Wiki Rvu..how do you read the rvu schedule

[bscott]

I am looking at the national phys fee schedule relative value file. What do I use for the RVU of a cpt code? They have total non facility. total facility, total work. total transitioned facility, total transitioned non-facility. This is for a surg at the hospital, codes are:

69436
42830

Any help would be great!

Thanks,

B-

 

[ajs]

I am looking at the national phys fee schedule relative value file. What do I use for the RVU of a cpt code? They have total non facility. total facility, total work. total transitioned facility, total transitioned non-facility. This is for a surg at the hospital, codes are:

69436
42830

Any help would be great!

Thanks,

B-

The formula for calculating 2012 physician fee schedule payment amount is as follows:

2012 Non-Facility Pricing Amount =
[(Work RVU * Work GPCI) +
(Transitioned Non-Facility PE RVU * PE GPCI) +
(MP RVU * MP GPCI)] * Conversion Factor (CF)

2012 Facility Pricing Amount =
[(Work RVU * Work GPCI) +
(Transitioned Facility PE RVU * PE GPCI) +
(MP RVU * MP GPCI)] * CF

The conversion factor for CY 2012 is $24.6712.


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Facility means the procedure is done at a hospital or other out-patient facility. Non-facility generally means in a physician office. Since you are stating these are done at the hospital, you would look at the Total Transitioned Facility number and calculate that against whatever conversion factor you use for determining price.