare data, we investigated the most common surgeries from these fields and determinedwhich 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-weightedand weighted (by surgical frequency/volume) compensation rates of shoulder/elbow surgery are greater than thatof hand surgery.Results: Among 30 shoulder/elbow procedures, arthroplasty and arthroscopic rotator cuff repair had the highest paymentand wRVU assignments. Among 83 hand procedures, upper-extremity flaps, carpal stabilization, distal radius openreduction internal fixation (ORIF), both-bone ORIF, and interposition arthroplasty had the greatest wRVU assignmentswith correspondingly high payments. A non-weighted comparison of the two subspecialties showed that hand surgeryhas 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), andreimbursement (21±4.7% vs. 18±5.1%) compared with shoulder/elbow surgery (all, P< 0.01). Non-weighted meanwRVUs/min were similar (0.12±0.03 vs. 0.13±0.03, P = 0.12). When weighted by procedure frequency, hand surgeryhad 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 proceduresare associated with greater overall mean wRVUs/min, payments/min, charges/min, and reimbursement compared withshoulder and elbow procedures. Hand-surgery fellowship applicants should be aware that subspecialty compensationis complex in nature but should seek shoulder/elbow elective experience to acquire an additional surgical skill-set asopposed to primarily monetary reason.Level of evidence: IIIکلیدواژه ها
Centers for Medicare and Medicaid Services, compensation, Hand surgery, Payment, Reimbursement, shoulder/elbow surgery, wRVUاطلاعات بیشتر در مورد COI
COI مخفف عبارت CIVILICA Object Identifier به معنی شناسه سیویلیکا برای اسناد است. COI کدی است که مطابق محل انتشار، به مقالات کنفرانسها و ژورنالهای داخل کشور به هنگام نمایه سازی بر روی پایگاه استنادی سیویلیکا اختصاص می یابد.
کد COI به مفهوم کد ملی اسناد نمایه شده در سیویلیکا است و کدی یکتا و ثابت است و به همین دلیل همواره قابلیت استناد و پیگیری دارد.