Wiki allotted time for surgical CPT

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KMCFADYEN

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Does anyone know where to find the allotted times for surgical CPT codes? (i.e. 2.0 hours for hip replacement, etc...)
 
KMCFADYEN said:
Does anyone know where to find the allotted times for surgical CPT codes? (i.e. 2.0 hours for hip replacement, etc...)
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Time is a big component of the Work RVU.

What is it that you're looking to analyze? If you're looking to compare the work involved for different surgical CPTs, work RVU is probably the simplest comparison.

Or are you looking for a different purpose?
 
The supporting data files that are used for RVU/Fee Schedule updates each year is available in the Final Rule.

There is a data file for the Final Rule Physician Work Time. I'm not sure how useful it is as a standalone document vs using the Work RVU that it supports. But you can find it on the Final Rule page for any given year.

Here's the link for 2023: https://www.cms.gov/medicaremedicar...chedpfs-federal-regulation-notices/cms-1770-f
 
My understanding is when codes are being proposed/created, the specialty societies usually query their members to compile an average physician time. That data is used in the calculation of the work RVU component.
There are some physicians who work slower or faster than average, for a variety of reasons. That does not mean they receive more or less payment. I have worked with both ends of the spectrum, but bottom line is if the CPT is 58571, they are receiving the same exact payment even if one surgeon averages 45 minutes and the other 3 hours.
It would probably help to understand why you are trying to determine this and what it is used for.
 
To find go to: cms, medicare, payment, fee schedules, physician fee schedules, federal regulation notices...pick the year you'd like to review!
Let me know if you have problems.
Jennie
 
also- there is modifier 22 if this is a rare occurrence. the MD would need to state in the op report what it was about a particular case that caused the extra work/time and how much longer in his opinion it took than usual. this modifier CANNOT be used just because the MD is slower at something than everybody else.
 
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