# RVU Calculations when modifiers are added to the CPT



## clabruna (Jun 8, 2017)

I am looking for a calculator (excel, application, vendor, etc) that shows that whenever a modifier is appended to a charge that affects the reimbursement, how it is calculated.  For instance, 20610 is billed with 1 unit but we need to add modifier 50 to show bilateral.  Modifier 50 reimburses at 1.50 of the wRVU.  So, the work rvu for one unit is .79 but, the actual wrvu, due to the modifier would be 1.18.  Does anyone know of any program that is available that works with billing software to help determine what the true wRVU value would be?


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## thomas7331 (Jun 8, 2017)

I'm not aware of any program that does this, and I don't think that you'll find this because modifiers don't affect change RVUs - a modifiers' affect on payment is applied to the final fee schedule amount, not to the RVU value.  Since work RVU is only one of several elements to go into the calculation of the fee schedule amount, it doesn't necessarily follow that the impact of the modifier will apply equally to all of the elements.  The practices I've worked with that want to adjust RVUs for physicians for such things as modifiers, multiple procedure reductions, etc., will usually come up with their own formulas or methods for doing so.


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## clabruna (Jun 9, 2017)

*RVUs and modifiers*

Many of the COOS in our group use the modifier multiplier on the work RVU to measure productivity and to negotiate contracts where they are paid by RVU.  We may need to develop something internally. Thanks for the response.


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